Constructive feedback means saying, You could do this better and here is how. Photograph: sturti/Getty Images

Many years ago, when I was a trainee physician, a formal feedback to track my progress never materialised. Instead, late one evening, with no prior notice, I was marched into a room and told by a clearly enraged consultant that he wished I had never been selected into the training program. I was stunned when the monologue ended in this dire pronouncement, Actually, Id say you are a disappointment to medicine.

Looking back, this ambit claim should have alerted me to muster my internal defences right there. It was only the beginning of my training; in the handful of years I had been a doctor, I had not presided over a string of unaccountable deaths nor had I bullied interns or abused patients. I was like every other trainee unexceptional but committed, aware of the difficult trek ahead but grateful for the opportunity. And while it may have been apparent to an experienced eye that I wasnt destined for high glory, it seemed a bit rich to foretell a doctors lifelong contribution to medicine by the first few unremarkable years.

But of course, none of this occurred to me at the time other than the sinking realisation that I wasnt just a disappointment to medicine but a certified failure. It didnt matter that the consultant had not got to know me; it didnt matter that his intemperance was common knowledge; all that mattered was that he had seen further into me than anyone else and proclaimed me an early failure. I wish I could say that the claim was so entirely unfounded and so wildly exaggerated that I banished it from my head but in fact, his words sank into my marrow and stayed there for years and years to come.

The ensuing years turned out to be far more interesting than I could have imagined. I became an oncologist and won a Fulbright award that transformed my life from a physician to a physician-writer and public speaker. Patients and colleagues complimented me but to me, those other skills felt like a feeble corrective to the unachievable goal, greatness in medicine. I felt like an imposter because someone in a position of knowledge and power had told me so.

Still, the experience didnt result in a crisis because I was shored up by good people for that one abusive encounter there were other constructive ones. I also came to recognise how the hospital is a hotbed of competition and politics and how one rotten relationship has a domino effect on other, utterly innocent, people.

Later, I learnt about the special irritation and impatience with others that comes from being the parent of children who wont sleep, fall ill, or cause more serious grief. And then there were my dying patients, who reminded me that life is short and that we should forgive people, not necessarily because they deserve it, but because we deserve it.

In other words, I came to intellectualise why a senior faculty might have behaved poorly. But what really puzzled me is how little this helped to erase the long shadow the diatribe cast over my career and why those ill-chosen words continued to play tricks with my self-esteem.

Eventually, I became a supervisor, borne out of an aspiration that no trainee should have to undergo a ritual of humiliation to somehow emerge the secure and well-adjusted doctor that society deserves. If doctors were to be genuine healers, they couldnt commence their career by licking their own wounds inflicted by their own colleagues. From the stories I still hear, we are not there yet.

Its a myth long perpetuated in medicine that trainees will only learn through tough love, but this tough love ignores constructive criticism, finding space to listen, providing room to grow, resting instead on public (or if youre lucky, private) shaming. I have seen plenty of doctors destroyed by it but have yet to meet someone who blossomed through such cruelty.

On the other hand, a veteran physician recently fretted that he had abandoned saying anything remotely critical for fear of being accused of harassment. In this heightened era of awareness of bullying and harassment in medicine, this is an observation worth pondering because a doctor who is given neither reason nor room to improve is being done a disservice. Most doctors strive to be better versions of themselves and are eager to find good role models. Being too quick to take offence will result in feedback crammed with platitudes and a piece of paper as meaningless as the encounter.

One solution might be to have an independent observer present at feedback but the real mentoring happens not at formal sessions but through countless corridor conversations, timely compliments, tactful rescues, and after-hour phone calls. Every doctor knows that these incidental things form the scaffolding of a career.

Many formal supervisors now undergo training which provides them a structure for giving feedback. This is one step towards being nuanced and sensitive to the changing face of medicine which boasts doctors who are pregnant women, young parents, former refugees, victims of war, as well as those tackling their own chronic illness or mental wellbeing.

But I think the key to feedback (and to trainee welfare in general) lies in every senior doctor taking the responsibility more seriously. Medicine is a lifelong apprenticeship where a young doctor learns from a cast of hundreds. We promote continuity of care for patients but it should apply equally to the care of doctors.

For far too long, feedback has been an automatic checklist and if you have not committed a grievous error, there is nothing to discuss. But constructive feedback means saying, You could do this better and here is how. It means showing vulnerability, I have made the same mistake, heres what I learnt. Above all, I have found it means reassuring a struggling trainee concerned for her future, I am here to support, not sink you.

But feedback isnt only about castigation but also commendation. Praise is largely a forgotten concept in medicine; we are quicker to laud an alcoholic for showing civility than applaud a doctor for resolving a crisis. The control of medicine by bureaucrats has resulted in the eye being on the bottom line more often than the workforce. I have seen doctors wearied by a lack of recognition, or worse, broken by criticism, but I cant immediately think of someone who went rogue after winning deserving praise.

Changing these ingrained habits is a responsibility that should not be shouldered by supervisors alone. Its a duty upon of all us to influence change. The doctor-patient relationship is sacrosanct but no less important is the doctor-trainee relationship. If there is nothing good about a trainee, its the senior staff who must look harder. Because when doctors genuinely care about doctors, its good medicine for society.

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Being told I was a disappointment to medicine haunted me for years - The Guardian

July 17, 2017 A Rice University professor has introduced a new method that takes advantage of plasmonic metals production of hot carriers to boost light to a higher frequency. An electron microscope image at bottom shows gold-capped quantum wells, each about 100 nanometers wide. Credit: Gururaj Naik/Rice University

A Rice University professor's method to "upconvert" light could make solar cells more efficient and disease-targeting nanoparticles more effective.

Experiments led by Gururaj Naik, an assistant professor of electrical and computer engineering, combined plasmonic metals and semiconducting quantum wells to boost the frequency of light, changing its color.

In a nanoscale prototype Naik developed as a postdoctoral researcher at Stanford University, custom-designed pylons that were struck by green light produced a higher-energy blue glow. "I'm taking low-energy photons and converting them to high-energy photons," he said.

Efficient upconversion of light could let solar cells turn otherwise-wasted infrared sunlight into electricity or help light-activated nanoparticles treat diseased cells, Naik said.

The work appears in the American Chemical Society's Nano Letters.

The magic happens inside tiny pylons that measure about 100 nanometers across. When excited by a specific wavelength of light, specks of gold on the tips of the pylons convert the light energy into plasmons, waves of energy that slosh rhythmically across the gold surface like ripples on a pond. Plasmons are short-lived, and when they decay, they give up their energy in one of two ways; they either emit a photon of light or produce heat by transferring their energy to a single electrona "hot" electron.

Naik's work at Stanford was inspired by the groundbreaking work of professors Naomi Halas and Peter Nordlander at Rice's Laboratory for Nanophotonics, who had shown that exciting plasmonic materials also excited "hot carriers" electrons and holes within. (Electron holes are the vacancies created when an electron is excited into a higher state, giving its atom a positive charge.)

"Plasmonics is really great at squeezing light on the nanoscale," said Naik, who joined Rice's faculty a year ago. "But that always comes at the cost of something. Halas and Nordlander showed you can extract the optical losses in the form of electricity. My idea was to put them back to optical form."

He designed pylons using alternate layers of gallium nitride and indium gallium nitride that were topped with a thin layer of gold and surrounded by silver. Instead of letting the hot carriers slip away, Naik's strategy was to direct both hot electrons and hot holes toward the gallium nitride and indium gallium nitride bases that serve as electron-trapping quantum wells. These wells have an inherent bandgap that sequesters electrons and holes until they recombine at sufficient energy to leap the gap and release photons at a higher frequency.

Present-day upconverters used in on-chip communications, photodynamic therapy, security and data storage have efficiencies in the range of 5 to 10 percent, Naik said. Quantum theory offers a maximum 50 percent efficiency ("because we're absorbing two photons to emit one") but, he said, 25 percent is a practical goal for his method.

Naik noted his devices can be tuned by changing the size and shape of the particles and thickness of the layers. "Upconverters based on lanthanides and organic molecules emit and absorb light at set frequencies because they're fixed by atomic or molecular energy levels," he said. "We can design quantum wells and tune their bandgaps to emit photons in the frequency range we want and similarly design metal nanostructures to absorb at different frequencies. That means we can design absorption and emission almost independently, which was not possible before."

Naik built and tested a proof-of-concept prototype of the pylon array while working in the Stanford lab of Jennifer Dionne after co-authoring a theoretical paper with her that set the stage for the experiments.

"That's a solid-state device," Naik said of the prototype. "The next step is to make standalone particles by coating quantum dots with metal at just the right size and shape."

These show promise as medical contrast agents or drug-delivery vehicles, he said. "Infrared light penetrates deeper into tissues, and blue light can cause the reactions necessary for the delivery of medicine," Naik said. "People use upconverters with drugs, deliver them to the desired part of the body, and shine infrared light from the outside to deliver and activate the drug."

The particles would also make a mean invisible ink, he said. "You can write with an upconverter and nobody would know until you shine high-intensity infrared on it and it upconverts to visible light."

Explore further: Measurement of 'hot' electrons could have solar energy payoff

More information: Gururaj V. Naik et al. Hot-Carrier-Mediated Photon Upconversion in Metal-Decorated Quantum Wells, Nano Letters (2017). DOI: 10.1021/acs.nanolett.7b00900

Photon Upconversion with Hot Carriers in Plasmonic Systems. ArXiv. arxiv.org/pdf/1501.04159.pdf

Journal reference: Nano Letters arXiv

Provided by: Rice University

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Plasmon-powered devices for medicine, security, solar cells - Phys.Org

E

ver since the first dental school was founded in the United States in 1840, dentistry and medicine have been taught as and viewed as two separate professions. That artificial division is bad for the publics health. Its time to bring the mouth back into the body.

In 1840, dentistry focused on extracting decayed teeth and plugging cavities. Today, dentists use sophisticated methods for prevention, diagnosis, and treatment. We implant teeth, pinpoint oral cancers, use 3-D imaging to reshape a jaw, and can treat some dental decay medically, without a drill. Weve also discovered much more about the intimate connection between oral health and overall health. Periodontal disease, also known as gum disease, has been linked to the development of diabetes, high blood pressure, and cardiovascular disease. Pregnant women with periodontitis are more likely to develop pre-eclampsia, a potentially serious complication of pregnancy, and deliver low-birth-weight babies.

As taught in most schools today, dental education produces good clinicians who have a solid understanding of oral health, but often a more limited perspective on overall health. Few dental students are equipped to take a holistic view that may include taking a patients vital signs, evaluating their risk of heart disease or stroke, spotting early warning signs of disease, or even assessing their mental health or looking for signs of drug abuse.

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Theres a better way to educate dentists so they can play larger roles in the management of their patients chronic diseases.

My school, the Harvard School of Dental Medicine, was founded 150 years ago on July 17, 1867. It was the first American dental school affiliated with a university and its medical school, and the first to grant the doctor of dental medicine (D.M.D.) degree. The schools mission is to develop and foster a community of global leaders dedicated to improving human health by integrating dentistry and medicine at the forefront of education, research, and patient care. At commencement, dental graduates are welcomed into a demanding branch of medicine.

Harvard dental students have always spent more than a year of their education attending the same classes as their medical school peers. They learn just as much about whats going on in the chest cavity as the oral cavity. Under a new curriculum, in their second year they work in a primary care clinic in the dental school, side by side with fourth-year dental students, nurse practitioners, and primary care physicians to learn how to assess a patients overall health. In a collaboration with Northeastern Universitys Bouv School of Nursing, nurse practitioners and nursing students work with dental students and faculty members to manage chronic diseases and provide oral care.

Poor oral health is more than a tooth problem. We use our mouth to eat, to breathe, and to speak. Oral pain results in lost time from school and work and lowered self-esteem. Inflammation in the gums and mouth may help set the stage for diabetes, cardiovascular disease, and other chronic conditions. Dental infection can lead to the potentially serious blood infection known as sepsis. In the case of 12-year-old Deamonte Driver, an infected tooth led to a fatal brain infection.

Writing in the Millbank Quarterly, John McDonough, professor of public health practice at the Harvard T.H. Chan School of Public Health asked, Might oral health be the next big thing? I believe that it needs to be and should be.

Just as dental and medical education are currently separate, so too are the ways care is delivered and how care is or isnt covered by insurance. That poses problems for access to care.

Today, 130 million Americans, most of them adults, have no dental coverage. Medicare has no dental benefits, and Medicaid has few benefits for adults. The high cost of dental care affects even those with coverage.

Its no wonder that the Centers for Disease Control estimates that the U.S. loses $6 billion in productivity each year due to oral health issues. Emergency department visits for oral pain cost nearly $2 billion a year and contribute to the epidemic of opioid addiction. And mounting evidence shows that poor oral health results in increased general medical costs.

To help break down barriers between medicine and dentistry, the Harvard School of Dental Medicine has created the Initiative to Integrate Oral Health and Medicine. In an effort to improve general health and lower medical costs, it brings together leaders in academia, health care, and industry to find innovative ways to integrate the two disciplines. Through the initiative, we seek to transform how dentistry is taught, practiced, financed, and evaluated so it becomes seamlessly integrated with the comprehensive health and social services required to keep individuals and communities healthy.

The school has also established the Oral Physician Program, a general practice dental residency program at the Cambridge Health Alliance, which integrates oral health, primary care, and family medicine training. We also plan to establish a new combined DMD/MD program with a hospital-based residency to train a new type of physician focused equally on oral health and primary care.

Other institutions are also expanding the concept of dental care and chipping away at the barriers between dental care and primary care. Kaiser Permanente Northwest, for example, has opened a truly integrated medical-dental practice in Eugene, Ore. The Marshfield Clinic in Wisconsin is advancing the concept with integrated medical-dental electronic health records.

Heres what an integrated dental health/primary care visit might look like to a patient: When you go for a routine teeth cleaning, you would be cared for by a team of physicians, dentists, nurses, and physician and dental assistants. One or more of them would take your blood pressure, check your weight, update your medications, see if you are due for any preventive screenings or treatments, and clean your teeth. If you have an artificial heart valve or have previously had a heart infection, or you are taking a blood thinner, your clinicians will manage these conditions without multiple calls to referring doctors.

Finding the political will to integrate dentistry and primary care is a challenge. Various organizations including the DentaQuest Foundation, the Santa Fe Group, and Oral Health America have taken up the task. The majority of this work is designed to raise awareness of oral health, educate non-dental health care providers, and create political interest in promoting oral health. However, while interprofessional education has met with some success, interprofessional practice remains elusive.

The culture of the dental profession must change to promote closer connections between dentistry and primary care. The move from solo practice to small- and large-group practices may provide the impetus for such change. Recent editorials in the dental literature, including the Journal of the American Dental Association, talk about the need for integration, including the use of diagnostic codes, integrated medical and dental electronic records, and the potential for melding medical and dental practices.

Unfortunately, incentives for creating this practice of the future are minimal at this time. Dentistrys reliance on procedures for payment and separate insurance coverage presents a problem. The slow movement toward bundled payments for health care to create value based upon outcomes, rather than volume, could help.

In 2000, the surgeon generals report Oral Health in America drew attention to the gap in oral health in the U.S. In a 2016 update, then-Surgeon General Vivek Murthy strongly recommended integrating oral health and primary care. Closer collaboration between dentistry and primary care could change the culture of health care, close the access gap, and improve general health by providing primary care services during dental visits. It could also improve population health and chronic disease care.

We cannot drill, fill, and extract our way to better oral and overall health. We need a fundamentally different approach, one that accentuates disease prevention and health management using a multidisciplinary, integrated, and patient-centric approach to overall health. And that means breaking down the wall between dentistry and medicine.

Bruce Donoff, D.M.D. and M.D., is professor of oral and maxillofacial surgery and dean of the Harvard School of Dental Medicine.

R. Bruce Donoff can be reached at hsdm_dean@hsdm.harvard.edu Add Bruce on Facebook

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It's time to break down the wall between dentistry and medicine - STAT

Community Internal Medicine of Athens is growing.

CIMA offers comprehensive outpatient care for adults from resident physicians and faculty.

CIMA has expanded into the entire lower floor of Building 200 in the Resource Medical Office Park at 1500 Oglethorpe Ave., just off the Athens Perimeter. The practices new suite number is 200-C.

In a corresponding move, Johnson & Murthy Family Medicine has relocated upstairs in the same building to Suite 200-A. Both practices are part of St. Marys Medical Group.

CIMA is expanding to accommodate new services and 12 new resident physicians, who began practicing with the Internal Medicine Residency Program on July 1.

The program is a collaborative effort between St. Marys and the Augusta University/University of Georgia Medical Partnership to address the shortage of physicians in Georgia.

Resident physicians are doctors who have graduated from medical school and are completing the final stage of their medical training. Fully capable physicians, they are working with physician faculty in an intensive three-year program to prepare them to become board-certified internal medicine physicians.

With the addition of the Class of 2020, the IMRP has now reached 33 resident physicians. Residents with the previous two classes already practice at CIMA on a rotating basis, coupling outpatient care at the practice with inpatient care at St. Marys Hospital.

The expansion of CIMA accommodates the additional residents by adding six patient exam rooms and a larger waiting area for patients. The expansion also allows CIMA to add a social worker to the staff and provide same-day appointments on most days.

Because care is provided by resident physicians under the direct supervision of physician faculty, patients typically receive more one-on-one time with their physician than is possible in a traditional primary care setting. For first-year residents, physician faculty not only review and approve clinical decisions but are often directly involved in evaluating patients side-by-side with the resident. As residents gain experience over the course of their residency, they assume greater responsibility and independence, though always with physician faculty supervision.

CIMA provides full internal medicine care for adults, including routine wellness visits, treatment of minor acute illnesses and injuries, and management of certain chronic conditions such as high blood pressure, chronic obstructive pulmonary disease, and diabetes. CIMA physicians can prescribe medications and order tests, including lab work and imaging.

While CIMA accepts some walk-in patients, most visits are by appointment. For more information or to make an appointment, call (706) 389-3875.

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Community Internal Medicine of Athens expands - Online Athens

Albany Business Review

How Ellis Medicine's new vice president will focus on patient care Albany Business Review ... is the new vice president and chief nursing officer at Ellis Medicine more. Photo courtesy of Ellis Medicine. Leslyn Williamson will use her more than 25 years experience in nursing and management to enhance quality patient care at Ellis Medicine.

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How Ellis Medicine's new vice president will focus on patient care - Albany Business Review

Therapix Biosciences of Tel Aviv, a specialty clinical-stage pharmaceutical company developing cannabinoid-based drugs, last week signed a memorandum of understanding with California-based CURE Pharmaceutical to enter into a research collaboration with Israels Assuta Medical Centers.

The two biopharma companies will jointly advance, research, develop and commercialize potential therapeutic products in the fields of personalized medicine and cannabinoids. Assuta will support the early research and development of potential projects at its eight hospitals and medical centers.

Robert Davidson, CEO of CURE Pharmaceutical, noted that Israel is at the forefront of cannabinoid-based research in the world and therefore is the perfect place to start the development of these products.

As CURE focuses on targeting unmet needs in traditional pharmaceutical markets that could be disrupted by cannabinoid-based options, we are continuously looking to help bring new therapeutic cannabinoid-based products to market and further efforts toward the creation of personalized medicine, Davidson said.

Therapix Biosciences lead compound, THX-TS01, is currently in Phase 2 clinical trials for Tourettes syndrome. The company intends to initiate a Phase 1 clinical study of another compound, THX-ULD01, for the treatment of mild cognitive impairment, for which no FDA-approved therapies currently exist. Approvals for these indications may lead to other applications including pain, cancer, anti-inammatory, dermatology, and psychiatric disorders.

Both compounds repurpose an FDA-approved synthetic THC, the principal psychoactive constituent of cannabis.

Therapix also is developing unique cannabinoid delivery technologies to improve drug administration, including nasal and sublingual delivery methods for THC, with formulations designed to increase efficacy compared with standard oral administration.

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Personalized medicine and cannabinoids deal inked - ISRAEL21c

People living with dementia discuss art at a Royal Academy InMind session. Photograph: Roy Matthews

A few weeks ago, turning on the radio, I hear a voice saying that creative writing can help wounds heal faster. Startled, I turn the volume up. Volunteers were given small wounds; half were then asked to write about something distressing in their life, the other half about something mundane. The wounds of the confessional writers healed substantially more quickly. A thought or a feeling is felt on the skin. Our minds, which have power over our bodies, are in our bodies and are our bodies: we cannot separate the two. Words, self-expression, can tangibly help pain and suffering. Art can be medicine, for body and soul.

Over and over again, I am reminded of the transformative power of art. Answering the phone, I hear a deep and husky voice: Doe, a deer, a female deer. My mother, 85, frail, registered blind, bashed about by cancer and several strokes, is having singing lessons. At school, she was made to mouth the words of songs and she never sang again until now. Eighty years after being told she was tone deaf, her voice is being released. Me, a name I call myself

Or recently I found myself in a hall in London, holding hands with a tiny woman from Jamaica and a large man from Birmingham, we dance. Bit by bit, our self-consciousness falls away and we grin at each other, laugh. Dementia has robbed them of their verbal ability but there are many different languages, many different forms of embodied knowledge and ways that we can connect with each other.

Dementia can look like solitary confinement and solitary confinement is a torture that drives most people mad

Or sitting in a church in Essex on a Sunday in June, I look across at my friends mother. She is in her 90s and has dementia. There are days when she is wretched, chaotic and scared, but each Sunday she is soothed and even enraptured by singing the hymns that she sang when she was a girl. The music has worn grooves in her memory and while she may not be able to speak in full sentences any more, she can sing Abide With Me in a true voice and her face, lifted up, looks young, eager, washed clean of anxiety. My friend thinks that at these moments her mothers brain comes together, like a flower reviving when its being soaked in water. People with dementia, she says, need to be drenched in art.

And this is precisely what the report of an all-party parliamentary group inquiry into arts, health and wellbeing, to be launched on Wednesday 19 July, will say. After two years of evidence gathering, roundtables and discussions with service users, health and social care professionals, artists and arts organisations, academics, policy-makers and parliamentarians, its unambiguous findings are that the arts can help keep us well, aid our recovery and support longer lives better lived; they can help meet major challenges facing health and social care ageing, long-term conditions, loneliness and mental health; and they can help save money in the health service and in social care.

Dementia is an area where the arts can radically enhance quality of life by finding a common language and by focusing on everyday, in-the-moment creativity. As Lord Howarth of Newport, co-chair of the all-party parliamentary group, said: The arts have a vital role to play for people with dementia. Research demonstrates that visual arts, music, dance, digital creativity and other cultural activities can help to delay the onset of dementia and diminish its severity. This not only makes a huge difference to many individuals but also leads to cost savings. If the onset of Alzheimers disease (which accounts for 62% of dementias) could be delayed by five years, savings between 2020 and 2035 are estimated at 100bn. Those are powerful statistics, but this isnt just about money; the arts can play a powerfulrole in improving the quality of life for people with dementia and for their carers.

Its what Seb Crutch and his team are exploring in their inspiring project at the Wellcome Foundation. Its what is happening with Manchester Cameratas Music in Mind or with Music for a While, a project led by Arts and Health South West with the Bournemouth Symphony Orchestra, with Wigmore Halls participatory Music for Life, with the project A Choir in Every Home and Singing for the Brain; with dance classes in hospitals and residential homes; with art galleries and museums that encourage those with dementia to come and talk about art.

There are optimistic, imaginative endeavours going on all over the country, in theatres, galleries, cinemas, community centres, pubs, bookshops, peoples houses. Its happening at a macro- and a micro-level. At a conference run by the Creative Dementia Arts Network, where arts organisations and practitioners gathered to share experience, I met two young students from an Oxford school who with fellow students go into local old peoples homes to make art: not the young and healthy doing something for the old and the frail, but doing it with them, each helping the other: this is the kind of project that is springing up all over the country.

I attended one of the monthly sessions at the Royal Academy in London where people with dementia who have been art-lovers through their life and are art-lovers still come to talk about a particular work, led by two practising artists. We sat in front of an enigmatic painting by John Singer Sargent, and there was an air of calmness, patience and above all, time, and there were no wrong opinions. There are many ways of seeing. People with dementia are continually contradicted and corrected, their versions of reality denied: its Sunday not Friday; youve already eaten your breakfast; Im your wife not your mother; anyway, you are old and she is dead . In this humanising democratic space, people were encouraged to see, think, feel, remember and express themselves. Slowly at first, they began to talk. There was a sense of language returning and of thoughts feeding off each other. They were listened to with respect and were validated.

Validation is crucial. We are social beings and exist in dialogue; we need to be recognised. In health, we live in a world rich with meanings that we can call upon as a conductor calls upon the orchestra, and are linked to each other by a delicate web of communications. To be human is to have a voice that is heard (by voice I mean that which connects the inner self with the outer world). Sometimes, advanced dementia can look like a form of solitary confinement and solitary confinement is a torture that drives most people mad. To be trapped inside a brain that is failing, inside a body that is disintegrating, and to have no way of escaping. If evidence is needed, this report robustly demonstrates that the arts can come to our rescue when traditional language has failed: to sing, to dance, to put paint on paper, making a mark that says I am still here, to be touched again (rather than simply handled), to hear music or poems that you used to hear when you were a child, to be part of the great flow of life.

I think of the wonderful film Alive Inside, made about a project in a huge care home in America: an old man with advanced dementia sits slumped in a wheelchair. He drools; his eyes are half closed and its impossible to know if he is asleep or awake. A few times a day, soft food is pushed into his mouth. Then someone puts earphones on his head and suddenly the music that he loved when he was a strong young man is pouring into him. Appreciation of music is one of the last things to go. His head lifts. His eyes open and knowledge comes into them. His toothless mouth splits into a beatific grin. And now he is dancing in his chair, swaying. And then this man who doesnt speak any longer is actually singing. The music has reached him, found him, gladdened him and brought him back into life.

Its like a miracle but one that happens every day, in care homes, in community halls, in hospitals, wherever kind and imaginative people are realising that the everyday creativity is not an add-on to the basic essentials of life, but woven into its fabric. Oliver Sacks wrote the function of scientific medicine is to rectify the It. Medical intervention is costly, often short-term and in some cases can be like a wrecking ball swinging through the fragile structures of a life. But art calls upon the I. It is an existential medicine that allows us to be subjects once more.

Nicci Gerrard is a novelist and author and co-founder of Johns Campaign johnscampaign.org.uk

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Art can be a powerful medicine against dementia - The Guardian

Along with teaching at the University of Oklahoma Health Sciences Center, Paul DeAngelis serves as chief scientist for four biotech companies he founded. [PHOTOS BY STEVE SISNEY, THE OKLAHOMAN]

It was a tiny advertisement in the corner of a crowded bulletin board at Harvard College that fortuitously sent Paul DeAngelis, a professor and scientist at the University of Oklahoma, on his career path of studying sugar polymers and the now real potential for a much safer and more effective form of the blood-thinner heparin, better delivery methods for all drugs, and more.

The year was 1981 and DeAngelis was a sophomore looking for a work/study job when he spied the scrap of paper about research involving carbohydrate chemistry. Most of the other research was on proteins or DNA regulation.

That work/study job is what started me off in the sugar world, DeAngelis said. I figured it was a new frontier and I could blaze my own trail.

And blaze he has.

Along with teaching at OU, DeAngelis serves as chief scientist for four biotech companies including 15-year-old Heparinex, which produces a synthetic bacteria-based anticoagulant, after animal-based heparin caused nearly 100 deaths in China, and 8-year-old Caisson Biotech, which uses a precursor to heparin a sugar molecule native to the human body for a new drug delivery method that lengthens drugs' effectiveness and lessens their side effects.

From his eighth-floor lab in the OU Medicine tower, DeAngelis, 55, sat down on Tuesday to talk with The Oklahoman about his life and career. This is an edited transcript:

Q: Based on your surname, I'm guessing you have Italian roots?

A: Yes. My dad was 100 percent Italian. My mom is German and Irish. All of my grandparents were born in the U.S. Funny once when I was visiting Sorrento, Italy, three different people mistook me as a native, inviting me to go somewhere or asking for a ride. I don't speak Italian; only the Spanish I learned in high school.

Q: What did your parents do?

A: When they met, my mom was a jockey and my dad was a trainer. But when it was time for me to start school, my dad got a job in a brewery bottling plant in Baltimore and my mom took care of us kids. I'm the oldest of five. After we all graduated high school, my parents moved out of the city to raise thoroughbreds. My mom, who's in her 70s, rode horses on the training track until 10 years ago. She still lives in Maryland; we've lost my dad. My siblings are scattered, but we all got together this past Easter at my sister's house in Florida.

Q: When did you decide to become a scientist?

A: I always liked science. As a kid, I grew plants and did experiments. My mom would say Don't make that smelly stuff in my kitchen, but she was really supportive. My parents, so that we'd be physically fit, also encouraged sports. I played three or four a year, including football and wrestling. In the spring, I'd ride my bike from lacrosse practice to baseball practice.

Q: Did you get a full scholarship to Harvard?

A: Pretty much. Every year, I had to earn $1,000, my parents would pay $1,000, and I'd take out a $1,000 student loan. I'm sure my parents were happy, because I easily could've eaten more than 1,000 bucks of food a year.

Q: What brought you to Oklahoma?

A: I did postdoctoral work at the University of Texas medical branch in Galveston with Paul Weigel, who recruited me here after he became chair of the Biochemistry and Microbiology Department; he's now chair emeritus. I joined the faculty in December 1994 as an assistant professor with my own projects. I'd never even driven through Oklahoma, but I knew it was a good opportunity. There already was glycobiology experience in Oklahoma, OU was proactive with biotech ventures, and people here are nice and work hard.

Q: Tell us more about your promising pharmaceuticals.

A: We discovered an enzyme in bacteria and harnessed the ability to make new and different-sized sugar polymers with repeating chains. That's opened up all sorts of possibilities for biomaterials and drug delivery; much like plastics, which includes plastic bags, plastic tubes and more.

One of the biotech companies I founded, Hyalose LLC, is focused on the commercialization of unique recombinant technologies for producing Hyaluronic Acid, an important biomolecule for many health care and cosmetic applications. Everything still is under evaluation, but hopefully will get into humans some time. Carbohydrates are more invisible and harder to study than proteins and DNA, which are easier to watch. There are fewer tools in the field, but we're learning new stuff all the time.

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Q&A with Paul L. DeAngelis: OU medicine professor doubles as biotech entrepreneur - NewsOK.com

Weve all been in the situation where you know you should go to the doctor, but its only a minor complaint. So, you decide to check first, Googling your symptoms...within half an hour you convince yourself that youve got an incredibly rare and incurable blood disorder.

Obviously you'd be better off actually seeking the advice of a medical professional, but who has time or the energy to trudge all the way to the doctor's office? If only there was a way you could get accurate, personalized medical advice on your phone.

Thats the mission of Babylon Health. Babylon already has an artificially intelligent chatbot that is being used by the UKs National Health Service (NHS) that can help you to figure out which health care professional you need, and has a dedicated app that can connect you to a GP on your phone.

You can pay per consultation or subscribe, see counsellors, and even get prescribed medicine. And the next generation is promising a whole lot more.

Created four years ago, the app now has over a million users worldwide, as well as a clinical service in Rwanda called babyl that connects people to medical professionals through smartphones and dedicated booths equipped with digital tablets. In the first six months of the service existing, almost 10% of the adult population of Rwanda has registered with babyl.

We met with Dr Ali Parsa, CEO and founder of Babylon Health to talk about his plans for Babylon and the future of healthcare.

Dr Ali Parsa: "I built a chain of hospitals. I got lucky and it did incredibly well. The business went from nothing to a few thousand employees and a few hundred million dollars of revenue. I took it public and I sold it."

"The reason I [sold it] was because when you run hospitals, you very quickly understand that the vast majority of peoples healthcare needs have very little to do with hospitals."

"Hopefully you have to spend maximum one month of your life in hospital. And if you take one month out of your life, its [around] 0.1% of your life. Most your healthcare needs for the rest of your life have nothing to do with that month."

"Its got to do with everything else: How do [healthcare professionals] keep you healthy? How do we deal with you when youre ill? How do we deal with your primary care, everything our GPs do? How do we take care of your mental health?"

"And then how do we do that at prices that everybody in the world can afford?"

"It is unbelievable that five billion people in the world have very little access to healthcare. Half of the population of the world have almost no access to healthcare. And yet they all have phones. I think that we can give most people in the world, most of the healthcare they need on most of the devices that they already have."

AP: "[In the NHS] every GP is a paid service. Its a business. So thats fine, but theyre being paid by the National Health Service."

"If you register with a great GP, theyll see you within a few hours or days. But if you have a GP who isnt so great they see you within two or three weeks."

"If you went to Babylon right now, the next available appointment is in 12 minutes. Why couldnt the NHS pay Babylon to be your GP?"

"You can be anywhere in the country and [Babylon] can see you in 12 minutes. One in ten times I have to send you to an actual physical person."

"One in ten times I tell you to see a GP near you and I pay that person. Say you [currently] go to the GP two times a year, that means once every five years I need to send you to someone physical."

AP: "We see you on the phone. We prescribe, we know exactly whats wrong, we cure you. You need no physical examination, youre done."

"It's not just the app, remember. Its a clinical service. In Rwanda, the app is only used by 5% of our users, the rest just use our clinical service. But behind the service sits the intelligence that powers the app in Rwanda."

"The BBC recently put Babylon in the top 10 science and technology innovations they believe are going to change the world. On the BBC Horizon programme last week there was a machine versus a doctor, and the machine was diagnosing as well as a doctor."

This is an interesting claim. In the episode, a GP gives herself an imaginary syndrome (fibroids), gives the chatbot her symptoms, and it manages to correctly diagnose her. Not only that but the doctor agrees with the second and third diseases in the list of differentials the AI provides.

Its very impressive, but it isnt exactly what Ali seems to be claiming here.This feels important as the moment the machine works better than the doctor, seems to us to call into question the need for the doctor. We asked Babylon about this and a spokesperson said:

"What you are seeing is the back end of the machine, this is not what the end user (patient) would see. Please keep in mind that this technology is a work in progress and is being continually developed every day. Version 3 of the babylon app will assist our doctors with diagnosis, giving them more time to focus on their patients.

AP: "Imagine putting into the hands of every human being on Earth through their mobile phone, a doctor who can diagnose them. That, I think, is a phenomenal thing to be able to do."

AP: "Were there."

AP: "We will be releasing a product in the next few months that can diagnose 80% of all primary care diseases. Now."

That's 80% of diseases it can get right, not that it will be right in 80% of all cases.

"Weve solved the problem scientifically. Thats what the BBC was testing. We just need to put it into the product so that you can have it too. Obviously, we need test it rigorously, then put it into the product. But, were there."

"In the next few months were going to do something else which is really cool which is create an avatar of every human being that uses our apps."

At this point Ali opens up a prototype of the next generation of the Babylon app, and shows us a blue avatar of a man with all the organs represented, the heart is the only organ that isnt blue, in a soft yellow. Underneath the avatar are individual sections for each part of the body, with readings that relate to that body part. Under the heart category, the cholesterol reading is yellow.

"I think [with this app] we can put a diagnostic engine into everybodys pocket. We can start putting an understanding of your body into your pocket. Because what that allows [Babylon] to do is to start predicting your health. And then try to foresee issues. Because thats where the costs are."

"Most diseases by the time they present their symptom, a 10 problem has become a 1,000 solution. Everything we do in Babylon is about this. How do you predict a disease ahead of time? What I just showed you, that avatar of me; behind that sits a massive amount of predictive analytics to constantly see how Im doing."

We asked Babylon exactly how this diagnostic tool would work and the spokesperson told us: "The monitor feature will track users health with a variety of different tools including patient history & data (doctors notes, medication, test results, frequently asked questions to the symptom checker), input from other health apps (ie, step count, daily km, sleep patterns) and input from non-health apps (ie emails, calendar)."

AP: "Eventually it will. Courses of action need to be curated country by country, its much more complex. So I can tell you that youre prone to diabetes and thats fine. But what diet you should take in India, is very different to what diet you should take in Britain. To get into that level of detail takes time."

AP: "I'm not saying that a machine will replace a doctor. Diagnosis does not need a doctor or empathy. Diagnosis is a probabilistic graphical modeling event. Im telling you what the probability of you having a disease is. Machines can do probability analysis much better than a human brain can."

"Also, diagnosis is about correlating my knowledge with your symptoms to tell you what is wrong with you. But my knowledge is limited because as a doctor, at best I can have three, four, five million strings of knowledge in my head. Our machine already has 300 million strings of knowledge. So Im looking at a much bigger pool of knowledge, I can do significantly do more, faster."

"But can a machine put its hand on your shoulder and say Trust me, Im going to look after you? Thats a fundamentally different part, and I think that Babylon will bring empathy back into medicine."

"Go to your GP with a symptom now, and they will spend five, eight, ten minutes with you to diagnose, then say okay, thats your problem, go. Wheres the empathy in that? If you went in and said, Ive used Babylon, it said this is the disease I have. They ask you a few questions to make sure its right, then they have five minutes left."

"Lets spend that five minutes to see how youre feeling. See what else is bothering you. How many patients with mental health problems do we catch? Why are GPs not catching people with mental health issues? Because they are focussing on the disease, not the full picture."

AP: "We have a whole list of restricted drugs that we never give. Our GPs work in the NHS. Why would they make a mistake and give you a drug here that they wouldnt give there? We have no interest in your drugs, we dont make money on your drugs."

We asked Babylon for further clarification on its policy and got this response: "All our doctors prescribe medication according to national guidelines for safe prescribing, in addition to following our own medication management policy which further safeguards our patients."

"When it comes to high risk medication, including drugs that people may misuse, babylon has extremely stringent policies to ensure safe prescribing. Furthermore, babylon has implemented mandatory photo identification for controlled medication which exceeds the requirements of the regulator (CQC). This is an example of our relentless pursuit of safe prescribing through a digital channel.

While discussing the potential dangers associated with the service Ali referenced internet banking, and the parallel between digital healthcare and digital banking. Undoubtedly there was a time when people were hesitant about using internet banking because they were worried about its safety, but we wonder whether the risks associated with medicine are greater than those with banking.

"I think weve got to be really careful. Everything that technology does, there are aspects that it will do better than existing, and there are elements that itll do worse. And its a choice."

AP: "To create a company that serves the globe takes 20 years. Thats just the reality. Even Uber, who is growing so fast, how old is it? Six, seven years old, and thats probably the fastest globalized company. And theyre in a tiny part of the globe still. Were in the business of creating the Google of medicine."

"I think that the software part of our business; the fact that we can put a diagnostic tool in the pocket of anyone in the world who wants it, we can create the avatar that I showed you for every human being on Earth. We can globalize that bit a lot faster."

"Putting doctors that can consult with you in every country; that takes longer. We have spent the last three years creating a product that is truly world beating. There is no product in the world that does what we do."

"You and I have the same access via mobile phone that Bill Gates has, and the cleaner in our office has. That is true democratization because it doesnt really matter how rich you are."

"Healthcare isnt like this. Even in the NHS, a lot of doctors do private work and in the private work they are much more accessible than in the public work. Even in the NHS we havent got democratized healthcare. There is no such thing as democratization of healthcare if I have to wait three weeks for it."

"Thats why I think we, or someone else like us, will fundamentally change that game. And that is brilliant for humanity. I hope somebody does it for education too and then well be a long way towards a better place."

It's difficult not to be intoxicated by the message behind Babylon. The idea of its service is very alluring, and of course it would be amazing to see a world where everyone has access to healthcare, but we feel it would be remiss of us not to consider the issues too.

As with all AI developments, if it takes away some of the work of the human currently doing the job, there is the risk that the human will just end up paid less, or working less, rather than freed by the development. And specifically with healthcare, does a paid service risk creating a world where only the wealthy can be healthy?

Scepticism aside, the ability to have an appointment with a doctor in minutes is a brilliant service, and that is reflected in the overwhelmingly positive reviews on the Google Play Store and App Store for the app. It will be interesting to see what form the diagnostic tools take in the next generation. Needless to say, we will be keeping a close eye on Babylon as it develops.

Read more:

Creating the Google of medicine: meeting the human CEO behind the AI doctor - TechRadar

BROOKLYN -

The Women's League of Science and Medicine awarded 21 scholarships Saturday to deserving students at a ceremony in the Flatlands.

The event was the organization's 57th annual awards luncheon. It has provided nearly 800 scholarships so far.

This year's theme was education.

Founded in 1960, the Women's League of Science and Medicine provides scholarships to students all over the tristate area.

Over the past five and a half decades, the organization has grown in size and continues encouraging the next generation of thinkers. The awards are given to high school, college and graduate students who have excelled in academics and are seeking to pursue their careers in fields ranging from medicine to science technology, law and more.

"They helped me through my transition into college. They definitely call me and my mother to make sure that I am OK and that I am accomplishing all that I need to," says three-time scholarship recipient Olivia Okeke. "They are definitely very supportive and they are a very big part of my support team and I am grateful."

Excerpt from:

Women's League of Science and Medicine hosts awards luncheon - News 12 Brooklyn

Ellis Medicine on Nott Street in Schenectady.

Ellis Medicine is working with several other medical facilities to improve quality and reduce costs of government-subsidized careand will judge the results to see how to shape future collaborations.

Its a process that could lead to formal affiliations or a merger, though none is yet planned, proposed or even a concept at this point. After a decade of agreements announced by other area health care facilities, Ellis is one of the few left in this region without a formal partnership with another hospital.

It will remain that way for the short or even long term, said CEO Paul Milton.

The board is doing its homeworkand educating themselves on whats going on in health care and seeing if we need to do anything, he said. Theres no preconceived ideas that we have to do something.

In recent years:

In the wake of all this, rumors sometimes surface about an Ellis merger, but Milton said those rumors are unfounded.

What needs to happen, for Ellis and every other hospital, is to find ways to keep the patient population more healthy for less money, Milton said. If they dont, the cost of health care will rise at an unsustainably high rate.

To that end, Ellis has formed two alliances: one at federal direction to improve treatment provided through Medicare, the other at state direction to improve treatment provided through Medicaid.

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In a nutshell, what the Medicaid program is trying to do is say, Here's 100,000 lives, help us to manage them better. Try to keep them out of the ER for inappropriate ER visits and try to reduce the re-admittance ... in the next 30 days.

Its loosely referred to as 'managing population health' we're learning to do that, Milton said.

The group working to improve care and reduce costs for Medicare patients comprises Ellis, St. Peters and St. Marys Healthcare in Amsterdam. The three also are working together toward the same goal with Medicaid, joined by Hometown Health Centers in Schenectady and Whitney Young Health in Albany.

One thing that quickly became apparent through this process is how important it is for the partners to share data, and how complicated that is thanks to the differences in their computer systems, Milton said.

Its manageable but not perfect by any means, he said.

The two affiliations provide a sort of test run to see how collaboration works for Ellisand what it wants to get out of future partnerships.

It also gives Ellis a look at what Milton said will be the coming model of reimbursement for medical care, in which both government agencies and commercial insurers incentivize health care providers to keep people healthy, rather than heal those who get sick.

"Ellis looks at these changes that are coming from the insurance side, he said. Making a reasonable assumption that, in the future, theres going to be fewer health care dollars whether theyre government dollars or commercial insurance dollars and were going through the education now. Can we stay alone, and continue to be alone and independent doing this? And (can we) continue to affiliate in these kind of arrangements, or do we need to go through and do a more formal type of merger?

Ellis is looking at the mergers and affiliations that have occurred locally, as well as in other states, to see how the process has worked.

The thought process is playing out now rather than later, Milton added, because theres the luxury of time now: Were in a good position now with the services we provide and our financials;were not in a position of weakness. You really want to have this education while youre in a position of strength.

A key administrator of one of the regions largest hospital affiliations is Dr. Steven Frisch, senior vice president for integrated delivery systems at Albany Medical Center. He works closely with leaders at Saratoga Hospital and Columbia Memorial, and they have a combined service area that stretches 100 miles from north to south, through the heart of the Capital Region and beyond.

He said mergers and affiliations are a national industry trend.

Do you need to affiliate? I think its increasingly challenging to stand by yourself regardless of what size you are, he said.

External factors beyond any hospitals control federal policy changes, cost of medicine, cyberthreats, technology upgrades are evolving faster than hospitals' ability to implement programs to provide better care more efficiently at lower cost.

Is it better for us to share those costs, or is better for each of us to re-create them? Frisch said.

Albany-based health insurer CDPHP said the trend is not a positive one for its 420,000 subscribersbecause hospitals that merge or affiliate have more bargaining power and are able to negotiate higher payments for services. Insurers then pass along those higher payments to subscribers in the form of higher premiums. About 33 cents of each premium dollar goes to hospitals, CDPHP spokeswoman Ali Skinner said.

Thats always sort of the front-end messaging, she said, referring to the promise of increased efficiency and quality of care when hospitals join forces.We think thats a great thing.

"While the intentions are good, the consequences are not: Patients wind up paying more money. The literature is clear, Skinner said, citing a Robert Wood Johnson Foundation study that showed cost increases have sometimes exceeded 20 percent in markets where hospitals merged.

Its a fair statement on their part, Frisch acknowledged. He added, though, that hospital costs might well have increased even more without consolidation.

Whether or not systems are consolidating, yes, theres this phase where costs will go up. Its frustrating because we are taking costs out.

Dr. William Streck, chief medical and innovation officer at the Healthcare Association of New York State, said evidence so far indicates gains in quality and efficiency of care after mergers or affiliations, but not reductions in costs. I think it is a work in progress, he said.

HANYS is an industry group that represents 500 health care organizations across New York state, including all hospitals.

There has been a clear impetus toward consolidation, Streck said. Its been driven by both market forces and state policy.

This wont change, he added.

There are a number of financial imperatives.

One step the hospital industry is taking to respond to the changing health care market is building urgent care facilities. These can range from storefront clinics to large standalone facilities open 24/7 and offering a wide range of services. Ellis Medicine in 2012 opened its 38,000-square-foot Medical Center of Clifton Park near Northway Exit 9, which is staffed by nurses and physicians around the clock.

Ellis said the facility fulfills several purposes: Foremost, it keeps people out of the emergency department, one of the most expensive places to provide medical care. Also, it diversifies the patient mix to increase revenue for Ellis so it can remain viable and serve its whole patient population. Finally, it provides a measure of convenience by meeting patients where they are.

Louis Lecce stands in front of the Albany Medical Center Urgent Care building at 1769 Union St. in Niskayuna on Feb. 2, 2017. (Peter R. Barber)

The move into Clifton Park brought Ellis closer to Saratoga Hospitals service area. Around the same time, Saratoga Hospital and Albany Medical Center, which were not affiliated at the time, collaborated to build an urgent care center of their own Malta Med Emergent Care near Northway Exit 12.

Albany Med also built one of its EmUrgentCare facilities in Glenville, a 4-mile drive from Ellis Hospital, and then another on Union Street in Niskayuna, not even 2 miles from the headquarters of Ellis Medicine.

Ellis leadership expresses no annoyance at thisnearby competition, which it said is happening with increasing frequency in the industry.

Ellis said this is good from the patient's standpoint, as it increases choices, and it is good from Ellis perspective, as its a reminder it must provide quality care with compassion. Doing so, it said, will keep patients coming to Ellis.

By one industry estimate, there are about 10,000 urgent care clinics nationwide and nearly 400 in New York state.

Milton said Ellis Medicine has a few factors working against it as it maps its future: Some of its facilities are decades old; it provides a significant amount of mental health care, on which it makes little profit; and it provides a significant amount of indigent and Medicaid care, on which it makes no profit.

Faced with this, and the need to move to a population health model, Ellis would consider affiliating with an entity that has developed an expertise needed in the region, rather than reinventing the wheel, Milton said.

Can a place this size do that well, or does it need to scale up to get expertise to do it? Access to capital comes up. Ive got old facilities here that are going to need some investments. And based on the scale we are on now, are we going to have access to the capital we need?

Milton joined what was then Ellis Hospital in 2008 as its chief operating officer, just as the state Berger Commission ordered a number of closures and mergers among New York hospitals. Ellis Hospital was directed to merge with St. Clares Hospital, nearby in Schenectady, and with Bellevue Womans Center, a few miles away in Niskayuna, to become Ellis Medicine.

St. Clares was renamed the McClellan Street Health Center and was converted to an outpatient care, short-term rehab and nursing home. Bellevue retained its name and its mission as a maternity hospital. Ellis Hospital is still known by that nameand is home to a wide range of services, as well as the Capital Regions second-busiest emergency department.

The process was not painless, but Ellis Medicine is better off for it, and importantly, so are its patients, Milton said: I think it was very successful for this community.

Benefit to the community will be a guiding consideration in any future affiliations Ellis contemplates, Milton said.

Were only going to do something that improves the situation in this community, he said. When we go through our education with the board, one of the things were looking at is, what can we do with a partner? Lets say if it was a full merger: What is a partner bringing here thats going to make the care in this community better for the people in Schenectady? Thats the main criterion.

Id want to be very careful that this community doesnt lose anything that it has in any kind of merger or affiliation, he said.

Streck, at HANYS, said an optimum result of any affiliation or merger is increased revenue for the larger hospital involved; increased access to technology infrastructure and patient treatment options for the smaller hospital; and improved efficiency and reduced costs for both.

Frisch, at Albany Med, said the goal with the Albany-Hudson-Saratoga Springs affiliation was first to expand the medical offerings in the three communities and second to understand how to deliver care to the 100-mile long region as a whole, more efficiently and effectively.

The three entities have more than 100 locations, he noted.

What should the right distribution be across that region? he said. Thats going to be years in figuring out.

Since the affiliation, Columbia Memorial Hospital has increased its cardiology staff, added an ear, nose and throat specialist, and begun offering foot and ankle surgery. Saratoga Hospital was able to recruit an invasive cardiologist and gain access to Albany Medical Centers analytic tools; an information technology team from Albany Med was in Saratoga on Monday morning doing demonstrations.

I think our existing affiliations are working very well, Frisch said, adding that there will likely be more partnerships in the future, perhaps involving Albany Med.

Acute care is consolidating industrywide.

Read the rest here:

Ellis Medicine stays solo despite partnerships all around - The Daily Gazette

KUALA LUMPUR: The World Health Organisation (WHO) is keen to work with Malaysia to promote exercise medicine which has the potential to treat and prevent four Non-Communicable Diseases (NCDs), says an expert in exercise medicine.

Dr Lee Chee Pheng said WHO's interest in exercise medicine raised the possibility of Malaysia taking the lead in formulating a new policy on its impact.

He said the therapy had the potential to be an alternative remedy to conventional medicine in preventing hypertension diabetes, obesity, and dyslipidemia through the prescription of the right kind of therapy.

"Everyone knows the importance of exercises, but if the dosages are not enough, there will be no physiological changes.

"Thus, this exercise medicine therapy has proven to produce many positive changes to the human body if executed in the right manner," he told Bernama.

Dr Lee, who is also Asia College of Exercise and Sports Medicine chief executive officer, led a five-member delegation to WHO's headquarters on July 5 to deliberate on exercise medicine and other issues of mutual interest.

He said Malaysia should take a serious view on the impact of exercise medicine as the country's mortality rate from NCDs was still escalating.

"Despite the advancement of medical technologies, the mortality rate has not been contained over the past 15 years," he said.

On another note, Dr Lee said he had discussed with WHO about various health concerns in Malaysia including the closure of several fitness centres which had affected the daily exercise routine of many.

He also sought support from WHO on the inaugural World Conference on Exercise Medicine to be held in Langkawi from Nov 19-21.

"WHO has agreed to send Dr Temo Waganivalu, coordinator for WHO's Department for the Prevention of Non-Communicable Diseases, to deliver a paper entitled Global NCD Target: To Reduce Physical Inactivity," he said. Bernama

Go here to read the rest:

WHO keen to work with Malaysia to promote exercise medicine: Expert - The Sun Daily

Mothers Against Senseless Killings founder Tamar Manasseh talks about the senseless violence in the city during a school supply drive on the corner of 51st Street and Lake Park Avenue last August. Spencer Bibbs

By TONIA HILL Staff Writer

Mothers Against Senseless Killings (MASK), an Englewood based organization is one of seven organizations that were recently awarded capacity building grants from University of Chicago (U. of C.) Medicine.

Tamar Manasseh, president and founder of MASK, an organization that seeks to prevent and disrupt violence in targeted communities by promoting good health and addressing safety issues, said she is grateful for the support from U. of C. Medicine.

The grants are to provide immediate support to community-based prevention, intervention, and recovery efforts on the south side.

Violent incidents in our community are more prevalent during summer months, Brenda Battle, vice president of Urban Health Initiative and chief diversity and inclusion officer for the University of Chicago Medicine, said in a written statement. As a community partner, it is imperative that we work with local grassroots organizations to identify and activate solutions that will help keep children and adults safe.

U. of C. Medicines Community Advisory Council and its Trauma Care and Violence Prevention programs came together to identify ways for U. of C. Medicine to respond to increasing violence at the end of the school year and the start of summer.

The concept that was developed out of those working sessions were rapid cycle grants to assist grassroots organizations that have violence prevention programs.

Community-based organizations were encouraged to apply for the grants in early May.

MASK headquarters is located on the 7500 block of South Stewart Avenue and the organization has a branch in Hyde Park. Manasseh said the organization would use the funds to support programs that are currently in place.

We feed about a hundred people a day every single day, Manasseh said. We are building a playground putting in turf, sod, and concrete to make the neighborhood a bit safer and to create a safe space for the entire community not just for the children.

Construction of the playground is underway, Manasseh said she wants the playground to be a place where everybody in the community can come together and talk and meet each other.

Additionally, MASK will use the grant money toward summer camps that they will begin in the coming weeks.

While Manasseh said she has seen a decline in shootings in the one-mile radius surrounding their hub of operation in Englewood since the organization formed three years ago, she believes there is still more work to be done.

She said she has been able to convince many kids in the area to stop shooting in the neighborhood.

I cant seem to get them jobs, so they still end up in jail for other crimes, Manasseh said. I cant pay their rent, buy their clothes, or feed their children. When people turn their lives around there are so few opportunities for them. I havent been able to find them the jobs or the field training that they may need.

The Hyde Park branch of MASK began boosting its presence in the area last year, Manasseh said members from Hyde Park regularly come to Englewood to volunteer.

Last year, members organized a massive school supply drive.

Hyde Park has a large school supply drive, Manasseh said. They collect a lot of school supplies and school uniforms in Hyde Park, and then we distribute them.

This year, Hyde Park MASK members will do the same. School supplies will be given to those in need at MASKs end of summer block party that will be held during Labor Day weekend this year.

MASK is also working in the Lawndale neighborhood in Chicago as well as Evansville, Ind., Memphis, Tenn., and Staten Island, N.Y.

Other grant recipients for the award include Breaking Bread, Crushers Club, Gary Comer Youth Center, Global Girls, Inc., Kids Off the Block, Inc., and Woodlawn East Community and Neighbors.

The rapid cycle grants are part of U. of C. Medicines ongoing effort to assist community organizations with evidence-based violence prevention programs.

t.hill@hpherald.com

Read more:

MASK to receive violence prevention grant from U. of C. Medicine - Hyde Park Herald

Consumers in this Internet age are accustomed to going online to check recommendations and ratings for all kinds of goods and services, often on third-party websites. Doctors and hospitals are no exception, with a variety of sites such as Healthgrades.com and RateMDs.com offering ratings and reviews of health care facilities and providers.

This week Nebraska Medicine became the first health system in the Omaha metropolitan area to launch its own star-based online rating system for the physicians in its clinics, based on surveys of past and current patients. The rating system, found under the Find a Doctor section of NebraskaMed.com/Doctors, also includes comments from patients.

Chad Brough, the health systems chief experience officer, said patients indicate that they value ratings and comments from other patients.

For most people, health care is still a very word-of-mouth experience, he said. Weve attempted to take that phenomenon and put it online so people can make informed choices.

University of Utah Health pioneered the strategy, he said, first posting star ratings and comments in 2012. Bryan Health in Lincoln began posting star ratings for its provider groups in August and added patient comments earlier this month. Nebraska Medicine officials estimated that about 40 organizations across the country now are posting ratings.

If people are looking for a doctor, its important for them to hear what current patients think, said Deb Boehle, a Bryan Health spokeswoman.

Officials with several other Omaha health systems said they have discussed or are exploring the possibility of adding online ratings, but none has established a timeline. Most already offer a Find a Doctor section on their websites that includes basic information about doctors and other providers.

Matt Hazen, division director of service excellence for CHI Health Clinic, said all practices of a certain size are required by the federal Centers for Medicare and Medicaid Services to conduct patient satisfaction surveys, and most organizations already are doing it as a matter of course.

CHI Health has been posting such scores internally for nearly four years, he said. Making them available publicly probably will await an upgrade in information technology capabilities.

Nebraska Medicine and Bryan Health officials said providing their own ratings and reviews ensures that patients are seeing reviews by their doctors actual patients.

Dr. Sarah Richards, Nebraska Medicines medical director of patient experience, said patients often have no way to know whether ratings or reviews on third-party sites were posted by people who actually saw the doctor. Some ratings may be based on only a handful of reviews. As a provider, you want accurate information out there, she said.

About 270 Nebraska Medicine physicians, physician assistants and nurse practitioners currently have received the minimum of 30 reviews required for their ratings to be posted. Eventually they should have them for about 350 providers. All averaged between four and five stars on the five-star scale.

Doris Peter, director of Consumer Reports Health Ratings Center, agreed that third-party sites ratings are flawed by their lack of validation. Those provided by health systems, she said, will become more valuable if they add more information, including cost and quality measures.

But Brough said offering provider ratings is an important first step. He anticipates that the health system eventually will post additional cost and quality metrics online. Consumers, who are taking a greater role in health care decision-making, increasingly are seeking such information.

The star ratings are based on 10 questions focused specifically on the care provider. Among other things they ask patients to rate the degree to which the provider talked with the patient using words the patient could understand and the patients confidence in the care provider. They post the average star ratings for each of the 10 questions plus an overall average. The questions dont address the outcome of the visit; say, whether a condition was improved through care.

The team met with doctors and other providers before the launch, explaining that making the ratings public gives them an opportunity to take ownership of their online reputations. They even asked providers to pull out their cellphones and Google themselves to see what ratings already were out there.

Dr. Sean Langenfeld, a colon and rectal surgeon with Nebraska Medicine, gives talks on social media to physicians around the country. What were saying is This is the future, he said. Patients are going to find their information online, so we need to provide them with good information.

Langenfeld said it can be difficult for doctors to respond to or correct negative ratings or comments on third-party websites. He got some on one third-party site about four years ago, from what appeared to be an angry patient. But the comments werent characteristic of how he practices, and he questioned whether they came from one of his patients. When he contacted the website operator to see how they validated reviews, he was told that hed have to subpoena the information.

The health systems surveys, on the other hand, can serve as a kind of report card, Langenfeld said.

Richards said comments are reviewed internally and will be edited or removed if they contain information that could identify patients in violation of privacy regulations. Doctors can contact the team if they have concerns. Comments also can be removed if they dont pertain to the provider in question.

But Chaise Camp, executive director of patient experience, said they wont pull negative opinions, of which there have been few so far. When one occurs, that validates all the great comments they get, he said.

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Nebraska Medicine is first health system in Omaha area to launch its ... - Omaha World-Herald

Dr. Keith D. Lindor is executive vice provost and ean of the College of Health Solutions at Arizona State University. He is an international authority on liver disease, current president of the American Association for the Study of Liver Diseases, and a former editor-in-chief of the preeminent journal Hepatology. He is also the former dean of Mayo Clinic School of Medicine. Dr. Lindor is but one of an impressive list of prominent doctors who have long shared a positive view of the benefits of alternative medicine and therapies.

Dr. Lindors views were shaped early in his career, working alongside a Native American medicine man at a reservation clinic. I had been trained to aggressively treat patients with drugs that often only made them even more ill, he told David E. Freeman in 2011. But he could often do much better with just a press of his hand.

In his new role with Arizona States College of Health Solutions, Dr. Lindor emphasizes a holistic approach to treatment in preparing the next generation of health professionals for entry into a quickly evolving health care system.

The notion that alternative medicine is a legitimate response to mainstream shortcomings is a message that has long been spreading. In recent years, integrative medical-research clinics were springing up all around the country, at least 42 of them at major academic medical institutions including Harvard, Yale, Duke, the University of California at San Francisco, as well as the Mayo Clinic. According to Newsmax, a national consortium to promote integrative health now counts more than 70 academic centers and health systems as members. There were eight in 1999.

Whether called complementary, alternative, or integrative treatment, an estimated 42 percent of all hospitals in the U.S. now offer nonconventional medical services. The Osher Center for Integrative Medicine at the University of California, San Francisco is on pace to get more than 10,300 patient visits this fiscal year and is expanding its clinical staff by a third. Duke Universitys integrative medicine clinic saw its total visits jump 50 percent in 2015 and the number continues to climb. Its estimated as many as 38 percent of all adult Americans are using some form of alternative therapy.

While the medical community seems grow more open to alternative medicines possibilities, the rise of alternative therapies has sparked tension. Many doctors and administrators hold fast to the view that alternative medicine is, at best, a dubious business that is undermining the credibility of medical institutions and science-based medicine.

Why all this institutional interest in alternative medicine? Money is certainly a part of it. Its a $37 billion-a-year business. Why wouldnt the medical establishment want a part of that? But what doctors really need to focus on is why patients want such care? In large part, its because mainstream medicine is failing them. This is especially true of people such as my wife, those who come into the system with a hard-to-pin-down ailment. Many doctors today dont seem to do well with things they dont understand, and how they handle being at a loss for a clear prognosis or treatment plan can make a patients situation even worse. Whats needed is to not lose focus on whats best for a patient. This is where alternative medicine, with its adherence to a healing model of patient care, can make a difference.

Why not encourage a patient to try an ancient remedy or a spiritual healing technique if its unlikely to cause them harm and may provide some relief? At this point of treatment, relieving patient stress needs to be a goal. Stress can make existing problems worse.

Once youre sick, stress can make it harder to recover and create a higher risk for a bad outcome. In this situation, whos to say that traditional Chinese medicine, which like many alternative approaches, focuses on patients feelings and attitudes, stress reduction and encouraging the patient to believe in self-healing is not of value?

In David H. Freedmans 2011 comprehensive report on alternative medicine for the Atlantic Monthly, nearly every physician he spoke with agreed the current system makes it nearly impossible for most doctors to have the sort of relationship with patients that would best promote health. Relationships where there is an actual conversation; where doctors can maybe follow the clues patients give them about what they feel might help them.

As he notes in the article, if an alternative practitioner is also a medical doctor, or works in conjunction with one, its hard to see whats being risked.

If it doesnt work, I dont know that youve lost anything. If it does, you do get to a better place, Dr. Richard Lang of the Cleveland Clinic Wellness Institute recently explained to STAT News.

While you can argue that the evidence of alternative medicines effectiveness is far from absolute, neither is the evidence for various pharmaceutical therapies that are routinely provided by doctors and hospitals. The list of much-hyped and often heavily prescribed drugs that have failed to combat complex diseases seems to grow daily, some with well-documented risks of horrific side effects. Some of the solutions, such as opioids to treat pain, have contributed to an addiction problem that has reached epidemic proportions.

The biggest problem with alternate medicine in an institutional setting is the costs. Insurance coverage has been slow to catch up with current medical practices that incorporate alternative approaches. Not all integrative medicine clinics are designed as big profit centers. Many are funded by philanthropists and some hospitals say they operate their alternative programs at a loss. The Mayo Clinic, for example, a medical center renowned for the excellence of its medical care, is known for its relatively low cost of care.

It also needs to be stressed that there is a lot of quackery out there under the guise of alternative medicine. Selecting an alternative medical provider and treatment should be done with care and trusted referrals.

Write to Chuck Norris with your questions about health and fitness. Follow Chuck Norris through his official social media sites, on Twitter @chucknorris and Facebooks Official Chuck Norris Page. He blogs at ChuckNorrisNews.blogspot.com.

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Chuck Norris powers up role of alternative medicine - WND.com

The potential for artificial intelligence in precision medicine is big, according to conclusions of a new study by the New York Genome Center and IBM.

The results, published in the July 11 issue of Neurology Genetics, a journal of the American Academy of Neurology, showed that researchers at the New York Genome Center, Rockefeller University and other institutions along with IBM verified the potential of IBM Watson for Genomics to analyze complex genomic data from state-of-the-art DNA sequencing of whole genomes.

[Also:IBM Watson, Illumina partner to deliver precision oncology on a large scale]

This study documents the strong potential of Watson for Genomics to help clinicians scale precision oncology more broadly, Vanessa Michelini, Watson for Genomics Innovation Leader for IBM Watson Health, said in a statement. Clinical and research leaders in cancer genomics are making tremendous progress towards bringing precision medicine to cancer patients, but genomic data interpretation is a significant obstacle, and thats where Watson can help.

The proof of concept study compared multiple techniques used to analyze genomic data from a glioblastoma patients tumor cells and normal healthy cells, putting to work a beta version of Watson for Genomics technology to help interpret whole genome sequencing data for one patient.

[Also:IBM Watson, FDA align to boost public health with blockchain]

Watson provided a report of potential clinically actionable insights within 10 minutes, compared to 160 hours of human analysis and curation typically required to reach similar conclusions, according to researchers.

The study also showed that whole-genome sequencing, or WGS, identified more clinically actionable mutations than the current standard of examining a limited subset of genes, known as a targeted panel. WGS requires significantly more manual analysis, so combining this method with artificial intelligence could help doctors identify potential therapies for more patients in less time, researchers concluded.

This informatics challenge is often a critical bottleneck when dealing with deadly cancers such as glioblastoma, with a median survival of less than 15 months following diagnosis, researchers noted.

Twitter: @Bernie_HITN Email the writer: bernie.monegain@himssmedia.com

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AI can speed up precision medicine, New York Genome Center-IBM ... - Healthcare IT News

As the healthcare industry continues to explore and define population health strategies, it is important that upcoming physicians have a foundation in the topic.

Wilson

Natalia Wilson, MD, MPH, authored the Population Health chapter of the Health Systems Science textbook that is expected to be used in medical schools across the country. The book was released in December 2016, and is a first in an effort by the American Medical Association (AMA) to educate medical students about the third pillar of medicine. This education initiative includes patient safety, quality improvement, teamwork, leadership, healthcare policy and economics, clinical informatics and population health. The textbook was co-written by members of AMAs Accelerating Change in Medical Education consortium.

Population health is a dynamic area that is continually evolving, thus necessitating innovation in our approach to teaching, frequent update of our teaching materials, and consideration of new methods of practice for medical students and trainees, says Wilson, a clinical associate professor at the School for the Science of Health Care Delivery at Arizona University, who teaches at the Mayo Clinic School of Medicine.

Wilson talks with Managed Healthcare Executive (MHE) about the importance of population health being taught to the next-generation of physicians, and how it will transform care in the future.

MHE: How much are population health strategies being taught in medical schools today?

Wilson: Population health is a relatively new curricular area in medical schools that is expanding and evolving. Inclusion of population health curriculum and approach to education differs between medical schools. For instance, at Mayo Clinic School of Medicine, medical students are required to earn a certificate in the science of health care delivery that is jointly taught with Arizona State University.

Examples from other medical schools include opportunity to pursue a dual Doctor of Medicine/Master of Science degree in population health, a population health scholar track, and involvement in population health initiatives during medical school.

MHE: What are some of the basic concepts that new physicians need to understand about population health?

Wilson: Accountability and responsibility for physicians is expanding to include the health of populations or groups of patients along with the traditional individual patient focus. Only 10% of the determinants of population health is attributed to healthcare. The majority is attributed to social circumstances, environmental factors and behavior.

The social determinants of health are recognized to be very influential on behavior and to contribute significantly to differences in health outcomes between groups of people. Improvement of population health will require focused work, influence and collaboration between multiple sectors that include healthcare delivery, the community, public health, policymakers, payers, employers and research.

MHE: How do you see population health changing what is being taught in medical schools?

Wilson: I see population health as augmenting and complementing the traditionally taught basic and clinical sciences. A population health focus has evolved in response to significant limitations in health and healthcare. The United States has high levels of chronic disease, an obesity epidemic, high healthcare costs, disparities in health and healthcare, and relatively poor population health. What has become necessary in response to these problems is expansion of knowledge and experiences for medical students, those training in health professions and in practice so considered in patient care is the impact of social determinants of health, community resources that could be used to support patients, data to better understand patients and groups of patients, health IT that can expand the reach of care, and a team approach. Very importantly, we are planting seeds in medical students that they are part of the solution.

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Population health expert highlights medicine's third pillar - ModernMedicine

Around 95 percent of expensive medicines are now unavailable, and hundreds of thousands of sick and injured Venezuelans lack the necessary treatments.

One of those people isMara Ayala, who suffers from stomach ulcers, with her condition worsening in recent months due to lack of treatment.

We dont want to feel like we are invisible, we want to live, Ayala told the AP during a protest outside the department of social security.

Some of the signs held by protesters read: death does not wait and we have no tomorrow.

The situation is alarming, there is a total absence of medicineaffecting around 300,000 people in Venezuela,said Francisco Valencia of the healthcare charity Codevida. We are living through an unprecedented crisis, mortalities are rising at an alarming rate and thousands have lost their quality of life.

As part of the socialist reforms of the countrys late leader Hugo Chvez, the right to health care was enshrined in the Venezuelan constitution. However, amid the countrys economic collapse, which could see inflation rise by a staggering 1700 percent, the government has been forced to make a series of drastic cuts, meaning hundreds of thousands of people cannot access adequate health care.

In March,Venezuelan dictator Nicolas Maduro pleaded with the United Nations to deliver humanitarian aid in the form of medical supplies, blaming private companies for waging an economic war against the country.

The United Nations has the most advanced and complete plans in the world to recover the pharmaceutical industrys production capacity and direct it toward medicines for the people, Madurosaid on national television, urging the U.N. to act. I trust in you to keep advancing the strengthening of the productive engines of the Bolivarian economic agenda.

The chronic lack of medicine has led to a series of health issues, such as a rise in amputations of infected limbs due to a lack of antibiotics, mastectomies due to a lack of cancer treatment, as well as HIV and teen pregnancies due to the shortage of contraceptives.

Other shortages in Venezuela include food and basic sanitary products.The Venezuelan government sets price caps on food products such as pasta, rice, and flour, but people areforced to queuefor hours in hot temperatures to buy them, with latecomers missing out altogether. Products such as red meat, dairy, and fresh vegetables are now too expensive for many people to buy.

Arecent reportfound that over 15 percent of Venezuelans have resorted to scavenging for food, while a majority of people go to bed hungry.

Meanwhile, sanitary products such as shampoo, toothpaste, toilet paper, and tampons are also in short supply, with many forced to ration their usage.

Ive always loved brushing my teeth before going to sleep. I mean, thats the rule, right? cosmetic worker Ana Margarita Rangel told The Washington Post, from one of the slums, known asbarrios,25 miles west of Caracas. Now I have to choose. So I do it only in the mornings.

Maduro recentlyraised the minimum wageto 97,531 bolivars a month,which on Venezuelas official exchange rate equates to around $70 a month but only holds areal market worthof$12.53. However, due to levels of inflation, the currency is rapidly losing value.

Daily protests are now taking place across Venezuela amid the countrys economic and political crisis.According to an ongoing analysis from Venezuelan outlet RunRunes, atleast 108peoplehave died since the countrys opposition called for daily protests in April as police usebrutalityto contain the protesters.

You can follow Ben Kewon Facebook, on Twitter at@ben_kew,oremail him at bkew@breitbart.com.

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With 95% of Basic Medicine Unavailable, Venezuelans Take to the Streets - Breitbart News

The rate of serious medication errors that occur outside of health care facilities doubled from 2000 to 2012, a new study finds. Gillian Blease/Getty Images hide caption

The rate of serious medication errors that occur outside of health care facilities doubled from 2000 to 2012, a new study finds.

When people take medicine at home, mistakes happen.

Some people end up taking the wrong dose of a medication or the wrong pill. Sometimes, they don't wait long enough before taking a second dose.

Other times, it's a health professional who's at fault. A pharmacist might have dispensed a medication at the wrong concentration, for example.

These kinds of mistakes are on the rise, according to a study published Monday in the journal Clinical Toxicology.

The researchers looked at a small subset of the medication errors that happen in the U.S. every year. The FDA estimates that about 1.3 million people are injured by medication errors annually in the U.S.

The study analyzed data collected by poison control centers across the U.S. and counted only errors that happened outside health care facilities and resulted in serious medical outcomes. That's defined in the study as symptoms that typically require some treatment to life-threatening situations and even death.

They found that the number of these cases doubled, from 3,065 cases in 2000 to 6,855 cases in 2012. In the 13 years covered by the study, more than 67,000 such errors occurred, and 414 people died as a result. Most of the mistakes were preventable, the study finds.

"We know that a third of the cases in this study resulted in hospital admissions, so these aren't minor errors. These can be pretty significant," says Nichole Hodges, a research scientist at Nationwide Children's Hospital in Columbus, Ohio, and the study's lead author. She says errors at home represent a significant public health burden and are likely undercounted.

"Since we're only including those non-health care facility errors that are reported to poison control centers, it's an underestimate of the true number," she says.

Jay Schauben, a former president of the American Association of Poison Control Centers, points out that not everyone calls a poison control center when they experience one of these events. And he says there could be "minor inaccuracies" in the data from poison control, because the employees who answer calls are relying on what the caller tells them, and if a physician calls about a patient, that physician might not know exactly what happened to the patient.

Despite these limitations, he says the study's findings are still valid and useful. And he says he's glad to see this study draw attention to medication errors happening at home.

"We focus on medication errors in health care facilities, and we tend to forget that these types of errors do occur in the home scenario and potentially go uncorrected, maybe unrecognized," Schauben says.

Cardiovascular drugs, including drugs used to treat high blood pressure, were associated with about one in five serious medication errors more than any other pharmaceutical category.

The number of errors with cardiovascular drugs doubled over the time period of the study, and errors linked to hormones and hormone antagonists mainly drugs used to treat diabetes more than tripled.

Hodges says they can't be sure about the reasons for these increases, but they have a theory.

"We know that use of cardiovascular medications is increasing. That's consistent with the findings of other studies," she says. "The same with the use of insulin. Because we have rising rates of diabetes in the U.S., prescribing of insulin is increasing. So we think that some of these increases in errors are a reflection of the increase in prescribing."

Cardiovascular medications and analgesics essentially painkillers, including acetaminophen and opioids were responsible for two-thirds of the deaths included in the study.

So what should people do to keep themselves safe from medication errors at home? Hodges has a few recommendations.

People who use weekly pillboxes to organize medicines should make sure they have some kind of lock and keep them out of sight of children, she says.

"The locks are great, but they're just child-resistant. They're not going to be child-proof," she says. "It basically buys you a little bit more time, but it's not going to keep the child out of it completely, so you still want to use safe storage."

And keeping a close eye on kids who are taking medication can also help them avoid taking the wrong pills, she says. The study found that kids in the 6- to 12-year-old group were the most likely to unintentionally take or be given another person's medication.

"Perhaps they are giving themselves their medication, especially if it's a daily," Hodges says. "They might be more likely to accidentally take someone else's medication."

She also recommends that parents and caregivers keep a written log to track the date and time when medications are given and the dose given especially when more than one person is giving medicine to the same person.

Schauben recommends that people call a poison control center if they have questions about medicines they're taking at home.

"It doesn't have to be an exposure," he says. "Those are questions that we could answer for them."

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More People Are Making Mistakes With Medicines At Home - NPR

OMAHA, Neb.

A Food and Drug Administration panel this week endorsed what could be a groundbreaking cancer treatment. The panel of 10 voted unanimously to recommend CAR T-Cell therapy for children and young adults with acute lymphoblastic leukemia, or ALL.

In the next few months, the FDA could decide to approve the therapy, which would make it the first gene therapy available in the U.S. The therapy is already being used at Nebraska Medicine for clinical trials.

Doctors diagnosed Roger Belohlavy with ALL in August 2015. The cancer returned even after a bone marrow transplant.

"Disappointed that it came back, but I managed in spite of that disappointment (to) keep a pretty good attitude," said Belohlavy.

Belohlavy had few treatments options to consider, but his doctor at Nebraska Medicine proposed a CAR T-Cell clinical trial.

"He said the clinical trial is pretty promising because it could give you a more durable remission and possibly even lead to a cure," Belohlavy said.

Through CAR T-Cell therapy, doctors take T cells from the patient.

"I always describe it as, like, a cream separator, where the patient's blood comes out, we spin in through a cream separator, we open the door right where we want the T cells at," said Dr. Matthew Lunning, hematologist and oncologist at Nebraska Medicine.

The cells are then sent off to a processing center where they're "trained" to take out a person's cancer. The patient undergoes chemotherapy and then gets an infusion with the modified T cells.

"When you inject it back into the patient, it goes out there and is like a trained assassin," Lunning said.

The T cells kill the cancerous cells, but there are risks associated with the treatment.

"I went out with the neurotoxic reaction," said Belohlavy. "I was on life support for 7 1/2 days on a ventilator."

Days later, Belohlavy said, doctors told him he was in complete remission.

"It's given me a whole different outlook on what I want to do with my future," said Belohlavy.

CAR T-cell therapy could also help give others a brighter future. The FDA will soon decide whether to officially approve the treatment for young ALL patients.

"The technology could be paradigm-shifting in that we're really talking about a population that's very difficult to treat," said Lunning. "(These patients) have broken through our standard lines of chemotherapy and this isn't chemotherapy. This is your own body fighting off cancer. I think that this will reach an unmet need population within this country and I hope that not only does it take hold in this country, but globally."

Lunning said if the FDA approves this therapy, patients at Nebraska Medicine would benefit from it. He said with the Buffett Cancer Center, Nebraska Medicine is on track to be a leader for CAR T-Cell therapy.

If the FDA approves CAR T-Cell therapy for ALL leukemia patients that are either children or young adults, "We will be able to reach into the adult or young adult population if that approval does come from the FDA," Lunning said.

A similar trial for adults with ALL, in which Belohlavy participated, took place at Nebraska Medicine. It has since ended.

Nebraska Medicine is currently involved in a CAR T-Cell clinical trial for non-Hodgkin's lymphoma. Nationwide, the trial has had a 60 percent remission rate after 30 days and a 40 percent remission rate after 60 days.

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FDA panel endorses cancer therapy performed in clinical trials at Nebraska Medicine - KETV Omaha