Improving the Patient Experience with Advanced Illness through Research on Technology – Video

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Improving the Patient Experience with Advanced Illness through Research on Technology
Arif Kamal, MD Assistant Professor of Medicine Division of Medical Oncology and Duke Palliative Care Duke University Medical Center Physician Director of Quality and Outcomes Duke Cancer Institute ...

By: Duke Clinical Research Institute

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Improving the Patient Experience with Advanced Illness through Research on Technology - Video

Wonkblog: Its not just Ebola. Health care is pretty dangerous work.

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The Ebola outbreak shows that being on the front lines of disease can be particularly dangerous business for health-care workers. More than 230 workers have died overseas trying to battle the deadly virus, and the infection of a Dallas nurse treating the first U.S. patient diagnosed with Ebola is a reminder that health-care workers put themselves at risk to treat the sick.

When it comes to treating Ebola patients, it's hard to understate how careful health-care workers must be. As this graphic explains, there's about 30 distinct steps workers have to take to avoid a risk of infection. After the infection of the Dallas nurse, the CDC is rethinking protocols for care and that's after the country's largest nurse's union has warned that its members haven't been adequately trained on Ebola.

Of course, Ebola is a special case, but health-care workers face significant risks on the job. In fact, working in health care is about the unhealthiest profession you could choose.

Health-care and social assistance workers reported 653,900 injury and illness cases in 2010, far more than any other private industry sector, according to the Occupational Safety and Health Administration. That's significantly more than manufacturing and construction, which used to be much more dangerous industries by comparison. The following chart showing injury and illness rates over a 20-year period indicates that health-care's modest safety improvements have been far outpaced by other sectors.

(Bureau of Labor Statistics)

So, what makes health care work so dangerous? Here's OSHA's explanation:

Healthcare workers face a number of serious safety and health hazards. They include bloodborne pathogens and biological hazards, potential chemical and drug exposures, waste anesthetic gas exposures, respiratory hazards, ergonomic hazards from lifting and repetitive tasks, laser hazards, workplace violence, hazards associated with laboratories, and radioactive material and x-ray hazards. Some of the potential chemical exposures include formaldehyde, used for preservation of specimens for pathology; ethylene oxide, glutaraldehyde, and paracetic acid used for sterilization; and numerous other chemicals used in healthcare laboratories.

Not for the faint of heart, basically. Fortunately, the U.S. health-care industry in the past 20 years has significantly reduced the risk of contracting pretty terrible diseases. Between 2003 and 2011, hospitals reported 37 cases of work-related fatalities from exposure to harmful substances about 14 percent of all workplace deaths reported for hospitals during that time, according to OSHA. And in 2011, exposure to substances accounted for just about 4 percent of all hospital worker injuries resulting in days off.

There's also been a huge drop in the reported cases of occupational transmissions of hepatitis B since federal regulators issued guidelines nearly 25 years ago to stem the epidemic of infections among health-care workers. Cases of contracting hepatitis B on the job decreased from 17,000 cases in 1983 to 400 in 1995, and there were only 10 reported cases in 2010, according to a Public Citizen report.

The health-care industry has been even better at preventing HIV transmissions. There's been just 57 cases of documented transmissions and 143 possible transmissions of HIV to U.S. health-care workers on the job, according to the Centers for Disease Control and Prevention. And it's been about 15 years since a reported case, though the CDC said it's possible this could be because of underreporting. Again, the improvements are the result of better federal guidelines for limiting transmission risks on the job, as well as treatments when possible exposures occur.

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Wonkblog: Its not just Ebola. Health care is pretty dangerous work.

Health-care union says its members unprepared for Ebola cases

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Originally published October 14, 2014 at 6:27 PM | Page modified October 14, 2014 at 7:30 PM

Officials of a union that represents 26,000 health-care workers in the state say its members particularly those who clean hospital rooms are not being properly equipped, trained or supported to deal with potential Ebola cases.

Its a big concern and our people are on the front lines, said Chris Barton, secretary-treasurer of Service Employees International Union Healthcare 1199NW, and a nurse herself.

Several medical workers and union staffers met with the media outside Swedish Medical Center/First Hill campus Tuesday.

Im very worried, said Carmencita Smith, a longtime environmental-services worker who cleans rooms at Swedish. We need better equipment.

Shes worried that by the time a patient is confirmed to have Ebola, hospital workers may have already been exposed.

Smith said in 25 years of cleaning up messes most people wouldnt want to talk about, shes had minor ailments that may have been caused or aggravated by what she comes in contact with at work. Thats why shes frightened to be around a virus as deadly as Ebola.

But Smith said that when she mentioned her fear to her supervisor this week, she was told not to worry because Swedish wont get any Ebola cases.

She remains concerned the hospital wont know when patients arrive whether they have the deadly virus.

The U.S. Centers for Disease Control and Prevention has said all hospitals should be prepared to recognize, isolate and treat potential Ebola patients.

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Health-care union says its members unprepared for Ebola cases

Are health care workers prepared?

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STORY HIGHLIGHTS

(CNN) -- In a matter of days, they transformed from caretakers into patients.

The two women live thousands of miles apart, but the first known Ebola cases contracted outside Africa during this outbreak have one striking similarity: Both were health care workers, caring for someone infected with the deadly virus.

As a nurse in Dallas and a nurse's assistant in Madrid fight for their lives, a key question looms: Are people who are putting themselves in harm's way to care for Ebola victims receiving the training and equipment they need?

No, says Zenei Cortez, vice president of National Nurses United.

"It's really a disaster waiting to happen," she told CNN's "The Lead with Jake Tapper" on Thursday.

The union is pushing for more equipment, training and education for nurses, Cortez said. A survey of 1,900 nurses by the union found that 76% said their hospital had not communicated any policy for the potential admission of patients infected by Ebola.

It's a "startling statistic," CNN Chief Medical Correspondent Dr. Sanjay Gupta said, particularly since the Centers for Disease Control and Prevention said in May that it was distributing guidelines to hospitals around the country.

"Infectious disease protocols, universal precautions should be the same, really, in hospitals all over the country. They should apply here with regard to Ebola as well," Gupta said. "But obviously, that's not happening. These nurses who are a part of that survey just don't feel comfortable as things stand now."

CDC chief blames protocol breach

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Are health care workers prepared?

Corruption of the health care delivery system

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PUBLIC RELEASE DATE:

14-Oct-2014

Contact: Annmarie Christensen Annmarie.Christensen@dartmouth.edu 603-653-0897 The Geisel School of Medicine at Dartmouth

LEBANON, NH The foundation of evidence-based research has eroded and the trend must be reversed so patients and clinicians can make wise shared decisions about their health, say Dartmouth researchers in the journal Circulation: Cardiovascular Quality and Outcomes.

Drs. Glyn Elwyn and Elliott Fisher of The Dartmouth Institute for Health Policy & Clinical Practice are authors of the report in which they highlight five major problems set against a backdrop of "obvious corruption." There is a dearth of transparent research and a low quality of evidence synthesis. The difficulty of obtaining research funding for comparative effectiveness studies is directly related to the prominence of industry-supported trials: "finance dictates the activity."

The pharmaceutical industry has influenced medical research in its favor by selective reporting, targeted educational efforts, and incentivizing prescriber behavior that influences how medicine is practiced, the researchers say. The pharmaceutical industry has also spent billions of dollars in direct-to-consumer advertising and has created new disease labels, so-called disease-mongering, and by promoting the use of drugs to address spurious predictions.

Another problem with such studies is publication bias, where results of trials that fail to demonstrate an effect remain unpublished, but trials where the results are demonstrated are quickly published and promoted.

"We do not know when healthcare decisions are guided by sound interpretations of the evidence and whether patients are engaged in the process," say Elwyn and Fisher. "Rather we observe that in the United States, one of the most highly developed healthcare systems, consumer demand for healthcare is manufactured and manipulated, driving up cost, waste and harm."

And even if the synthesis is competent, they say, more evidence remains inaccessible and presented in a way that is difficult to translate into effective communication about harms and benefits.

"The problems of greatest concern to patients are often left uninvestigated, with emphasis given to research that expands market share," say Elwyn and Fisher.

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Corruption of the health care delivery system

Rare genetic disease protects against bipolar disorder

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PUBLIC RELEASE DATE:

14-Oct-2014

Contact: Jim Fessenden james.fessenden@umassmed.edu 508-856-2688 University of Massachusetts Medical School @UMassMedNow

WORCESTER, MA A team of scientists led by researchers at the University of Massachusetts Medical School (UMMS) and the University of Miami Miller School of Medicine (UMMSM) have identified what is likely a key genetic pathway underlying bipolar (manic depressive) disorder, a breakthrough that could lead to better drugs for treating bipolar affective disorder, as well as depression and other related mood disorders.

The new findings, published online this week in Nature Molecular Psychiatry, show that a rare genetic dwarfism called Ellis van-Creveld (EvC) syndrome protects against bipolar affective disorder. The discovery was made thanks to decades of translational research in a few Old Order Amish families of Pennsylvania with a high incidence of both diseases. Forty years of documented research across multiple generations showed that no person with EvC has been reported with bipolar disorder.

"No one doubts that bipolar affective disorder has an important, disease causing genetic component," said neurologist and geneticist Edward I. Ginns, MD, PhD, professor of psychiatry at UMMS and lead author of the study. "In our search for the causes of bipolar affective disorder, this is a paradigm changing discovery that could lead to better treatments."

Bipolar affective disorder is a common psychiatric illness characterized by recurring swings from periods of high energy and mania to periods of low energy and sadness. During periods of mania the need for sleep is reduced and a person feels or acts abnormally happy, energetic and impulsive. They often make poorly thought out decisions with little regard for the consequences. Cycles of depression may include crying, poor eye contact with others, and a negative outlook on life. Patients suffering from bipolar disorder have a higher risk for suicide and self-harm and suffer from other ailments, such as heart disease, related to poor lifestyle choices.

Though many factors likely contribute to onset of the disease, various studies over the years have provided ample evidence that there is an important genetic component to the illness. However, previous attempts to isolate individual genes connected to bipolar disorder have been unsuccessful.

In her research among the Old Order Amish, which extends back more than 40 years, Janice A. Egeland, PhD, professor emerita of psychiatry and behavioral sciences at UMMSM and co-author of the current study, found that both EvC and bipolar were prevalent in an extended family descended from the same progenitor. Both conditions clearly travelled together over the generations in a few families extending from this same pioneer. Yet no person with EvC was ever reported with bipolar disorder despite decades of research across multiple generations.

"Few research efforts can claim to have extended over half a century using various building stones to reach a goal," said Dr. Egeland.

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Breast cancer genetic screening offers vital information, uncertainty

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New technologies, and a little help from the U.S. Supreme Court, have made it possible for large numbers of women to find out whether they carry genetic mutations that increase their risk of breast cancer - a development warmly welcomed by experts in the field.

But the availability and relative affordability of multigene-panel tests can also lead to anxiety and confusion about what course of action to choose, because the risk associated with many of those genes remains unknown.

"Genetic testing holds a lot of potential and a whole lot of uncertainty," said Beth Peshkin, a professor of oncology and senior genetic counselor at Georgetown Universitys Lombardi Comprehensive Cancer Center in Washington.

"The more genes we test, the more variants were likely to find," explained Peshkin. "A recent study found that about 40 percent of people who underwent panel testing had variants, or genetic changes, that we dont know how to interpret."

In 2013 the Supreme Court invalidated Myriad Genetics patents on the two major genes that predispose women to breast and ovarian cancer, ruling that human genes cannot be patented.

Since then, several companies have begun testing for mutations in those genes, BRCA1 and BRCA2, which are responsible for about 80 percent of hereditary breast cancer cases; and the genes have been incorporated into panels that use so-called next-generation sequencing to test for multiple genes simultaneously.

The problem arises because some of the mutations detected in those panels are relatively rare and scientists do not yet know how much additional risk they confer, if any.

In August, the New England Journal of Medicine published a study showing that certain mutations in a gene called PALB2 were associated with a lifetime risk of between 33 percent (for carriers with no family history of breast cancer) and 58 percent (for those with a strong family history). Thats similar to the risk associated with a BRCA2 mutation, but lower than that for BRCA1.

The average lifetime risk for an American woman is about 12 percent. The vast majority of breast cancer cases are not linked to any known hereditary factor.

"Investigators from 14 centers around the world pooled data from all of their families with PALB2 mutations," said Dr. Jane Churpek, co-director of the Comprehensive Cancer Risk and Prevention Program at University of Chicago Medicine. "So, for the first time, we had a large enough series to get an estimate (of risk) for carriers of mutations in this gene. The hope is well see similar efforts for each gene on these panels."

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Breast cancer genetic screening offers vital information, uncertainty

Penn Medicine's Basser Research Center for BRCA announces $6.9 million in new grants

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PUBLIC RELEASE DATE:

14-Oct-2014

Contact: Katie Delach katie.delach@uphs.upenn.edu 215-349-5964 University of Pennsylvania School of Medicine @PennMedNews

PHILADELPHIA - The University of Pennsylvania's Basser Research Center for BRCA has announced $6.9 million to research teams both at Penn and at five other institutions across the United States, aimed at advancing the care of patients living with BRCA1 and BRCA2 mutations through multi-disciplinary collaboration. Penn Medicine's Abramson Cancer Center, home to the Basser Center, will serve as steward of the grants.

The new funding includes the first recipients of the new Basser External Research Grant Program, a unique funding mechanism for high-impact translational cancer research projects with the potential to advance rapidly into clinical practice.

"The projects funded this year are at the forefront of BRCA-related cancer research, and will help bring targeted therapies to a new level," said Susan Domchek, MD, executive director of the Basser Research Center for BRCA and the Basser Professor of Oncology at the Abramson Cancer Center. "BRCA research has come so far since the initial discovery twenty years ago, and working in collaboration with colleagues across the nation, we are making strides every day toward providing better care for these high-risk patients."

Among the five external recipients is a multi-institutional team led by Junjie Chen, PhD, chair of the department of Experimental Radiation Oncology at the University of Texas MD Anderson Cancer Center in Houston. The group is the recipient of the first Basser Team Science Award, which will fund a project focusing on developing new forms of chemotherapy for BRCA1/2-related cancers, and overcoming resistance to these medications.

Other recipients of funding through the External Grants Program include research teams at Johns Hopkins University, Fox Chase Cancer Center, and Drexel University College of Medicine, all of whom will work to enhance the effectiveness of various therapies which have potential for alleviating BRCA1/2-related cancers. For example, the project led by researchers at Drexel University College of Medicine will work to analyze the effect of specific genetic inhibitors in BRCA1/2 cells alone and in combination with therapeutic drugs, and to study the mechanisms of homologous recombination a key pathway to repairing DNA damage in human cells. In contrast, the project led by the team at Fox Chase Cancer Center, will aim to identify and characterize additional BRCA1 mutations that are capable of contributing to DNA repair and drug resistance. Researchers at Columbia University, who will design and conduct a community outreach effort aimed at minority women to determine eligibility for genetic counseling, also received funding.

The External Grants Program was made possible by a $5 million donation made earlier this year by University of Pennsylvania alumni Mindy and Jon Gray. Their latest gift brings their total giving to Penn to $30 million, following a $25 million gift which established the Basser Center in 2012. The Center was created in memory of Mindy Gray's sister Faith Basser, who died of BRCA-related ovarian cancer at age 44.

"We are enormously grateful to the Grays for extending their generosity to support these research programs," said Domchek. "Their gift allows us to work more closely in collaboration with colleagues at academic institutions around the world. In a time when medicine is making such great strides but federal funding for biomedical research is waning, it's vital that we find new channels to continue supporting progress across the field of BRCA research."

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Penn Medicine's Basser Research Center for BRCA announces $6.9 million in new grants

New Gene Therapy for "Bubble Boy" Disease Appears to be Safe, Effective

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PHILADELPHIA A new form ofgene therapyfor boys with X-linked severe combined immunodeficiency syndrome (SCID-X1), a life-threatening condition also known as bubble boy disease, appears to be both effective and safe, according to an international clinical trial with sites inBoston, Cincinnati, Los Angeles, London, and Paris.

Early data published in theNew England Journal of Medicinesuggests that the therapy may avoid the late-developing leukemiaseen in a quarter of SCID-X1 patients in previous gene-therapy trials in Europe that took place more than a decade ago. Left untreated, boys with SCID-X1 usually die of infection before their first birthday.

The lab of coauthorFrederic Bushman, PhD, professor of Microbiology, from thePerelman School of Medicine at the University of Pennsylvania, carried out the deep DNA sequencing on patient specimens to track and verify distributions of integration sites of the vector.The vector used in the new trial was engineered to remove molecular signals implicated in cancers in the first trial.

Eight of nine boys recruited to date to the present trial are alive between 12 and 38 months after treatment, with no SCID-X1-associated infections. The gene therapy alone generated functioning immune systems in seven of eight boys. Genetic studies showed that the new viral vector did not lead to vector insertions near known cancer-causing genes, raising cautious hopes about the vector's long-term safety.

We showed that fewer cells accumulated with integration sites near cancer genes in the second trial, suggesting that the adverse properties had indeed been engineered out, explains Bushman So far there are no clinical adverse events in the present trial -- the integration site data has suggested improved safety.

The modified vector created for the current trial is a self-inactivating gammaretrovirus, designed to deliver its payload effectively while minimizing the chance of inadvertently turning on oncogenes that could lead to leukemia.

The core question of the trial was whether the new self-inactivating viral vector could safely and successfully shuttle a gene called theIL-2 receptor gamma(IL2RG) subunit into the patients' hematopoietic stem cells. In boys born with SCID-X1, mutations render theIL2RGgene inactive, robbing the children of the ability to produce a functional immune system.

For more information, see theDana-Farber/Boston Children's Cancer and Blood Disorders Centersnews release.

###

Penn Medicine is one of the world's leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of theRaymond and Ruth Perelman School of Medicine at the University of Pennsylvania(founded in 1765 as the nation's first medical school) and theUniversity of Pennsylvania Health System, which together form a $4.3 billion enterprise.

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New Gene Therapy for "Bubble Boy" Disease Appears to be Safe, Effective

Ingenuity & Inspiration: Futurist Jack Uldrich to Keynote ABB New Product Launch

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Houston, TX (PRWEB) October 14, 2014

Following on the heels of a highly successful keynote at the Emerson 2014 Global Users Exchange in Orlando, futurist and trend expert Jack Uldrich will deliver a series of keynotes for ABB/Thomas and Betts new product launches across the U.S. On October 13th he spoke in at the first ABB/Thomas & Betts event in Hollywood, CA., and on October 15th he will deliver his talk, "Breakthrough: Ten Technological Trends Transforming Tomorrow" again at their event in Houston, TX.

Aaron Hand of Automation Times noted that, "Jack Uldrich urged everyone at Emerson Exchange this week to step away from the daily grind and think about the future. Technological capabilities are skyrocketing everywhere, and we need to change the way we think about them if were going to jump that curve."

Jumping the curve by knowing what it is you are up against is precisely what Uldrich does best. His savvy insights into future trends coupled with a dynamic speaking presence has his audiences everywhere standing at attention, and changing they way they are thinking.

Among some of the topics Uldrich covers in his "Ten Technological Trends" talk are wearable technology, 3D manufacturing. nanotechnology (Uldrich is the author of the best selling book, "The Next Big Thing is Really Small,") robotics, sensors, genomics, computers, Big Data, renewables and collaborative consumption. These trends arent creeping up linearly. Theyre shooting up exponentially, says Uldrich.

In addition to his stops in Hollywood and Houston, Uldrich will also be delivering keynotes for ABB/Thomas & Betts product launches in Chicago, Atlanta and New York City. He also speaks this month at the American Sportfishing Association, and he returns to the PMA in California as well as the CRS Client Conference in Texas. He delivers keynotes to a wide variety of industries including healthcare, finance, manufacturing and education.

Parties interested in learning more about Jack Uldrich, his books or speaking availability are encouraged to contact Amy Tomczyk at (651) 343-0660. His blog posts can be seen on his website jumpthecurve.net.

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Ingenuity & Inspiration: Futurist Jack Uldrich to Keynote ABB New Product Launch

Jason Hope Predicts Growth of Internet of Things at Home

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Scottsdale, AZ (PRWEB) October 14, 2014

In the next five years, Jason Hope predicts that the average home will be smarter and more connected than ever before. With millions of people embracing the Internet of Things and connected devices almost daily, adoption and awareness is high for connectivity at home, and the home is the next frontier where these devices will be embraced to the fullest.

Hope is not the only one making note of this trend. In a recent article by Business Insider titled: THE CONNECTED-HOME: Forecasts And Growth Trends For The Leading 'Internet Of Things' Market, reported on the growth in this market as it relates to shipments and revenue. They found that the shipments of connected-home devices would grow by a rate of 67 percent over the next five years, until it reaches a point of 1.8 billion units shipped in 2019. In addition, connected-home devices will make up 25 percent of the Internet of Things shipments in 2014, and this will grow each year going forward.

What types of devices are leading this home connectivity revolution? "We are seeing great interests in home-energy equipment and security systems," states Hope. "This makes sense, as these items are easily connected to technology. As the Internet of Things continues to grow, adoption in other areas, like appliances and even personal care items, will begin to take off."

The BI Intelligence report also indicated the potential value of the Internet of Things. According to the report, this year the Internet of Things will bring in $61 billion in revenue. That is expected to grow at 52 percent through 2019.

Before people will be willing to embrace the Internet of Things at home to its fullest, Hope warns that security questions have to be addressed. "People want to know that the devices they are bringing into their homes are not going to put their safety at risk," he states. "Once security protocols and platforms are in place, we will see the Internet of Things take over in the home connectivity sector."

About Jason Hope

Jason Hope's charitable work has earned him a reputation as a philanthropist with an eye for bettering the health and technology future for people. He lives and works in Scottsdale and offers help as a technology expert and futurist. Learn more about his work at http://www.jasonhope.com.

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Jason Hope Predicts Growth of Internet of Things at Home

Tomomi Adachi Delivers Bizzare Evening in CFA Hall

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Dan Fuchs/ArtsEditor

Every once in a while, you see something you simply cannot comprehend. Its not that its over your head, confusing, or made poorly. It just defies any sort ofexplanation.

Japanese composer Tomomi Adachi specializes in this brand of bizarre, avant-garde art. Surrealism, Dadaism, and futurism all blend in his work to create something totally brilliant and at the same time utterly nonsensical. Performing to a small audience at the CFA Hall on Thursday night, Adachi forced viewers to wrestle with their conceptions ofsound.

Adachis performance didnt even begin with him onstage. Sitting in front of a board covered with circuit boards and wires, Peter Blasser GRAD manipulated bass-heavy ambient tones by alternating wires in the two dozen or so boards. Dancer Ayako Kataoka, at times herself attached to wires, twirled and convulsed on stage, her movements seemingly altering the sounds. After several minutes, Adachi joined them, sampling sounds that came out of an amplified metal box full of wires, essentially a man-made electricguitar.

From there, Adachi jumped into his solo pieces, which were more conceptual. Its unclear what exactly inspired any of these pieces, but each had its own unique voice. The first, Torturing Twitter, was a spoken-word piece in which Adachi read, in real-time, five Twitter hashtag feeds: power, economy, war, cooking, and sex. Each feed was introduced gradually, and what began with tweets about President Obama eventually became a flood of porn. It was a fascinating, if not humorous, presentation of what people tweet about on a dailybasis.

The second piece, Another Ear Stretching, was by far the most interactive. A video of Adachi, projected on a screen, instructed viewers to move as ambient and natural sounds played. In essence, if we followed Adachis directions, we would manipulate the way that we heard the sounds. If we placed our hands against our ears, the sound became hollow and muffled. If we turned our heads to the right, the sound to the left became drownedout.

The third piece, which wasnt introduced with a title, was not dissimilar from the prelude, as Adachi once again used his strange string instrument to create dissonance. Here, as with the first piece, Adachi displayed an interest in found objects; the instrument of choice, while certainly functioning, seemed cobbled together with woodblocks andstrings.

Voice Sound Poetry Form Ended With X, a Dadaist sound poem, was one of the stranger pieces of the night. For about eight minutes, Adachi repeated patterns of nonsensical sounds. Some were vocal (eees and oohs), while others were more guttural, like the clicking of his tongue. In any case, the poem became an odd, ambient composition as the sounds blended into each other. The piece ran a tad long, but it was nonetheless an interesting way to examine the nature of rhythm andlanguage.

The final piece, Voice and Infrared Sensor Shirt, was the most exciting. Beginning with a sampling of ambient sound waves, Adachi then put on a collared shirt covered in microphones and sensors. At this point, his entire body became an instrument, each motion drastically affecting the sound. A tongue-click followed by an upward arm motion might play the sound in reverse. Another motion might raise the pitch. Even the act of putting on and taking off this sound-shirt produced specific, high-pitchedsounds.

This was, in short, a performance unlike anything else. Many of the performances forced us to interrogate our own understandings of sound. A piece like Another Ear Stretching revealed how our bodies play a role in the creation and intake of sound. Voice Sound Poetry Form Ended With X, by making poetry out of nonsense, made clear that words are simply constructions of other sounds. Everything here, however enigmatic, seemed to have an inherent purpose. It was one of the strangest nights of my life, but it was also one of the most thought-provoking. And therein lies Tomomi Adachis genius: his performances, though dense at first, stay with you. They crawl their way into your subconscious and make you wrestle with your environment. It was a performance that could only have been seen (or, indeed, heard) to bebelieved.

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Tomomi Adachi Delivers Bizzare Evening in CFA Hall