Penn Medicine Pediatrician and Bioethicist Honored for Outstanding Care, Compassion and Advancements in Palliative Care

PHILADELPHIA Chris Feudtner, MD, PhD, MPH, associate professor of Pediatrics in the Perelman School of Medicine at the University of Pennsylvania and the Steven D. Handler Endowed Chair of Medical Ethics at the Childrens Hospital of Philadelphia, was recently presented with the 2014 Hastings Center Cunniff-Dixon Physician Award in the mid-career category. Presented annually, the Cunniff-Dixon Physician Awards recognize five physicians who have distinguished themselves in advancing the practice of palliative care and model exemplary skill and compassion at the bedside.

In nominating Dr. Feudtner for the award, Ezekiel Emanuel, MSc, MD, PhD, Diane v.S. Levy and Robert M. Levy University Professor, and chair of the Department of Medical Ethics and Health Policy at the Perelman School of Medicine at the University of Pennsylvania, wrote that Dr. Feudtners plural excellences extraordinary success as a nationally recognized researcher and ethicist combined with exceptional face-to-face skills make him, in my mind, the epitome of the kind of doctor all worried parents would want for their sick children and the embodiment of the clinical leader needed by complex health care organizations serving sick children and their families.

In addition to his roles as associate professor of Pediatrics and the Steven D. Handler Endowed Chair, Dr. Feudtner is also the director of the department of Medical Ethics and director of research for the Pediatric Advanced Care Team at CHOP. He is recognized for his leadership in promoting better, more patient-driven care for children at the end of their lives, as well as for their families and has received numerous awards for his teaching, mentoring, and research.

Dr. Feudtner has published more than 180 articles and book chapters on pediatric health care; palliative, end-of-life, and bereavement care; health service use and quality; child outcomes; and medical ethics. He has also published a book,Bittersweet: Diabetes, Insulin, and the Transformation of Illness. Among his many research efforts, Dr. Feudtner helped establish the Pediatric Palliative Care Research Network, a group of leading researchers in the U.S. and Canada who work collectively on improving pediatric palliative care services.

The five 2014 Cunniff-Dixon Physician Awards were presented in three categories: one senior physician, one mid-career, and three early-career awards. The honorees are considered exemplary in one or more of four areas: medical practice, teaching, research, and community. The Cunniff-Dixon Foundation, whose mission is to enrich the doctor-patient relationship near the end of life, funds the awards. The Hastings Center, a bioethics research institute that has done groundbreaking work on end-of-life decision-making, cosponsors the awards. The Duke Institute on Care at the End of Life oversees the selection process.

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Penn Medicine Pediatrician and Bioethicist Honored for Outstanding Care, Compassion and Advancements in Palliative Care

Audio-Digest Foundation Announces the Release of Orthopaedics Volume 36, Issue 23: Surgical Insights

Glendale, CA (PRWEB) January 28, 2014

Audio-Digest Foundation Announces the Release of Orthopaedics Volume 36, Issue 23: Surgical Insights.

The goal of this program is to improve evaluation and treatment of proximal humerus fractures, massive rotator cuff tears, the snapping hip, and labral tears. After hearing and assimilating this program, the clinician will be better able to:

1. Review the nonoperative and operative management considerations for proximal humerus fractures. 2. Recognize the roles of fatty infiltration and timing of repair for massive rotator cuff tears. 3. List key steps in the surgical management of massive rotator cuff tears. 4. Identify etiologies and current treatment options for the snapping hip. 5. Describe indications and the technique for labral reconstruction with iliotibial band autograft.

The original programs were presented by Laurence D. Higgins, MD, Associate Professor of Orthopaedic Surgery, Harvard Medical School; Chief, Sports Medicine and Shoulder Service, Department of Orthopaedics, Brigham and Womens Hospital, Boston, MA, and Marc J. Philippon, MD, Managing Partner, Sports Medicine and Hip Disorders, The Steadman Clinic; Co-Chair, Steadman Philippon Research Institute, Vail, CO.

Audio-Digest Foundation, the largest independent publisher of Continuing Medical Education in the world, records over 10,000 hours of lectures every year in anesthesiology, emergency medicine, family practice, gastroenterology, general surgery, internal medicine, neurology, obstetrics/gynecology, oncology, ophthalmology, orthopaedics, otolaryngology, pediatrics, psychology, and urology, by the leading medical researchers at the top laboratories, universities, and institutions.

Recent researchers have hailed from Harvard, Cedars-Sinai, Mayo Clinic, UCSF, The University of Chicago Pritzker School of Medicine, The University of Kansas Medical Center, The University of California, San Diego, The University of Wisconsin School of Medicine, The University of California, San Francisco, School of Medicine, Johns Hopkins University School of Medicine, and many others.

Out of these cutting-edge programs, Audio-Digest then chooses the most clinically relevant, edits them for clarity, and publishes them either every week or every two weeks.

In addition, Audio-Digest publishes subscription series in conjunction with leading medical societies: DiabetesInsight with The American Diabetes Association, ACCEL with The American College of Cardiology, Continuum Audio with The American Academy of Neurology, and Journal Watch Audio General Medicine with Massachusetts Medical Society.

For 60 years, the global medical community of doctors, nurses, physician assistants, and other medical professionals around the world has subscribed to Audio-Digest specialty series in order to remain current in their specialties as well as to maintain their Continuing Education requirements with the most cutting-edge, independent, and unbiased continuing medical education (CME).

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Audio-Digest Foundation Announces the Release of Orthopaedics Volume 36, Issue 23: Surgical Insights

Harvard Medical School doctor becomes patient, and gets a crash course in America’s medical care

After falling down a flight of stairs, breaking his neck and nearly dying, a Massachusetts physician is now speaking out about the stark deficiencies he saw in his own treatment -- and how those shortcomings relate to more general problems he sees plaguing medical care in America.

Writing in the New York Review of Books, Harvard Medical School faculty member Arnold Relman -- who is in his 90s -- documents the course of his treatment from arrival at Massachusetts General Hospitals emergency room on June 27 to his discharge from Spaulding Rehabilitation Hospital ten excruciating weeks later.

As he says, Since then, I have made an astonishing recovery, in the course of which I learned how it feels to be a helpless patient close to death. I also learned some things about the U.S. medical care system that I had never fully appreciated, even though this is a subject that I have studied and written about for many years.

Specifically, Relman says, I always knew that the treatment of the critically ill in our best teaching hospitals was excellent. That was certainly confirmed by the life-saving treatment I received in the Massachusetts General emergency room. Physicians there simply refused to let me die.

But what I hadnt appreciated was the extent to which, when there is no emergency, new technologies and electronic record-keeping affect how doctors do their work. Attention to the masses of data generated by laboratory and imaging studies has shifted their focus away from the patient.

Doctors now spend more time with their computers than at the bedside. That seemed true at both the ICU and Spaulding. Reading the physicians notes in the MGH and Spaulding records, I found only a few brief descriptions of how I felt or looked, but there were copious reports of the data from tests and monitoring devices.

- Arnold Relman

"Conversations with my physicians were infrequent, brief and hardly ever reported.

Within this vacuum of personal care, Relman says the role of nurses has never been greater in ensuring a patient is not only comfortable during their convalescence, but actually ultimately gets well.

I had never before understood how much good nursing care contributes to patients safety and comfort, especially when they are very sick or disabled, he wrote.

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Harvard Medical School doctor becomes patient, and gets a crash course in America's medical care

Finding the ‘why’ in med school applications

The Premedical Advisory Committee application is what I, as a pre-med, send to the Office of Preprofessional Advising to declare that I would like to apply to medical school in the upcoming summer. Its long, with three multi-page essays and about 20 150-word short answer questions, and theres a little table to fill out with all of your activities.

After I send in the PAC application, the committee can say yes or no to me after an interview. The PAC application then supplements the letter Advising sends to all the medical schools Im applying tothis is called the committee letter. Its extensive, incorporating information from all over the PAC application. But thats not why Im spending time staring at my laptop and trying to come up with good answers. The PAC application forces anyone who completes it to dig deep and come up with substantive answers to simple questionsWho are you? and Why do you want to be a doctor? These are the things that we, as pre-meds, need to know if were going to make it through the long days of medical school and residency.

I felt really silly telling my parents that my work over break was to apply to medical school, but thats what the PAC application is. But, instead of doing that, I stared at my computer screen. I couldnt write. I cant writeIm writing this instead. Ive wanted to be a doctor since I was five and I cant figure out how to express to the committee why I want to go to medical school. Im still staring at itthe pages and pages of questions, asking me to explain why I want to be a doctor.

In the PAC application, I have to write about what extracurriculars have been significant to me during my time at college and how my clinical experiences have affected me. Its not an easy application or even a sure path to applying next year, but its important, because we as pre-meds need to be able to articulate why we deal with 8:40 Orgo and sit in labs for hours on end. We need to know why we want to go to medical school, and we need to be able to express that answer.

I mean, think about itgetting in to medical school right now is insane, let alone actually going. In my previous op-ed about the pre-med community, I talked about how were competitive and how thats a bad thing, because the checklistthe things we actually need to get into medical schoolis a lot shorter than most of us think. However, despite my desire for a nicer, more cohesive (and less competitive) pre-med community on campus, I dont think having that is going to make it any easier to make it past a 5 percent admission rate.

But we try anyway, because we want to be doctors. We all have different reasons, and we rarely talk about them, but we want to be doctors. Figuring out my personal reason took a good week of staring at my laptop, opening up Word, and quitting it again, because I couldnt fully express my why. Im still not really happy with my answer. When I was little and people asked me what I wanted to be when I grew up, I said, A doctor! I never had to say why. Now that I do, its hard to articulate.

That why is important, and that process of self-discovery is why we have to complete the PAC application. Im not done yetIm not sure I will be until Feb. 17 at 4:59 p.m.but I hope that once Im finished, I will have a better idea of why I want to be a student for another 10 years, work 12-hour days, and come out of it a doctor. We all know, more or less, what were getting ourselves into, and were not going to come out of it alive unless we know why were there.

The author is a Columbia College junior majoring in art history.

To respond to this op-ed, or to submit an op-ed, contactopinion@columbiaspectator.com.

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Finding the 'why' in med school applications

Med school tweaks grading system

The Alpert Medical School MD Curriculum Committee passed a motion last month to grade all preclinical courses the entirety of the first two years of medical study solely Satisfactory/No Credit, beginning with the MD class of 2017.

The schools previous policy graded all preclinical courses S/NC but also allowed students to earn honors distinction in select courses following their first semester.

Med School administrators and students said there has long been widespread interest in eliminating honors grading for preclinical classes.

Med School Student Senate members of the class of 2017 raised the issue to the rest of the Student Senate, which unanimously voted for the change prior to the motions adoption by the MDCC. A survey of first-year medical students found that 65 percent of students favored the change, wrote Dan Ebner MD17, Class of 2017 MDCC student representative, in an email to The Herald.

This strong student support prompted Luba Dumenco, chair of the subcommittee on years one and two of the MDCC, to conduct extensive research on the issue, which showed that solely S/NC preclinical grades are very common. The majority of the U.S. News and World Reports top 20 medical schools have pass/fail grades without honors for preclinical classes.

A 2011 Mayo Clinic College of Medicine study designed to evaluate the effects of grading on preclinical medical students concluded that the way students are evaluated has a greater impact than other aspects of curriculum structure on their well-being. Curricular reform intended to enhance student well-being should incorporate pass/fail grading.

A 2011 University of Massachusetts study reached a similar conclusion.

I went into this in a very unbiased fashion, Dumenco said. Increasingly, as people saw the data, they became more interested in it, and thats because the data were strong.

But some expressed doubt about the extent of the studies conclusions.

I dont think the absence of honors would have affected my stress levels tremendously during years one and two, wrote Greg Elia MD15 in an email to The Herald, though he added that he supported the change on the whole.

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Med school tweaks grading system

Jeffrey Tucker Talks To Marc Abela About Liberty.me’s International Presence – Video


Jeffrey Tucker Talks To Marc Abela About Liberty.me #39;s International Presence
Liberty.me is not about arbitrary national boundaries or state lines drawn in sand. We are about future where liberty thrives globally in the city in the clo...

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Liberty Global Snags Dutch Cable Company Ziggo

Liberty Global (LBTYA) reached a deal Monday to buy the rest of Dutch cable operator Ziggo for $9.44 billion in cash and stock, marking John Malones latest move to expand the media giants cable footprint in Europe.

The London-based company, which already has a 28.5% stake in Ziggo, was in pursuit of the cable company as early as October. Ziggo rejected an initial takeover attempt by Liberty Global, saying the bid was too low.

Ziggo shareholders are set to receive 11 a share, about $15 a share, in cash, plus Class A and Class C ordinary shares in Liberty Global. The price values Ziggo at roughly 34.53 a share, a 22% premium over its share price before Liberty Globals initial overture was turned down.

The deal is valued at a total of $13.7 billion, including debt.

According to Dow Jones Newswires, Ziggo chief financial officer Bert Groenewegen said at a press conference that he expects shareholders to welcome the Liberty Global offer.

Liberty Global said it intends to merge Ziggo with UPC, another Dutch cable provider in its portfolio. The combined companies will generate annual revenue of around 2.5 billion, or $3.4 billion.

Our combined operations will reach over 90% of all Dutch households, allowing us to compete more effectively with the other national telecommunications and satellite platforms in the Netherlands, Liberty Global CEO Mike Fries said.

The company added that it is confidence the European Commission will provide regulatory approval of the acquisition. It anticipates closing the transaction in the second half of 2014.

Malone led an effort last summer to acquire Kabel Deutschland, Germanys largest cable operator, but ultimately lost the race to Vodafone (VOD). Liberty Global already brought in two other German cable companies, including No. 2 Unitymedia, since 2009.

Last year, Liberty Global completed its $15.8 billion acquisition of U.K. cable giant Virgin Media.

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Liberty Global Snags Dutch Cable Company Ziggo

Liberty Global strikes Ziggo deal

NEW YORK (The Deal) -- Acquisitive cable company Liberty Global (LBTYA) on Monday, Jan. 27, announced an agreement to buy the outstanding shares in Dutch cable company Ziggoin a deal with an enterprise value of 10 billion euros ($13.7 billion).

Liberty, of Englewood, Colo., said it would offer Class A and Class C shares, as well as 11 per share in cash, to buy the 71.5% of the Dutch cable company it doesn't already own. The bid is worth 34.53 euros per Ziggo share, a 4% premium to the company's Friday close and 12% higher than Ziggo's close on Dec. 11, the day before it revealed the latest round of talks.

It values the target's total equity at 6.9 billion euros.

"Our combined operations will reach over 90% of all Dutch households allowing us to compete more effectively with the other national telecommunications and satellite platforms in the Netherlands, and at the same time generate significant revenue and operating efficiencies," said Liberty CEO Mike Fries in a statement.

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Liberty Global strikes Ziggo deal

Liberty Global offers $9 billion for Ziggo

Ziggo NV, a Dutch cable company, will come under the Liberty Global umbrella under an agreement announced Monday. (Peter Dejong, The Associated Press)

AMSTERDAM Liberty Global PLC has agreed to buy Dutch cable company Ziggo NV for $9.44 billion in the latest offensive by Douglas County media mogul John Malone on the European telecommunications industry.

Liberty Global, Malone's international cable holding company, already owns 28.5 percent of Ziggo and had been in acquisition talks since August. Ziggo said in October that it had rejected a takeover offer but remained in talks, with the cash-and-stock deal finally announced Monday.

Under the terms of the agreement, which has the full support of Ziggo's management and supervisory board, Ziggo shareholders will get 11 euro ($15.03) in cash, 0.2282 Liberty Global Class A ordinary shares and 0.5630 Liberty Global Class C ordinary shares for each share they own. Based on Liberty Global's share price on Jan. 24, the offer implies a price of approximately $47.19 per Ziggo share.

Including debt, the deal values Ziggo at $13.7 billion.

Because of structural challenges and a weak European economy, consolidation in the continent's fragmented telecom industry is widely expected to continue at a brisk pace. London-based Liberty Global has already been an active deal maker on the continent, buying U.K. cable-television and Internet provider Virgin Media for $16 billion last year. It also raised its stake in Telenet Group Holding NV of Belgium.

Still, Liberty Global sees plenty of scope for further consolidation. "The European cable sector still has about 6,000 to 7,000 cable companies, compared to about a dozen in the U.S.," Liberty Global senior vice president Manuel Kohnstamm said.

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Liberty Global offers $9 billion for Ziggo

First Read Minute: Obama’s Last Best Chance?

Half of all Millennials ages 25-32 believe that the American dream the ability to lead a middle class lifestyle is disappearing for their generation, according to new research.

MassMutual discloses this finding in its State of the American Family Study, a biennial survey conducted in 2009, 2011 and 2013 for MassMutual by the Forbes Consulting Group, LLC. Conducted last February, the 2013 study comprised 1,337 interviews with American households with children under age 18 for whom they are financially responsible.

The survey reveals that Millennials pessimism about the future is shared by older Baby Boomers: 45 percent of those ages 54-64, also share their belief, an increase of 15 percent over the past two years.

Though Americans both young and old generally hold bearish views on the economy, the definition of the American Dream is in flux. While older respondents hold close to its traditional definitions 78 percent of older Boomers consider home ownership a key component and 80 percent consider financial independence an equally important element younger respondents show notably less engagement with these historic benchmarks for financial achievement, instead focusing on developing a monthly budget, suggesting views around financial satisfaction are undergoing fundamental shifts, according to the study.

"We've found that American families hold similar core values when it comes to their finances, but one of the study's key takeaways is that the emphasis placed on these financial views vary [among] demographic groups," says Mike Fanning, executive vice president, U.S. Insurance Group, MassMutual. "Between generations, ethnicities, and family types, the goals families hold, the confidence they feel, and the financial products and services they use differ in clear and diverse ways."

Additional findings from the survey include:

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First Read Minute: Obama's Last Best Chance?

Ken Krawchuk (K’14 #011) addressing the Board of Directors of the Libertarian Party of Pennsylvania – Video


Ken Krawchuk (K #39;14 #011) addressing the Board of Directors of the Libertarian Party of Pennsylvania
Ken Krawchuk, Libertarian for Pennsylvania Governor in 2014, gives his stump speech at the monthly meeting of the Board of Directors of the Libertarian Party...

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Ken Krawchuk (K'14 #011) addressing the Board of Directors of the Libertarian Party of Pennsylvania - Video