Tuesday, November 30, 2010

How to Manage Food Allergies in Children

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How to Manage Food Allergies in Children

New Guidelines to Help Parents, Pediatricians, and School Officials Cope With Kids’ Food Allergies
By Katrina Woznicki
WebMD Health News
Reviewed by Laura J. Martin, MD

Kids in school cafeteria

Nov. 29, 2010 -- Pediatricians play a key role in preventing and treating food-related allergic reactions among school-aged children, and can help implement plans concerning the way food allergies are managed in the school setting, according to a clinical report published by the American Academy of Pediatrics.

Food allergies are estimated to affect about one in 25 school-aged children. Research suggests that as many as 18% of children with food allergies experience a reaction while in school, indicating that the school environment is an important place to help prevent and treat allergic responses. Food allergy is also a common trigger of anaphylaxis, a possibly life-threatening reaction to a particular food.

Published in the December issue of Pediatrics, the journal of the American Academy of Pediatrics, the report includes:

  • Advice for pediatricians on diagnosing and documenting any potential life-threatening food allergies, including identifying any food that might truly be life-threatening.
  • Developing and writing down age-appropriate management and emergency response plans and including children, parents, and school officials in the planning process.
  •  Determining whether a health care professional, such as a nurse, is available to help the child in the event of a reaction at school.
  • Prescribing self-injectable epinephrine and, if schools permit and if age-appropriate, allowing children to carry their own epinephrine in the event of an emergency, such as outside of the school cafeteria, because delays in treatments have been linked to fatalities.
  • Teaching children and their families how to use and store medication properly.
  • Informing children, families, and schools how to identify signs of anaphylaxis and how to best respond to expedite treatment.
  • Understanding the school’s anaphylaxis response protocols. The report notes that 25% of anaphylaxis cases that occur in schools are among children without a previous diagnosis of food allergy.

Building Partnerships

“Partnerships with students, families, school nurses, school physicians, and school staff are important for individualizing effective and practical care plans,” the authors write.

The report did not include infants, toddlers, and preschool age children, since these children are cared for in a variety of settings and would require their own set of prevention and treatment guidelines.

According to the Food Allergy and Anaphylaxis Network, an advocacy group, an estimated 3 million children have food allergies. Eight foods account for 90% of all food allergies in the U.S.: milk, eggs, peanuts, tree nuts (such as almonds and walnuts), wheat, soy, fish, and shellfish. Food allergies account for more than 300,000 ambulatory care visits per year among children.

Great article from Web MD on management of Food Allergies. Here is an integral part of the pediatrician's role in your child's health.

To Your Best Health,
The Personal Medicine Team

Posted via email from Personal Medicine

Friday, November 26, 2010

Uwe Reinhardt: Medicare and Hospital Payments

Essential reading for everyone who still wonders why healthcare is so expensive...Princeton Economics Prof...

Posted via email from Personal Medicine

Wednesday, November 24, 2010

HealthDay Articles

Children Born 'Late Pre-Term' More Prone to Low IQ

Risk of attention problems at age 6 also rises for those born between 34 and 36 weeks, study finds

By Serena Gordon
HealthDay Reporter

TUESDAY, Nov. 23 (HealthDay News) -- Being born just a few weeks early might have a long-term impact on a child's IQ and ability to pay attention, new research suggests.

In a study that compared babies born at term (40 weeks) to those born between 34 to 36 weeks (called "late pre-term"), researchers found that the children born early had more than twice the risk of having an IQ score below 85 and about double the risk of having socioemotional difficulties, such as attention problems, at age 6.

"There's a subgroup of children born late pre-term that have an increased risk of developing problems by age 6," concluded study author Nicole Talge, a postdoctoral research associate in the department of epidemiology at Michigan State University in East Lansing, Mich.

"What this study tells us is that late prematurity is not a benign situation. Not every kid will have a problem, but there's a higher chance for some to have interaction problems, attention problems and lower IQ," added one expert, neonatal psychologist Cheryl Milford of Magee-Women's Hospital at the University of Pittsburgh Medical Center.

Milford said the reason for the risk is that the brain simply isn't developed enough at 34 to 36 weeks. "A lot of the development of higher-order functioning in the brain is occurring in the 34-to-36-week range," she explained, adding that "there's a reason that humans gestate for 40 weeks."

The current study included 168 pairs of babies -- one born at term and one born between 34 and 36 weeks. The babies were born during 1983 and 1985. At age 6, they had their IQ scores measured and their teachers reported on classroom behaviors.

The Michigan team found that late pre-term birth more than doubled the risk of having an IQ score of less than 85. Furthermore, the odds of having emotional difficulties, such as attention problems, were about twice as high for those born a little bit early compared to the children born at full-term.

Results of the study appear in the December issue of Pediatrics.

Talge said it's important to note that not every child born at 34 to 36 weeks had problems. In fact, most didn't. "Only about 20 percent fell below that IQ threshold, and that means 80 percent were above that. And, about 20 to 30 percent had internalizing or attention problems," she said.

"We now have a greater understanding that each week matters," said Dr. Michael Msall, chief of developmental and behavioral pediatrics at the University of Chicago Medical Center. However, he sad that "the good news from this study is that at age 6, even in a different era of neonatology [the 1980s], these kids did quite well. Yes, on a population basis, there may have been some problems, but I think that it may be like being five pounds overweight on a population basis, and most of these differences may be subtle."

However, he said that if parents see that their child is struggling with schoolwork, or is having a hard time paying attention in school, they shouldn't hesitate to ask for help. "Talk to your child's pediatrician or their teacher; let them know you want to make sure your child stays on track. Recognize the problems and develop a strategy to manage them," said Msall.

Milford agreed. "Babies who are born late pre-term look like small, full-term babies, and for a long time the perception was that they were just a little early, but that they were mostly developed," she said. "The reality is, if you had a late pre-term infant, you should be looking to see if they're on track. Do they have any behavioral issues? If so, you need to find out what resources are available to you in the community and at school."

More information

Learn more about premature birth and what you can do to help prevent it from the March of Dimes.

SOURCES: Nicole Talge, Ph.D., post-doctoral research associate, department of epidemiology, Michigan State University, East Lansing, Mich.; Cheryl Milford, Ed.S., neonatal psychologist, Magee-Women's Hospital, University of Pittsburgh Medical Center, Penn.; Michael Msall, M.D., chief, developmental and behavioral pediatrics, University of Chicago Medical Center; Dec. 2010 Pediatrics

Last Updated: Nov. 23, 2010

Copyright © 2010 HealthDay. All rights reserved.

As if we need ANOTHER reason to warn against late preterm births. Moms these are those last days of pregnancy when you're thinking to yourself, " I want this OVER WITH" from 34 to 36 weeks. There are a multitude of complications that occur in this group. The baby is NOT finished yet. This study suggests a variety of mental health concerns and even LOWER IQ! Unless your OB has a concern, sit tight.

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

White Out Now

Parents here is a great video from Dr Alan Greene, which compels us to stop feeding babies white rice cereal as their first food, and replace it with fruit/veggies/whole grains... please send this out to your friends. It's time to put a stop to the obesity epidemic now. It starts with breastfeeding and training babies palates in the first year.

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

Tuesday, November 23, 2010

CDC - Influenza (Flu) | Weekly Report: Influenza Activity Interactive Map

Trying to share this week's influenza map from the CDC... if the link doesn't work, try clicking on this link below... still time to get your flu shot folks...


To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

Monday, November 22, 2010

The Promise of Cloud Computing -- cloud computing -- software as a service -- SaaS -- Web applications

Physicians, get your practice in the cloud... save yourself 80%... we can show you how...

The Personal Medicine Team

Posted via email from Personal Medicine

Green Beans with Toasted Walnuts and Dried-Cherry Vinaigrette Recipe at Epicurious.com

Still looking for that perfect green bean recipe for Thanksgiving? Here is one I like from Epicurious. I learned from John la Puma that walnut's eaten before a meal vasodilate your arteries... a good thing for your heart, right John?

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

Sunday, November 21, 2010

Martha Rose Shulman Cooks With Lentils

Here is a great Lentil Recipe by New York Times, high in fiber and protein, lentils are a great addition to your wellness routine!

To Your Best Health,
The Personal Medicine Team

Posted via email from Personal Medicine

Epilepsy’s Big, Fat Miracle

Cool Article on Ketogenic Diet use in pediatric Epilepsy...

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

CDC Health-e-Cards - The Flu Ends with U - New Moms Please RT

Look at these cool ecards that providers can send out to there patients electronically, courtesey of CDC, Way to go you down in Atlanta. Please Forward to your friends!

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

Thursday, November 18, 2010

Pediatricians group offers tips on antibiotic use

Pediatricians group offers tips on antibiotic use

Associated Press

5:37 a.m. CST, November 17, 2010


The American Academy of Pediatrics says it's Get Smart About Antibiotics week and it's offering advice on how to avoid overusing these important medicines.

With the arrival of cold and flu season, the academy has partnered with the federal Centers for Disease Control and Prevention in raising awareness about appropriate antibiotic use.

The drugs work against bacteria but not illnesses caused by viruses. That includes colds and the flu, and also most coughs and sore throats. Using antibiotics for those illnesses can be dangerous because it can help make germs more resistant to the drugs.

Illnesses that antibiotics can treat include bacterial pneumonia, some sinus infections and sore throats caused by strep bacteria.

The academy says be sure to use all doses of antibiotics; otherwise the infections could return.

Copyright 2010 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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Here is a nice article on the smart use of antibiotics by AAP and CDC

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

Monday, November 15, 2010

At the End of their Rope, Some Parents sedate their kids...

What do you think parents?

Posted via email from Personal Medicine

amednews: Cyberbullying a high-tech health risk for young patients :: Nov. 15, 2010 ... American Medical News

A few years ago, patients of child and adolescent psychiatrist Niranjan Karnik, MD, PhD, began talking to him about online harassment. Some of the youths were teased on social networking sites. Others received threatening text messages.

Since then, such complaints have been on the rise at the University of Chicago clinic where Dr. Karnik works. To address the growing problem, he continues to ask about traditional bullying but has added a new topic to office visits -- cyberbullying, in which technology is used to repeatedly harass an individual. The incidents can occur through e-mails, text messages, Twitter and social networking sites.

"We do see more of this happening, [partly because] it's so simple to do," said Dr. Karnik, assistant professor of psychiatry at the University of Chicago. "It doesn't require you to stand in front of a person to bully them."

Mental health professionals are urging primary care physicians to address this mounting problem with their young patients by educating them on the topic and screening for possible victims and perpetrators. They say leaving the issue unchecked can result in anxiety, depression and, in some instances, suicide among those involved.

Suicide rates for cyberbullying victims and perpetrators were above those of students not involved in the activity, just as the rates for victims and perpetrators of traditional bullying also were elevated, according to a July 2010 Archives of Suicide Research study based on 1,963 sixth- through eighth-graders in one of the largest school districts in the U.S. Cyberbullying has gained more public attention recently due to several high-profile suicides in 2010 that followed such harassment.

Cyberbullies and their victims have higher suicide rates than their peers.

Although research indicates that cyberbullying seems to occur most frequently among teenagers, anyone who spends time online can be harassed, according to child and adolescent psychiatrists.

To help identify youths who are affected by such incidents, pediatricians and family physicians should ask all of their patients if they use the Internet and have a cell phone, said Boston psychiatrist Tristan Gorrindo, MD. Patients who answer "yes" to either question are vulnerable to being a cyberbully victim or perpetrator, he said.

Despite the growing prevalence and publicity of cyberbullying, many physicians are not yet seeing patients with complaints of such harassment, said Gwenn Schurgin O'Keeffe, MD, an executive committee member of the American Academy of Pediatrics' Council on Communications and Media. She said the topic won't be brought up in a doctor's office until primary care physicians ask patients about it.

"I recognize that doctors have a lot on their plate. This is all new for everybody. But everyone has to have a heightened sense of awareness that children are being bullied [with technology], and it's happening more than people want to admit," said Dr. O'Keeffe, a Hudson, Mass., pediatrician.

Technology spreads, cyberbullying follows

About 43% of teenagers age 13 to 17 reported being cyberbullied during the previous year, according to 2006 data from a National Crime Prevention Council survey. The council is a Virginia-based nonprofit that addresses the cause of crime and violence and aims to reduce it.

That study is among the most recent and widely cited on the prevalence of cyberbullying. But mental health experts estimate that these numbers have increased with the growth of mobile access to the Internet and the involvement of youths in technology at younger ages. In fact, many psychiatrists said the cyberbully victims they see in their practices are getting younger.

About 43% of teenagers age 13 to 17 reported being cyberbullied in 2005.

In 2009, 58% of 12-year-olds owned a cell phone, up from 18% in 2004, according to a survey of 800 adolescents by the Pew Research Center's Internet and American Life Project. Overall, 75% of teens age 12 to 17 had a cell phone in 2009.

Experts say the rise of social media is making cyberbullying more common. In 2009, 73% of teenagers who spent time online used a social networking site. The figure was 55% in 2006.

But even as younger children become more active online, cyberbullying probably will remain most problematic for teenagers, said Dr. Gorrindo, a child and adolescent psychiatrist at Massachusetts General Hospital in Boston.

He noted that the developmental task of teenagers is to figure out who they are. This group already has an unstable image of themselves, which can be further weakened by moving to a new school or uncertainty about their sexuality, he said.

Dr. Gorrindo stressed that for many individuals, cyberbullying is largely a nuisance and will not lead to suicide or other serious mental health issues. A 2006 Pediatrics study of 1,500 Internet users found 38% of 10- to 17-year-olds who were the target of Internet harassment reported "emotional distress."

But for adolescents who have a less stable sense of their identity, including individuals with mental health issues and those who are perceived as outsiders by their peers, cyberbullying can drive them deeper into depression.

"In children with these [types of] vulnerabilities, cyberbullying is probably worse" than traditional, face-to-face harassment, he said.

Dr. Gorrindo noted that taunts on social networking sites can be viewed by hundreds of Internet friends, compared with traditional bullying, which often is witnessed by a small group of people. Cyberbullying is difficult for victims to escape because the attacks can occur in private moments over a computer and through cell phones.

Identifying victims and perpetrators

To identify potential victims and perpetrators of such harassment, Dr. Gorrindo suggests that physicians ask all their patients who use the Internet what they do online. He recommends that physicians specifically inquire about whether they use social networking sites and ever felt as if they were harassed. Additionally, he said doctors should ask patients if they bully other people. Dr. Gorrindo, in his experience, said children will be honest and forthcoming with their answers.

Adolescent medicine specialist Elizabeth Alderman, MD, said that children bully others for a reason, which could include depression or abuse by a parent. If a patient admits to cyberbullying, physicians should help the individual identify his or her actions as a problem and then involve the parent or guardian in the situation, said Dr. Alderman, a professor of clinical pediatrics at Montefiore Medical Center and Albert Einstein College of Medicine in New York.

58% of 12-year-olds owned a cell phone in 2009, up from only 18% in 2004.

When patients acknowledge that they have been victims, doctors first should assure the individuals that it's not their fault and then determine their level of danger for self-harm or acts inflicted by others, said Dr. O'Keeffe, of the AAP.

She said patients who need counseling should be referred to a mental health professional. Physicians should urge families to contact police if threats made against a patient seem credible, she added.

"Like almost any disease, the earlier we recognize [cyberbullying] and treat it, almost without exception, the better the outcome will be," said Henry J. Gault, MD, a child and adolescent psychiatrist in Deerfield, Ill.

"If you can intervene, you can protect a child from a great deal of harm," he said.

This content was published online only.

Back to top


Identifying cyberbullies and victims

All adolescents are at risk of cyberbullying, according to mental health professionals. But there are characteristics that make certain individuals more vulnerable to such harassment than others -- and more likely to commit cyberbullying.

Most susceptible patients:

  • Individuals with mental health issues
  • Those with a developmental disability
  • Adolescents who are gay or lesbian, or those who are struggling with their sexuality or gender identity
  • Youths who recently moved to a new school
  • Children who are perceived as outsiders by their peers
  • Adolescents who spend a lot of time online

Signs that a patient could be a cyberbully victim or perpetrator:

  • Problems sleeping
  • Anxiety
  • A sudden disinterest in school
  • Increase in somatic complaints, such as stomachache and headache
  • Bed-wetting in younger children
  • A decrease in social activity

Back to top


"Bullying, cyberbullying, and suicide," Archives of Suicide Research, July (www.ncbi.nlm.nih.gov/pubmed/20658375)

"Social Media & Mobile Internet Use Among Teens and Young Adults," Pew Research Center, Feb. 3 (www.pewinternet.org/reports/2010/social-media-and-young-adults.aspx)

National Crime Prevention Council on teens and cyberbullying (www.ncpc.org/resources/files/pdf/bullying)

"Examining characteristics and associated distress related to Internet harassment: Findings from the Second Youth Internet Safety Survey," Pediatrics, October 2006 (www.ncbi.nlm.nih.gov/pubmed/17015505)

Back to top

Copyright 2010 American Medical Association. All rights reserved.

Good article for parents. Cyberbullying is real and has contributed to the suicide deaths of several teens over the past year. Social Media platforms can accelerate the problem. Parents can stay connected to your preteen and teen children's social media presence. We'll be reading more and more about this.

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

Healthcare sector among top adopters of iPad | Healthcare IT News

This is what we have been talking about. Game Changer.

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

Saturday, November 13, 2010

Use of World Health Organization and CDC Growth Charts for Children Aged 0--59 Months in the United States

Here is a hot off the press recommendation for changing to utilizing WHO growth charts for babies, with the gold standard for growth being breastfeeding. Now time to change everything... Again. This is refreshing, as it grows tiring having breastfed mom's concerned about their baby's growth when they are compared to our current bottle fed curves. Progress...

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

Mom, Dad, You’re Stressing Me Out! - The Juggle - WSJ

Parents there is a nice article noting the effects that parental stress has on kids. An important reminder to put the kids second. ( I always say second, because you have to put your marriage first) So where does that put your career? Third...

To Your Best Health,

The Personal Medicine Team

Posted via email from Personal Medicine

Friday, November 12, 2010

Adults may not be spreading whooping cough: study | Reuters

Adults may not be spreading whooping cough: study

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    By Julie Steenhuysen

    CHICAGO | Thu Nov 11, 2010 4:25pm EST


    (Reuters) - Children largely spread whooping cough among themselves, so blanket vaccination campaigns targeting teens and adults may be a waste of time, according to a study that looks at how social patterns affect disease transmission.

    The findings, published on Thursday in the journal Science, contradict the notion that infected adults are behind outbreaks in California and elsewhere of whooping cough, a contagious disease caused by the bacterium Bordetella pertussis.

    A U.S. advisory panel last month recommended that adults over 65 be given a booster of the "Tdap" vaccine for tetanus, diphtheria and pertussis, or whooping cough, to protect infants under a year old, who are too young to be vaccinated.

    But older people may not be the main culprit, Pejman Rohani of the University of Michigan and colleagues say.

    Whooping cough, which causes uncontrollable, violent coughing, infects 30-50 million people a year globally and kills about 300,000, mostly children in developing countries.

    There are regular outbreaks in developed countries, including one in California that has affected more than 6,400 people and killed at least 10 infants, the U.S. Centers for Disease Control and Prevention said.

    To study the effects of social interactions on spreading whooping cough, the research team used a situation in Sweden.

    That country halted its whooping cough vaccination program in 1979 because of vaccine safety concerns, and did not resume routine vaccination for 17 years. But health authorities continued to track cases of whooping cough by age group.

    "We took advantage of an unplanned natural experiment," Rohani said in a telephone interview.

    The team compared this to a 2008 study of more than 7,000 people from eight European countries that tracked social contacts by age. They plugged this into a computer model to see how social contacts affected the spread of whooping cough.

    The team found that when Sweden resumed vaccinating young children, there was a big drop in the number of cases of whooping cough in all age categories except in teenagers.

    With the patterns of social mixing, children mostly interact with other children, and are unlikely to be infected by adults, they found.

    "Infant immunization produces a protective effect for other children, who are likely to be mixing with other infants," the team wrote. Infected adults did not play a major role in spreading whooping cough to children.

    Rohani said other studies would be needed to explain how social networks affect regional disease outbreaks.

    But he said looking at social networks is another way to better understanding how infectious diseases are spread -- and may save health officials the time and expense of mass vaccination campaigns that may not work.

    (Editing by Vicki Allen)


    Add a Comment
    *We welcome comments that advance the story directly or with relevant tangential information. We try to block comments that use offensive language or appear to be spam and review comments frequently to ensure they meet our standards. If you see a comment that you believe is irrelevant or inappropriate, you can flag it to our editors by using the report abuse links. Views expressed in the comments do not represent those of Reuters.

    Interesting study on the spread of pertussis.

    To Your best Health,

    The Personal Medicine Team

    Posted via email from Personal Medicine

    Thursday, November 11, 2010

    Doctor Payment Rates Cut Again Under New Medicare Rules - Kaiser Health News

    Check out this website I found at kaiserhealthnews.org

    Eeks... further medicare rate cuts for physicians 21% on December 1...

    Posted via email from Personal Medicine

    PhillyInc: Hints on the future of employees' health care | Philadelphia Inquirer | 11/10/2010

       There is little agreement over what the U.S. employer-based health-insurance system will look like 10 years from now.

       Some have speculated that the Patient Protection and Affordable Care Act will prompt more businesses to drop coverage. Others say that the employee benefit is too prized and that employers would be very reluctant to drop it.

       On Tuesday, the Mercer consulting firm provided some new hints about what businesses say they might do. The results of a survey of more than 2,800 employers indicates only 6 percent of companies with at least 500 workers say they're likely to drop their health coverage in 2014.

       That's the year when the state health insurance exchanges are expected to begin operating. Under the new rules, employers could drop their plans in 2014 and pay a penalty that could actually be less than their annual expenditure on health benefits.

       Among small businesses, the percentage is greater. About 20 percent of those with between 10 and 499 workers said they would be likely to drop coverage, Mercer said.

       But even if they might save money, would they do it?

       Mercer doesn't think so, citing employers' actions in Massachusetts, where insurance exchanges have been functioning for more than three years. Enrollment in employer plans there has actually grown over that time, according to a study published in the June issue of the journal Health Affairs.

       More worrisome is how a proposed 40 percent excise tax on the most generous, high-cost insurance plans might affect employers.

       The Mercer survey found that 39 percent of employers with 50 or more employees could trigger the excise tax when it first takes effect in 2018, and that might be costly enough to prompt "a significant change in health-benefit strategy."

       But that hammer is also eight years away from falling. I think employers are more concerned with how 2011 benefits will nail their budgets.

    Card check

       I heard from Greg Smith, president of PSECU, a credit union in central Pennsyl-

    vania, after a recent column about what various financial institutions pay colleges under affinity-card marketing arrangements.

       I'd noted that PSECU was the fourth-largest issuer behind national players Bank of America Corp., U.S. Bank, and Chase Bank USA. According to data collected by the Federal Reserve, PSECU has agreements with 13 state-owned universities.

       Smith did not think I stressed enough that his credit union's payments to those institutions are quite small compared with the $2.8 million Bank of America paid to the Penn State Alumni Association in 2009.

       "The real story here is that unlike what BA and the others would have you believe, a card issuer can actually build a very profitable program (we think cards are our most profitable asset) without financially abusing consumers," Smith wrote in an e-mail.

       "When your card is a true consumer value, you don't have to pay 7-figure sums to get schools to hold their noses while they help sell the cards to unsuspect-

    ing students," he wrote.


    Contact Mike Armstrong at 215-854-2980 or marmstrong@phillynews.com. See his blog at www.phillyinc.biz.


    Interesting, the penalties for businesses dropping coverge for employees are still less than their annual expenditures on health benefits...

    Posted via email from Personal Medicine

    Bill Gates talks mHealth and Vaccines | mobihealthnews

    Bill Gates talks mHealth and Vaccines

    Thursday - November 11th, 2010 - 07:26am EST by Brian Dolan | | | | |  |

    Brian Dolan, Editor, MobiHealthNewsForget for a moment that Bill Gates founded Microsoft. Forget that Gates now chairs a philanthropic foundation that works in a number of areas. During his keynote session at the mHealth Summit in Washington DC this week, Bill Gates arrived with a single, focused message: Vaccines.

    When asked whether mobile phones offered some advantages over previous computing platforms, Gates responded:

    “Computing technology has been great for healthcare, but primarily on the research side,” Gates explained. “That is: Anything that facilitates the invention of new vaccines is fantastic. That is the miracle intervention in healthcare on a worldwide basis. Although it would be hard to measure, some combination of the Internet, digital databases, collaboration tools, really have changed medical research. Although in the drug field in the last decade, research hasn’t been that great. In the areas that are of particular interest to the poor — AIDS, drugs, and vaccines — it’s actually been a period of great productivity. So in that indirect sense there is a lot of impact.”

    “In the case of the cell phone there is a chance to go beyond that and actually be there with the patient in the clinic, which may or may not be staffed with a fully-trained doctor,” Gates said. “There are a lot of opportunities. I think we have to approach these things with some humility though. There are not Internet and data connections [everywhere] out there. People… in most cases when they’re sick, are often too sick for some cell phone type services to do something for them. I do think there is absolutely some role, but I think we need to hold ourselves to some pretty tough metrics to see if we are really making a difference or not.”

    When pushed for specific examples of the (potentially) most impactful mobile health services, Gates discussed the dramatic reduction in infant and child mortality since 1960: It went from 20 million to about 8.5 million.

    “That’s been achieved — about a third of it — by increasing income, which gives you better nutrition, better living conditions. The majority of it has been done through vaccines,” Gates said. “Smallpox was killing 2 million a year, now it kills zero per year. Measles was killing 1.5 million, now it kills about 300,000 a year.”

    So where do mobile phones fit in to the vaccines discussion? Gates asked that same question. Then he answered it:

    “If you could register every birth on the cell phone, get fingerprints, get a location, then you could take these systems, go around and make sure the immunization happens,” Gates said. “Then you could run them in a more effective way. Vaccine coverage in the very poorest regions like the north of Nigeria and north of India are below 50 percent.”

    In areas like those healthcare providers could see a huge improvement if they manage to “just take the vaccines we have today” and make sure they get delivered.

    Bill Gates, the founder of Microsoft and chair of the Bill & Melinda Gates Foundation sees the greatest opportunities for mHealth in and around vaccine delivery and tracking. Or maybe since he’s become so laser focused on the issue he sees how mobile can help. When prompted, Gates made a passing remark about PHR platforms like Google Health and Microsoft HealthVault and was dismissive about mHealth’s potential to motivate those that exercise “zero percent” to get off the couch.

    While Gates’ vision for mHealth seemed fairly limited on-stage, his blog post the day following his appearance at the mHealth Summit showed a different side. After discussing various point of care diagnostic sensors enabled by mobile technology, he concluded his post on mobile health like so: “Cell phones are amazing tools. For some of us, they’re about staying in touch. For millions of people, it could be about staying alive.”

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    This entry was posted on Thursday, November 11th, 2010 at 7:26 am and is filed under Uncategorized. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.

    Here is a great article from Brian at Mobihealthnews on Bill Gates address at the recent mHealth Summit. Wonder what Mr gates would think about Personal Medicine, the Mobile Physician Network? We like his notion of utilizing the mobile globally at the birth of infants utilizing geolocation and then delivering vaccines accordingly. Nice. Let us know how we can help Mr Gates.

    To Your Best Health,

    The Personal Medicine Team

    Posted via email from Personal Medicine

    Tuesday, November 09, 2010

    Coriander Crusted Sea Bass and Asparagus over Sweet Potato Puree - Paging Dr La Puma

    The carotenoids of sweet potatoes and the omega-3s of fish combine to make you

    14.2 days younger.
    Preparation Time:  12 minutes
    Cooking Time:  18 minutes
    Servings  4
    Serving Size:


    2 large sweet potatoes (about 11/4 pounds)
    1 bunch (about 14 ounces) asparagus spears
    21/2 teaspoons olive oil, divided (1/2 teaspoon, 1 teaspoon, and 1 teaspoon.)
    4 (4 ounce) sea bass fillets, cut 1 to 11/4 inches thick
    2 teaspoons coriander, ground
    11/4 teaspoons salt, divided,(½ teaspoon and ¾ teaspoon)
    1/4 teaspoon cayenne pepper
    2 teaspoons coriander seeds
    1/4 cup low-salt chicken broth or reserved sweet potato cooking water
    1/4 cup chopped toasted pistachios


    Heat oven to 425 degrees. Bring a large saucepan of salted water to a simmer. Cut sweet potatoes into 1 inch chunks. Cook in simmering water uncovered about 15 minutes or until tender. Meanwhile, arrange asparagus in a shallow baking dish. Add 1/2 teaspoon oil, rotating asparagus to coat with oil. Bake 8 to 10 minutes or until crisp-tender, depending on thickness of asparagus. Rinse and pat fish dry with paper towel. Rub 1 teaspoon of the oil over meaty side of fish; sprinkle ground coriander, 1/2 teaspoon salt and cayenne pepper over fish. Press coriander seeds into fish. Heat a large nonstick ovenproof skillet over medium-high heat until hot. Add fish, seed side down. Cook 3 minutes or until fish is browned and seared. Turn fish over; transfer skillet to oven. Bake 8 to 10 minutes or until fish is opaque and slightly firm to touch. Drain sweet potatoes; return to saucepan. Add remaining 1 teaspoon oil, 3/4 teaspoon salt and chicken broth. Mash with a potato masher. Transfer to four serving plates. Top with fish and asparagus. Garnish with nuts.


    Halibut fillets may replace the sea bass and boniato (a white-fleshed starchy Cuban style tuber) may replace the sweet potato. The boniato should be peeled and needs a few more minutes of simmering to become tender, and more chicken broth than the sweet potato does, but is deliciously filling.

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    Here is a passionate Physician who is making waves in creation of healthy cuisine that takes your family well beyond " diet food" try this recipe tonight!

    To Your best Health,

    the Personal Medicine team

    Posted via email from Personal Medicine

    Monday, November 08, 2010

    Parenting Solved


    It’s been a tough week for he anti-vaccine movement.  Mounting evidence of fraudulent manipulation of data by Andrew Wakefield has all but put the light out on the MMR autism connection.  The U.S. Court of Federal Claims put the kibosh on the compensation of thousands of families by the U.S. government when it found no evidence linking vaccines with autism.  And over at Age of Autism, anger is advancing to bargaining and acceptance like the Kubler-Ross progression of a terminally ill patient.  Gone are the glory days of thimerosal.  

    And what’s become of the man who started it all?

    The emasculated Andy Wakefield, unable to practice medicine in the U.K., has taken safe refuge at the Thoughtful House in Austin where Texas law allows him only to watch patients from a distance, much like a curious nurse’s aide.  Wakefield’s muted existence is a far cry from his heady days in the spotlight when the world believed for a moment that his contrived ideas actually amounted to something.

    While I’d like to say that it’s finally over, the vaccine-autism connection was dead before it ever began.

    Those still at the party should heed the insight and courage of Alison Singer, executive vice president of Autism Speaks, who recently resigned her post recognizing that the game was finally up.  It’s time to give children with autism the attention and resources they deserve, she noted.  It’s time to move on. 

    Nice Post on Wakefield and the Fall of the Vaccine Autism Connection

    Posted via email from Personal Medicine

    Monday, November 01, 2010

    One Year and 41 Days with the MacBook Air - PCWorld

    When it comes to laptops and desktops, nothing matters to me more than reliability. While I may be directly or indirectly responsible for thousands of servers, desktops, and laptops, the one that matters the most is the one I'm using to manage all of those resources. My laptop is my gateway to everything I do. It must be absolutely reliable and available constantly.

    I'm currently on my third MacBook Air. I bought (and reviewed) the first one back in February 2008 when it was released; I then upgraded to the next iteration in June 2009. Last week, the new MacBook Air arrived, and I wasted no time in putting it to good use.

    [ See Paul Venezia's review of the latest MacBook Air. | Microsoft Office for Mac 2011 is a huge step forward from Office 2008. See "InfoWorld review: Microsoft Office for Mac 2011 gains ground." | Stay abreast of key Apple technologies in our Technology: Apple newsletter.]

    Over the past few years, I've used some model of MacBook Air for probably 85 percent of my computing needs: email, browsing, more xterms than you can shake a stick at, writing, reading, creating, and consuming. With the exception of my review of the iPad (which was written on the iPad), every word I've written for publication in the past 2.5 years has been written on a MacBook Air. I've logged over 100,000 miles with them and carried them all over the globe.

    They've never let me down.

    Here's a quick history of the punishment I afflicted on my previous Air. I purchased it in early June 2009, and until last week, I used it constantly. I tend to run a ton of processes that have connections to other computers: xterms with ssh sessions to dozens of servers, RDP sessions, and so forth. I don't like to break and recreate those connections, so I just leave the laptop open and running with the screen blank if I'm not actively using the system. I also never shut down and reboot only when required by an OS update.

    According to my calculations, in the 406 days I had my previous Air in full-time use, it was on and running for over 9,500 hours. That's 23.5 hours a day, every day of that time period. I did not have a single problem with the unit the entire time.

    Would you recommend this story? YES3 NO1

    Here is a review of the Macbook air by a technologist who notes in 406 days of use having the computer up and running for 23.5 hours a day, and not having a single problem with it for that entire time.

    Here is the problem with healthcare. Having spent the last 8 years seeing patients paperlessly, I discovered that one of the major roadblocks for physicians implementing health IT is the device. Major hospital institutions are making massive hardware purchases of pc based computers.

    I have the same great experience with my macbook pro and ipad and iphone. It's time for the next generation of health IT to lead the next generation of physicians to meaningful use, but with an ecommerce twist.

    To Your Best Health,

    The Personal Medicine Team

    Posted via email from Personal Medicine