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Validation of PROMIS Pain Interference and Pain Behavior for Rheumatoid Arthritis – Clinical Pain Advisor

October 18th, 2019 6:46 pm

The PatientReported Outcomes Measurement Information System (PROMIS) is a universally applicable set of itembanks for the evaluation of patientreported health. Both the PROMIS Pain Interference (PROMISPI) and the PROMIS Pain Behavior (PROMISPB) itembanks were found to have good psychometric properties for patients with rheumatoid arthritis and to be useful as computerized adaptive tests (CATs) in clinical practice and research, according to a study published in Arthritis Care & Research.

The objective of the current study was to evaluate the psychometric properties of the PROMIS-PI and the PROMIS-PB item banks (40 and 39 items, respectively) in Dutch and Flemish patients with rheumatoid arthritis. Properties examined in those assessments are unidimensionality, crosscultural validity (Differential Item Functioning [DIF] for language [Dutch vs Flemish]), other forms of measurement invariance, floor and ceiling effects, monotonicity, Graded Response Model (GRM) fit, local dependence, construct validity, and reliability.

Both the PROMISPI and PROMISPB item-banks were found to have sufficient unidimensionality (OmegaH 0.99 and 0.95; ECV 0.95 and 0.78; respectively), to have negligible local dependence (0.3% and 1.4% of itempairs), good monotonicity (scalability coefficient of the scale, 0.75 and 0.46), and a good graded response model fit. Both item-banks also showed good cross-cultural validity (absence of differential item functioning for language), measurement invariance (absence of differential item functioning for age, sex, disease activity, and administration mode), good construct validity, high reliability (>0.90 in the range of patients with rheumatoid arthritis), and absence of floor and ceiling effects (0% maximum or minimum score for both). The PROMIS-PI correlated strongly with the Dutch-Flemish PROMIS Global Health Pain intensity (r=0.80), the Short-Form Health Survey Physical Functioning scale (r=-0.71) and the Health Assessment Questionnaire Disability Index (r=0.71). The PROMIS-PB also correlated strongly with the Dutch-Flemish PROMIS Global Health Pain intensity 266 (r=0.61). These findings add to the evidence that the PROMIS item-banks provide an adequate assessment of pain interference and behavior, respectively.

Both the PROMIS-PI and PROMIS-PB banks showed good psychometric properties in patients with [rheumatoid arthritis]. Using the highly efficient PROMIS-PI and PROMIS-PB CATs in research and clinical practice is considered to be user-friendly and feasible with little administration time, and has the potential for valid and precise standardized and routine patient monitoring of pain interference and pain behavior, concluded the study authors.

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Reference

Crins MHP, Terwee CB, Westhovens R, et al. First validation of the full PROMIS pain interference and pain behavior item banks in patients with rheumatoid arthritis [published online September 28, 2019]. Arthritis Care Res (Hoboken). doi: 10.1002/acr.24077

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Positive Opinion of Upadacitinib for Active Rheumatoid Arthritis – Pharmacy Times

October 18th, 2019 6:46 pm

The European Medicines Agencys (EMA) Committee for Medicinal Products for Human Use (CHMP) agreed on a positive opinion for AbbVies upadacitinib (RINVOQ), according to the company. The JAK inhibitor is a once-daily selective treatment used for adult patients with moderate to severe active rheumatoid arthritis who are intolerant to 1 or more disease-modifying antirheumatic drugs.

CHMP's positive opinion is a scientific recommendation for marketing authorization to the European Commission, which authorizes marketing approval in the European Union. This opinion is supported by data from a global phase 3 SELECT rheumatoid arthritis program. 4400 patients with moderate to severe active rheumatoid arthritis were evaluated in 5 different trials, including SELECT-NEXT, SELECT-BEYOND, SELECT-MONOTHERAPY, SELECT-COMPARE, and SELECT-EARLY.

All primary and secondary endpoints were met, including low disease activity based on Disease Activity Score 28 C-Reactive Protein. Improved response was seen with upadacitinib, both as a monotherapy and in combination with conventional synthetic DMARDs compared to placebo.

The SELECT program showed a consistent safety profile across all five studies, with the most frequent adverse reactions being infections.

REFERENCE

AbbVie receives chmp positive opinion for upadacitinib (rinvoq) for the treatment of adults with moderate to severe active rheumatoid arthritis [news release]. North Chicago, Ill.; PR Newswire: October 18, 2019. https://www.prnewswire.com/news-releases/abbvie-receives-chmp-positive-opinion-for-upadacitinib-rinvoq-for-the-treatment-of-adults-with-moderate-to-severe-active-rheumatoid-arthritis-300940994.html. Accessed October 18, 2019.

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Top 9 Drugs With the Biggest Price Increases Over 2 Years – Pharmacy Times

October 18th, 2019 6:46 pm

Nine widely-used medications have experienced substantial price surges over the past 2 years, adding $5.1 billion to overall drug spending during this time period, according to a new report.

Furthermore, 7 of these 9 drugs were found by the Institute of Clinical and Economic Review (ICER) to be lacking sufficient clinical evidence to support such price increases. Not only did adalimumab top the list of best-selling drugs last year, but the anti-inflammatory medication ranked first in terms of the most substantial price hikes from 2016 to 2018.

Of the drugs listed, the ICER indicated that lenalidomide and dimethyl fumarate were the only 2 with new clinical evidence. However, the report noted that this is not a determination that the new evidence necessarily justified these prices increases.

Below are the top 9 drug price hikes based on wholesale acquisition cost (WAC) increase, net price increase, and overall estimated increase in drug spend.

1.Adalimumab (Humira)

WAC increase: 19.1%Net Price increase: 15.9%Drug spending increase: $1.86 billion

Indicated for: Rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, juvenile idiopathic arthritis, adult and pediatric Crohn disease, ulcerative colitis, plaque psoriasis, adult and adolescent hidradenitis suppurativa, and adult and pediatric non-infectious uveitis.

2.Rituxan (rituximab)

WAC increase: 17%Net Price increase: 23.6%Drug spending increase: $806 million

Indicated for: non-Hodgkin lymphoma, chronic lymphocytic leukemia, rheumatoid arthritis, pemphigus vulgaris, granulomatosis with polyangiitis, and microscopic polyangiitis.

3. Pregabalin (Lyrica)

WAC increase: 28.3%Net Price increase: 22.2%Drug spending increase: $688 million

Indicated for: Neuropathic pain associated with diabetic peripheral neuropathy, neuropathic pain associated with spinal cord injury postherpetic neuralgia, adjunctive therapy for partial-onset seizures in patients 1 month of age and older, and fibromyalgia.

4. Elvitegravir, Cobicistat, Emtricitabine, Tenofovir (EVG/COBI/FTC/TAF) (Genvoya)

WAC increase: 14.3%Net Price increase: 21.7%Drug spending increase: $651 million

Indicated for: HIV in antiretroviral (ART)-nave adults and pediatric patients aged 12 years and older and to replace the current ART regimen in virologically suppressed patients.

5. Emtricitabine/Tenofovir Disoproxil Fumarate (Truvada)

WAC increase: 14.3%Net Price increase: 23.1%Drug spending increase: $550 million

Indicated for: to be used in combination with other antiretroviral agents for the treatment of HIV-infected adults and childred aged 12 yeas and older and for pre-exposure prophylaxis (PrEP) to reduce the risk of sexually acquired HIV in adulst and adolescents at high risk.

5. Pegfilgrastim (Neulasta)

WAC increase: 14.6%Net Price increase: 13.4%Drug spending increase: $489 million

Indicated for: decrease the incidence of infection as manifested by febrile neutropenia in patients with non-myeloid malignancies receiving myelosuppressive anti-cancer drugs associated with a clinically significant incidence of febrile neutropenia and to increase survival in patients acutely exposed to myelosuppressive doses of radiation.

6. Tadalafil (Cialis)

WAC increase: 26.2%Net Price increase: 32.5%Drug spending increase: $403 million

Indicated for: erectile dysfunction and benign prostatic hyperplasia

7.Dimethyl Fumarate (Tecfidera)

WAC increase: 16.7%Net Price increase: 9.8%Drug spending increase: $313 million

Indicated for: relapsing forms of multiple sclerosis

8.Lenalidomide (Revlimid)

WAC increase: 25.8%

According to the report, ICER received public comment that lenalidomide experienced important price increases, but due to uncertainties in the volume of unit sales, they were unable to accurately determine the change in drug spending.

Indicated for: myelodysplastic syndromes, mantle cell lymphoma that has relapsed or progressed after 2 prior therapies, and multiple myeloma.

Reference

Institute for Clinical and Economic Review. Unsupported Price Increase Report. October 8, 2019.https://icer-review.org/wp-content/uploads/2019/01/ICER_UPI_Final_Report_and_Assessment_100819_Final.pdf. Accessed October 9, 2019.

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US Survey Finds 60% of Americans Struggle to Afford Medications for JA, Other Rheumatic Diseases – Juvenile Arthritis News

October 18th, 2019 6:46 pm

Nearly 60% of respondents in a national survey of people with juvenile arthritis and other rheumatic diseases reported struggling to afford their medications in the past year.

The online survey, conducted by the American College of Rheumatology (ACR) in June, with the results recently released, included 1,517 adults living in the U.S. Participants were asked about their lifestyle, access to healthcare, and its affordability.

Results showed that although most of the respondents (90%) had health insurance coverage, nearly 60% had difficulties affording their treatments.

Nearly half reported that insurance companies impose a step therapy, in which patients must take and fail to respond to an insurer-preferred treatment before they are covered for therapy options prescribed by their doctors. This occurred even when a patients doctor doubted the efficacy of the insurer-preferred option.

Out-of-pocket costs greater than $1,000 a year were reported by one in four of the respondents. In 6% of the cases, yearly out-of-pocket costs skyrocketed to over $5,000.

While more than 50% of the respondents are currently followed by or have been referred to a rheumatologist, the waiting period before a first consultation was more than 30 days in approximately 60% of the cases.

Nearly two-thirds of patients (63.81%) reported impairments to their daily lives, with the disease affecting their ability to perform simple tasks such as eating, getting dressed, cooking meals, or running errands.

These findings make clear that Americans living with rheumatic disease regardless of age, gender, or income level struggle to find affordable care, Paula Marchetta, MD, president of the American College of Rheumatology, said in a press release.

To address these challenges, it is crucial for patients, clinicians, and policymakers to work together to improve access to rheumatology care so that patients can live longer, healthier, and more fulfilling lives, Marchetta added.

Together with people with rheumatology, ACR staffers recently attended the annual Advocates for Arthritis event at Capitol Hill, to push for changes to legislation. Specifically, the advocates urged for a stop in the excessive use of step therapy by insurance companies and for legislation that would increase the number of rheumatologists.

The 2019 survey followed last years 2018 ACR survey, which asked patients from all 50 states and the District of Columbia, How easy is it to live with rheumatic disease in my state? This years assessment adds further information on the challenges faced by people diagnosed with a rheumatic disease.

According to the Centers for Disease Control and Prevention, nearly one in four Americans have a rheumatic disease, which includes juvenile arthritis, rheumatoid arthritis, systemic lupus erythematosus, and Sjgrens syndrome. As as many as 300,000 children in the country are estimated to have juvenile arthritis.

Patricia holds her Ph.D. in Cell Biology from University Nova de Lisboa, and has served as an author on several research projects and fellowships, as well as major grant applications for European Agencies. She also served as a PhD student research assistant in the Laboratory of Doctor David A. Fidock, Department of Microbiology & Immunology, Columbia University, New York.

Total Posts: 11

Ana holds a PhD in Immunology from the University of Lisbon and worked as a postdoctoral researcher at Instituto de Medicina Molecular (iMM) in Lisbon, Portugal. She graduated with a BSc in Genetics from the University of Newcastle and received a Masters in Biomolecular Archaeology from the University of Manchester, England. After leaving the lab to pursue a career in Science Communication, she served as the Director of Science Communication at iMM.

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New Study Adds Concern That Medication To Treat Painful Bladder Condition Linked To Vision-Threatening Eye Condition – Forbes

October 18th, 2019 6:45 pm

Age-related macular degeneration with neovascularization of torn and rolled-up retinal pigmented ... [+] epithelium. (Photo By BSIP/UIG Via Getty Images)

Evidence continues to mount that a drug commonly prescribed for decades to treat a painful bladder condition known as interstitial cystitis (IC) is linked to retinal damage and toxicity. The retina is the light-sensing tissue at the back of the eye that allows us to see our world.

A 2018 study by Nieraj Jain, M.D, Assistant Professor of Ophthalmology, Emory University School of Medicine, Emory Eye Center, reported reading difficulty and visual changesespecially under dark conditionsamong six patients who had been taking the drug, Elmiron (pentosan polysulfate sodium, PPS) for an average of 15 years (range of 12-20 years).

Jain found that this group of six patients (median age 60; age range 37-62) all had atypical changes in their macula, the central part of the retina that allows us to have clear central vision. The patients described difficulty reading in dim light and diminished central visual acuity. The patients underwent genetic testing to determine if there was any basis for hereditary retinal loss, with none demonstrating any such evidence of a link. Other than Elmiron, there was no clear etiology based on other findings in their medical history that explained the concerning retinal changes found in all six patients. This led the researchers to issue a warning in 2018 that long-term use of Elmiron could potentially lead to retinal damage.

An additional 10 patientsage range of 38-68 years of agewith similar retinal changes were also reported by the same researchers in May of 2019, and presented at the 2019 annual meeting of the American Urological Association. The authors concluded that structural changes in the retina were certainly present, stating that it was unclear if stopping the medication would reverse the noted changes.

This ongoing concern led researchers from Kaiser Permanente in Northern California to study this phenomenon further in their own patients taking this medication.

They found that about 25% of their patients with significant exposure to Elmiron showed clear evidence of retinal damage. The concern is that toxicity from this medication could also appear to mimic other well-known retinal conditions, such as age-related macular degeneration (AMD) or an uncommon retinal condition known as pattern dystrophy.

The research was presented last week at AAO 2019, the 123nd Annual Meeting of the American Academy of Ophthalmology.

Interstitial cystitis (IC) is a cause of unrelenting pain in the bladder and pelvic regions of the lower abdomen. Its estimated that at least 1 million people, mostly women, in the U.S. have thispainful condition. While other pharmacologic (NSAIDS, antihistamines, bladder installation therapy) and behavioral approaches are available, Elmiron is the only FDA-approved medication to treat this painful and disabling condition. It effectively works by forming a protective coating on the inner lining of the bladder that reduces irritation by substances present in the urine. Since its a first-line drug used for many decades, its believed that at least several hundred of thousand people have likely been exposed to the drug.

Robin A. Vora, M.D., Consultant in Medical Retina, Chair of Ophthalmology, Kaiser Permanente, Northern California and colleagues (Amar Patel, M.D., and Ronald Melles, M.D.) described a woman on long-term Elmiron who was misdiagnosed as having a retinal dystrophy, a genetic cause of progressive vision loss that may lead to permanent blindness. As a result of their concern that more patients that could be affected, they decided to evaluate all 4.3 million Kaiser patients.

Searching the database, they identified 140 patients who had each taken an average of 5,000 pills over a period of 15 years. Ninety-one patients of the 140 were evaluated. The investigators captured retinal images and rated them as normal, possible abnormality, or definite abnormality. The toxicity involved specialized cells known as retinal pigmented epithelium (RPE) that help nourish precious vision-producing cells in the retina known as the macula. Twenty-two of the 91 patients showed clear signs of drug toxicity. The rate of toxicity increased with the amount of drug taken, from 11% of those taking 500 to 1,000 grams to 42% of those taking 1,500 grams or more.

Its unfortunate, said Vora. You have a patient with a chronic condition like interstitial cystitis, for which there is no cure and no effective treatment. They get put on these medications because its thought to have few side effects and few risks, and no one thinks about it again year after year, the number of pills theyre taking goes up and up.

Since there is no comprehensive data yet available to guide treatment, Vora recommends patients who are asymptomatic and show no retinal signs of toxicity be screened for retinal damage at least annually. Patients who are showing signs of toxicity need to have a conversation with their health care provider whether to stop taking the medication.

Urologists and gynecologists are the primary medical providers for patients with IC. Elizabeth Kavaler, M.D., a urologist with Lenox Hill Hospital in New York City, suggested active retinal surveillance of patients would be prudent in managing patients with IC.

The impact of IC on the life of people who suffer with it cannot be minimized, she said. For women who have had good success with Elmiron, and are able to live their lives without chronic, unremitting pain, perhaps yearly or biyearly retinal exams should be done.

The mechanism behind the toxicity is unclear, but may involve the production of a toxic metabolite of Elmiron. Jains team has suggested that a component of Elmiron, a glycosaminoglycan (GAG) with a highly negative charge, may also play a potential role in disrupting the interphotoreceptor matrix in the macula. Other research by Singh and colleagues from Cleveland Clinic has suggested that Elmiron acts as an antagonist of signaling pathways related to fibroblast growth factor (FGF), a protein integral to retinal maintenance and function. There is no research that has yet elucidated the exact mechanism.

Jain has been in contact with the FDA, which is aware of his and other research linking Elmiron to retinal damage. To date, the FDA has not taken any action or issued any alerts regarding the toxicity of the medication.

The researchers are expressing growing concern that the presentation of these patients is unique and does not resemble any other identified acquired or hereditary maculopathy. At this time, an association or link with PPS exposure and maculopathy exists, but no definitive cause and effect relationship. The broader question is whether visual problems may be an unrecognized effect of IC; there have been no studies to link these two conditions as of yet.

If the changes are picked up early, its unclear whether retinal damage is reversible by discontinuing the medication. Long term monitoring will be required to make this clinical determination. For those with no clear evidence of damage who are currently taking the medication, close monitoring is critical, according to Vora and Jain. However, in later stages, toxicity can resemble late-stage dry atrophic age-related macular degeneration (AMD) and result in permanent vision loss.

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New Study Adds Concern That Medication To Treat Painful Bladder Condition Linked To Vision-Threatening Eye Condition - Forbes

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2019 Celibate Clergy Candidates for Election to the Episcopacy – Official Documents – Greek Orthodox Archdiocese of America

October 18th, 2019 6:44 pm

2019 Celibate Clergy Candidatesfor Election to the Episcopacyof the Greek Orthodox Archdiocese of America

Updated on Oct.17, 2019

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Current Assignment: Transfiguration Of Christ Church, Mattituck, NYDirect Archdiocesan District

Date of birth: May 15, 1968Education: B.A., Hellenic College, Brookline, MA (1990)M.Div., Holy Cross, Brookline, MA (1993)

Ordinations/OffikionTo Diaconate: April 19, 1995To Priesthood: June 18, 1995Archimandrite: August 5, 2018

Current Assignment: Holy Cross Church, Whitestone, NYDirect Archdiocesan District

Date of birth: August 18, 1969Education: B.S., Computer Technology, Northeastern University, Boston, MA (1994)M.Div., Holy Cross, Brookline, MA (2004)

Ordinations/OffikionTo Diaconate: August 17, 2003To Priesthood: August 24, 2003Archimandrite: April 15, 2006

Current Assignment: Chancellor, Metropolis of Chicago

Date of birth: October 4, 1952Education: B.A., Hellenic College, Brookline, MA (1975)M.Div., Holy Cross, Brookline, MA (1978)

Ordinations/OffikionTo Diaconate: Sep. 14, 1980To Priesthood: October 5, 1980Archimandrite: May 12, 1985

Current Assignment:Saint John the Baptist Church, New York, NYDirect Archdiocesan District

Date of birth: November 15, 1945Education: A.A., Philosophy/Psychology, Kingsborough Community College, Brooklyn, NY (1992)B.A., Byzantine & Modern Greek Studies, Queens College, Queens, NY (1998)M.Div., Holy Cross, Brookline, MA (2005)

Ordinations/OffikionTo Diaconate: March 27, 2005To Priesthood: September 18, 2005Archimandrite: January 7, 2012

Current Assignment:Saint George Cathedral, Philadelphia, PAMetropolis of New Jersey

Date of birth: September 4, 1964Education: Lic., Theology, Aristoteleion University, Thessaloniki, GR (1991)M.A. Theology, Belford University School of Theology, Humble, TX (2008)M.A. Theology, Aristoteleion University, Thessaloniki, GR (2014)M.A. Ecclesiastical History, Seton Hall University-Immaculate Conception Theological Seminary (2015)PhD. Aristoteleion University, Thessaloniki, GR (2018)

Ordinations/OffikionTo Diaconate: November 24, 1985To Priesthood: January 12, 1992Archimandrite: January 12, 1992

Current Assignment:Saint George Church, Downey, CAMetropolis of San Francisco

Date of birth: August 13, 1957Education:strong> B. S., Biology, University of Richmond, VA (1979)M.S., Biology, University of Richmond, VA (1981)M.Div., Holy Cross, Brookline, MA (1987)

Ordinations/OffikionTo Diaconate: December 14, 1991To Priesthood: December 15, 1991Archimandrite: July 23, 1995

Current Assignment:Hellenic College/Holy Cross, Brookline, MADirect Archdiocesan District

Date of birth: June 7, 1954Education: M.Div., Holy Cross, Brookline, MA (1979)M.A., Byzantine History, Penn State, PA (1986)Ph.D., Byzantine History, Penn State, PA (1992)

Ordinations/OffikionTo Diaconate: December 9, 1979To Priesthood: December 23, 1979Archimandrite: May 16, 1998

Current Assignment: Saint George Church, Piscataway, NJMetropolis of New Jersey

Date of birth: December 4, 1964Education: B.A., Modern Languages, Citadel University, Charleston, SC (1987)M.Div., Holy Cross, Brookline, MA (1990)

Ordinations/OffikionTo Diaconate: February 2, 1991To Priesthood: May 11, 1996Archimandrite: May 11, 1996

Current Assignment: Kimisis Tis Theotokou Church, Brooklyn, NYDirect Archdiocesan District

Date of birth: September 11, 1944Education: B.A., Hellenic College, Brookline, MA (1973)M.Div. and S.T.M., Holy Cross, Brookline, MA (1974)

Ordinations/OffikionTo Diaconate: May 6, 1973To Priesthood: November 4, 1974Archimandrite: May 21, 1980

Current Assignment: Saints Constantine & Helen Church, Palos Hills, ILMetropolis of Chicago

Date of birth: April 14, 1967Education: B.A., Hellenic College, Brookline, MA (1985)M.Div., Holy Cross School of Theology, Brookline, MA (1992)

Ordinations/OffikionTo Diaconate: December 19, 2010To Priesthood: March 20, 2011Archimandrite: January 6, 2017

Current Assignment: Saint Barbara Church, Durham, NCMetropolis of Atlanta

Date of birth: March 9, 1957Education: B.A., Hellenic College, Brookline, MA (1980)M.Div., Holy Cross, Brookline, MA (1983)

Ordinations/OffikionTo Diaconate: September 14, 1986To Priesthood: October 19, 1986Archimandrite: June 6, 1999

Current Assignment: Saint Nicholas Church, Oak Lawn, ILMetropolis of Chicago

Date of birth: January 22, 1976Education: B.A., Hellenic College, Brookline, MA (2003)M.Div., Holy Cross, Brookline, MA (2006)

Ordinations/OffikionTo Diaconate: July 2, 2006To Priesthood: December 3, 2006Archimandrite: December 6, 2016

Current Assignment: Annunciation Cathedral, Baltimore, MDMetropolis of New Jersey

Date of birth: July 30, 1965Education: B.A., Hellenic College, Brookline, MA (1992)M.Div., Holy Cross, Brookline, MA (1994)

Ordinations/OffikionTo Diaconate: February 11, 1996To Priesthood: June 9, 1996Archimandrite: August 4, 2002

Current Assignment: Holy Apostles/Saints Peter & Paul Church, Haverhill, MAMetropolis of Boston

Date of birth: August 5, 1965Education: B.A., Hellenic College, Brookline, MA (1987)M.Div., Holy Cross, Brookline, MA (1990)ThD., Aristotelion University (2017)

Ordinations/OffikionTo Diaconate: January 30, 1991To Priesthood: February 17, 1991Archimandrite: December 31, 1996

Current Assignment: Holy Trinity Cathedral, Salt Lake City, UTMetropolis of Denver

Date of Birth: August 25, 1969Education: B.A., Hellenic College, Brookline, MA (1996)M.Div., Holy Cross, Brookline, MA (1999)

Ordinations/OffikionTo Diaconate: September 14, 1999To Priesthood: December 5, 1999Archimandrite: March 24, 2004

Current Assignment: Transfiguration of Christ Church, Corona, NYDirect Archdiocesan District

Date of Birth: October 11, 1964Education: B.A., Political Science, New York Institute of Technology, New York, NYCertificate, Antiochian House of Studies (2010)M.Div., Holy Cross, Brookline, MA (2015)

Ordinations/OffikionTo Diaconate: November 13, 2010To Priesthood: August 6, 2015Archimandrite: November 30, 2015

Current Assignment: Unassigned

Date of birth: January 1, 1958Education: M.A., Church Services, Hellenic College, Brookline, MA (1986)M.Div, Holy Cross, Brookline, MA (2007)After Hellenic College (1986) he traveled to the Monastery of Archangel Michael, Rhodos, where he was tonsured a monastic on October 21, 1991.

Ordinations/OffikionTo Diaconate & Priesthood: October 11, 1992 (Monastery of Archangel Michael, Rhodos)Archimandrite: October 20, 1994 (Church of St. Gerasimos, Pylona, Rhodos)NOTE: In 2015 incardinated into the Greek Orthodox Archdiocese of America from the Greek Orthodox Archdiocese of New Zealand. (Note: The number of years of service listed in the GOA Charter is no less than 5 years in the GOA.)

Current Assignment: Saint Demetrios Cathedral, Astoria, NYDirect Archdiocesan District

Date of birth: June 6, 1967Education: B.S., Electrical Engineering, Polytechnic University, NYC (1990)M.S., Electrical Engineering, Polytechnic University, NYC (1995)M.Div., St. Vladimirs Seminary, Crestwood, NY (2000)

Ordinations/OffikionTo Diaconate: June 16, 2002To Priesthood: January 18, 2004Archimandrite: January 18, 2004

Current Assignment: Three Hierarchs Church, Brooklyn, NYDirect Archdiocesan District

Date of birth: July 23, 1940Education: B.A., St. Johns University, Queens, NY (1962)M.Div., Holy Cross, Brookline, MA (1966)Lic., Theology, Aristotelion University, Thessaloniki, GR (1974)Diploma, Theology, Ecumenical Institute at Bossey, University de Geneve (1975)

Ordinations/OffikionTo Diaconate: January 30, 1966To Priesthood: May 29, 1966Archimandrite: May 29, 1971

Current Assignment: Lay Profession (Opthalmologist)Metropolis of New Jersey

Date of birth: April 22, 1977Education: B.A., Biology, Cornell University, Ithaca, NY (1998)MS, Science, SUNY, New York, NY (2003)O.D., Opthalmology, SUNY, New York, NY (2003)M.Th., St. Vladimirs Orthodox Seminary, Yonkers, NY (2010)

Ordinations/OffikionTo Diaconate: December 27, 2010To Priesthood: March 6, 2016Archimandrite: December 24, 2016

Current Assignment: Saints Constantine & Helen Church, Boise, IDMetropolis of Denver

Date of birth: November 7, 1945Education: Diploma*, Theology, St. Tikhons Seminary, South Canaan, PA (1973)B.A., Sociology, Kings College, Wilkes-Barre, PA (1974)* St Tikhons was granted the right to confer the M.Div. in 1988

Ordinations/OffikionTo Diaconate: December 21, 1975To Priesthood: October 3, 1976Archimandrite: November 4, 2001

Current Assignment: Saint George Cathedral, Manchester, NHMetropolis of Boston

Date of birth: April 21, 1957Education: B.S., Business Administration, Western New England College, Springfield, MA (1979)M.Div., Holy Cross, Brookline, MA (2005)

Ordinations/OffikionTo Diaconate: August 22, 2004To Priesthood: May 15, 2005Archimandrite: January 10, 2010

Current Assignment: Saint Anna Church, Roseville, CAMetropolis of San Francisco

Date of birth: September 20, 1971Education: B.A., Hellenic College, Brookline, MA (1993)M.Div., Holy Cross, Brookline, MA (1996)M.S., Science, Northeastern University, Boston, MA (1996)

Ordinations/OffikionTo Diaconate: November 17, 1996To Priesthood: February 2, 1997Economos: July 25, 2013

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2019 Celibate Clergy Candidates for Election to the Episcopacy - Official Documents - Greek Orthodox Archdiocese of America

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Ambulatory Healthcare IT Market Trends, Syndicated Reports With AmSurg Corp, Surgical Care Affiliates, Surgery Partners, Healthway Medical Group,…

October 18th, 2019 6:44 pm

Ambulatory Healthcare IT Market report uses a range of steps for collecting, recording, analysing and interpreting market data to make this report all-inclusive. market report also endows with the list of the leading competitors and their moves such as joint ventures, acquisitions, and mergers etc.

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Ambulatory care is also referred as outpatient care. It is a medical care given on outpatient criteria such as consultation, rehabilitation, observation, intervention, diagnosis, and treatment services. Ambulatory care involves emergency care, primary care, ambulatory services, and others. In this intervention and surgery, overnight hospital stay is not required.

The Ambulatory Healthcare IT Market research report provides the comprehensive and in depth study of the market which sheds light on each segment and provides precise investigation considering attractiveness, demand production and sales volume and growth prospects. Moreover this Ambulatory Healthcare IT Market report features the segmentation analysis to facilitate clients with a shrewdness that helps them to select appropriate segments of the Ambulatory Healthcare IT Market

Global Ambulatory Healthcare IT Market By Type (Ambulatory Services, Primary Care Offices, Outpatient Departments, Emergency Departments, Surgical Specialty, Medical Specialty, Others), Modality (Hospital-affiliated, Freestanding), Surgery Type (Opthalmology, Orthopedics, Gastroenterology, Pain Management, Others), Application (Laceration Treatment, Bone Fracture Treatment, Emergency Care Service, Trauma Treatment), Geography (North America, South America, Europe, Asia-Pacific, Middle East & Africa) Industry Trends and Forecast to 2026

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Few of the major market competitors currently working in the global ambulatory healthcare IT market are AmSurg Corp, Surgical Care Affiliates, Surgery Partners, Healthway Medical Group, SurgCenter, Trillium Health Partners, Medical Facilities Corporation, Nueterra Capital, Aspen Healthcare, Suomen Terveystalo Oy, IntegraMed America, Inc., SHERIDAN HEALTHCARE, NueHealth, Athenahealth, GENERAL ELECTRIC, Optum, Inc., Apria Healthcare Group, Inc., DaVita Inc., LVL Medical, Fresenius Kabi AG, Sonic Healthcare among others.

Summary of the research report

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Deepak Chopra Has Never Been Sick – The New Yorker

October 18th, 2019 6:44 pm

Deepak Chopra, the doctor and self-help guru, who turns seventy-three next week, has written more than one book for every year he has been alive. Chopra was born in New Delhi and studied medicine in India before moving to the United States, in 1970. After practicing as an endocrinologist in Massachusetts, he became involved in the Transcendental Meditation movement. He eventually relocated to the West Coast, left T.M. behind, and became a spiritual adviser to Michael Jackson and other celebrities. A quarter century later, his books have sold millions of copies, and his television appearancesespecially alongside Oprah Winfreyhave made him perhaps the most prominent advocate for alternative medicine recognizable around the world.

Chopras work evinces a consistent skepticism toward the scientific consensushe has called into question whether evolution is merely a process of the mindand a firm belief that mental health can determine physical reality. He has written of a place called perfect healththe title of one of his books, and now the slogan for one of his wellness retreatsin which human beings can go somewhere internally that is free from disease, that never feels pain, that cannot age or die. These beliefs have made him controversial among doctors and scientists. In 1998, Chopra was awarded the satirical Ig Nobel Prize for his unique interpretation of quantum physics as it applies to life, liberty, and the pursuit of economic happiness. A random Chopra-quote generator is popular online, and Chopra has been called out for tweeting and writing phrases that, in the words of one paper, may have been constructed to impress upon the reader some sense of profundity at the expense of a clear exposition of meaning or truth. (Example: Attention and intention are the mechanics of manifestation.)

Chopras latest book is Metahuman: Unleashing Your Infinite Potential, and it touches on a number of themes that have been present throughout his career: that human beings can become metahuman by reaching a new place of awareness; that science has served to block the way to the absolute freedom that metahuman holds out; and that self-improvement can move creation itself. I recently spoke by phone with Chopra. During our conversation, which has been edited for length and clarity, we discussed controversial remarks he has made about cancer and AIDS, his claim to have never been even a tiny bit sick, and whether there is a reality that exists independently of our own minds.

How do you define yourself and what you do?

I would say that to define oneself is to limit oneself. But Ive had various roles through my life. Im an internist, an endocrinologist, a neuro-endocrinologist; a teacher of integrative medicine and an author; a husband, a son, a father, a child.

I know you are a doctor, but does thinking about yourself as a doctor seem limiting to you in some way?

It seems limiting to me, but I would say I think of myself closer to a healer. Because, when I look at healing and the origins of the word healing, its related to the word whole. So wholeness means everything, including body, mind, and spirit, and the environment. I think of myself as a doctor who is interested in the physical body, but also in all aspects of human experiencehuman emotions, human thinking, human experience, and, ultimately, in understanding ourselves beyond the conditioned mind. So I would say I want to be a healer. Thats my aspiration.

At what point in your career did you become famous?

Some people think it happened with The Oprah Winfrey Show, in 1993, when she did a one-to-one with me for a book called Ageless Body, Timeless Mind, which then stayed on the New York Times best-seller list for thirty-some weeks. Actually, my most well-known book is The Seven Spiritual Laws of Success. But I have to say that Oprah helped me a lot with the launch of my career, and shes been an ally ever since. Weve taught six million people meditation online together.

How many books have you written now?

This is my ninetieth book.

Would you say your writing process has changed between your first and your ninetieth?

Yes. My process was more structured in the past. And now I feel its more a flow than anything else. I used to always be told by media and publishers, and even the BBC when I was in England, to dumb everything down, and I used to, and I dont anymore. I feel free to say whatever I want to.

Ive been looking for a through line in your work, and the one that Ive noticed most is the idea that our minds can determine reality, or that theres a connection between our minds and reality. Is that a fair way of phrasing it?

Yes. The correct phrase would be that our experience of the world, and of our body, is a projection of our conditioned mind. So, when youre born, you have no human constructs. Youre looking at the world as a messy, gooey experience of color, form, shapes, sounds, pictures, smells, tastes, and random thoughts, which are yet not clear. But then a construction process begins. And so youre told, Youre male, youre of a religious background, ethnic background, nationality, gender. And that begins to create a provisional identity. And then that provisional identity has perceptual experiences but interprets them as the physical body and the world. But, in the deeper reality, theres no such thing. All there is is consciousness experiencing itself perceptually, as perceptual activity, which is species-specific. You dont see the same world as a painted lady, a species of butterfly that smells the world with an antenna, tastes the world with her feet. So what is the picture of the world to a snake that navigates through the experience of infrared?

If you and a snake perceive the world differently and experience it differently, does that mean that the world is actually different? Or does it just mean that we perceive it differently?

We can only experience a narrow band with our perceptual reality. So there is no such thing as a physical world. Thats where Im going. Our experience of the world is species- and culture-specific. And that is what we interpret as fundamental reality.

You once said, Consciousness is key to evolution and we will soon prove that. What did you mean?

You know, Ive said in the past that Darwinian evolution is a human constructthat, ultimately, consciousness drives at least human evolution. We can direct our evolution by the choices we make. And now that we know the science of epigenetics and neuroplasticity, we can see very clearly that, because we are self-aware, unlike other species, we can consciously direct our evolution. And that is what epigenetics and neuroplasticity are showing us.

Epigenetics is not that we can direct our evolution, though, is it?

Well, we can trigger the activity of certain genes and decrease the activity of certain other genes. So, when people practice self-reflection or mindful awareness, or they have the experience of transcendence, you can actually see which genes get activated and which genes get deactivated. Theres a mechanism to that. So you can actually activate the genes that cause self-regulation or homeostasis, and actually decrease the activity of the genes that cause inflammation. So what is healing? It is nothing but self-regulation or homeostasis. And what is disease is mostly linked to chronic inflammation. Only five per cent of disease-related gene mutations are fully penetrant, which means they guarantee the disease. That includes everything, from Alzheimers to cancer to autoimmune disease. Only five per cent is related to genetic determinism. The rest is influenced by life style. [Gerard Karsenty, the chair of the Department of Genetics and Development at Columbia University Irving Medical Center, says, Those assumptions include non-Mendelian diseases. It is for now hard to precisely assess in multigenic diseases the extent of the contribution of gene mutations and the one of lifestyle taken in a broad sense. This is particularly true for autoimmune diseases that hit at all ages, including during childhood and with a higher incidence in women.]

You tweeted, An emerging view, alternate to Darwins random mutations & natural selection is that consciousness may be the driver of complexity/evolution.

Correct. But there are a few people who agree with that.

So, you know, scientists generally are nave realists. Which means they look at the picture of the world, and thats what it is.

What do you do, if not that?

Ive become aware of that which is having the experience rather than the experience, which in spiritual traditions is called the self. The body, the mind, and the world are the self.

It seems like all of these things are fitting under the rubric of what we were talking about earlier about consciousness and reality. I know you once said something like, The moon doesnt exist unless someone sees it. Is that right?

No, no. That was Einsteins quote, by the way. He actually said, I refuse to believe that the moon doesnt exist if no one is looking at it. [In his biography of Einstein, Abraham Pais recounted an interaction he had with the physicist who asked me if I really believed that the moon exists only if I look at it.] Thats a statement coming from a nave realist. The moon that you and I see is a human experience. A horseshoe crab doesnt have that experience living in the depths of the ocean.

Einstein was incredulously asking someone whether they really believe that the moon only exists when its looked at. Correct?

Yes. The moon is an experience in human consciousness. The moon that you and I see is an experience in human consciousness. If there was no human consciousness, no body, mind to go with it, there would be no awareness of the moon.

But the moon would still be there, correct?

How do you prove that? How do you validate that? How do you disprove that? How do you prove an unobserved phenomenon?

The moon is a human story. The universe is a human story. Its a human construct, or human experiences, and interpreted by the human mind.

So this would be akin to the question, which Im sure weve all heard, that if a tree falls in the forest and no one hears it, does it make a sound?

Correct. The sound is only in consciousness. Before that its a vibration of air molecules.

But the vibration of air molecules are occurring. Correct?

The vibration of air molecules is a human construct for a human mode of knowing and experience in human consciousness, so yes, they are constructs. The air molecules are as much of a construct as latitude and longitude, as The New Yorker, as Greenwich Mean Time, as money, as Wall Street, as Manhattan.

Im not sure what that means.

Human constructs are human ideas around modes of human knowing.

I see.

So an atom, a molecule, a force field, vibration of moleculesthese are all human constructs.

So its not that the tree is making a sound and we just happen to be there or not there to hear it. Its that the sound is only present to the degree that we are also present.

Actually, there is no tree and there is no sound and there is no body and there is no mind. Theres only consciousness thats having an experience. The rest is human constructs.

In your book Quantum Healing, you wrote, Research on spontaneous cures of cancer conducted in both the United States and Japan has shown that just before the cure appears, almost every patient experiences a dramatic shift in awareness. He knows that he will be healed and he feels that the force responsible is inside himself, but not limited to him. It extends beyond his personal boundaries throughout all of nature. Suddenly he feels, I am not limited to my body. All that exists around me is part of myself. At that moment, such patients apparently jumped to a new level of consciousness that prohibits the existence of cancer. Then the cancer cells either disappear, literally overnight in some cases, or at the very least stabilize without damaging the body any further.

So if you were a scientist and you saw one case of that, one in a billion, youd want to know the mechanism. And I feel the mechanism is a return to fundamental homeostasis, which means self-regulation, and total absence of fear, including the fear of death. Because your identity is no longer your body-mind.

And so is that more important than medicine?

No, I think medicine is very useful for acute illness. If you have pneumonia, I certainly tell you to take an antibiotic. You break your leg, Id have you see an orthopedic surgeon. If you have cancer, there are many types of chemotherapy and radiation and stem-cell therapies and immunotherapies that will help you. But, in todays age, if you dont understand that integrating that with good sleep, with meditation, with stress management, with mindfulness, with healthy emotions, with good food that actually changes the activity of your microbiomeif you dont conform to that, then youre out of date.

This is from your book Perfect Health: There exists in every person a place that is free from disease, that never feels pain, that cannot age or die. When you go to this place, limitations which all of us accept cease to exist. They are not even entertained as a possibility. This is the place called perfect health. Visits to this place may be very brief, or they may last for many years. Even the briefest visit, however, instills a profound change. As long as you are there, the assumptions that hold true for ordinary existence are altered. If you can be in this place, why would you necessarily need medicine to stay healthy?

We dont. Ive never used medicine myself. Im seventy-three years old, never been in the hospital, never had surgery. Cant even remember having a cold.

You would vaccinate your children, correct?

Of course I would, if Im in a surrounding where there is... You know, I would not vaccinate a child in New York City for polio, because it doesnt exist. But I would for measles, because it does exist.

Even if the child was in this state that you call perfect health?

The child is in a state of perfect health if its born normally. Its in a state of homeostasis. But we also live in a world that has environmental toxins, that has climate change, that has extinction of species, that has poison in our food chain, and that is ready for extinction. And all of that is the projection of our collective insanity.

You say, The cause of disease is often extremely complex, but one thing can be said for certain: no one has proved that getting sick is necessary.

Right. My own situation says that.

Because youve never been sick.

Yes.

Because youre in this place called perfect health?

Because Im aware of being aware and I can choose the experiences I want and I focus on love, compassion, joy, equanimity, and Im beyond the fear of personal death because I dont identify with my provisional, personal, so-called identity. The question you asked me when we started, How do you define yourself?I dont.

If we were all in this place, would we need medicine?

Yes. Because of the world weve created, we would, yes.

But not because

And, besides that, the ecosystem is a predatory play of consciousness where, you know, its a recycling of experience. Birth, death, illness: they are part of our provisional identity, but I dont identify with that identity. If you do not identify with the experience, if consciousness that is aware of experience, if the awareness of experience is not the experience, then youre intrinsically free of the experience. Do you know what Im saying?

Im not sure.

O.K. If you are aware of a thought, then youre not the thought, youre the awareness of the thought.

Dr. Stacia Kenet Lansman, whos a leading vaccine skeptic, cited your work as an inspiration. Do you

I have never been against vaccination.

I know you havent.

I have never spoken against medical treatment or intervention. You should do whatever works.

But do you worry that the idea that we can achieve this place of perfect health based on our own mental state can give license to anti-scientific thinking, like we see in the anti-vaccine movement?

You asked me if I worry about that. I dont worry about anything.

Which is why you havent gotten sick.

But people can take what I say and interpret it how they want to. Theres also a difference between scientism and science. Science is a very neutral activity: theories, observation, experiments, validation or invalidation. Period. I am a big proponent of science as the greatest adventure that human consciousness has taken. With scientism, its a different thing. Its being a fundamentalist and believing that science has all the solutions for human problems, including the existential dilemmas we have about our identity, our fear of old age, infirmity, and death.

There was an interview you gave many years ago, with Tony Robbins, about AIDS. Hed put forth the idea that H.I.V. is not the source of AIDS. You said, H.I.V. may be a precipitating agent in a susceptible host.The material agent is never the cause of the disease.It may be the final factor in inducing the full-blown syndrome in somebody whos already susceptible. He then asked,Butwhat made them susceptible? You answered, Their own interpretations of the whole reality that theyre participating in. Do you still feel that way about H.I.V. and AIDS?

I still feel that pathogens are precipitating factors in susceptible hosts, and that the outcome of illness and recovery is very complex. Now, having said that, when you can find a single agent that you can either attack or get rid of, then, of course, thats the solution. You know, you and I can be exposed to a pneumococcus and one person gets pneumonia and the other doesnt. So you can see that illness is not just one mechanistic happening, an encounter with the pathogen. It has to do with everything. Are you deeply rested, are you stressed, whats your nutrition, what are your personal relationships, what is your emotional stateall of these things have an influence. Every experience we have is ultimately metabolized into a molecule in the body. If I gave you bad news right now, your blood pressure would go up. In fact, if I sent a mean tweet to Mr. Trump, his blood pressure would go up even further.

You went on to say, I have a lot of patients with so-called AIDS, this label that weve given them, that are healthier than most of the population thats living in downtown Boston. They havent had a cold in ten years. And then Robbins said, But someone has told them they have this disease. You said, Yes, somebody has told them that. And Robbins says, And they bought into it. And you said, Exactly.

Listen. You can do a five-hour interviewyou can edit it into any way you want. You can take statements out of context.

No, thats the whole context.

And then you can say, This is what you said. Right? I had that experience myself as a physician. I said to the patient, You have cancer. Immediately, he looked like he was going to have a stroke. He was going to faint. And then I realized I read the wrong chart and I said, Sorry, that was somebody else. In two seconds I could see him recover from high blood pressure, sticky platelets, a jittery heart, and so on. So, you know, there is a lot more to reality than just a simple diagnosis and the label.

But to go on to the point youre just making now, about diagnosis, when Robbins said about the diagnosis of AIDS, People are accepting this, and when they accept this, what happens to them? You replied, When they accept it, then they make it happen. It is a self-fulfilling prophecy. Is that what youre saying?

Yeah. I might have said that. And, if I did, I regret it.

What I say today is, Believe the diagnosis, but dont believe the prognosis.

Youve been criticized before for selling products that people claim can help cure cancer or other diseases via meditation.

No, Ive never claimed that. No.

Never?

If you find a reference of that, let me know.

Well, there was a video called Return to Wholeness: A Mind-Body Approach to Healing Cancer. And the release about it says, Meditation and visualization are two of the most

Right. That video was a program to help people visualize and get into a relaxed state. I believe it was promoted as that on my Web site until I became aware of it, and then it was taken off.

And then you took it down?

Yeah. It was actually an artificial-intelligence program for meditation and self-regulation. And, by the way, used at many cancer-therapy clinics across the world as an aid to relaxation. [A member of Chopras staff named Cancer Treatment Centers of America as one of the clinics that use the video, but a representative for the treatment centers was unable to verify this.]

So, when you say in your best-sellers, like Super Brain, that increased self-awareness can reduce the risks of aging and help people achieve freedom and bliss, do you feel that youre doing that at all, or not?

I am. Of course. Im seventy-three years old, and I dont think my biological age is seventy-three. In fact, I have publicly declared that I am slowing down my aging process. And I think you can go on social media and look at all the pictures over the last few years and you can see, physically, that I am not looking as old, or feeling as old, as I was twenty-five years ago. I know what Ive said is outrageous, but, if people actually listen carefully, they will see that they determine a lot of what goes into well-being and health. And, ultimately, I dont think that health is physical at all. Because, ultimately, we are all going to die, and all going to have some kind of infirmity. But most of what we do is creating anxiety from living a full life in the present moment.

So you feel that youve reached a different stage of human existence?

Im just following the example of people who have lived long, healthy lives without any infirmity and died peacefully in meditation. In the Indian tradition, its called mahasamadhithe big meditation.

When youre selling books by saying that theres a network of intelligence in the human body that has the potential to defeat cancer, heart disease, and even aging itself, is that not selling to people that cancer can be beaten by something other than medicine?

Have you read the book? Or have you read criticisms of the book?

Ive read several of the books, and some criticisms.

So then you have to make up your own mind. Im not a purveyor of false hope. In fact, I think the term false hope is an oxymoron. Either you have hope or you dont. And those that have hope do better than those who dont.

So there is no false hope?

Its up to you how you interpret this, and it doesnt actually affect me. You know, Im at a stage in my life where Ive gone beyond criticism and/or flattery. I dont need that.

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Deepak Chopra Has Never Been Sick - The New Yorker

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UCI professor named to CDC committee on sexually transmitted infections – Newswise

October 18th, 2019 6:44 pm

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Newswise Irvine, Calif. October 15, 2019 Sean Young, PhD, professor at the University of California Irvine School of Medicine and Donald Bren School of Information and Computer Sciences, has been appointed to the National Academies of Sciences, Engineering, and Medicine ad hoc committee to address the alarming increase in sexually transmitted infections (STIs). The Center for Disease Control (CDC) through the National Association of County and City Heath Officials requested the formation of the committee.

STIs have reached epidemic proportions nationally and continue to rise. Our committee is charged with investigating the problem and recommending novel and implementable solutions, said Young. Solutions exist. We are optimistic about the CDCs request for help that there will be resources and support to implement the committees solutions.

The Prevention and Control of Sexually Transmitted Infections in the United States committee will examine the epidemiological dimensions of STIs in the United States and factors that contribute to the epidemic (changes in population demographics, sexual and other behaviors, social determinants), as well as changes in the understanding of the agents that cause STIs.

Additionally, the study will attempt to address the economic burden associated with STIs and review current public health strategies and programs to prevent and control STIs (including STI diagnostics, STI vaccines, STI monitoring and surveillance, and treatment. Barriers in the healthcare system and insurance coverage associated with the prevention and treatment of STIs will also be surveyed.

Young was appointed to the committee due to his work at UCI leveraging social and behavioral data to detect real-world problems. He applied insights from psychology to online behavior change interventions and saw social norms could be modified.

Young uses this approach to transform time-consuming and expensive community-based interventions into online variants that more efficiently reach the masses. By analyzing peoples behaviors, problems from these behaviors can quickly be detected and addressed. Working with public health officials, Young is now developing tools that mine social data to identify potential areas of disease outbreak, crime, and poverty. His expertise will be used to address the STI epidemic.

We can now use technologies as a way of predicting and changing behavior, leading to positive and ethically delivered social change, said Young.

About the UCI School of Medicine: Each year, the UCI School of Medicine educates over 400 medical students, as well as 200 doctoral and masters students. More than 600 residents and fellows are trained at UC Irvine Medical Center and affiliated institutions. The School of Medicine offers an MD; a dual MD/PhD medical scientist training program; and PhDs and masters degrees in anatomy and neurobiology, biomedical sciences, genetic counseling, epidemiology, environmental health sciences, pathology, pharmacology, physiology and biophysics, and translational sciences. Medical students also may pursue an MD/MBA, an MD/masters in public health, or an MD/masters degree through one of three mission-based programs: the Health Education to Advance Leaders in Integrative Medicine (HEAL-IM), the Leadership Education to Advance Diversity-African, Black and Caribbean (LEAD-ABC), and the Program in Medical Education for the Latino Community (PRIME-LC). The UCI School of Medicine is accredited by the Liaison Committee on Medical Accreditation and ranks among the top 50 nationwide for research. For more information, visit som.uci.edu.

About the University of California, Irvine: Founded in 1965, UCI is the youngest member of the prestigious Association of American Universities. The campus has produced three Nobel laureates and is known for its academic achievement, premier research, innovation and anteater mascot. Led by Chancellor Howard Gillman, UCI has more than 36,000 students and offers 222 degree programs. Its located in one of the worlds safest and most economically vibrant communities and is Orange Countys second-largest employer, contributing $5 billion annually to the local economy. For more on UCI, visit http://www.uci.edu.

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UCI professor named to CDC committee on sexually transmitted infections - Newswise

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Altru hosts Pretty in Pink, women’s health event at Red River High School – Grand Forks Herald

October 18th, 2019 6:44 pm

Altru Hospital is hosting its Pretty in Pink event in the commons of Red River High School from 6 to 8 p.m. Wednesday, Oct. 16.

The annual event is held by the hospital to celebrate Breast Cancer Awareness Month. The event is free and open to the public. Parking is available at the Cushman Field entrance. Attendees are asked to use door 1.

Beginning at 6 p.m., people can explore educational booths and community resources such as Womens Way, Breast Reconstruction Awareness, and get information about Altrus prosthetics and orthotics.

The evening will feature a little pampering as well, with free nail painting and chair massages, in an effort to bring community members together for the womens health awareness event.

People can sign up to win a bicycle donated by Scheels All Sports, and there is also a raffle with several prizes, as well as door prizes. All proceeds from the raffle go to Altrus Breast Cancer Coalition Fund, which seeks to help patients with breast health services not covered by insurance. All attendees will get a small gift to take home.

From 7 to 8 p.m., there will be presentations by breast cancer survivor Wendy Dahlberg, and Jen Haugen, supervisor of Integrative Medicine at Altru Health System.

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Altru hosts Pretty in Pink, women's health event at Red River High School - Grand Forks Herald

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Concerns in covering alternative therapies in PM-JAY – The Hindu BusinessLine

October 18th, 2019 6:44 pm

Two pet ministries of Prime Minister Narendra Modi Ministry of Ayurveda, Yoga, Unani, Siddha and Homeopathy (AYUSH) and Ministry of Healths National Health Authority which runs Pradhan Mantri Jan Arogya Yojana (PM-JAY) are not on the same page, when it comes to practicing integrative medicine.

Currently, PM-JAY cashless insurance up to 5 lakh for poor families only offers hospitalisation based on allopathic medicine. However, the AYUSH Ministry is keen on pushing alternative treatments in the scheme.

A Health Authority official said that inclusion of AYUSH packages in PM-JAY is not feasible currently. It will be too difficult to work our way around fraud control in AYUSH procedures, where we will not be able to ascertain if hospitalisation is for correct purposes, said the official.

AYUSH Secretary Vaidya Rajesh Kotecha said that even though such an inclusion has not happened yet, the Ministry is trying hard to get the packages included. We will help the NHA with adequate fraud control mechanisms, Kotecha added.

Last month, AYUSH Minister Shripad Yesso Naik had said that a total of 33 packages had been sent to the Health Authority for consideration to be included under PM-JAY.

The list of pacakges proposed by AYUSH, seen by BusinessLine, includes 19 Ayurveda, Unani and Siddha, eight Yoga and six Naturopathy treatments. These are treatment of respiratory disorders such as asthma, pneumonia, gastrointestinal problems like hepatitis, stomach ulcers, cardiac issues like high blood pressure, metabolic disorders like diabetes, thyroid, gynaecological issues like endometriosis, reproductive tract infections, infertility, skin problems like vitiligo, psoriasis, neurological disorders like mental retardation, Parkinsons, Alzheimers, Dementia, eye problems like diabetic retinopathy and glaucoma.

It also proposes to include mental health issues such as clinical depression, anxiety, manic disorders, and other miscellaneous illnesses like varicose veins, diabetic foot in the in-patient hospitalisation packages. AYUSH Ministry has proposed a flat rate of 4,000 per day for hospitalisation in a routine ward, and has said that the average length of stay of a patient could be 14 days costing 56,000 and could extend up to 28 days costing 1.2 lakh. Similarly, cost for Yoga and Naturopathy related to above disorders has been pegged at 1,000 for each specialty per day of hospitalisation.

According to experts, while there is a need to include AYUSH treatments for access to poor, standardisation of procedures is a must. Naresh Trehan, Chairman of Gurgaon-based Medanta Medicity said, There is no harm in including AYUSH packages in PM-JAY, however, standardisation must be done. The authority must ascertain if a hospital is certified to mete out alternative treatments, otherwise anybody can open a centre and claim to give those treatments.

Partha Dey, Chief Operating Officer at Artemis Health Institute in Gurgaon said, It is difficult to control fraud as of now in the scheme, even with allopathic treatments. As far as AYUSH packages are concerned equal standard setting is a must. Dey also said that there is a resistance from patients on addition of alternative therapies apart from allopathy and it causes a confusion for them.

Kotecha said that while there is a popular perception that there are no standards as far as alternative treatments are concerned, this is not entirely true. AYUSH is working with All India Institute of Medical Sciences to develop integrative model for treatment of breast cancer patients. Also, it has been seen that adding ayurvedic treatments to Tuberculosis regimen reduces liver damage. The ministry also showed evidence in Germany for treatment of Osteoarthritis through Ayurveda, he said.

However, Kotecha too agreed that there is a need to have quality services. For this we have proposed to National Accreditation Board of Hospitals that such hospitals which provide alternative therapies should receive Entry Level Certification, he said.

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Concerns in covering alternative therapies in PM-JAY - The Hindu BusinessLine

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How To Get Access To Holistic Practitioners No Matter Where You Live – mindbodygreen.com

October 18th, 2019 6:44 pm

Luckily, new tech-forward startups are finding ways to solve that problem. Enter: Begin To Heal, an online platform connecting patients with vetted holistic health professionals. Started by a former busy exec who found herself battling adrenal fatigue and frustrated by traditional medicine, Pooja Khanna finally found healing in holistic medicine. Determined to make this type of treatment more widely available, Pooja developed Begin To Heal. "The idea is to make alternative medicine as accessible as possible, especially to those who might be hesitant to seek less conventional methods of healing due to unfamiliarity with the industry," explains Pooja.

Begin To Heal is partnered with more than 200 licensed wellness practitioners, with services including everything from acupuncture, nutrition coaching, and integrative medicine to hypnotherapy, energy healing, reiki, spiritual coaching, ayurveda, and psychotherapy.

You can view practitioner profiles, sort by specialty, read reviews from other customers, and book your session, all through their website. The Begin To Heal team has even taken sample sessions with every practitioner on the site and verified their licenses and certifications.

And the best part: You can schedule virtual appointments, meaning even if you don't live in New York, where their in-person practitioners are based, you can have access to top holistic healers and alternative therapies through secure HIPAA-compliant video calls. Energy healing from the couch, anyone?

Plus, they offer online courses and guided meditations to round out your care. "Think of it like matchmaking for healing, and then add to it the comfort of being healed in your own home," Pooja explains. "Having it be an online service gives us the capability to create a global wellness universe."

Another New Yorkbased health practice, Parsley Health, just announced they'll start seeing patients virtually as well with new telehealth memberships. Billed as a primary care practice with a whole-body approach, Parsley's online membership is currently available in four states, with plans to go nationwide over the next six months.

When asked why they had expanded to online services, Parsley Health founder and mbg Collective member Robin Berzin, M.D., said it's all about access. While much of Parsley's practice was already digital, with doctor-patient messaging services and video call follow-ups, the first visit always had to be in person. "People shouldn't have to wait for a Parsley Health center to come to their area. We wanted to make Parsley accessible to them now," Berzin explained. "Our new telemedicine memberships will allow anyone, anywhere to do all of their visits online, including the first oneand that's really special."

Worried you won't be getting the "full Parsley experience" by doing it digitally? Robin promises, "For many, it will be even better. The convenience of anywhere access means you can kick off your journey with us from your home or office." Can't beat that.

Another newcomer, Milwaukee-based WellnessScript, has created their own virtual holistic health care program. To get you started, they offer a symptom quiz to learn more about where you are coming from. From there, you can book a one-hour phone or video consultation, followed by two 30-minute follow-up sessions with one of their licensed practitioners. Founded by two physicians, WellnessScript is committed to providing quality functional medicine to anyone, anywhere.

While not all of the services on these online platforms are covered by major health insurers right now, in many cases FSA/HSA benefits and out-of-network reimbursements can be used to cover most of the cost. Hopefully, as alternative medicine options become more widely available, the price will go down, make holistic health care even more accessible. As Robin put it, "This is just the next step. We have so many more steps to take to make comprehensive, holistic, personalized medicine available and accessible to everyone who needs it."

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What Are the Benefits of Turmeric? – The New York Times

October 18th, 2019 6:44 pm

Dr. Amit X. Garg, a professor of medicine at Western University in London, Ontario, knew about turmerics medicinal use because of his Indian heritage. He knew firsthand of its rich cultural significance too: On his wedding day, his relatives rubbed the spice all over him because it is believed to be cleansing.

After seeing the effectiveness of curcumin, in smaller studies, Dr. Garg and his colleagues decided to test it on a larger scale in hopes it would make elective aortic surgery safer by reducing the risk of complications, which include heart attacks, kidney injury and death. In the randomized clinical trial that followed, about half of the 606 patients were administered 2,000 milligrams of curcumin eight times over for four days, while the others were given a placebo. It was a bit disappointing, but we couldnt demonstrate any benefit used in this setting, Dr. Garg said of the study, published last year in the Canadian Medical Association Journal.

In fact, there is not enough reliable evidence in humans to recommend turmeric or curcumin for any condition, according to the National Center for Complementary and Integrative Health. Turmeric became a nutritional golden child partly because of its promise in laboratory studies cellular and animal. Some research indicates that both turmeric and curcumin, the active ingredient in turmeric supplements, have anti-inflammatory, antioxidant, antibacterial, antiviral and antiparasitic activity. But this has mostly been demonstrated in laboratory studies, and, in many cases, the benefits of preclinical research isnt observed in clinical trials.

According to Natural Medicines, a database that provides monographs for dietary supplements, herbal medicines, and complementary and integrative therapies, while some clinical evidence shows that curcumin might be beneficial for depression, hay fever, hyperlipidemia, ulcerative colitis, osteoarthritis and nonalcoholic fatty liver disease, its still too early to recommend the compound for any of these conditions.

And Natural Medicines has found there isnt enough good scientific evidence to rate turmeric or curcumins use for memory, diabetes, fatigue, rheumatoid arthritis, gingivitis, joint pain, PMS, eczema or hangovers.

Physicians say more research is needed. Dr. Gary W. Small, a professor of psychiatry and biobehavioral sciences at the David Geffen School of Medicine at the University of California, Los Angeles, who studies curcumins effect on memory, sees a lot of therapeutic potential. He also states that existing research demonstrates curcumins biological effects.

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Does Relaxing Make You Anxious? Here’s Why, According To New Research – mindbodygreen.com

October 18th, 2019 6:43 pm

Have you ever sat down to meditate, only to feel a swell of anxiety and fear? If you have, you're not alone, and you've probably been dealing with relaxation-induced anxiety. As Bindiya Gandhi, M.D., integrative medicine doctor and certified yoga instructor, explains, "Most people actually do well with relaxation therapy, and their symptoms improve. However, there is an extreme group of people who this may not work well on as the study cites," she says.

So why does it happen? It could be something called "contrast avoidance," a theory one of the authors on the study, Michelle Newman, developed in 2011. As she explains it, "The theory revolves around the idea that people may make themselves anxious intentionally, as a way to avoid the letdown they might get if something bad were to happen."

In other words, you could be using worry as a sort of insurance policy or "pay in advance" policy against bad things that might occur. In their recent paper, published in the Journal of Affective Disorders, the authors explain that "the contrast avoidance model postulates that individuals with generalized anxiety disorder [...] fear a sharp spike in negative emotion, and thus prefer to worry to maintain their negative affect, rather than being in a more euthymic state, such as relaxation."

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International Health Experts to Discuss Advancing the Science & Art of Integrative Oncology at 16th International Conference of Society for…

October 18th, 2019 6:43 pm

NEW YORK (PRWEB) October 14, 2019

More than 400 healthcare professionals, patients and advocates from 35 countries will convene at the Society for Integrative Oncology (SIO) 16th International Conference, to be held October 19-21, 2019, in New York, NY, to discuss the latest in evidence-based research and clinical practice in person-centered integrative cancer care. This multi-disciplinary forum includes physicians, scientists, researchers, nurses, psychologists, nutritionists, naturopaths, acupuncturists, and other complementary care practitioners.

This years theme Advancing the Science & Art of Integrative Oncology aims to advance the scientific understanding of the role integrative therapies play in cancer care and to promote patient-centered care that recognizes the values, preferences, and rights of patients and families. SIO continues to be a critical hub, advancing the latest evidence-based research, insights, and collaborations of the multidisciplinary teams dedicated to improving the lives of people affected by cancer, said SIO President Lynda Balneaves, PhD, RN. The sessions will highlight the collaborative and multidisciplinary approach involving healthcare professionals and patients.

The conference is presented in cooperation with Memorial Sloan Kettering Cancer Centers Integrative Medicine Program, which is celebrating the 20th anniversary of its creation.

Integrative oncology approaches help prevent cancer, facilitate cancer treatment and recovery, and aid in its control through use of diet and complementary therapeutic options, including physical activity, nutritional supplementation, botanical products, mind-body therapies, acupuncture, massage therapy, and more. The options are strategically integrated within conventional medical care models, which often include chemotherapy, radiation therapy, surgery and targeted agents informed by genomic and molecular diagnostics.

Today, significant portions of cancer patients use some types of integrative or complementary therapeutic approaches throughout their cancer journey. In addition to conventional therapies, they want to learn about and utilize an integrative approach to personalized comprehensive care. Integrative oncology interventions have been shown to decrease some of the side effects of traditional cancer treatment, allowing many patients to tolerate their full, prescriptive course, thereby improving clinical outcomes and quality of life. Many health consumers also incorporate lifestyle medicine approaches to help prevent the onset of cancer.

About the Society for Integrative Oncology

The Society for Integrative Oncology is the leading worldwide organization dedicated to integrative medicine specific to cancer patients. A non-profit, multi-disciplinary organization founded in 2003, the organizations mission is to advance evidence-based, comprehensive, integrative healthcare to improve the lives of people affected by cancer. For more information or to register for the conference, visit our conference web site or contact the SIO at 518-694-5543.

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Male Infertility: What to Know and How to Cope – NYT Parenting

October 18th, 2019 6:43 pm

Dr. Peter Schlegel, M.D., urologist-in-chief at New York-Presbyterian/Weill Cornell Medical Center and president of the American Society for Reproductive Medicine, Jan. 6, 2019

Barbara Collura, president of RESOLVE: The National Infertility Association, Jan. 10, 2019

Dr. Gloria Bachmann, M.D., director of the Women's Health Institute at Rutgers Robert Wood Johnson Medical School in New Jersey, May 22, 2019

Dr. Marc Goldstein, M.D., director of the Center for Male Reproductive Medicine and Microsurgery at the NewYork-Presbyterian Hospital/Weill Cornell Medical Center, Jan. 4, 2019

Alice Domar, Ph.D., an associate professor of obstetrics, gynecology and reproductive biology at Harvard Medical School and director of Integrative Care at Boston I.V.F., Jan. 11, 2019

Paul Flynn, 46, a social worker in Sacramento, Calif., Jan. 17, 2019

Denny Ceizyk, 52, author of Almost a Father: A Memoir of Male Infertility, Jan. 19, 2019

Diagnostic Evaluation of the Infertile Male: A Committee Opinion, Fertility & Sterility, March 2015

Treatment of Male Infertility (Beyond the Basics), UpToDate, September 2019

Temporal trends in sperm count: a systematic review and meta-regression analysis, Human Reproduction Update, November 2017

Maternal, infant and childhood risks associated with advanced paternal age: The need for comprehensive counseling for men, Maturitas, July 2019

The Negative Impact of Higher Body Mass Index on Sperm Quality and Erectile Function: A Cross-Sectional Study Among Chinese Males of Infertile Couples, The American Journal of Mens Health, Jan. Feb. 2019

Tobacco smoking and semen quality in infertile males: a systematic review and meta-analysis, BMC Public Health, January 2019

Habitual alcohol consumption associated with reduced semen quality and changes in reproductive hormones; a cross-sectional study among 1221 young Danish men, BMJ Open, September 2014

Type of underwear worn and markers of testicular function among men attending a fertility center, Human Reproduction, September 2018

Diet and men's fertility: does diet affect sperm quality? Fertility & Sterility, September 2018

Report on varicocele and infertility: a committee opinion, Fertility & Sterility, December 2014

Mens Experience of Infertility: Findings from a Qualitative Questionnaire Study, Fertility Network U.K., November 2017

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Kombucha, CBD oil, and 3 more: Do these popular wellness products actually work? – The Daily Briefing

October 18th, 2019 6:43 pm

Wellness products such as kombucha, CBD oil, and even "activated charcoal," have grown in popularity in recent years, thanks to their purported health benefits, but do these products actually do what they claim to do? The New York Times' Dawn MacKeen and Amitha Kalaichandran investigatedfive popular wellness products to find out.

Cheat sheets: Evidence-based medicine 101

Kombucha is a fermented drink that is typically carbonated and is made by brewing sugar, black or green tea, liquid from a previous batch, and symbiotic culture of bacteria and yeast, sometimes called the scoby.

Proponents of kombucha say it improves digestion, boosts the immune system, reduces blood pressure, and can be beneficial to diabetics.

However, few studies have looked at how effective kombucha really is. Only one study has looked at its health benefits in humans, according a literature review, and it found that the 24 adults with non-insulin dependent diabetes who consumed kombucha for three months saw their mean blood sugar levels stabilize. However, the study was neither controlled nor randomized, and its authors noted that many of the claims about kombucha are based on anecdotal and unverified evidence.

Other research on cells and animals has found that kombucha may have anti-inflammatory and antimicrobial properties, but according to Franck Carbonero, a microbiome scientist at Washington State University-Spokane, "We don't know if it does anything."

Celery juice is purported to help alleviate digestive problems and treat autoimmune disorders, psoriasis, acne, and a whole host of other health problems.

However, according to Rachel Scherr, an assistant research scientist in nutrition at the University of California, Davis, "There's no scientific evidence to support any of the claims being made."

But that doesn't mean you need to avoid it, as it's "overall a healthy juice," according to Elizabeth Bradley, medical director of Cleveland Clinic's Center for Functional Medicine. According to MacKeen, celery juice has greater amounts of potassium and vitamin K than tomato and carrot juices.

Activated charcoal refers to charcoal that has had gases such as oxygen added to it at high temperatures, creating pores in the charcoal that allow it to bind to other substances.

Proponents of charcoal say it works as a detoxifier that can remove teeth stains and even help stop aging, MacKeen reports.

But does the substance live up to the hype? Not quite.

A study in January 2019 found that activated charcoal in toothpaste was not as effective as other whitening agents at whitening cow, goat, and sheep teeth, and another review from 2017 of 118 studies did not find enough evidence to support the safety or efficacy of charcoal-based toothpastes or powders.

Cannabidol (CBD) comes from the cannabis sativa plant, perhaps best known for also containing tetrahydrocannabinol (THC), which is the high-inducing chemical found in marijuana. Proponents of CBD say it can relieve anxiety, depression, and post-traumatic stress disorder (PTSD).

CBD has been shown to potentially help reduce nervousness and cognitive impairment in patients with social anxiety. However, another, double-blind study, found healthy participants who took CBD saw small or non-existent changes in their emotional reactions to unpleasant images or words.

Harriet de Wit, co-author of the study and a professor at the University of Chicago's department of psychiatry and behavioral neuroscience, said, "If it's a calming drug, it should change their responses to the stimuli. But it didn't."

Mallory Loflin, an assistant adjunct professor at the University of California, San Diego, said she believes CBD could help treat PTSD, but more research is needed on the subject. "Our top therapies attempt to break the association between reminders of the trauma and the fear response," she said. "We think that CBD, at least in animal models, can help that process happen a lot faster."

Overall, CBD is "pretty safe" as long as you take "pure CBD," according to Marcel Bonn-Miller, an adjunct assistant professor at the University of Pennsylvania's Perelman School of Medicine.

Turmeric for thousands of years has been used in Ayurvedic medicine, which refers to a holistic healing system that originated in India more than 3,000 years ago. The spice is believed to work as an antiviral, antibacterial, and antiparasitic in Ayurvedic medicine. It's also purported to help with a variety of conditions, including high cholesterol, hay fever, depression, and hangovers.

However, a 2017 paper published in the Journal of Medicinal Chemistry concluded that turmeric doesn't have the health benefits it's purported to have. In fact, according to the National Center for Complementary and Integrative Health, there isn't enough reliable evidence for turmeric to be recommended for any condition.

Moreover, if a patient is taking turmeric, experts recommend patients inform their doctors, as high doses of turmeric and its constituents could have some unpleasant side effects like diarrhea and nausea (MacKeen, New York Times, 10/16 [1]; MacKeen, New York Times, 10/16 [2]; Kalaichandran, New York Times, 10/16; MacKeen, New York Times, 10/17 [3]; MacKeen, New York Times, 10/17 [4]; WebMD.com, accessed 10/17).

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Healthcare Systems Offer Expert Breast Cancer Care to Long Islanders – Long Island Press

October 18th, 2019 6:43 pm

Between 2012 and 2016, there were 13,064 new cases of female breast cancer in Nassau and Suffolk counties, according to the U.S. Centers for Disease Control and Prevention.

In response, New York State and Long Island healthcare systems continue to raise the bar in care and treatment for patients facing a breast cancer diagnosis, enhancing their approach from an emotional, physical, and physiological perspective and making it more accessible overall. To date, most healthcare systems have embraced a multidisciplinary approach to treating breast cancer, as well as innovative practices to improve their patients outcomes.

Its easier to share information and sharing information leads to more consistency and higher quality care, says Dr. Brian OHea, director of the Carol M. Baldwin Breast Care Center in Stony Brook.

As an academic medical center, Stony Brook has access to the most current clinical trials, in addition to standard of care, he says.

We also have a radiation oncology team looking for ways to treat patients successfully with less radiation treatments, he says, noting that the goal is patient-centered and patient-focused care.

Dr. OHea was the first fellowship-trained breast surgeon on Long Island.

Breast cancer surgery was [initially] mixed in with hernia and gall bladder surgery, he says. The advent of breast fellowships and specially trained breast surgeons trained on the technical aspects of breast cancer surgery, and also including adjuvant therapies, was a huge innovation for women.

Stony Brook was also the first in New York State to receive accreditation from the National Accreditation Program for Breast Centers (NAPBC), he notes.

Going forward, Stony Brook remains committed to research, for example, looking for better imaging of the armpit lymph nodes to see whether there is cancer or not using a special MRI coil, Dr. OHea says.

The center isnt alone in its innovation. South Nassau Communities Hospitalin Oceanside recently partnered with Mount Sinai to become Mount Sinai South Nassau.

We are pleased to be the flagship hospital for Mount Sinai, says Dr. Christine Hodyl, director of breast services at Mount Sinai South Nassau. All of the components are here in the hospital, with less travel and having expertise in breast cancer care in a patients own backyard.

Mount Sinai is embracing new approaches to breast cancer surgery, utilizing oncoplastic techniques.

We provide the most innovative surgical techniques that have excellent cosmetic results and improve the functional quality for a patient, Dr. Hodyl says. For example, We are now placing implants above the muscle and we are able to do an immediate implant reconstruction at the same time as a mastectomy, leaving the muscle in place; and this leads to less pain, quicker recovery and a smaller number of surgical procedures.

Mount Sinai is also adding genetic testing programs, genetic counselors, and nurse navigation to its protocol in order to best serve patients with breast cancer.

NYU Langone Medical Center and Winthrop-University Hospital in Mineola united several years ago to enhance their healthcare networks on Long Island.

We are able to provide the same kind of care that is provided at NYU Langone at the Perlmutter Cancer Center on Long Island, says Dr. Nina DAbreo, medical director for Breast Health at Perlmutter Cancer Center at NYU Winthrop.

Perlmutter aims to improve the multidisciplinary approach to breast cancer care and breast cancer survivorship. Dr. DAbreo chairs an annual breast health symposium committed to offering up-to-date care and the latest innovations right from prevention to survival, she says. This includes everything from education and screening to social work and navigation to research and advanced treatments.

Perlmutter has dedicated breast surgeons who are skilled in minimally invasive techniques for breast surgery-reducing lymph node surgery, as well as Savi Scout technology, which uses radar technology to guide a surgeonand target breast tissue during a lumpectomy or biopsy procedure, Dr. DAbreo notes. Perlmutter helped pioneer prone breast radiation therapy, which minimizes radiation damage to the lungs and the heart, she adds.

The Perlmutter Center is researching immune therapy for triple negative breast cancer, participating in local and national clinical trials, says Dr. DAbreo.

Located in Uniondale, Memorial Sloan Kettering Nassau offers expert cancer care including chemotherapy, immunotherapy and radiation with greater convenience for Long Islanders.

At Memorial Sloan Kettering, we have many clinical trials that are available to patients in all stages of breast cancer treatment both up front, as well as clinical trials that have cutting-edge therapies for metastatic disease, says Dr. Tiffany Troso-Sandoval, board-certified medical oncologist at Memorial Sloan Kettering.

The role of DNA molecular profiling gives a more comprehensive understanding of the DNA mutations that contribute to the cancers function, she says. This test is run on every patient that has recurring or metastatic cancer. Results are placed in a databank shared with physicians and patients so if a clinical trial should arise and a patient has that same gene, our computers will pick that up immediately.

MSK is considered to be one of the top organizations with cutting-edge evaluation and therapy for breast cancer, she continues. Our facility at Nassau has full-time social work, nutrition, and physical therapy, in addition to layers of supportive nursing and multiple subspecialty positions to help support the patients physically and emotionally.

Northwell Health is committed to assuring that patients are better informed, more supported and experience a better journey when theyre diagnosed, says Dr. Karen Kostroff, chief of breast surgery at Northwell Health. Northwells cancer centers throughout Long Island including Huntington, Great Neck and the Imbert Cancer Center in Bay Shore make expert care accessible and offer everything from screening and diagnosis to surgery to posttreatment, which includes a breast survivorship program.

Northwells multidisciplinary team allows for consultation and discussion to ascertain an appropriate plan of treatment for individual breast cancer patients. Treatment could include radiation, chemotherapy, surgery, etc., however, there is no one-size-fits-all approach, explains Dr. Kostroff, noting that genetic history and testing is also valued.

Dr. Kostroff leads a systemwide tumor board that addresses patients whose cancer is uniquely challenging and complicated. This forum includes 12 sites throughout the Northwell system.

All of these physicians are learning and discussing sharing updated information on new clinical trials and education, she explains. We are also involved in a tumor donation program, where instead of the tissue being discarded once its studied, it is given to Cold Spring Harbor Laboratories so they to can research on a fresh tumor.

With Northwell Healths Center for Wellness and Integrative Medicine, patients can also focus on taking care of their bodies through programs such as reiki, Pilates, massage and more, says Dr. Kostroff.

Catholic Health Services offers patients diagnosed with breast cancer treatment and services throughout Long Island. CHS six hospitals include Good Samaritan Hospital Medical Center in West Islip, Mercy Medical Center in Rockville Centre, St.Catherine of Siena Medical Center in Smithtown, St.Charles Hospital in Port Jefferson, St.Francis Hospital The Heart Center in Roslyn, and St.Joseph Hospital in Bethpage.

CHS offers early detection and imaging services, utilizes minimally invasive techniques for breast disease, and also provides genetic counseling for individuals who have an increased risk for breast cancer. Education and support groups are offered to ensure patients are provided with emotional as well as physical care. Like the majority of, if not all healthcare systems, CHS also embraces a multidisciplinary approach to breast cancer.

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SANGHA Retreat by OCTAVE Institute Presents the 2019 AT ONE International Festival: New Paradigm, New Era of Wellbeing, November 15-17, 2019 – PR Web

October 18th, 2019 6:43 pm

SANGHA Retreat

SUZHOU, China (PRWEB) October 15, 2019

New Paradigm, New Era of Wellbeing is the theme of this years AT ONE International Festival at SANGHA Retreat by OCTAVE Institute in Suzhou, China. The festival will focus on redefining wellbeing, wellness, healthcare and integrative medicine.

The annual event, open to the public, brings together thought leaders and holistic practitioners from around the world to address scientific discoveries, the reemergence of ancient practices, and humanitys challenges of the 21st century. The festival pushes boundaries and celebrates life towards a common destiny for all humanity.

Founded by Frederick Chavalit Tsao, author of Quantum Leadership: New Consciousness in Business and Founder/Chairman of SANGHA Retreat by OCTAVE Institute, the three-day festival is a showcase of discovery, learning, fun and human connection. This year, a one-day conference will bring thought leaders together to challenge the status quo, inspire a new way of thinking, and share a vision of the essential oneness of the world. A new paradigm is needed for new world challenges, and in order to flourish, humans must learn to become the CEO of their own lives, says Tsao.

The festival begins with a forum for speakers and panelists, followed by the AT ONE International Conference where participants will discuss:

The three-day festival is open to the public Nov 15-17, offering 150 experiential learning activities designed to help formulate healthy living habits, connect to the soul, and lead towards mental and physical wellbeing. International, regional and local practitioners will join the festival to offer interactive workshops, master classes and lectures at SANGHA Retreat and AT ONE Healing Spa.

Last years festival was attended by 3,000 guests, with 400 participants at the International Conference. To register for this years event, visit https://www.atonefestival.com/conference-en/

SANGHA Retreat by OCTAVE Institute Located west of Shanghai on the outskirts of Suzhou, China, SANGHA Retreat combines Eastern philosophies backed by Western science to help people awaken to a life of greater purpose and personal wellbeing. With a focus on raising consciousness, it has been created for the need of our time by visionary Fred Tsao, fourth-generation steward of a family business that started in The Shanghai Bund before 1906.

The 47-acre retreat, designed by Tsao & McKown, includes AT ONE guest suites; AT ONE Clinic, offering comprehensive wellness assessments and wellbeing programs; AT ONE Healing Spa with extensive spa treatment menu and hydrotherapy circuit; THOUGHT FOR FOOD restaurant; the Meditation Dome; and a seasonal schedule of fitness activities and mindfulness classes designed around the bodys circadian rhythm.

For more information and reservations, visit sangharetreat.com. Reservations can also be made through Hidden Doorways Travel or a preferred travel agent.

OCTAVE Institute More than a school of life, OCTAVE Institute is a platform to help people find clarity, harmony and a new level of consciousness and freedom. It is comprised of SANGHA Retreat, the VILLAGE, and AITIA in Suzhou; and THE LIVING ROOM, an urban support center in Shanghai. The VILLAGE is a live-work-learn community for personal and communal learning, executive retreats, conferences, summits and festivals including the AT ONE International Festival, an annual, international festival that brings together thought leaders and holistic practitioners to address current issues. AITIA powers the communal programs at OCTAVE Institute. Together they create the foundation for growth towards a purposeful life, mindfully lived. http://www.octaveinstitute.com/

Media Contacts: Sheila Donnelly & Associates Babs Harrison | babs@sheiladonnelly.com Cassie Kim | cassie@sheiladonnelly.com

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Emmerdale’s Leah Bracknell dies aged 55 after brave battle with lung cancer – Mirror Online

October 18th, 2019 6:43 pm

After a battle with lung cancer, Emmerdale actress Leah Bracknell has died at the age of 55, her manager has announced.

In a statement they said: "It is with the deepest sadness that Leah Bracknell's family confirm that Leah passed away in September, three years after her diagnosis with stage 4 lung cancer.

"They would like to thank all the public for their support and generosity which contributed to the extension and quality of her life over the past three years.

"Leah continued to embrace life and faced her illness with positivity. Many aspects of her journey can be found on her blog.

"Leah was best known and much loved as Zoe Tate in Emmerdale.

"She also had roles in Judge John Deed, A Touch of Frost, The Royal Today and DCI Banks to name just a few, as well as numerous appearances on stage and in pantomime.

"As well as acting, Leah was also an accomplished yoga teacher and shamanic healer.

"Leah had an energy and enthusiasm for life, a kind heart and much love to give to those around her.

"Her family have asked for privacy at this very sad time."

After announced her diagnosis in September 2016, Leah said: I was feeling perfectly well, fit and healthy.

Teaching yoga classes and workshops, it was a time of new beginnings: preparing to move house, youngest child fleeing the nest, and excited to be starting rehearsals for a comedy play, being back onstage, going on tour.

But, it turns out that the universe had other plans. Life was about to be unexpectedly turned on its head.

I began to feel breathless climbing stairs ... I just put it down to a bit of stress.

"My abdomen suddenly ballooned - and within a matter of a few days I looked heavily pregnant.

"I could barely walk or breathe. Then, one Saturday night at the beginning of September I ended up in A&E.

Her Emmerdale co-stars immediately rallied around her at the time of the diagnosis, with Dominic Brunt, who played Paddy Kirk, saying: I visited my friend Leah. There is always hope.

In August 2017 it was announced her targeted biological therapy had stopped working and that she had been surviving solely on expensive alternative treatments for several months.

Her quest to undergo alternative treatments of immunotherapy and integrative medicine in Germany led many to dip into their pockets and donate to Leahs treatment. Within a few days, kind-hearted benefactors had donated 50,000.

Choosing not to say how long doctors had given her to live,Leah thanked everyone for their support and donations, saying in a statement: I really did not expect or feel deserving of such interest and kindness.

And, I want to thank everyone from the bottom of my heart for all the donations, the messages of encouragement, and for sharing the campaign.

I feel extremely blessed. We did not expect to raise anywhere near that amount, and certainly not in such a short space of time.

She remained positive and upbeat, and in 2019 she confirmed she was on an immunotherapy clinical trial which kept her cancer stable.

Leah remained hopeful of a cure, and credited her positive thinking with keeping her alive. Speaking in August, she said: "People think, Oh, shes crazy, but I believe in thinking outside the box.

"Medical science is an amazing thing and it is keeping me alive, but it has limitations because it is to do with the logical mind.

But things we call miracles, things we dont understand, happen all the time, they happen outside the realms of logic and scientific data.

"Nobody knows why they happen, but it is possible for the impossible to happen. I still hope I could get my impossible miracle.

"And if not, I am going to have a bloody good time along the way.

I dont need to go and fulfil a bucket list, thats not my style, I just want to do the things I want to do while I am healthy and strong, I wont let myself live in fear, Im just going to live a good life.

Leah was born Alison Rosalind Brachnell on July 12 1964 to the late English television director David Ian Bracknell and Chinese-Malaysian actress Li-Er Hwang. She grew up in London and Oxford and spent a year in New Zealand and Fiji.

First appearing on our screens in 1976 in TV show The Chiffy Kids, directed by her father, Leah joined ITVs Emmerdale as vet Zoe Tate in 1989 less than two years after attending the Webber Douglas Academy of Dramatic Art.

Playing the first lesbian character on a British soap, she was nominated for the 2002 National Television Award for Most Popular Actress, and won the 2006 British Soap Award for Best Exit after her character sensationally blew up Home Farm in a scene still remembered by fans.

After leaving the show, she turned to the stage, appearing in Gaslight and Strangers on a Train, before touring the 2008 production of Turn Of The Screw in the lead role of the governess.

Stepping out of the spotlight, she moved to Worthing, Sussex, and taught yoga and meditation, while also designing jewellery.

Leah is survived by her two daughters, Lily and Maya, from her marriage to Lyall Watson, and her partner, Jez Hughes.

Head of drama at Emmerdale John Whiston said: "Everyone is very sad to hear of the death of Leah Bracknell. Leah was a hugely popular member of the Emmerdale cast for over 16 years. During that time she featured in some of the show's most high profile and explosive plots and always delivered a pitch perfect performance.

"Zoe Tate was one of soaps first lesbian characters and Leah made sure the character was both exciting and credible. Leah herself was a very generous and caring colleague, much loved by cast and crew alike."

More here:
Emmerdale's Leah Bracknell dies aged 55 after brave battle with lung cancer - Mirror Online

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