”You only live once, but if you work it right once is enough.” – Joe E. Lewis "As soon as man does not take his existence for granted, but beholds it as something unfathomably mysterious, thought begins." – Albert Schweitzer
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posted Feb 27, 2012 11:58 PM by Christoph Sandler
Years ago, Charlie, a highly respected orthopedist and a mentor of mine, found a lump in his stomach. It was diagnosed as pancreatic cancer by one of the best surgeons in the country, who had developed a procedure that could triple a patient's five-year-survival odds—from 5% to 15%—albeit with a poor quality of life.
Charlie, 68 years old, was uninterested. He went home the next day, closed his practice and never set foot in a hospital again. He focused on spending time with his family. Several months later, he died at home. He got no chemotherapy, radiation or surgical treatment. Medicare didn't spend much on him.
It's not something that we like to talk about, but doctors die, too. What's unusual about them is not how much treatment they get compared with most Americans, but how little. They know exactly what is going to happen, they know the choices, and they generally have access to any sort of medical care that they could want. But they tend to go serenely and gently.
Doctors don't want to die any more than anyone else does. But they usually have talked about the limits of modern medicine with their families. They want to make sure that, when the time comes, no heroic measures are taken. During their last moments, they know, for instance, that they don't want someone breaking their ribs by performing cardiopulmonary resuscitation (which is what happens when CPR is done right).
In a 2003 article, Joseph J. Gallo and others looked at what physicians want when it comes to end-of-life decisions. In a survey of 765 doctors, they found that 64% had created an advanced directive—specifying what steps should and should not be taken to save their lives should they become incapacitated. That compares to only about 20% for the general public. (As one might expect, older doctors are more likely than younger doctors to have made "arrangements," as shown in a study by Paula Lester and others.)
Why such a large gap between the decisions of doctors and patients? The case of CPR is instructive. A study by Susan Diem and others of how CPR is portrayed on TV found that it was successful in 75% of the cases and that 67% of the TV patients went home. In reality, a 2010 study of more than 95,000 cases of CPR found that only 8% of patients survived for more than one month. Of these, only about 3% could lead a mostly normal life.
Unlike previous eras, when doctors simply did what they thought was best, our system is now based on what patients choose. Physicians really try to honor their patients' wishes, but when patients ask "What would you do?," we often avoid answering. We don't want to impose our views on the vulnerable.
The result is that more people receive futile "lifesaving" care, and fewer people die at home than did, say, 60 years ago. Nursing professor Karen Kehl, in an article called "Moving Toward Peace: An Analysis of the Concept of a Good Death," ranked the attributes of a graceful death, among them: being comfortable and in control, having a sense of closure, making the most of relationships and having family involved in care. Hospitals today provide few of these qualities.
Written directives can give patients far more control over how their lives end. But while most of us accept that taxes are inescapable, death is a much harder pill to swallow, which keeps the vast majority of Americans from making proper arrangements.
It doesn't have to be that way. Several years ago, at age 60, my older cousin Torch (born at home by the light of a flashlight, or torch) had a seizure. It turned out to be the result of lung cancer that had gone to his brain. We learned that with aggressive treatment, including three to five hospital visits a week for chemotherapy, he would live perhaps four months.
Torch was no doctor, but he knew that he wanted a life of quality, not just quantity. Ultimately, he decided against any treatment and simply took pills for brain swelling. He moved in with me.
We spent the next eight months having fun together like we hadn't had in decades. We went to Disneyland, his first time, and we hung out at home. Torch was a sports nut, and he was very happy to watch sports and eat my cooking. He had no serious pain, and he remained high-spirited.
One day, he didn't wake up. He spent the next three days in a coma-like sleep and then died. The cost of his medical care for those eight months, for the one drug he was taking, was about $20.
As for me, my doctor has my choices on record. They were easy to make, as they are for most physicians. There will be no heroics, and I will go gentle into that good night. Like my mentor Charlie. Like my cousin Torch. Like so many of my fellow doctors.
By Dr. Ken Murray, a retired clinical assistant professor of family medicine at the University of Southern California. Adapted from an article originally published on Zocalo Public Square.
Source: The Wall Street Journal |
posted Feb 20, 2012 5:21 AM by Christoph Sandler
"Social networks like Facebook, Twitter and Path [...] are free services in which we are actually the product that these businesses are selling to advertisers"
Nick Bilton
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posted Dec 7, 2011 3:53 AM by Christoph Sandler
"I found out three weeks ago I have cancer. I'm 49 years old, have been married for almost 20 years and have two kids. My husband has his own small computer business, and I run a small nonprofit in the San Fernando Valley. I am also an artist. Money is tight, and we don't spend it frivolously. We're just ordinary, middle-class people, making an honest living, raising great kids and participating in our community, the kids' schools and church.
We're good people, and we work hard. But we haven't been able to afford health insurance for more than two years. And now I have third-stage breast cancer and am facing months of expensive treatment.
To understand how such a thing could happen to a family like ours, I need to take you back nine years to when my husband got laid off from the entertainment company where he'd worked for 10 years. Until then, we had been insured through his work, with a first-rate plan. After he got laid off, we got to keep that health insurance for 18 months through COBRA, by paying $1,300 a month, which was a huge burden on an unemployed father and his family.
By the time the COBRA ran out, my husband had decided to go into business for himself, so we had to purchase our own insurance. That was fine for a while. Every year his business grew. But insurance premiums were steadily rising too. More than once, we switched carriers for a lower rate, only to have them raise rates significantly after a few months.
With the recession, both of our businesses took a huge hit — my husband's income was cut in half, and the foundations that had supported my small nonprofit were going through their own tough times. We had to start using a home equity line of credit to pay for our health insurance premiums (which by that point cost as much as our monthly mortgage). When the bank capped our home equity line, we were forced to cash in my husband's IRA. The time finally came when we had to make a choice between paying our mortgage or paying for health insurance. We chose to keep our house. We made a nerve-racking gamble, and we lost."
Read the full article (Source: Los Angeles Times)
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posted Nov 29, 2011 10:57 AM by Christoph Sandler
Neuron transplants have repaired brain circuitry and substantially normalized function in mice with a brain disorder, an advance indicating that key areas of the mammalian brain are more reparable than was widely believed.
Collaborators from Harvard University, Massachusetts General Hospital (MGH), Beth Israel Deaconess Medical Center (BIDMC) and Harvard Medical School (HMS) transplanted normally functioning embryonic neurons at a carefully selected stage of their development into the hypothalamus of mice unable to respond to leptin, a hormone that regulates metabolism and controls body weight. These mutant mice usually become morbidly obese, but the neuron transplants repaired defective brain circuits, enabling them to respond to leptin and thus experience substantially less weight gain.
Repair at the cellular-level of the hypothalamus — a critical and complex region of the brain that regulates phenomena such as hunger, metabolism, body temperature, and basic behaviors such as sex and aggression — indicates the possibility of new therapeutic approaches to even higher-level conditions such as spinal cord injury, autism, epilepsy, ALS (Lou Gehrig’s disease), Parkinson’s disease, and Huntington’s disease.
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posted Nov 29, 2011 8:26 AM by Christoph Sandler
Growing up in gritty East San Jose, Calif., Gurbaksh Chahal struggled to fit in. Emigrating from India with his family at age 4, he wore a traditional head covering for Sikh children called a patka to school. It was just one cultural difference that his pint-sized peers bullied him about. But instead of succumbing to what he recalls as a "wild, wild west for minorities," Chahal leaned into his close-knit family for the strength that would become his entrepreneurial fuel.
He dropped out of high school at 16, started a business and never looked back.
Fascinated by online advertising and the "concept of a click," Chahal founded ClickAgents in December 1998. Less than two years later, he sold it for $40 million. Staying hungry for growth, he started online advertising network BlueLithium in 2004. Yahoo Inc. bought it within three years for $300 million. The latest entrepreneurial venture for Chahal, now 29, is RadiumOne, a fast-growing ad network that leverages social data on the Web.
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posted Nov 22, 2011 6:54 AM by Christoph Sandler
A new generation of contact lenses that project images in front of the eyes is a step closer after successful animal trials, say scientists.
The technology could allow wearers to read floating texts and emails or augment their sight with computer-generated images, Terminator-syle.
Researchers at Washington University who are working on the device say early tests show it is safe and feasible.
But there are still wrinkles to iron out, like finding a good power source.
Currently, their crude prototype device can only work if it is within centimetres of the wireless battery.
And its microcircuitry is only enough for one light-emitting diode, reports the Journal of Micromechanics and Microengineering.
But now that initial safety tests in rabbits have gone well, with no obvious adverse effects, the researchers have renewed faith about the device's possibilities.
They envisage hundreds more pixels could be embedded in the flexible lens to produce complex holographic images.
For example, drivers could wear them to see journey directions or their vehicle's speed projected onto the windscreen.
Similarly, the lenses could take the virtual world of video gaming to a new level.
They could also provide up-to-date medical information like blood sugar levels by linking to biosensors in the wearer's body. Delicate materials
Lead researcher Professor Babak Praviz said: "Our next goal is to incorporate some predetermined text in the contact lens."
He said his team had already overcome a major hurdle to this, which is getting the human eye to focus on an image generated on its surface.
Normally, we can only see objects clearly if they are held several centimetres away from the eye.
The scientists, working with colleagues at Aalto University in Finland, have now adapted the lenses to shorten the focal distance.
Building the end product was a challenge because materials used to make conventional contact lenses are delicate.
Manufacturing electrical circuits, however, involves inorganic materials, scorching temperatures and toxic chemicals. Researchers built the circuits from layers of metal only a few nanometres thick, about one thousandth the width of a human hair, and constructed light-emitting diodes measuring one third of a millimetre across.
Dr Praviz and his team are not the only scientists working on this type of technology.
A Swiss company called Sensimed has already brought to market a smart contact lens that uses inbuilt computer technology to monitor pressure inside the eye to keep tabs on the eye condition glaucoma.
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posted Nov 21, 2011 9:13 AM by Christoph Sandler
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updated Nov 21, 2011 9:15 AM
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The most influential business thinker on earth right now is Clayton Christensen, according to Thinkers 50, a just-released ranking done every two years by the consulting team Crainer Dearlove.
The top runners-up, sharing the No. 2 spot: W. Chan Kim and Renée Maborgne, two professors at INSEAD business school whose book Blue Ocean Strategy lays out a system for developing and executing large-scale plans that has been adopted by businesses, nonprofits, and governments worldwide.
No. 3 is Prof. Vijay Govindarajan, a professor at the Tuck School of Business at Dartmouth. He is known for his theory of reverse innovation and has been chief innovation consultant to General Electric.
4. Jim Collins, former Stanford professor and author most recently of Great by Choice.
5. Michael Porter, Harvard professor and creator of the Five Forces Framework.
6. Roger Martin, dean of the Joseph L. Rotman School of Management, in Toronto, and author most recently of Fixing the Game.
7. Marshall Goldsmith, executive coach and author of books including What Got You Here Won’t Get You There.
8. Marcus Buckingham, consultant whose books include First, Break All the Rules and Now Discover Your Strengths.
9. Don Tapscott, author of Wikinomics: How Mass Collaboration Changes Everything and Macrowikinomics: Rebooting Business and the World.
10. Malcolm Gladwell, the New Yorker writer, whose books include The Tipping Point, Blink, and Outliers.
Read the full article |
posted Nov 8, 2011 7:12 AM by Christoph Sandler
Pretty cool video on the little conveniences of the future ...
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posted Jan 27, 2011 1:25 AM by Christoph Sandler
Sometimes this very useful website URL slips off my mind, so I am posting it here for easy reference:
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posted Nov 15, 2010 4:40 AM by Christoph Sandler
In terms of robotics and use of robots in the healthcare setting, Japan is in many aspects leading the way. Already today robots can mow the lawn, clean or play soccer. Next robots shall take of the elderly in Japan.
One successful example of such caring robot was the development of Paro. This electronic seal is already deployed at various nursing homes in Japan and other countries.
Michael Funk, Technical University Dresden, states: "Yes, maybe we Europeans could learn something from the Japanese, why not".
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