Better Living Through Well Being

Proponents of clinical guidelines produced in a process called Evidence-Based Medicine (EBM) claim their method relies on “objective” scientific evidence coming from well designed and conducted research. This sounds good, but neuroendocrinologist Hermann W. Borg, MD writes in the fall issue of the Journal of American Physicians and Surgeons that the objectivity of EBM is dubious as its final product of writing clinical guidelines is in fact a result of consensus between variously biased and opinioned experts. To make his point, Borg draws some compelling comparisons to a process used in medicine in Prussia during the era of the Enlightenment. Consensus is the basis of politics not science, he points out. The stated goals of the Prussian medical system appeared to be noble and benevolent, as do those of EBM, but in both schemes the decision-making process is being outsourced. It is removed from the individual patient-physician interaction. The system in Prussia during the Enlightenment had the effect of delaying the German renaissance in medicine until the beginning of the 20th century, Borg explains.

“Ordinary medical orthodoxy and peer pressure can have similar deleterious effects, even without committees writing ‘evidence-based’ guidelines,” Borg points out. He gives two classic examples. Viennese physician Semmelweis was criticized and rejected by his peers in 1847 for drawing a connection between the washing of hands by physicians before surgery and reduction of maternal fatalities following childbirth, in spite of the fact his practice reduced mortality rates from 30 percent to 1 percent. In another more recent example, Australian physicians Marshall and Warren showed that Helicobacter pylori is the cause of most peptic ulcers, but they were not believed because the medical books said bacteria could not survive in the stomach. Their evidence finally gained acceptance by the medical community and they were awarded the Nobel prize in 2005.

Borg’s cautions regarding the danger of EBM are worth a close look. History has already shown the Prussian medical system failed, but what the historical outlook on EBM for our current medical system will be remains to be seen, Borg says.

Other articles of interest in this Fall 2015 TMIS eNewsletter:

* Biometric wristbands may soon be available to “see inside” bodies of people with autism and predict behavior change.

* A cooperative award provides R&D funding to advance breakthrough molten salt technology to lower cost of 24-hour Concentrating Solar Power.

* Local government managers organization will establish a prominent national recognition program to energize local solar marketplaces.

* Author and therapist Debra M. Roberts gives couples and other significant relationships the simple tools they need to create better relationships with “The Relationship Protocol.”

I am grateful to be in a collaborative business with many talented and skilled professionals. Additional feedback and recommendations for our products and services at TM Information Services are always welcome.

- Mary Michele McLaughlin

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"Evidence-Based Medicine" Compared with Prussian "Enlightened Absolutism" in Journal of American Physicians and Surgeons
Tucson, Arizona

"Evidence-based medicine" has been elevated to the status of an obligatory "gold standard" of medical care. Physicians who deviate from the EBM "standard of care" are likely to be marginalized and face malpractice liability or even the ruin of their careers. In the fall issue of the Journal of American Physicians and Surgeons, Hermann W. Borg, M.D., draws some historic parallels to medicine in Prussia at the time of the Enlightenment.

"There are striking similarities between the culture of the early Enlightenment and today's post-modern digital revolution," he writes. There was rapid change, with empowerment of new groups, as knowledge became more widely available. This threatened the existing power structure. Outright suppression by force backfired. So the political aristocracy outwardly seemed to embrace the new ideas while covertly sabotaging and subverting them.

The Prussian model shows most clearly the effects of injecting political power into medical practice, Borg explains. The Prussian system conferred the title Geheim Rath (secret or confidential counsel) on persons of recognized professional achievement, who had great influence both inside and outside academia. "The main stated objectives were to improve the quality, effectiveness, and affordability of medical care throughout the kingdom," Borg writes, just like today. "This was supposed to be done by elimination of 'nonscientific' treatment methods through leveraging the expertise of accomplished physicians."

The guiding principle of EBM is also the old Prussian principle of "one elegant formula can solve all the problems," Borg states. Enlightenment theorists could not understand why medicine did not achieve spectacular advances like those in industry and agriculture. "Perhaps the idea that treating patients cannot be compared to making machines or farming did not occur to them," he suggests.

Instead of improving medical care, the Geheim Rath system caused chaos, fostered corruption and exploitation of young physicians, and promptly became fossilized and interfered with any innovations, especially those contradicting government dogma, he states.
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Organic Trade Association targets organic opportunities with state agricultural directors
Washington, DC

Organic Trade Association Executive Director and CEO Laura Batcha has told the National Association of State Departments of Agriculture (NASDA) that state agriculture directors are critical in the creation of much-needed policies that provide more choice and opportunity, including the organic option, in today's U.S. agricultural system. "This is a great time for farms of all sizes to look at how organic might fit into their operation," Batcha said. "The State Departments of Agriculture play a key role in developing and delivering sound public policy that supports diversity in agriculture, including the organic choice for farmers and ranchers of all sizes and backgrounds."

Batcha noted that organic farm-gate prices are in some cases two to three times higher than that for their conventional counterparts, and that combined with forecasted long-term growth for organic demand and the opportunity for stable contract and supply chain relationships, the organic option has never looked better. "The greatest challenge facing the $39.1 billion organic industry is how to meet the burgeoning demand for organic food with adequate supply of crops, ingredients, and feed. Imports of organic products outpaced exports, amounting to nearly $1.3 billion in 2014. This amounts to a 'Help Wanted' message for American farmers. Please support them when they answer this call," Batcha told the agricultural officials.
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Could a vaccine prevent cancer from spreading after surgery?
Toronto, Canada

A researcher in Ottawa has received a grant from the Canadian Cancer Society to investigate whether a vaccine could stop cancer from spreading after surgery. Dr Rebecca Auer, a scientist and surgical oncologist at The Ottawa Hospital, received a $450,000 grant to study this promising new therapy. Appreciating the potential impact of this study, a group of cancer organizations, the Canadian Cancer Society, the National Pancreatic Cancer Canada Foundation (NPCCF), Craig's Cause Pancreatic Cancer Society and the QEII Foundation, have teamed up to co-fund this work.

The main treatment for many types of cancer is surgery. In fact, more than half of all people with cancer will have some type of surgery to remove as much of the tumour as possible. But it can be challenging to find and remove all cancer cells. Unfortunately, sometimes cancer is more likely to spread after surgery, which is the problem that Dr Auer is addressing for pancreatic cancer. The trauma of surgery can weaken the immune system, rendering it less able to detect and destroy any leftover cancer cells. "The immune system is in a constant battle with the cancer," says Dr Auer, who is also an assistant professor at the University of Ottawa. "While surgery itself does not cause cancer to spread, it can lower immunity, giving any residual cancer cells a fighting chance to grow back and spread."

"I am delighted that the NPCCF is partnering with the Canadian Cancer Society, Craig's Cause and QEII Foundation in funding this innovative research for pancreatic cancer. Creating a vaccine that prevents cancer from spreading after surgery is very encouraging to those of us in the pancreatic cancer world," says Betty Aldridge, founder and past president, National Pancreatic Cancer Canada Foundation.

Currently there is nothing being done routinely to boost a patient's immune system to prevent cancer from spreading after surgery. To tackle this problem, Dr Auer has developed a vaccine containing oncolytic (or cancer-killing) viruses. This type of vaccine is intended to outsmart cancer cells, which often trick the immune system and escape detection. Oncolytic viruses are designed to safely travel through the body to seek out and destroy cancer cells while leaving normal cells intact. At the same time, the viruses can be engineered to strengthen the immune system to mount a powerful attack on cancer cells. It is this 2-pronged approach that makes the vaccine so promising.
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Female Doctors in Leadership Roles Report More Job Satisfaction Than Non-Leader Colleagues, According to New Medscape Survey
New York, New York

Female physicians, particularly those in leadership positions, report a higher degree of happiness in their professional and personal lives than non-leaders, according to results of Medscape's newly released "Women as Physician Leaders" report. The survey results, released during Women in Medicine Month and available to the public on Medscape.com, run counter to recent trends pointing to widespread professional dissatisfaction among physicians, and a presumption that work-life balance and gender bias concerns dissuade female physicians from valuing and aspiring to leadership roles. In fact, the results show that female physicians place high value on attaining a leadership role at work, and once there, report being "very happy" at work, even more often than non-leaders.

The results also suggest that female doctors pursue leadership roles more for altruistic reasons, such as effecting change and inspiring others, rather than strictly for career advancement.

The "Women as Physician Leaders" survey reflects responses from 3285 practicing female physicians about the challenges and opportunities they face in their careers. The poll was designed to measure similarities and distinctions between leaders (i.e., those who hold top positions in their practice or within a professional association or academic department) and non-leaders. More than half of respondents have held, or currently hold at least one leadership post.
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New Study Shows Only High-Powered Near-Infrared Light Regenerates Damage from Traumatic Brain Injury
Centennial, Colorado

Hailed as a "breakthrough" treatment for people suffering from the effects of traumatic brain injury (TBI), researchers have found a unique method of applying high-powered near-infrared light (NIR) that can penetrate the skin and skull to reach the damaged portions of the brain, and effectively accelerate regeneration of the brain cells' functionality with minimal skin irritation.

Published in the Neuropsychiatric Disease and Treatment, the study "Near-infrared photonic energy penetration: can infrared phototherapy effectively reach the human brain?" was conducted and authored by Theodore Henderson, MD, PhD and Larry Morries, DC, both based in Denver, Colorado and co-founders of the Neuro-Laser Foundation. The study compared penetration levels of low-power NIR, such as that from light-emitting diodes (LED) with high-power NIR on skin, bone, tissue and brain.
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Biometric Wristbands Could 'See Inside' Bodies of People With Autism and Predict Behaviour Changes
Manchester, England

Biometric technology which helps 'see inside' the bodies of those with autism by measuring minute physiological changes such as surface skin temperature and heart rate, could be commercially available in the form of simple wristbands within two to five years.

That's according to Dr Matthew Goodwin, a world-leading authority on wearable bio sensors who will present his research findings to delegates at Autech 2015, a conference on autism and technology in Manchester in October. Autech 2015 has been organised by charity Wirral Autistic Society to highlight key innovations - such as robotics and cloud-based technology - that have the power to transform the lives of people with autism.

People with severe autism, who are unable to communicate through words or body language, are apt to dramatic behavioural changes that include self injury, aggression, and running away. Through ten years of research in America, Goodwin, from Boston's Northeastern University, and a team of experts from universities across the US, have established that body signals may be able to predict these sometimes violent changes before they happen. This allows carers the opportunity to take appropriate action.

Dr Goodwin is working with a lightweight wristband, similar to a watch, which measures four physiological signals. Along with heart rate and skin temperature, it measures the amount of sweating at the surface of the skin and the three dimensional movements of the limb that's wearing the sensor (rapid, repetitive movements are often a sign of agitation in people with autism). He is also exploring ways to stream information from wristbands live to mobile phones, via an app. This would enable a family member or teacher to monitor closely the person they are caring for. A simple traffic light visualisation of colours could denote the level of agitation; red could be used as a warning of behavioural change. Blue could denote under-stimulation, or boredom.
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SolarReserve Receives Award From U.S. Department of Energy SunShot Initiative to Develop Advanced Design Concentrating Solar Technology
Santa Monica, California

SolarReserve, a leading global developer of utility-scale solar power projects and advanced solar thermal energy storage technology, announced today that it is the recipient of a CSP APOLLO program award from the U.S. Department of Energy SunShot Initiative.

The Concentrating Solar Power: Advanced Projects Offering Low LCOE Opportunities (CSP: APOLLO) program funds research and development (R&D) projects to improve the performance and increase the efficiency of all components of CSP plants, ultimately lowering the cost of solar electricity and producing affordable, clean and renewable energy, even at night, by storing the heat generated by the sun.

SolarReserve will co-fund the solar technology advancements along with $2.4 million in funding from the Energy Department, and will work with the University of California, San Diego and Trex Enterprises Advanced Materials Group to benefit from their expertise in selective absorber coatings and ceramic production, respectively.

"We are excited to participate in the SunShot Initiative and aggressively drive innovation that will deliver affordable clean energy to American homes and businesses," said Kevin Smith, SolarReserve's CEO. "Through this award, we can help make lasting change and further CSP's ability to replace traditional forms of electric power generation in terms of functionality, energy storage, and lower costs."

SolarReserve's U.S.-developed CSP technology with molten salt energy storage captures and stores the sun's power to reliably provide electricity whenever it's needed most, even after the sun has set. Thousands of tracking mirrors called heliostats follow the sun throughout the day and reflect and concentrate sunlight onto a large heat exchanger called a receiver that sits atop a central tower. Within the receiver, molten salt flows through piping that forms the external walls, absorbing the heat from the concentrated sunlight. After passing through the receiver, the high temperature molten salt flows down the piping inside the tower and into an insulated thermal energy storage tank. When electricity is required, day or night, the high temperature molten salt is passed through a steam generation system to produce high-quality superheated steam to drive a standard steam turbine at maximum efficiency, generating electricity. The steam generation process is identical to the process used in conventional gas, coal or nuclear power plants, except that it is 100 percent renewable with zero harmful emissions or waste and zero fossil fuel.
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ICMA to Lead SunShot Initiative Program Recognizing Communities for Solar Progress
Washington, DC

The International City/County Management Association (ICMA), the professional and educational organization for appointed local government managers, administrators, and assistants announced today that it is the prime recipient of a multi-year cooperative agreement with the U.S. Department of Energy SunShot Initiative.

The new award, part of the Solar Powering America by Recognizing Communities (SPARC) program, will establish a prominent national recognition program to energize local solar marketplaces. Building on SunShot's success in community-focused solar efforts, the SPARC program will qualify at least 300 leading communities that seek to achieve designation and engage hundreds more through robust competitions and awards initiatives.

By awarding local governments with a "stamp of approval" for their efforts in building stronger solar environments around the country, this program will help encourage the adoption of best practices in solar soft cost areas, such as permitting, inspection, and interconnection. The SPARC program supports the goals of the SunShot Initiative to make it faster, cheaper, and easier to go solar.

"The role of local governments in building stronger and more resilient communities has never been more apparent," said ICMA Executive Director Robert J. O'Neill, Jr. "As one of the nation's largest consumers of electricity, our cities, towns and counties have the opportunity to make an impact on the financial, environmental, and economic health of the country by adopting solar energy technologies."

The SPARC program awards and competitions will celebrate communities and other stakeholders that break new ground, make remarkable progress, and develop new innovations, signaling to the marketplace that participating communities are market ready for solar jobs and economic activity.
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"The Relationship Protocol" Receives Praise, Takes 4th Place in 2015 Readers Favorite International Book Contest
New York, New York

"The Relationship Protocol: How to Talk, Defuse and Build Healthier Relationships," by Debra M. Roberts, LCSW, won 4th place in the 2015 Readers Favorite International Book Contest, earning an Honorable Mention in the Nonfiction Relationships category, amongst hundreds of other entries.

Author and therapist Debra M. Roberts, LCSW believes that everyone wants simpler and more satisfying relationships. In her book, she describes The Relationship Protocol model (also known as the RP). Roberts' encourages readers to shift their thinking, and "turn toward" the other person in the relationship, to not be so "I", or "Me" focused, but make it more about the "Us and We," a relationship perspective. She emphasizes the importance of intentions, giving the benefit of the doubt and being kind. Roberts believes that if you approach and/or respond differently, you can change the outcome of an interaction and even an entire relationship. She has seen the Relationship Protocol model make a big difference in relationships quickly, because, as she says, "It's not rocket science, it's based on practical and simple concepts, nothing fancy or too psychological."

Roberts has been using the RP model successfully in her private practice for over 20 years. She says that most people are uncomfortable or ill equipped to deal with conflicts in their relationships. Roberts explains "Look at it this way, conflicts and problems are inevitable in all close relationships -- wouldn't it be nice to have basic tools for navigating through those conflicts while at the same time building a stronger relationship? That's the Relationship Protocol!"
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More Patient Empowerment = More Successful Clinical Studies: World's First Clinical Study Matching Software for Patients
Newtown, Pennsylvania

Optimal Strategix Group (OSG) has announced that the company's CAVII app is ready for download in the Apple App Store. CAVII is the world's first iOS-based clinical study matching and analytics platform. Ushering in a new era of patient engagement, CAVII's aim is to revolutionize clinical studies through the use of analytics for superior patient matching. Through CAVII, clinical studies become more cost-effective, efficient, and ultimately more engaging and insightful for patients and clinicians.

Commenting on the launch, Giri Iyer, OSG's EVP of Analytics stated, "There's a simple truth about global healthcare: all of us will be patients in the future, and hopefully we'll enjoy more and more advanced solutions. However, studies show that an average clinical studies costs upwards of $2.5B dollars, and barely 10% of the clinical studies finish on time. 50% of patients in the US simply don't know about clinical studies or how to sign up for one, leading to a massive problem with proper patient recruitment. Our mission with CAVII is to get patients worldwide involved in clinical studies, using analytics and a big data platform that OSG has developed. CAVII allows users to import their health data from thousands of top hospitals and medical facilities in the US (an estimated 150 million electronic medical records) thanks to our partner, HumanAPI and their tremendous expertise."

Ashvanni Srivastava, Executive Vice President of OSG's Healthcare Practice, believes that CAVII will help ring in a new era of cost-effective patient controlled healthcare. Mr. Srivastava, stated "Given the enormous expense involved with clinical studies, a 1% improvement in the current bureaucracy-heavy studies process will save the average Pharmaceutical Company $20-30M a year. CAVII will put tools in the hands of patients so that they can manage their own studies journey, delivering a beneficial and cost-effective result for patients, clinicians, and pharma companies."
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Mayors Sign Proclamation and Pledge to Reduce Climate Risks
Dubuque, Iowa

U.S. mayors have made a historic commitment to take action to reduce climate risks and protect the future of their communities. The Midwestern mayors, from St. Louis to St. Paul, Dubuque, and others, signed the The Path to Positive Proclamation to pledge their leadership, prepare for climate change, and promote solutions that advance prosperity for their cities, towns, and citizens.

"I signed the Proclamation today to show I am committed to building a better future for the citizens of my community, and ensure the Mississippi River Basin continues to be a stable resource for the more than $400 billion in GDP it drives for our country. The River is a keystone that supports our nation's infrastructure. With the increases in extreme heat, flooding, and catastrophic storms we have witnessed, it's clear that preparing for a different future is imminent," said Hyram Copeland, Mayor of Vidalia, LA, and Co-Chair of the Mississippi River Cities & Towns Initiative.
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