Co-creation in health
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Only 16% of hospitals actively use social media

Only 16% of hospitals actively use social media | Co-creation in health |

Hospitals should beware employees on social media, not patients
A hospital without an engaging social media presence soon may be viewed with the same suspicion as a business that has no website,"

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Co-creation in health
E-citizens, e-patients, communities in shaping e-health, health literacy.
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Why Physicians Need ‘Right Compassion’

Why Physicians Need ‘Right Compassion’ | Co-creation in health |
To be effective in relieving suffering, doctors must strike a balance between paucity and excess of empathy.

As a young doctor working in the E.R. my capacity for compassion, and that of my colleagues, was often stretched; this was particularly the case when my patients could be said to have brought misfortune on themselves. I saw drug addicts suffering overdose, teenagers retching after self-poisoning, thieves injured through being arrested, all treated more brusquely than other theoretically more blameless patients.

I tried hard to maintain empathy, reflecting that the overdosed, self-poisoned and criminal may no more have brought their problems on themselves than those with skiing or horse-riding injuries or heart palpitations through overwork.

But it’s complicated: I’ve stitched up many slashed wrists cut not through willfulness but as a release from intense anguish; I’ve attended alcoholics for whom alcohol was clearly a substitute for love.

I may not have always succeeded, but I always hoped that my humanity, or my professional duty to provide a high standard of care, would step in when my compassion was running low.

NY Time  Opinion Pages


Via Edwin Rutsch
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Hybrid Pedagogy, Digital Humanities, and the Future of Academic Publishing 

Hybrid Pedagogy, Digital Humanities, and the Future of Academic Publishing  | Co-creation in health |

It is not enough to write monographs. It is not enough to publish. Today, scholars must understand what happens when our research is distributed, and we must write, not for rarified audiences, but for unexpected ones. New-form scholarly publishing requires new-form scholarly (digital) writing. Digital academic publishing may on the surface appear as a lateral move from print to screen, but in fact it brings with it new questions about copyright, data analysis, multimodality, curation, archiving, and how scholarly work finds an audience. The promise of digital publishing is one that begins with the entrance of the written, and one that concludes with distribution, reuse, revision, remixing — and finally, redistribution.

Digital publishing is a field worthy of rigorous research and deep discourse. In a post-print environment, for example, social media — Twitter, Facebook, Pinterest, WordPress, or Tumblr — have supplanted the static page as the primary metaphors for how we talk about the dissemination of information. Digitized words have code and algorithms behind them, and are not arrested upon the page; rather they are restive there.


Via Pierre Levy
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What to Do When You Get a New Boss Every Few Months

What to Do When You Get a New Boss Every Few Months | Co-creation in health |

In some workplaces, reorgs and personnel changes are constant, which means that you might be getting a new boss every few months. How do you develop an effective relationship with your manager when the person filling that role keeps shifting? How much of an investment should you make? How can you get what you need to succeed and grow in your role? And is maintaining continuity your responsibility?

What the Experts Say
Managing your relationship with your boss is challenging enough as it is. When that person changes every six months, the task becomes a lot more difficult—and time-consuming. “There’s a big part of work that is relational,” says Reb Rebele, an instructor in the Master of Applied Positive Psychology (MAPP) program at the University of Pennsylvania and co-author of “Collaborative Overload”. “You’re dealing with people on a regular basis, getting to know them, establishing norms, and establishing patterns. If your manager is constantly changing, you’re doing a lot of extra relational work and it’s a much bigger investment of your time and energy.” Priscilla Claman, the president of Career Strategies, a Boston-based consulting firm and a contributor to the HBR Guide to Getting the Right Job, agrees that having to cycle through new managers is “one of the world’s most frustrating things.” Your “impulse may be to duck and hide,” she says, but you must instead be proactive. It’s never easy to have several bosses in as many years, but there are ways to make this challenging situation more tolerable. Here are some tips.

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How to Pay for Health Care

How to Pay for Health Care | Co-creation in health |

The United States stands at a crossroads as it struggles with how to pay for health care. The fee-for-service system, the dominant payment model in the U.S. and many other countries, is now widely recognized as perhaps the single biggest obstacle to improving health care delivery.


Fee for service rewards the quantity but not the quality or efficiency of medical care. The most common alternative payment system today—fixed annual budgets for providers—is not much better, since the budgets are disconnected from the actual patient needs that arise during the year. Fixed budgets inevitably lead to long waits for nonemergency care and create pressure to increase budgets each year.

We need a better way to pay for health care, one that rewards providers for delivering superior value to patients: that is, for achieving better health outcomes at lower cost. The move toward “value-based reimbursement” is accelerating, which is an encouraging trend. And the Centers for Medicare & Medicaid Services (CMS), to its credit, is leading the charge in the United States.

That doesn’t mean, however, that health care is converging on a solution. The broad phrase “value-based reimbursement” encompasses two radically different payment approaches: capitation and bundled payments. In capitation, the health care organization receives a fixed payment per year per covered life and must meet all the needs of a broad patient population. In a bundled payment system, by contrast, providers are paid for the care of a patient’s medical condition across the entire care cycle—that is, all the services, procedures, tests, drugs, and devices used to treat a patient with, say, heart failure, an arthritic hip that needs replacement, or diabetes. If this sounds familiar, it’s because it is the way we usually pay for other products and services we purchase.

We need a way to pay for health care that fosters the delivery of superior value to patients.

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For patients, social media is much more than selfies and cat videos

For patients, social media is much more than selfies and cat videos | Co-creation in health |
Emerging social media sites targeting patients are increasingly playing a vital role in societal “information sharing” research announced today by the University of Warwick, Coventry, U.K.Sites such as HealthUnlocked in the U.K. allow patients to tap into a community with the same health challenges for moral support, shared information about health care providers and practical advice to manage their medical condition.

“People receive care from each other — moral support, encouragement, hope. A formal health system is not set up to offer this at a community level,” Eivor Oborn, professor of health care management at Warwick Business School and lead study author, told HCB News. “Chronic illness management is part of everyday life for an increasing number of people. Learning how to support each other … especially for behavior changes, such as weight loss … rather than relying only on professional advice, is important.”
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Should Your Driverless Car Hit a Pedestrian to Save Your Life?

Should Your Driverless Car Hit a Pedestrian to Save Your Life? | Co-creation in health |

People say that one day, perhaps in the not-so-distant future, they’d like to be passengers in self-driving cars that are mindful machines doing their best for the common good. Merge politely. Watch for pedestrians in the crosswalk. Keep a safe space.

A new research study, however, indicates that what people really want to ride in is an autonomous vehicle that puts its passengers first. If its machine brain has to choose between slamming into a wall or running someone over, well, sorry, pedestrian.

In this week’s Science magazine, a group of computer scientists and psychologists explain how they conducted six online surveys of United States residents last year between June and November that asked people how they believed autonomous vehicles should behave. The researchers found that respondents generally thought self-driving cars should be programmed to make decisions for the greatest good.


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Palliative care is not just for those who are dying

Ana Todorovic reflects on the things that helped her when facing the death of her unborn daughter Nadia

“There is no easy way to say this, but your baby is very, very sick.” I was 37 weeks pregnant, and they had just found our baby had severe dilated cardiomyopathy. The doctor thought she would die within days. He suggested injecting potassium in her heart, to be certain that she would not survive terribly impaired.

She kicked and squirmed inside me as I tried to wrap my mind around this, stunned with shock. It made no sense to take action. Could we not simply let her die in peace? He said this was not an option. But later—perhaps because I asked—we found palliative care mentioned in the discharge note.

And so at our …
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How Inequality Affects Our Health

How Inequality Affects Our Health | Co-creation in health |

The key factors that determine our health and mortality often lie outside the healthcare system, says Sir Michael Marmot, President of the World Medical Association. Just look at life expectancy in two different neighborhoods in the same city. In Baltimore's inner-city neighborhood of Upton/Druid Heights, a man's life expectancy is sixty-three; not far away, in the Greater Roland Park/Poplar neighborhood, life expectancy is eighty-three.

Poverty alone doesn't drive dramatic differences in health, but inequality does, argues Marmot. He talked to Leonard about why access to guns should be considered a public health issue, how poor education and healthcare affect life expectancy, and why, despite rampant inequality, he is still optimistic. His latest book is The Health Gap: The Challenge of an Unequal World.


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Doctors Who Take Money from Drug Companies Prescribe More Expensive Drugs

Doctors Who Take Money from Drug Companies Prescribe More Expensive Drugs | Co-creation in health |

When a doctor takes out his or her pad and writes a prescription, patients typically take it for granted that they are being guided towards the most effective medicine available for their problems, regardless of the price.

But a new study by ProPublica, the independent, non-profit news organization, discovered an intriguing finding: Doctors who receive payments from the pharmaceutical and medical device industries tend to prescribe brand-name medications far more than physicians who don’t accept payments, gifts or other honoraria.

Related: Ignoring Warnings, Drug Companies Hike Prices By 10 Percent

Moreover, the larger the payment, the more doctors tend to steer their patients to brand-name drugs instead of less expensive generic drugs that have essentially the same effect, the study found.

“Doctors who got money from drug and device makers—even just a meal– prescribed a higher percentage of brand-name drugs overall than doctors who didn’t, our analysis showed,” according to the report released on Thursday and authored by Charles Ornstein, Ryann Grochowski Jones and Mike Tigas. “Indeed, doctors who received industry payments were two to three times as likely to prescribe brand-name drugs at exceptionally high rates as others in their specialty.”


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Nuove strategie di approccio all’osteopatia pediatrica

Nuove strategie di approccio all’osteopatia pediatrica | Co-creation in health |

Siamo un piccolo gruppo di osteopati e amiche che si incontra regolarmente per scambiare idee, discutere casi clinici, trattare bambini con problematiche complesse ma soprattutto per consolidare il lavoro svolto negli anni e migliorare le strategie di approccio all’osteopatia pediatrica.

Vogliamo condividere questo percorso con chi è interessato, proponendo spunti che potranno essere personali o selezionati dalla letteratura. Invitiamo inoltre quanti si sentono coinvolti da questo progetto a sostenerlo inviando articoli o suggerimenti che saranno molto graditi e che verranno pubblicati ; sarà un modo per mantenere viva una piccola comunità di osteopati “dedicati” al mondo dell’infanzia e adolescenza.

Grazie a tutti quanti vorranno partecipare

              Christina Siegl, Antonella Braglia, Morena Cremonini

Potete inviare materiale al seguente indirizzo:

Per iscriversi a "Osteopatia pediatrica"


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This Woman Is Walking 1,000 Miles Topless For Beautiful Reason

This Woman Is Walking 1,000 Miles Topless For Beautiful Reason | Co-creation in health |

One woman is walking topless across the country to draw attention to the tough, but all-too-often hidden realities of breast cancer.

Paulette Leaphart is a breast cancer survivor, who had her breasts removed in a double mastectomy in 2014. On May 1, she began a 1,000-mile walk from Mississippi to Washington, D.C. — completely topless.

Her goal is to raise awareness about breast cancer, and to show other survivors that there is no reason to be ashamed of their scars.

“We have scars for a reason,” she says in the teaser for “Scar Story,” an upcoming film documenting stories of breast cancer. “They’re our story of survival. Scars let us know that hey, yes, I had cancer — and I kicked its ass.”

When pop star Beyoncé caught wind of Leaphart’s mission, she featured her in the video for her visual album “Lemonade,” according to Business Insider. The singer met Leaphart on set, and even offered to walk a mile of the journey beside her.


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Pharma payments influence doctor prescriptions

Pharma payments influence doctor prescriptions | Co-creation in health |

Pharmaceutical reps certainly haven’t wasted their time wining and dining doctors all these years.

A new analysis of payments made by drug makers to doctors shows that physicians who accept payments or other things of value from businesses, including meals, are more likely to prescribe name-brand medications than doctors who don’t rub elbows with pharma reps.

The analysis, conducted by ProPublica, a nonprofit investigative journalism site, found that doctors in five different fields were all more likely to prescribe name brands than generics. The correlation was significant.


For instance, internists who received more than $5,000 a year from the medical industry prescribed name brands 30 percent of the time, while their colleagues who had received no payments prescribed the higher priced drugs 20 percent of the time.

RELATEDCDC: Opioids are a last resort

The CDC says opioid treatment is no longer the starting point for chronic pain.

Family doctors who received more than $5,000 prescribed name brands 25.8 percent of the time, while those who didn’t receive payments did so 18.7 percent of the time.

Even ophthalmologists who didn’t receive a dime from pharma reps prescribed name brand drugs 46.4 percent of the time, but those who got more than $5,000 did so a whopping 64.6 percent of the time.

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La ricerca la decide il pubblico. di Francesca Cerati - In the past, scientists decided what health research would be done.
Now, YOU have a voice.

La ricerca la decide il pubblico. di Francesca Cerati - In the past, scientists decided what health research would be done.<br/>Now, YOU have a voice. | Co-creation in health |
Il concetto alla base di WellSpringboard, piattaforma di crowdsourcing e crowfunding, è quello di collegare direttamente i pazienti e le loro idee sulla ricerca con i ricercatori che possono realizzarle


“Vogliamo portare la voce del pubblico nel mondo della ricerca sanitaria, per dare risposte alle domande che sono più importanti per i pazienti di qualunque età e per le persone che si occupano di loro” – racconta Matthew M. Davis, ricercatore dell’Università del Michigan -. Allo stesso tempo vogliamo dare la possibilità ai ricercatori di scambiare idee che possono attirare l’attenzione del vasto pubblico e degli investitori”.

Da questa doppia volontà è nata la piattaforma di crowdsourcing e crowdfunding dell’Università del Michigan che, in pratica, chiede l’aiuto del pubblico per decidere le linee di ricerca, sostenere idee di altri in modo che acquistino valore e, una volta che un ricercatore accetta la presa in carico di un’idea, contribuire donando online o partecipando come volontario.

Un pannel composto da revisori esperti e membri del pubblico sceglie il vincitore che viene finanziato attraverso la piattaforma unica.

Il sito accoglie qualunque proposta, ma sono cinque le aree su cui si focalizza in particolare: cardiologia e oncologia infantile, disturbi del sonno, diabete, malattie intestinali infiammatorie come morbo di Crohn e colite.

“Sappiamo che il pubblico in generale, e in particolare i pazienti e le loro famiglie, possono essere una grande fonte d’ispirazione e di supporto per i nostri ricercatori – sottolinea Davis, alla guida del team che ha aiutato WellSpringboard a decollare – e la nostra piattaforma fornisce un nuovo modo per realizzare questi obiettivi”.

Piccole quantità di denaro che, insieme, possono fare accadere grandi cose. Il concetto alla base di WellSpringboard è quello di collegare direttamente i pazienti e le loro idee sulla ricerca con i ricercatori che possono realizzarle.

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I nemici della scienza - di Giovanni Bignami

I nemici della scienza - di Giovanni Bignami | Co-creation in health |

Giovanni Bignami - la Repubblica

PUGLIA, la ricreazione è finita. Lo ha detto la Ue al ministro delle Politiche agricole: entro trenta giorni si dia esecuzione all’ordinanza comunitaria, che ordina l’abbattimento di un numero limitato di ulivi, pena multe sempre più gravi. Science e Nature, le due riviste scientifiche più importanti del mondo, non hanno dubbi nell’imputare la colpevole inerzia italiana alla mancanza di fiducia del pubblico nella scienza, riflessa, ancor più colpevolmente, in inchieste giudiziarie per bloccare ogni azione degli scienziati competenti, anche contro il parere, stavolta chiaro e tempestivo, della Accademia dei Lincei.

A Modena, invece, incredibile battaglia tra genitori se fare vaccinare o no la figlia. L’incredibile non è che due genitori litighino, ma che il tribunale senta il bisogno di nominare dei periti (con grave perdita di tempo), dimostrando di prendere sul serio una posizione antiscientifica, andando anche contro le decisioni dell’Ordine dei Medici e della Regione. Sono due episodi che dimostrano un clima antiscientifico sempre più diffuso in Italia.
Negli Usa si chiama science denialism, il negazionismo della scienza. Nel Paese che venne pensato e fondato anche da scienziati, come Benjamin Franklin, e che è stato ed è un pilastro per la qualità, la quantità ed il peso politico della sua scienza, è uscito il libro drammatico: The War on Science. Racconta una realtà sempre più preoccupante.
Ricorderete la donna che ebbe quasi in mano i codici per scatenare la guerra nucleare, Sarah Palin. La bella Sarah, pur di mantenere la nascita del mondo a qualche migliaio di anni fa, si dice convinta, con prove fotografiche, che dinosauri e uomini coesistessero sulla Terra (i primi, come è noto, si sono invece estinti circa sessanta milioni di anni prima che comparissero i nostri antenati). E chissà se chiedessimo a Donald Trump… eppure il partito repubblicano non è sempre stato così. Negli anni 1920, un suo esponente di spicco fu Edwin Hubble, proprio l’uomo che fondò la moderna cosmologia osservativa.
Ma non è solo usando argomenti populisti o da setta religiosa, con un repertorio infinito e anche divertente di stupidaggini basate sulla paura, l’arroganza, la superstizione o semplice ignoranza, che si attacca la scienza. Anche grosse multinazionali, in evidente malafede, hanno cercato di propagare spettacolari falsità: “Allegria, non c’è pericolo di cancro al polmone se fumate, è tutto un complotto di medici comunisti...” ovvero: “Ma quale cambiamento climatico, l’uomo (e il petrolio che egli brucia) non fanno danni al pianeta...”. A ben altro livello, citiamo, con profondo rispetto, il Dalai Lama: «Se il Buddhismo è sbagliato e la scienza è giusta, deve essere il Buddhismo ad adeguarsi alla scienza ».
E nell’Italia di oggi, chi nega la scienza? Non solo chi crede negli oroscopi, cioè nel fatto che ogni mattina, complice la Rai, ci dividiamo in dodici squadre zodiacali, tutte destinate alla stessa giornata perché così dice l’oroscopo, comune a ciascun segno. È ridicolo, ma in fondo innocuo. C’è di molto peggio: anche da noi è in corso una deriva antiscientifica e gli esempi sono innumerevoli. Patetici, ma pericolosi, i casi Di Bella o Vannoni, alimentati dalla disperazione di chi soffre. Gravissimi anche altri casi di scellerate decisioni giudiziarie, come il condannare al “rimborso” chi ha vaccinato un bambino poi dimostratosi autistico ( perseverare diabolicum a Modena?), l’inquisire chi ricercava (bene, secondo l’Accademia dei Lincei e la Ue) sulla Xylella degli ulivi, o il trascinare per anni, per poi prosciogliere, Ilaria Capua dalla accusa di essere una “untrice”.
E via elencando nella galleria delle buffonate tragicomiche: si va dai complottisti che sanno tutto sul Dna come prova di giudizio, agli esperti (da bar/facebook) di Ogm, che non sanno di vivere già in un mondo geneticamente modificato da secoli, e per fortuna che lo è, se no saremmo tutti morti di fame. Dai social agli uffici giudiziari ai ministeri, ce n’è per tutti.
Certo, l’Italia ha scuse storiche per temere la scienza. La breccia di Porta Pia, la fine del potere temporale del Papa, è di solo un secolo e mezzo fa, e fu seguita da un occhiuto controllo della Chiesa su scuola e governi. Più grave il danno prodotto dagli epigoni di Benedetto Croce, che dava definizioni sprezzanti sulla matematica e chi la studia. A molte generazioni di italiani, me compreso, fu inculcato che non conoscere i classici è inaccettabile, ma non sapere di scienza è un vezzo da esibire.
Questa spaccatura nel Paese spiega, tra l’altro, il numero risibilmente basso di scienziati tra i 900 parlamentari, a parte i senatori a vita Cattaneo e Rubbia. Spiega anche la cronica disattenzione, governo dopo governo, nel costruire una popolazione di ricercatori italiani capaci di competere in Europa. A parte le brillanti eccezioni, sono i totali che contano: abbiamo la metà dei ricercatori necessari, e sono strangolati dalla dittatura della burocrazia ministeriale. Difficile rispondere ad una guerra senza le truppe e il loro rancio.
Per di più, oggi la scienza è confusa da molti con le sue applicazioni iperspecialistiche. Per fortuna c’è chi, come Piero Angela, sa attaccare a tutto campo il virus dell’antiscientismo, proponendo una visione della scienza dall’alto, forse senza troppi dettagli, ma unitaria e unificante, con attenzione alle ricadute sociali. Comunicare la scienza è imperativo quanto viverla, per poi invece fare, tutti insieme, la guerra all’ignoranza.
L’autore, presidente dell’Istituto nazionale di Astrofisica fino al 2015, è membro dell’Accademia dei Lincei
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How Not to Cut Health Care Costs

How Not to Cut Health Care Costs | Co-creation in health |

Health care providers in the United States and much of the rest of the world are trying to respond to the tremendous pressure to reduce costs. Many of their attempts, however, are counterproductive, ultimately leading to higher costs and sometimes lower-quality care.

What’s going on? Our findings show that to identify cost-cutting opportunities, hospital administrators typically work from the information that is most readily available to and trusted by them—namely, the line-item expense categories on their P&L statements. Those categories, such as personnel, space, equipment, and supplies, are attractive targets: Reducing spending on them appears to generate immediate results. But the reductions are usually made without considering the best mix of resources needed to deliver excellent patient outcomes in an efficient manner.

  • Mistake #1: Cutting Back on Support Staff
  • Mistake #2: Underinvesting in Space and Equipment
  • Mistake #3: Focusing Narrowly on Procurement Prices
  • Mistake #4: Maximizing Patient Throughput
  • Mistake #5: Failing to Benchmark and Standardize
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Les ePatientes, ces héroïnes

Les ePatientes, ces héroïnes | Co-creation in health |
Les ePatientes ? Courageuses. Audacieuses. Déterminées. Les ePatientes sont des patientes actives, émancipées, qui s’investissent dans la prise en charge de leur santé et font bénéficier d’autres patients de leurs connaissances.
Via Giovanna Marsico
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Enhancing compassion in general practice: it’s not all about the doctor

Enhancing compassion in general practice: it’s not all about the doctor | Co-creation in health |
‘ Patients were left lying in soiled sheets or sitting on commodes for hours. Some patients needing pain relief got it late or not at all. ’1 Such were the findings from the Mid Staffordshire Inquiry with recommendations for recruiting compassionate staff and having clinician compassion training.2 However, this call for compassion is not new. Medical codes of practice require us to practise with compassion. Compassionate care should be routine, a daily motivation and practice not unlike antisepsis and hand washing.

The crisis of compassion in medicine is multifaceted in origin and no universal panacea is likely to be found. Many of us cannot define compassion or articulate the differences between compassion and empathy. Others might argue that compassion training is redundant as doctors are either compassionate or not. We remain remarkably ignorant about compassion, unsure of what it is, where it comes from, or what might influence compassion in our practices.

Compassion comes from the Latin roots com , which means ‘together with’, and pati , ‘to bear or suffer’.3 Compassion is built on the capacity to empathise — a form of cognitive and emotional perspective taking — but involves the additional step of wanting to alleviate suffering.4 The distinction is important. An after-hours GP may recognise and feel the distress of a crying child having an asthma attack but, because he is now 30 minutes late in picking up his wife at the airport, rushes to the car park and lets colleagues manage the child. The family concerned might feel fobbed off and is unlikely to have experienced compassion as part of the clinical interchange. The doctor was empathetic but, technically, was not compassionate. Empathy without compassion is not only out of step with professional requirements but also is differentially likely to sustain negative …
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Pharmacist to Pharma: 7 Reasons I Thank You for Free Lunch!

Pharmacist to Pharma: 7 Reasons I Thank You for Free Lunch! | Co-creation in health |

I stand up for the rights of pharmaceutical companies to buy lunches or host dinners that are educational in nature. Academics, reporters, and politicians who fear this practice is driving up the costs of health care need to calm down and think differently.


As a pharmacist, I’ve gotten to know many pharmaceutical representatives over a sandwich. We talk about health care, drugs, side effects, and how to help patients. Those conversations are valuable to me, and I don’t mind the sandwich. 

Here are 7 reasons to relax about the free pharma lunch:

1. Most health care providers work long hours and don’t have much availability in their day-to-day schedules. Many are on call nights, holidays, and weekends. In spite of this, they have to remain on the cutting edge of medical science, including knowledge about new drugs. Therefore, it’s simply efficient to combine learning opportunities with meals. 

2. A health care provider’s time is extremely valuable. Every provider is needed at virtually all times. It’s all hands on deck every day to care for patients and save or improve lives.  As such, every minute spent “working” is important and valuable. A relatively inexpensive meal in exchange for 15 to 20 minutes of time is a bargain. 

3. The fact that prescribing frequency increases after engaging in lunch-and-learn sessions doesn’t mean that physicians wrote prescriptions out of guilt because they were given a free tuna fish sandwich, as they could afford their own lunch quite easily. The prescribing frequency could just as easily be tied to the education.

4. Providing a meal is a socially acceptable means for showing kindness and respect. If I want to thank you for your time, I might bake you a cake or cook you a casserole. You came over and fixed my computer? You’re getting a pizza. Sales representatives are responsible for educating prescribers in their territory through face-to-face meetings. A meal represents a tangible token of appreciation for their time.

5. Patients benefit when health care providers develop relationships with pharmaceutical companies. Many of these companies offer educational resources to patients and financial assistance to the uninsured or underinsured. But, getting these benefits to patients typically requires building relationships with providers. As a pharmacist, I can say I’m very grateful for some of the outstanding sales representatives I’ve gotten to know, because the services their companies offer are useful to my patients. Sometimes, these relationships have been built over a burger. Is that a crime?

6. Yes, it’s possible for incentives to go too far, but we’re talking about $18 to $20 meals, not lavish trips to the Swiss Alps.

7. Health care providers aren’t computers or machines. Learning takes time, and reminders about how a drug fits into the current recommended treatment regimen is appreciated. A drug representative gets to be an expert on a particular molecule, but we have to know all the molecules. So, spending a few moments with an expert on 1 specific drug helps reinforce best practices and treatment standards. 

Via Pharma Guy
Pharma Guy's curator insight, July 2, 7:36 AM

It seems some physicians value the sandwich more than the education. Read, for example, “When Big Pharma Paid for Lunch & Learn Sessions, Academic Physicians Showed Up on Time - Now, Not So Much!”;

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The measure of success

The measure of success | Co-creation in health |

When I was a Ph.D. student, a respected professor at our school had a heart attack in his office and died. As he was whisked away to the ambulance, I numbly watched familiar faces in the department succumb to shock. I didn't know it at the time, but this deeply troubling experience would shape my thinking about how to craft my academic career after I faced my own life-changing illness. While I was a postdoc, a sudden neurological disorder left me unable to walk, took my vision, and held me in the grip of vertigo and crushing migraines. With the help of a small army of health professionals, I began to improve. My brain started compensating for the lost neurons, and my muscles learned to fire again, but I don't know whether I will ever recover completely. This harsh reality check has made me think seriously about why academia promotes unhealthy work habits and how I can pursue the research I love while also taking care of myself.

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Se il dottore mangia bene
poi la pillola va giù. I medici prescrivono
ai loro pazienti i farmaci prodotti dalle
aziende che offrono loro pasti, feste,

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Researchers reveal the healthiest countries in Europe

Researchers reveal the healthiest countries in Europe | Co-creation in health |

With the knock-outs of the Euro 2016 championship underway, hosts France, ever-organised Germany and slick-passing Spain are tipped as favourites to lift the trophy

But how would the top nations fare in a similar competition based on health? 

An array of factors including air pollution, life expectancy and alcohol consumption were used to determine the healthiest countries on the continent.

Norway - who failed to even qualify in the football tournament - would be victorious at the European Championships of Health - if it was to ever take place - researchers have revealed.

In fact, the whole Scandinavian contingent scored highly, with Sweden ranked third, Denmark eighth and Finland 14th.

Switzerland was deemed the healthiest country to compete in the Euros this summer as they were awarded second place in the health rankings - despite missing out to Poland on penalties.

All factors included, Turkey was found to be the unhealthiest, despite having the lowest alcohol consumption rates in Europe by far.


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Can Big Pharma Actually Buy a Doctor’s Allegiance for a $20 Meal?

Can Big Pharma Actually Buy a Doctor’s Allegiance for a $20 Meal? | Co-creation in health |

“Every man has his price,” as the saying goes, but one has to wonder whether it only takes a $20 sandwich and bowl of soup for the drug industry to buy off many in the medical profession.


Doctors in recent years have come under intense scrutiny for the dubious practices of promoting pricey new brand name drugs after accepting trips, consulting fees and gifts from the pharmaceutical companies that manufacture them.


[Read “More Free Pharma Lunches Served to Docs = More Prescriptions of the Sponsored Drug”;]


There was a time when drug companies seeking to increase their share of the lucrative prescription drug industry were tossing around real money. Drug makers at one time lavished gifts and gratuities on doctors recruited to study and promote their new drugs, and those gifts could range from free golf trips and vacations to tickets to hot sports events


However, as The Wall Street Journal reported Tuesday, the drug companies over time began to curtail the gifts and gratuities handed out. Many restrictions were imposed on drug company payments under a code of conduct adopted in 2002 by the Pharmaceutical Research and Manufacturers of America, the drug industry’s leading advocate.


The code allows companies to provide “modest meals” to doctors, which can range from free book and beverages brought to a doctor’s office to free meals at restaurants where doctors can listen to other doctors and sales representatives discuss new drugs coming on the market, according to the Journal.


[However, there have been many breaches of such codes and some codes don’t include meals. Read, for example, “U.S. Seeks Records of 80,000 Novartis `Sham' Events for Doctors”; and "’Free Lunch Flaw’ Loophole in Aussie Pharma-Doc Code of Conduct”; ]


In the greater scheme of things, meals of this sort are small potatoes. And one has to wonder how such trivial perks can be so effective in motivating a doctor when it comes to prescribing the best medicine for a patient – or whether it is simply a coincidence.


[You might like to read: “The Slippery Slope of Pharma Physician Phreebies”; which argues that such thinking is a "slippery slope" on which "Physicians fail to recognize their vulnerability to commercial influences due to self-serving bias, rationalization, and cognitive dissonance."]


As ProPublica’s senior health care reporter Charles Ornstein noted in an analysis of the latest study, “The researchers did not determine if there was a cause-and-effect relationship between payments and prescribing, a far more difficult proposition, but their study adds to a growing pile of research documenting a link between the two.”


And PhRMA complained to the Journal that the study essentially “cherry picked” physician-prescribing data “to advance a false narrative.”

Via Pharma Guy
Pharma Guy's curator insight, June 25, 7:38 AM

Read “More Free Pharma Lunches Served to Docs = More Prescriptions of the Sponsored Drug”; 


Note: There have been many breaches of such codes and some codes don’t include meals. Read, for example, “U.S. Seeks Records of 80,000 Novartis `Sham' Events for Doctors”; and "’Free Lunch Flaw’ Loophole in Aussie Pharma-Doc Code of Conduct”; 


You also might like to read: “The Slippery Slope of Pharma Physician Phreebies”; which argue that "Physicians fail to recognize their vulnerability to commercial influences due to self-serving bias, rationalization, and cognitive dissonance."


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Un site internet pour faciliter la vie des patients atteints de maladies chroniques

Un site internet pour faciliter la vie des patients atteints de maladies chroniques | Co-creation in health |
C’est une première en France : les Hôpitaux de Paris (APHP) vont créer une communauté de patients atteints de maladies chroniques. Objectif : mieux comprendre leur vie quotidienne.


Diabète, asthme, sclérose en plaque, mucoviscidose, VIH, dépression : un Français sur cinq est atteint d’une maladie chronique. Pour eux, pas de guérison en vue, le traitement médical les suivra toute leur vie ! Leur vie, justement : comment s’accommode-t-on au quotidien de la lourdeur de ces traitements ? Pour répondre à cette question, l’APHP (Assistance Publique – Hôpitaux de Paris) vient de lancer un site internet, baptisé Cohorte-compare.

 « Le fait d’être malade devient quasiment un travail à temps plein pour le patient. » - Dr Dechartres, épidémiologiste

Grâce à cette plateforme, les chercheurs espèrent recruter 200 000 patients atteints d’une affection de longue durée, et les suivre pendant dix ans. Objectif : tenter de comprendre, grâce à des questionnaires réguliers, comment ils vivent et soignent leur maladie : « Il y a de plus en plus de patients qui présentent plusieurs maladies chroniques, cela représente pour eux un fardeau extrêmement important » explique le Dr Agnès Dechartres, épidémiologiste. « Le fait d’être malade devient quasiment un travail à temps plein pour le patient. C’est un concept qui nous intéresse énormément : on a besoin d’étudier l’impact de leur prise en charge sur leur vie quotidienne.

Faciliter et accélérer la recherche
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Pride in autistic diversity - The Lancet

Pride in autistic diversity - The Lancet | Co-creation in health |

The annual Autistic Pride Day falls every June 18, with an ongoing theme of neurodiversity. The pride label is intended to encourage a celebration of autistic differences, rather than reinforcing stereotypical perceptions of autism as a disease. Autistic Pride Day educates people directly from the experiences of autistic people themselves, and celebrates autistic lives inclusive of wide variation, aiming also to progress a recognition of the achievements of autistic people. Society is still some way from understanding and accepting the range of autistic differences, and changing attitudes is a necessary step towards enabling autistic people to lead fulfilling lives without discrimination, and allowing them to participate in and contribute to all aspects of society.

Autism spectrum disorders (ASD) are a set of diverse neural development variables that are characterised most commonly by difficulty with social interactions and behavioural difficulties. It is a spectrum that manifests in a range of presentations, and is increasingly described by the autistic community, and by some clinicians and researchers, as a condition rather than a disorder. Prevalence is 1–1·5% of the population (one in 68 children in the USA, according to the US Centers for Disease Control and Prevention), and has previously been thought more common in men and boys, although current debates suggest that this might be an effect of basing diagnosis on behaviour, which varies between sexes. Diagnoses centred on behavioural issues can lack precision, as behaviour may be suppressed, camouflaged, and normalised by autistic people in order to fit in and avoid social stigma.

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Chine: les effets tragiques de la publicité mensongère sur les patients - The Lancet

Chine: les effets tragiques de la publicité mensongère sur les patients - The Lancet | Co-creation in health |

On April 12, 2016, a 21-year-old man died in China, generating many reactions and questions. He had been diagnosed in 2014 with synovial sarcoma, a malignant tumour with no effective therapies.1, 2He searched for a treatment strategy on Baidu—the largest Chinese language search engine. An attractive therapeutic method based on bioimmunotherapy3 was displayed as the first search result, and brought hope for the patient and his family. After four treatment sessions, the family had spent most of their money, but the patient died. Some media companies reported that the advertisement for this treatment was false advertisement, because the alleged technical collaboration with a US university did not exist. Probably, similar tragedies occur every day.

Via Giovanna Marsico, Lionel Reichardt / le Pharmageek
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Cancer Incidence and Mortality Through 2020

Cancer Incidence and Mortality Through 2020 | Co-creation in health |
Preventing Chronic Disease (PCD) is a peer-reviewed electronic journal established by the National Center for Chronic Disease Prevention and Health Promotion. PCD provides an open exchange of information and knowledge among researchers, practitioners, policy makers, and others who strive to improve the health of the public through chronic disease prevention.
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