jenuesse health

Watching the recent angry back-and-forth between Russian President Putin and Turkish President Erdogan has caused many of my friends in the medical world to wonder: Why do high ranking national officials stoop to apparently immature approaches in their disputes, approaches that might lead to an expansion of a conflict to something that neither party wants? And then I remind them of behavior they have witnessed between senior doctors in their hospitals' operating rooms, intensive care units, and treatment floors. Sheepish looks quickly follow. There is a school of thought that suggests that your effectiveness as a negotiator is enhanced when you display anger. Professor Alison Wood Brooks at Harvard Business School presents the alternative view in a recent HBR article : [T]here’s a body of research . . . that documents the consequences of feeling angry while negotiating. This research shows that anger often harms the process by escalating conflict, biasing perceptions, and making i...

How many people do you know who've bought a Fitbit or similar device to track their exercise patterns--who have then let the whole venture lapse? The Fitbit now resides comfortably and peacefully in their drawer! Well, there's a useful way to recycle them, offered by Tufts University professor Lisa Gulatieri. As noted in this article : Gualtieri started RecycleHealth in April with the goal of giving unused activity trackers — mostly Fitbits so far, but RecycleHealth accepts all devices — a second life. The company has collected about 20 devices so far and has plans to donate them to the Montachusett YMCA in Fitchburg, Massachusetts, where they will be used to help older and lower income individuals have access to devices, as well as to learn about how those populations interact with activity trackers. Check out the Facebook page for stories on how the idea is spreading, plus more information, including how to get free mailing labels.

Just in time for Thanksgiving preparation, I ran into Maria Speck the other day, and we started talking about ancient grains.  She published her second cookbook on the topic a few months ago, and I've now had a chance to look through it. Beyond some really beautiful pictures by Erin Kunkel, there's lots to view in this compendium.  Of course there's background information from amaranth to wild rice, with stops along the way for freekeh, millet, sorghum, and more.  We learn, too about the absorption method of cooking, contrasted with the pasta method and others.  Should we rinse?  Soak? Toast?  How do we know when it's done?  There are handy charts with cooking times, so we can be more secure about planning ahead. And then, of course, the recipes. By the dozen, in all kinds of categories. This encyclopedia is a joy to read.  I'm looking forward to sampling its contents.

In her day job, Susan Hackley is chief administrative and financial officer for the Harvard Program on Negotiation, but her prior experience in a variety of public policy and other positions offers her a crisp view on many issues facing the country and the world.  She decided to devote her observational skills to a new project, "A Child's Guide to War," when she realized that for American children aged 13 and younger, we have been at war their entire lives. As noted : A Child’s Guide to War is a documentary film project that is helping to bridge the civilian–military divide in the United States. A wide gulf exists in America between those who have served in the military and their families and those who haven’t. While respect for the military is high, real knowledge is not. luminesce skin care Through the film, a public television program, teaching materials and public meetings we are hosting, we will help Americans better understand the role of the military in our d...

How's this for a lesson plan? Serendipity is allowed . . . and even encouraged. It is a philosophy set forth by Ed Moriarty , an instructor at MIT's Edgerton Center.  Opening the doors of the strobe lab for "that Saturday thing," as it is called by the students, Ed provides mentorship and asks challenging questions of children and adults of all ages who drop by to play and experiment. Here is learning at its most creative, combining physical manipulation of electrical components with thoughtful observation.  There is no syllabus, just the joy of learning. We were giving some friends a tour of MIT and we had explained that the philosophy of play is an important component of life at MIT.  We walked by the strobe lab at an opportune moment and were immediately hijacked by Ed. He said, "Hey, come in here. I want to show you some stuff." He borrowed a circuit that eight-year-old Amelia had constructed and asked us, "What kind of shadow is created when you ...

As turmoil continues around the world, back here in Massachusetts there's been a kerfuffle surrounding Governor Charlie Baker's remarks about limiting Syrian refugees' access to the state. Several of us, including me , we appalled by what he said. Among those was US Representative Seth Moulton.  Moulton's criticism was, in turn, deemed partisan by the Governor, an accusation Moulton roundly denied. The Governor, too, said that his remarks had been taken out of context, and he appeared upset that he had been accused of a lack of compassion. Indeed, he declined to sign a letter from other Republican governors asking President Barack Obama to suspend efforts to resettle Syrian refugees in the U.S. A friend on Facebook noted, with regard to this last item: At least our governor is intelligent enough to listen to his constituency. And it shows we can push him on things, which is a good thing. Bravo Baker for listening and learning from your people. The question that I a...

While I hate to promulgate stereotypes about any particular group of medical specialists, this short video is too good to leave without broader dissemination.

I've just finished editing the blog roll on the right hand side of my blog's home page.  I've deleted sites that have been inactive for six months or more.  If yours is no longer listed and you think it should be, please let me know.  Likewise, if you have a new (or old) blog to which I've not linked, please let me know.

Thanks to Brian Klepper for alerting me to this: Here's a poignant personal story about modern medicine from my friend Michael Millenson. Michael is a journalist who has played a significant role in ushering in the quality and safety movements in American health care. The lede: When I was a newborn — a preemie struggling to survive in a hospital nursery’s incubator — an article deep inside The Washington Post saved me from becoming blind. The article — on Page A22 — discussed research showing that too much oxygen in an incubator could cause babies to lose their sight. When my worried parents phoned the hospital, they were told doctors had also seen the piece and promptly adjusted the incubator’s air mixture. What none of them knew was that the sight in my right eye had already been destroyed by what is now called retinopathy of prematurity, or ROP. Fortunately, the vision in my left eye remained intact, saving me from a lifetime in the dark. That was way back in 1953...

As we approach the Thanksgiving holiday here in the US, I'm reminded that it is almost the anniversary of Monique Doyle Spencer's death.   Here's a repeat of a post from 2013.   I just found a few more copies of the book.  If you'd like one, free, just leave a comment with your full name and snail mail address. When Monique Doyle Spencer wrote The Courage Muscle, A Chicken's Guide to Living with Breast Cancer , she couldn't find a publisher willing to take the book on.  It was funny, you see, and all the publishers thought it was inappropriate to have a funny book about cancer.  She showed me a draft, and I said that our hospital would publish the book, and we did.  Since then, it has brought good-humored hope and advice to patients and families around the world.  As one reviewer said:  "It should become a textbook for the medical professions and a guidebook for all who must confront, or support those who do, breast cancer. It is a beautiful bo...

I've worked for a lot of governors and have known a lot of governors, and I have always appreciated their need to balance what they might want to say about an issue with the political realities of their job.  But the best of our leaders are the ones who rise above the exigencies of local politics and manage to display a sense of commitment to human needs and values during periods of political stress--and in so doing remind us that compassion is often the best antidote for fear and unrest. So it was with a tremendous sense of loss that I heard of Governor Charlie Baker's comments about Syrian refugees. Loss as in a lost opportunity to bring people together rather than being divisive. And lost admiration on my part as the Governor stooped to a level that I could never have imagined coming from his mouth. According to the Boston Globe , here's what he said: In the wake of the deadly terrorist attacks in Paris, Massachusetts Governor Charlie Baker has joined a group of nearly ...

There are a lot of terrible lessons that come from the sad case of Amy Reed and other women who have developed more widespread cancer as a result of morcellation of uterine growths. Here's a comment from a pathologist friend: I remember, when these morcellators first came out, saying to the gyn's that if a woman had an unexpected endometrial cancer, I would not be able to stage it because you can't tell how deep it went into the uterine wall when the uterus is in pieces. And yes, we were puzzled about the leiomyomas, too. We used to have a rule that you took so many microscopic sections per centimeter of leiomyoma (i.e. larger ones are more likely to be sarcoma) to look for sarcoma. But how could you tell how big it was or which one was which from pieces? We were ignored of course. It all goes back to how new things are introduced - there is no vetting process at all. Let's consider this deeply. Pathologists are highly trained MDs who specialize in the identific...

At his talk at Harvard last week , the Aga Khan reflected on the state of things in the world and spent a moment on the role of technology.  He noted one adverse result: The more we communicate, the harder it can sometimes be to evaluate what we are saying. More information often means less context and more confusion.  We were treated to a prime example of this during Saturday night's debate among the Democratic candidates for president.  As we watched the debate, we were presented with a visual hodgepodge.  The candidates were in the middle of the screen.  To the right was a semblance of a Twitter feed, showing real-time reactions to the debate from . . . .  Wait, from whom?  Who knows.  The chosen tweets were the ones some CBS functionary had decided were noteworthy enough to share with the millions of people viewing the debate.  Who were these chosen gods and goddesses of political observation, the ones whose 140-character notes were de...

The Aga Khan delivered the Samuel L. and Elizabeth Jodidi Lecture at Harvard University yesterday .  He has been a strong proponent of pluralism in the world and has devoted billions of dollars in resources from the Aga Khan Development Network to enhancing education, health care , culture, and economic development in the world's poorest countries in Asia, Africa, and the Middle East. The full text is here , but I offer a pertinent excerpt, with lessons about an increasingly divisive level of political debate in the US and elsewhere: In looking back to my Harvard days (in the 1950s), I recall how a powerful sense of technological promise was in the air — a faith that human invention would continue its ever-accelerating conquest of time and space. I recall too, how this confidence was accompanied by what was described as a “revolution of rising expectations” and the fall of colonial empires. And of course, this trend seemed to culminate some years later with the end of ...

I came across this cartoon on Facebook (with thanks to UK surgeon Isam Osman) and it prompted me to write about a trend I've noticed while refereeing youth soccer games. I've seen a tendency for younger and younger players to imitate the bad behavior that is evident in professional matches.  By younger, I mean nine-year-old boys.  What kind of behavior?  The first set are comments or complaints about the referee's calls (or non-calls).  "Didn't you see that?" is one comment. Or, on the other side, when a player is whistled for a foul, the "What me?" reaction is more and more prevalent. The second set--per the cartoon above--is a tendency to "take a fall" when gently nudged, in the hope the referee will call a foul against the other team and issue a free kick to the "aggrieved" party. It used to be the case that you didn't see this stuff until the boys were a bit older. Now, the little boys have learned it. Of course, these tac...

Unclear about whether sex is consensual? The issue is presented in a crystal clear manner in this video, compairing sex to drinking a cup of tea. According to Metro , the advert is part of the #ConsentisEverything campaign being launched by Thames Valley Police. "If they're unconscious, they don't want tea," is an example of the advice. Here's the video .

I think we're all a bit gun shy of terms like financial engineering because of the degree to which unscrupulous or ill-advised investment bankers and others created financial instruments that almost destroyed the world economy back in 2008. But if we can put aside that prejudice for a while, we can recognize that use of some financial instruments and strategies can permit society to advance on many fronts with an appropriate amount of risk. It is in that light that I highly recommend that you watch this TEDxCambridge talk by MIT's Andrew Lo. Andrew has a thoughtful concept that might speed the development of cancer treatment drugs. He asks "Can financial engineering cure cancer?" and notes: This short non-technical exposition highlights the impact that each of us can have on treating cancer and other diseases, no matter who we are or what we do for our day jobs. I’ve been amazed at the connections that have emerged from random conversations with total strangers ...

My most read blog post is one I published in April 2007, called, " For students: Don't collect degrees. " It was prompted by a question I received from a student: As someone who is in on the business/medical/policy of today's health care system, what do you think about the career prospects of those pursuing a joint JD/MPH? Is it worth it? Virtually every day--even over eight years later--it tops the list on my blog statistics in terms of viewers, and it has prompted about three dozen comments.  I'm very pleased young people have found it helpful as they consider their career paths. Here's the latest inquiry that's come across the transom: Mr. Levy, I would appreciate your thoughts. I have a MPA in H.C.Administration and a MS in Organizational Change Management. I've been a generalist as I enjoy change and have many interests: acute, ambulatory, and long term care as well as work in social services providing services to individuals with I/DD and i...

Please check out this new article I've written for the athenahealth Health Leadership Forum, one in an occasional series.  Comments are welcome there or here.

This has been my week to discuss networks ( Internet and electricity ), but I would be remiss if I didn't spend a few moments on the networks that are most likely to rob us of personal choice and increase costs: Health care networks.  Wait, didn't President Obama promise us that the new health care law would preserve choice for us? Didn't he promise us lower costs?  Well, in spite of much good that the law accomplished in terms of providing access to health insurance, these are two areas that have gone awry. For a variety of reasons--most of which have little to do with providing you with better care--the hospital world has grown more centralized. It's done so to reduce competition and get better rates from insurance companies. It's done so to create larger risk pools of patients under the "rate reform" that incorporates more bundled and capitated payments. It's done so to keep you as a captive customer for your health care needs. It's been aided ...

My post earlier this week about incorporating end users of the Internet into the network to enhance its performance and stability reminded me about a research project I was involved in back in 1979 at MIT. *  A group of us, led by the late MIT professor Fred C. Schweppe (one of the world’s experts in electric power systems control) took a look at how a dynamic electric power system might function.   The term for the project was coined by project member Richard Tabors , who was trained in biology: “Homeostatic utility control.” As Richard reminded us, a human body responds in real time to changes in the environment and other challenges to moderate heart rate, respiration, and the like to keep us on a steady keel. We eat that Halloween candy, and our pancreas figures out how much insulin we need to convert sugars. We take a run to work off the candy calories, we get hot from the exercise, and we sweat to cool down our bodies.   We face the danger of a territorial dog as ...

For those of us who have been involved in running or regulating network infrastructure, there's been a sea change in the framework for deciding on appropriate policy concerns.  In the old days, all we had to "worry" about were what the economists call network externalities. These externalities could either be positive or negative in nature. A positive externality occurred every time someone would join up to a network, say, by subscribing to the early telephone system.  While each person received a certain value in subscribing, all other uses also received an enhanced value from that person joining the system.  Why? Well, simply put, everyone could now reach an additional subscriber at minimal extra cost. A negative externality would occur when the network would become congested.  In such a case, each additional subscriber would slow or degrade the service quality for all the incumbents, causing a need for capital investment to restore service quality, or a time-of-us...