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Dennis OConnor

Integrative Considerations during the COVID 3.18.20.pdf - 1 views

covid Integrative-spaces

shared by Dennis OConnor on 20 Mar 20 - No Cached
  • Dennis OConnor on 20 Mar 20
     
    Recommended by Dr. Michael Kurisu D.O.: There is a high level of interest in integrative strategies to augment public health measures to prevent COVID-19 infection and associated pneumonia. Unfortunately, no integrative measures have been validated in human trials. Notwithstanding, this is an opportune time to be proactive. Using available in-vitro evidence, an understanding of the virulence of COVID-19, as well as data from similar, but different, viruses, we offer the following strategies to consider. Again, we stress that these are supplemental considerations to the current recommendations that emphasize regular hand washing, social distancing, stopping non-essential travel, and getting tested if you develop symptoms.
Dennis OConnor

Data strategy for achieving a patient-centric future - Partner Content - 0 views

www.mmm-online.com/...eving-a-patient-centric-future

data strategy

shared by Dennis OConnor on 20 Sep 22 - No Cached
  • Dennis OConnor on 20 Sep 22
     
    "Life science companies seeking further advances toward a truly patient-centric future should consider working with an external partner that has extensive experience and a reliable, transparent and proven information portfolio. Leveraging core data linked and integrated with data generated by patients, and providing access to novel, on-demand data sources through a network of curated data partners provides enriched data that goes beyond the patient experience with a particular brand. By understanding the full details of the patient journey, optimal engagement of patients and HCPs can be enabled, thereby delivering the right treatment to the right patient, supporting adoption and adherence and achieving the ultimate goal of patient-centricity."
Dennis OConnor

Leroy Hood, MD, PhD · Institute for Systems Biology - 1 views

www.systemsbiology.org/...leroy-hood

Lee-Hood pattern-computer precision ecosystem

shared by Dennis OConnor on 16 Jun 18 - No Cached
  • Dennis OConnor on 16 Jun 18
     
    "Leroy Hood, MD, PhD SVP and Chief Science Officer, Providence St. Joseph Health; Chief Strategy Officer, Co-founder and Professor, ISB"
Dennis OConnor

What Went Wrong with Coronavirus Testing in the U.S. | The New Yorker - 0 views

www.newyorker.com/...-coronavirus-testing-in-the-us

covid testing research

shared by Dennis OConnor on 18 Mar 20 - No Cached
  • n February 5th, sixteen days after a Seattle resident who had visited relatives in Wuhan, China, was diagnosed as having the first confirmed case of COVID-19 in the United States, the Centers for Disease Control, in Atlanta, began sending diagnostic tests to a network of about a hundred state, city, and county public-health laboratories⁠. Up to that point, all testing for COVID-19 in the U.S. had been done at the C.D.C.; of some five hundred suspected cases⁠ tested at the Centers, twelve had confirmed positive. The new test kits would allow about fifty thousand patients to be tested, and they would also make testing much faster, as patient specimens would no longer have to be sent to Atlanta to be evaluated.
  • Before a state or local lab could use the C.D.C.-developed tests on actual patients
  • verification
  • ...33 more annotations...
  • larger number, about thirty-six of them, received inconclusive⁠ results from one of the reagents.
  • Another five,
  • had problems with two reagents
  • On February 8th
  • e cascading effects that they’ve had on the country’s COVID-19 preparations suggest a much larger problem with the way the United States has structured its pandemic response.
  • the verification problems were “part of the normal procedures⁠.” In the meantime, she said, until new reagents could be manufactured, all COVID-19 testing in the United States would continue to take place exclusively at the C.D.C⁠.
  • The public-health-laboratory network was never intended to provide widespread testing in the event of a pandemic.
  • the three-week delay caused by the C.D.C.’s failure to get working test kits into the hands of the public-health labs came at a crucial time.
  • The void created by the C.D.C.’s faulty tests made it impossible for public-health authorities to get an accurate picture of how far and how fast the disease was spreadin
  • In hotspots like Seattle, and probably elsewhere, COVID-19 spread undetected for several weeks, which in turn only multiplied the need for more tests.
  • The problem was that containment was not done very well.
  • we’re looking at exponential growth, and we need to figure out how to meet an exponential demand.”
  • Yet flexibility was not what Jerome and his lab found when they tried to get an E.U.A. for their COVID-19 test.
  • problem was exacerbated by a President who has simultaneously underplayed the severity of the outbreak and overpromised the means available to fight it
  • problems with COVID-19 testing in the United States have obscured
  • several labs reported their problems to the C.D.C. In a briefing a few days later,
  • Chinese scientists uploaded a copy of the virus’s genome to an online repository⁠, and virologists around the world set to work to develop diagnostic tests for the new disease
  • January 21st, a team in Berlin, led by Christian Drosten, one of the scientists who discovered the original SARS virus, in 2003, submitted the first paper to describe a protocol for testing for SARS-CoV-2.
  • That protocol would form the basis for a test disseminated, early on, by the World Health Organization
  • That same day, Messonnier announced that the C.D.C. had finalized its own test⁠, which it used to confirm the first known case of COVID-19 in the U.S.
  • The U.W. virology lab
  • started, probably in earnest in mid-January, to prepare what we call a laboratory-developed test,⁠
  • It took a team at the lab, working under the direction of Alex Greninger, about two weeks to develop a working version
  • But, as soon as Alex Azar, the Secretary of Health and Human Services, declared a public-health emergency, on February 4th, a new regulatory regime took effect. From that point on, any lab that wanted to conduct its own tests for the new coronavirus would first need to secure something called an Emergency Use Authorization from the F.D.A.
  • This shift in the regulations sounds perverse, since it restricts the use of new tests at precisely the moment they’re most needed.
  • E.U.A. process is supremely flexible.
  • triumph of modern medical science
  • hen there’s a big emergency and we feel like we should really do something, it gets hard. It’s a little frustrating. We’ve got a lot of scientists and doctors and laboratory personnel who are incredibly good at making assays. What we’re not so good at is figuring out all the forms and working with the bureaucracy of the federal government.”
  • At one point, he was very frustrated because he’d e-mailed them what we were doing so they could review it,”
  • Here we are in this SARS-CoV-2 crisis, and you have to send them something through the United States Postal Service. It’s just shocking.
  • Despite these difficulties, Jerome said, the F.D.A. ultimately proved responsive to the lab’s entreaties. “They had good and substantive feedback that made our testing better, and the response time was typically just a couple of days.”
  • believe it was, February 29th,” he said. “And then we got a specimen from one of the people who were the two original cases in Washington
  • The E.U.A. regulations, however, prohibited the lab from reporting the results to the doctors who had ordered the tests for their patients.
  • Dennis OConnor on 18 Mar 20
     
    "Sharfstein, too, thinks that it's fair to criticize the federal government for not recognizing that its pandemic plans had a single point of failure. The C.D.C. quickly developed a working test, and it was understandable, at some level, that people at the Centers thought that fixing the faulty reagents for the public-health labs would be faster than shifting to an entirely different protocol. Nevertheless, Sharfstein said, "Why are we relying only on the C.D.C.? What the F.D.A. could have done, and eventually did do, is say, 'You can use other approaches.' " Even so, he said, "I don't think it's quite fair to totally blame the F.D.A. for this. The F.D.A. can design an approach to support the public-health strategy, but someone has to tell F.D.A. the public-health goal." The delay in clearly establishing those goals, he said, shows why the decision to shut down the N.S.C. directorate was so consequential. "People talk about, like, why does it matter that they closed the White House office on pandemic preparedness? This is one reason.""
Dennis OConnor

Home - HealthSTAR Patient Engagements - 0 views

healthstarpe.com

patient-centered patient-experience

shared by Dennis OConnor on 13 May 21 - No Cached
  • Dennis OConnor on 13 May 21
     
    "At HealthSTAR Patient Engagements (HPE), we are both brand partners and advocates for the patient. We bring innovation and experience to patient engagement with a caring approach. Leveraging over two decades of commercial success and proprietary technologies, HPE uses a proven, holistic approach to patient engagement, from strategy and content development to support and logistical services, with a comprehensive foundation of compliance, data management, and analytics. We call it the Ecosystem of Patient Engagement. "
Dennis OConnor

Love 2.0 - Online Tools - 1 views

www.positivityresonance.com/survey.php

love positivity wellness Love2.0

shared by Dennis OConnor on 28 Sep 19 - No Cached
  • Given your ever-shifting emotional landscape, any single measure of your positivity ratio can only capture so much.
  • view your score for any given day with some skepticism
  • more trustworthy
  • Dennis OConnor on 28 Sep 19
     
    "Kabir Recommends: The Positivity Self Test is a brief, 20-item survey that asks you to report on your experiences of several emotions over the past 24 hours. Each item on the test includes a trio of words that are related, but not quite the same, for example, "hopeful, optimistic, or encouraged" and "sad, downhearted, or unhappy." With this strategy, each item captures a set of emotions that share a key resemblance and this short test becomes that much more accurate. Keep in mind that the Positivity Self Test merely provides a snapshot of your emotions. Everybody's emotions change by the day, hour, and minute. Some scientists would say that they change by the millisecond. Given your ever-shifting emotional landscape, any single measure of your positivity ratio can only capture so much. One way to overcome such measurement hurdles is to measure repeatedly. Even if you complete the Positivity Self Test as honestly as possible, you should view your score for any given day with some skepticism. Was this particular day representative? Probably not. Days vary. So the more days you can average together to create your estimate, the more trustworthy that estimate becomes. You can get a clear picture of your typical positivity ratio by completing the Positivity Self Test every evening for two weeks. Take the Positivity Self Test In the scientific literature, the Positivity Self Test is also know as the modified Differential Emotions Scale, or mDES, created by Dr. Fredrickson based on an earlier scale developed by pioneering emotion scientist, Carroll Izard. The scholarly references are: Fredrickson, B. L. (in press). Positive emotions broaden and build. In E. Ashby Plant & P. G. Devine (Eds.) Advances in Experimental Social Psychology. Elsevier. Fredrickson, B. L., Tugade, M. M., Waugh, C. E., & Larkin, G. (2003). What good are positive emotions in crises? A prospective study of resilience and emotions following the terrorist attacks on the United States on September 11
Dennis OConnor

CCMI - Centre for Collaboration, Motivation and Innovation - 0 views

centrecmi.ca

patient-centered collaboration

shared by Dennis OConnor on 15 Dec 19 - No Cached
  • Dennis OConnor on 15 Dec 19
     
    "Creating Partnerships, Motivating Individuals, Facilitating Change The Centre for Collaboration, Motivation and Innovation (CCMI) helps individuals and organizations create partnerships that improve health and well-being. We do this by working collaboratively to inspire new ways of thinking about helping relationships, teach practical skills that foster partnerships, and implement strategies for system-wide change."
Dennis OConnor

Coronavirus and Its Impact on US Healthcare Providers (PDF) - 0 views

survey patient-experience

shared by Dennis OConnor on 12 May 20 - No Cached
  • Dennis OConnor on 12 May 20
     
    Discovered by DeAunne Denmark, MD. Phd, with the statement "It isn't clear to me how this information was collected." A new survey conducted by Public Opinion Strategies in partnership with Jarrard Phillips Cate & Hancock examines some of the critical questions facing America's health care delivery system... (including) What will be required to ensure Americans are once again comfortable and safe in a hospital or health care setting? The Executive Summary of the online survey of 1,000 adults was conducted nationally on April 16-20, 2020.
Dennis OConnor

The n-of-1 clinical trial: the ultimate strategy for individualizing medicine? - 0 views

www.ncbi.nlm.nih.gov/...PMC3118090

research N-of-One

shared by Dennis OConnor on 26 Jan 19 - No Cached
  • Dennis OConnor on 26 Jan 19
     
    "N-of-1 or single subject clinical trials consider an individual patient as the sole unit of observation in a study investigating the efficacy or side-effect profiles of different interventions. The ultimate goal of an n-of-1 trial is to determine the optimal or best intervention for an individual patient using objective data-driven criteria. Such trials can leverage study design and statistical techniques associated with standard population-based clinical trials, including randomization, washout and crossover periods, as well as placebo controls. Despite their obvious appeal and wide use in educational settings, n-of-1 trials have been used sparingly in medical and general clinical settings. We briefly review the history, motivation and design of n-of-1 trials and emphasize the great utility of modern wireless medical monitoring devices in their execution. We ultimately argue that n-of-1 trials demand serious attention among the health research and clinical care communities given the contemporary focus on individualized medicine. Keywords: clinical equipoise, early-phase trials, individualized medicine, n-of-1, remote phenotyping, single patient trial, treatment repositioning, wireless health"
Dennis OConnor

This Is How We Beat the Coronavirus - The Atlantic - 1 views

www.theatlantic.com/...608389

covid testing research

shared by Dennis OConnor on 20 Mar 20 - No Cached
  • We’re closing schools and businesses and committing to social (really, physical) distancing. But as the sobering charts from the analysis show, this isn’t enough.
  • Asian countries have engaged in suppression; we are only engaging in mitigation.
  • At the moment, we can’t even test everyone who is sick.
  • ...15 more annotations...
  • Testing will allow us to isolate the infected so they can’t infect others. We need to be vigilant, and willing to quarantine people with absolute diligence.
  • To achieve this, we need to test many, many people, even those without symptoms.
  • Our primary approach is social distancing—asking people to stay away from one another.
  • Our efforts are good, temporizing measures.
  • Social distancing cannot prevent these infections, as they’ve already happened. Therefore, things will appear to get worse for some time, even if what we’re doing is making things better in the long run.
  • buried in the Imperial College report is reason for optimism. The analysis finds that in the do-nothing scenario, many people die and die quickly. With serious mitigation, though, many of the measures we’re taking now slow things down. By the summer, the report calculates, the number of people who become sick will eventually reduce to a trickle.
  • We can create a third path. We can decide to meet this challenge head-on. It is absolutely within our capacity to do so. We could develop tests that are fast, reliable, and ubiquitous. If we screen everyone, and do so regularly, we can let most people return to a more normal life. We can reopen schools and places where people gather. If we can be assured that the people who congregate aren’t infectious, they can socialize.
  • We can build health-care facilities that do rapid screening and care for people who are infected, apart from those who are not.
  • We can even commit to housing infected people apart from their healthy family members, to prevent transmission in households.
  • We will need to massively strengthen our medical infrastructure. We will need to build ventilators and add hospital beds. We will need to train and redistribute physicians, nurses, and respiratory therapists to where they are most needed. We will need to focus our factories on turning out the protective equipment—masks, gloves, gowns, and so forth—to ensure we keep our health-care workforce safe.
  • most importantly, we need to pour vast sums of intellectual and financial resources into developing a vaccine that would finally bring this nightmare to a close
  • If we commit to social distancing, however, at some point in the next few months the rate of spread will slow. We’ll be able to catch our breath. We’ll be able to ease restrictions, as some early hit countries are doing. We can move toward some semblance of normalcy.
  • The temptation then will be to think we have made it past the worst. We cannot give in to that temptation. That will be the time to redouble our efforts. We will need to prepare for the coming storm. We’ll need to build up our stockpiles, create strategies, and get ready.
  • We need to keep time on the clock, time to find a treatment or a vaccine.
  • We all have a choice to make. We can look at the coming fire and let it burn. We can hunker down, and hope to wait it out—or we can work together to get through it with as little damage as possible.
Dennis OConnor

POONACHA MACHAIAH - 0 views

poonacha.com/poonacha-home

wellness ecosystem Apollo

shared by Dennis OConnor on 30 Nov 19 - No Cached
  • Dennis OConnor on 30 Nov 19
     
    "Poonacha Machaiah is a global leader among a new breed of social entrepreneurs who is applying his corporate expertise from 25 years as a business leader in Fortune 100 companies as well as his background in advanced technological strategies to tackling social and environmental problems. Machaiah has collaborated extensively with Deepak Chopra, M.D., world-renowned mind-body medicine pioneer and New York Times best-selling author, in their shared mission of "personal transformation and societal wellbeing." Together they have designed and overseen the launch of wellbeing programs in corporations and communities around the world."
Dennis OConnor

2020 Spinal Cord Injury Highlight - Acute Intermittent Hypoxia as a Multi-Functional Th... - 0 views

cdmrp.army.mil/...20hypoxia_highlight

Acute intermittent hypoxia

shared by Dennis OConnor on 23 Jul 21 - No Cached
  • acute intermittent hypoxia, where a person breathes in repeated cycles of low oxygen air (hypoxia) followed by normal oxygen air for a short periods of time. This is a relatively safe and noninvasive therapy and can be coupled with physical rehabilitation strategies to maximize effectiveness.
  • promoting walking, upper limb, bladder, and respiratory recovery in persons with SCI.
  • Dennis OConnor on 23 Jul 21
     
    Janice found this article. It looks highly relevant to her condition.
Dennis OConnor

Stakeholders Identify Actions for Providers, Patients & Research Community to Advance P... - 0 views

academyhealth.org/...-advance-patient-centered-care

shared by Dennis OConnor on 06 Oct 19 - No Cached
  • Supported by the Robert Wood Johnson Foundation (RWJF), AcademyHealth convened meeting participants whose comments grouped into six major areas of discussion and related actionable strategies. Ideas outlined in the full meeting report include the need to:  Strengthen training opportunities for providers, patients, and caregivers Improve the diversity of the health care workforce Engage community members as partners in patient care Keep patients at the center of innovations in service delivery Improve the transparency of care and costs Invest in implementation research
Dennis OConnor

In the coronavirus pandemic, we're making decisions without reliable data - 4 views

www.statnews.com/...ecisions-without-reliable-data

covid testing research pandemic data

shared by Dennis OConnor on 19 Mar 20 - No Cached
  • A fiasco in the making? As the coronavirus pandemic takes hold, we are making decisions without reliable data
  • This evidence fiasco creates tremendous uncertainty about the risk of dying from Covid-19.
  • As most health systems have limited testing capacity, selection bias may even worsen in the near future.
  • ...8 more annotations...
  • The one situation where an entire, closed population was tested was the Diamond Princess cruise ship and its quarantine passengers. The case fatality rate there was 1.0%, but this was a largely elderly population, in which the death rate from Covid-19 is much higher.
  • Projecting the Diamond Princess mortality rate onto the age structure of the U.S. population, the death rate among people infected with Covid-19 would be 0.125%. But since this estimate is based on extremely thin data — there were just seven deaths among the 700 infected passengers and crew — the real death rate could stretch from five times lower (0.025%) to five times higher (0.625%).
  • Although successful surveillance systems have long existed for influenza, the disease is confirmed by a laboratory in a tiny minority of cases.
  • Some worry that the 68 deaths from Covid-19 in the U.S. as of March 1610 will increase exponentially to 680, 6,800, 68,000, 680,000 … along with similar catastrophic patterns around the globe. Is that a realistic scenario, or bad science fiction? How can we tell at what point such a curve might stop?
  • In the absence of data, prepare-for-the-worst reasoning leads to extreme measures of social distancing and lockdowns.
  • This has been the perspective behind the different stance of the United Kingdom keeping schools open12, at least until as I write this. In the absence of data on the real course of the epidemic, we don’t know whether this perspective was brilliant or catastrophic.
  • One of the bottom lines is that we don’t know how long social distancing measures and lockdowns can be maintained without major consequences to the economy, society, and mental health.
  • At a minimum, we need unbiased prevalence and incidence data for the evolving infectious load to guide decision-making.
  • Dennis OConnor on 19 Mar 20
     
    Dr. Michael Kurisu D.O. "My take is this article is written by a very credible source. John P.A. Ioannidis is from Stanford and great resource. Makes argument that we are basing a LOT of our decisions on faulty or NO data ! Its fascinating to me that there has been less than 10,000 deaths globally and we have had SO MUCH DISRUPTION in the economy. I definitely feel we should be tracking the amount of deaths that are going to occur from people that will be pushed into poverty as well as the number of people being denied access to medical care right now. Yes… with COVID19, it CAN get much worse…. But maybe not… we don't know yet. This article actually increased my morale and put me on track to help GET MORE DATA. Then we can make informed decisions. And then TRACK ALL THE DATA moving forward.
  • Dennis OConnor on 19 Mar 20
     
    DeAunne Denmark, MD, PhD, "Excellent piece spelling out the pervasive and critical issues due to abysmal lack/tardiness in US testing, especially of large populations where initial outbreaks occurred, for those both visibly sick and not. And most importantly, healthcare workers. We cannot even begin to estimate CFR, much less develop reliable projection models, without valid data on everybody who is carrying. "The most valuable piece of information for answering those questions would be to know the current prevalence of the infection in a random sample of a population and to repeat this exercise at regular time intervals to estimate the incidence of new infections."
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