Startup gets green light to use Apple Watch to track Parkinson's symptoms

Remote monitoring

Software that enables Apple Watch-based tracking of Parkinson’s disease symptoms has received clearance from the Food and Drug Administration, a move that could open doors for its maker as it strives to reach more people living with movement disorders — and potentially, those who haven’t developed them yet.

The StrivePD system uses Apple’s Movement Disorder API to track tremors and dyskinetic symptoms of Parkinson’s from the Apple Watch. The data is all collected in an iPhone application, which allows patients to record their symptoms and keep tabs on medication.

The system has been used to monitor patients since last year at the University of California San Francisco and Mount Sinai, and the company is expanding its work further this year. The new FDA clearance specifically pertains to Rune’s Apple Watch-based symptom tracking capabilities and will make it possible for clinicians to use certain billing codes when reviewing data from the device. It will also allow trial sponsors to use the data as endpoints in studies submitted to regulators.

 StrivePD was developed by Rune Labs, a neurological data startup run by Brian Pepin, a former engineer from Alphabet life science company Verily. The company announced last year that it had raised nearly $23 million to continue to develop its neurology data platform. Also last year, the company launched a partnership with Medtronic to pilot data collection from the company’s Percept​​ PC Deep Brain Stimulation device. The StrivePD platform can integrate data from these devices, making it a kind of one-stop shop for clinicians and clinical trial sponsors who want to review data.

The company didn’t actually need regulatory clearance for how it displays the data to clinicians right now. But Pepin said it’s an important milestone for the company as it seeks to expand its work with pharma and med device companies. He also hopes the news will jumpstart an effort to identify people who have early signs of Parkinson’s.

There are several medical grade devices capable of tracking Parkinson’s symptoms, but using a device already familiar to consumers has many theoretical advantages. Millions of people already own Apple Watches, which could make it easier to recruit trial patients, including people who live in remote places or for whom travel is difficult. And because the device is popular and appeals to consumers, it’s more likely that someone using the tool to monitor symptoms long-term will stick with tracking consistently. The downside is that the Apple Watch and iPhone are relatively expensive devices inaccessible to many people. An Android version of StrivePD is not yet available.

Pepin said that as it becomes possible to track more validated metrics with the Apple Watch, it grows increasingly compelling for its capabilities as well as its wide distribution.

“We’ve invested in this infrastructure around the watch, and we’re able to pretty quickly — as the huge team at Apple that’s working on this stuff is able to spin out new features — take advantage of those,” he said. “And then, I think in some cases, we’ll be able to hopefully do more of what we did here, which is work with Apple to take it to the next step, which is this kind of formal FDA validation.”

Startup gets green light to use Apple Watch to track Parkinson's symptoms

A Hospital Designed for Patients? - Proto Magazine

A Hospital Designed for Patients?

A

A hospital building can feel timeless. While the halls echo with the sound of ultramodern equipment, basic structural ideas might be familiar to the first practitioners of modern medicine in the 19th century, or to some degree, even the denizens of Europe’s first hospitals in the Middle Ages. Yet each era has left its mark on the way these buildings are built and used—some for the better, some for the worse.

In this day of fiscal restraint for health care, government cutbacks, and pre- authorization there are few new hospitals being built.  Most new construction is for building additions, rehabilitating old structures or adding on a 'Center for Excellence".

The Covid19 pandemic stimulated interest in constructing expandable hospital structures which could be easily increase hospital capacity, and mothballed when not in use. Most current hospital structures were augmeneted by pop up tents, awnings, or trailers for triage and isolating sick from well patients. Other than providing shelter from the sun or rain, they provided little in the way of utilities, water, electric or sterile areas. Many were set up as drive through access to expedite services.

A Hospital Designed for Patients? - Proto Magazine

Best Hospitals in America

If you or a family member are looking for the best hospitals a way to judge them is how the staff feels about working there.

Happy staff usually means happy patients.  Staff members usually know what is going on in their institution.  They work on a daily basis with physicians and other professionals.  Word of an incompentent professional spreads quickly amongs staff.

The list below indicates the most satisfied employees at the exceptinal institutions listed below.

Doximity 

A Musical Vision: High Touch: The Course in Compassion

A Musical Vision: High Touch: The Course in Compassion. published in 2013 (credits to Vincent Deluise M.D. , Professor, Yale Univeersity)

Today it is 2022, nine years later, and nothing has changed.  Despite the outcry all attempts have fallen short.  The system is so complex and there is no one thing that could make it simpler.  Even in the U.K. the N.H.S. struggles with overload.

 

How many times a week do you hear "Healthcare is Broken" ?

We all know how difficult it is to obtain acess to a provider without that 'plastic card' and oh yes, your official government I.D. Once you gain access the guardians at the gate will see you or  refer to the appropriate expertise on the part of the anatomy that is confounding your quality of life.

Today, more people are insured thanks to the Affordable Care Act (Obamacare), however in 2022 there are still a significant number of uninsured citizens.  The number of Americans lacking health insurance ticked up slightly last year, marking the first annual increase in the uninsured rate in nearly a decade, the U.S. Census Bureau reported Tuesday.  The uninsured rate rose from 7.9 percent in 2017 to 8.5 percent last year, amounting to nearly 2 million more uninsured people, as experts said the Trump administration’s efforts to undermine the Affordable Care Act were partly to blame. The tax penallty form being uninsured was removed as well.  

Headquartered in Alexandria, VA, the National Association of Free & Charitable Clinics (NAFC) was founded in 2001 by a group of grassroots medical providers and organizers who recognized that health care was not being provided at a local level to the working poor, uninsured and underinsured in our country in a way that was cost-effective, accessible and affordable.

Many people do not realize that there are approximately 1,400 Free and Charitable Clinics and Charitable Pharmacies throughout the nation who since the 1960s have been filling in the gap for those who “fall through the cracks” in our current health care system. These clinics/pharmacies receive little to no state or federal funding, do not receive HRSA 330 funds and are not Federally Qualified Health Centers or Rural Health Centers. Volunteer doctors, pharmacists and medical students support this effort without compensation.  Often vendors, and medical supply companies donate equipment to be used at these "free clinic".

Clinical Trials, How to enroll

Patients and providers sometimes exhaust proven treatments for chronic disease and cancer treatments. The Food and Drug Administration approves drugs for human use only after the drug has passed a clinical trial.

BioNews Clinical | BioNews

Welcome to the Virtual Meeting Ground 

Patients           

Find out more

Are you recruiting for a Clinical Trial?

Gov. Newsom signs landmark MICRA modernization bill into law

 Gov. Newsom today signed AB 35 into law, and in doing so put an end to a decades long political battle and ushered in a new era of stability around malpractice liability.

Since California’s landmark medical malpractice reforms – the Medical Injury Compensation Reform Act (MICRA) – were enacted almost 50 years ago, they have successfully struck a balance between compensatory justice for injured patients while maintaining an overall health care system that is accessible and affordable for Californians.

Since that time, California’s physician and provider communities have repeatedly defended MICRA through expensive battles at the ballot, in the courtroom and in the legislature.

This year, we were again facing another costly initiative battle. The so-called Fairness for Injured Patients Act, which had qualified for the November 2022 ballot, would have obliterated existing safeguards for out-of-control medical lawsuits and would have resulted in skyrocketing health care costs. This act demanded that patients who are injured have the right to seek compensation from alleged providers who 'injured' them. The original MICRA act of thee1970s limited compensation to $250,000.

But for the first time in a generation, we were met with an opportunity to achieve a meaningful consensus between competing interests through a revised framework that could protect both the rights of injured patients while keeping MICRA’s essential guardrails solidly in place for patients and providers alike.

“With today’s signing of AB 35, we have achieved what few thought was possible,” said California Medical Association President Robert E. Wailes, M.D 

AB 35 passed through the California Legislature with nearly unanimous support, demonstrating broad bipartisan support. As part of the landmark agreement reflected in AB 35, proponents of the Fairness for Injured Patients Act have withdrawn the initiative. The initiative cannot be returned to the November 2022 ballot.

California’s new modernized MICRA statutes will provide predictability and affordability of medical liability insurance rates for decades to come, while protecting existing safeguards against skyrocketing health care costs. It will also bring greater accountability, patient safety and trust by making it possible for physicians and patients to have a full and open conversation after an unforeseen outcome. 

Under the modernized MICRA law reflected in AB 35, which will go into effect on January 1, 2023, the underlying principles of MICRA were preserved – ensuring access to care and protecting our health care delivery system from runaway costs. Important guardrails of MICRA will continue unchanged, including advance notice of a claim, the one-year statute of limitations to file a case, the option of binding arbitration, early offer of proof for making punitive damage allegations and allowing other sources of compensation to be considered in award determinations. Furthermore, a new provision has been added to the law that protects expression of sympathy by a health care provider to an injured patient and their family, allowing physicians to express empathy, benevolence and even statements of fault after an unforeseen outcome without fear that such statements or gestures will be used against them.

The element that has garnered the most interest surrounds changes to the limit on non-economic damages in medical malpractice cases, which has been $250k since 1975. As opposed to the ballot measure, which would have effectively eliminated the cap on non-economic damages entirely, under the agreement:

Cases not involving a patient death will have a limit of $350k on the effective date of January 1, 2023, with an incremental increase over the next 10 years to $750k and a 2.0% annual inflationary adjustment thereafter.

Cases involving a patient death will have a limit of $500k on the effective date of January 1, 2023, with an incremental increase over the next 10 years to $1 million and a 2.0% annual inflationary adjustment thereafter.

Other critical MICRA guardrails that will remain in place with modest updates include the ability to pay awards of future damages over time and limits on plaintiff's attorney's contingency fees. CMA has prepared a publicly available fact sheet that provides additional details on this important legislation.

“CMA is proud to have been part of this landmark achievement for the benefit of all Californians,” said Dr. Wailes. “We look forward to a new era of long-term stability around MICRA that will allow California’s physician and provider communities to focus on other ways to improve access to care and public health for all Californians.

Gov. Newsom signs landmark MICRA modernization bill into law:

Digital Health News - Digital Salutem

Digital Health came upon the scene in 2005, with a nationwide effort to transform health care with  digital transformation. Anyone practicing medicine would not recognize how healthcare would transform between 20012 and today, 2022. 

Scientific peer reviewed journals in medicine have a plethora of articles documenting the efficacy and efficiency for better cost effective medicine and evidence based information to sustain it's utility and further development, and proof of ROI.

In 2020 as the COVID 19 pandemic exploded across the globe digital health allowed for our health system to not implode, even when stretched to overcapacity.

Computing power allowed for data analytics, tracking and reporting of the pandemic.

The World Health Organization and Johns Hopkins University produced daily maps and statistics individualized to state, and nationality of the pandemic as it progressed. These were available on the internet in real time.

Daily Moving Average (in real time)

Three trends in eHealth you need to know

3 new trends in eHealth

Here are 3 recent innovations or trends in eHealth:

Virtual clinics: Virtual clinics let you see an expert doctor remotely at home on your computer instead of having to travel outside your home (or waiting in line). The idea behind this type of solution is that doctors can make appointments from anywhere in the world instead of having doctors based around your area (which means you can get more high quality health care). This is great for consumers because it allows them to see specialists or other specialists outside their area (for example as part of an emergency room) but less so for patients because remote care requires trained staff who are highly specialized and often expensive to get hold of.

Remote Clinical Care: A lot of people simply do not want or need access to an actual doctor when they need help with their health issues, especially if they live far away from an actual hospital (which is why there are so many virtual clinics available). But if we combine remote clinical care with virtual clinics then you can get high quality accurate care anywhere any time, be it at home or online, without needing access to an actual doctor at all! This allows patients who might not feel comfortable calling out sick or going into hospitals on their own but still need help with something like diabetes or heart disease can go online and see someone who has experience treating those issues remotely rather than having them deal directly with doctors at hospitals near them.

Virtual medical centers: are used to provide services easier and more cost-effectively when you call. A virtual clinic is a planned contact by the Healthcare Professional Responsible for Care with a patient for the purposes of clinical consultation, advice and treatment planning. It has been found to increase patient access to healthcare services, enhance health outcomes, improve patient experience and make optimal use of scarce medical resources.

Digital Health has made possible Precision Medicine whereby treatments can be specifically tailored to individual patients. 

The University of California San Diego (as well as many others) has developed a Digital Health Lab,  founded by Professor Edward J. Wang as a joint research laboratory of UCSD Design Lab and the Electrical & Computer Engineering department of Jacobs School of Engineering.

Digital Health News - Digital Salutem

Perspectives from the Frontline of the Fight for Public Health: A Live Q...

Leana Wen likes to say: “Public health saved your life today. You just don’t know it.” Join the conversation as she describes her experience on the frontlines of this critical—and often invisible—field.

FAKE NEWS ? Psilocybin treatment for major depression effective for up to a year for most patients - ScienceBlog.com

DISCLAIMER: 

This information is neither a recommendation nor advice for treatment.  The reader is cautioned to consult with their personal physician prior to using psilocybin for the treatment of any medical or psychiatric condition.

For readers who wish to dive deeper into the subject, read this

Psilocybin is not an FDA approved drug

Previous studies by Johns Hopkins Medicine researchers showed that psychedelic treatment with psilocybin relieved major depressive disorder symptoms in adults for up to a month. Now, in a follow-up study of those participants, the researchers report that the substantial antidepressant effects of psilocybin-assisted therapy, given with supportive psychotherapy, may last at least a year for some patients.

A compound found in so-called magic mushrooms, psilocybin produces visual and auditory hallucinations and profound changes in consciousness over a few hours after ingestion. In 2016, Johns Hopkins Medicine researchers first reported that treatment with psilocybin under psychologically supported conditions significantly relieved existential anxiety and depression in people with a life-threatening cancer diagnosis.A report on the new study was published on Feb. 15, 2022 in the Journal of Psychopharmacology.

The study was done under carefully controlled scientific studies by professional monitors who sat side-by-side with the patient.

• 11-4-20 Psychedelic Treatment with Psilocybin Relieves Major Depression, Study Shows (1 of 2 videos)

• 11-4-20 Psychedelic Treatment with Psilocybin Relieves Major Depression, Study Shows (2 of 2 videos)
• 
  

• 11-4-20 Roland Griffiths on psilocybin research.mp4

Magic Mushrooms have been used for many decades by drug users. It is a powerful psychedelic drug produced by many different fungi, and ingested orally. Like LSD it has been proposed for treatment (Timothy Leary). Leary earned a PhD at U.C. Berkeley and was a psychologist at Harvard University and famous for a speech given "Turn up, turn in, and turn out ". 

John Lennon and Yoko Ono were patrons of Leary, Lennon composed the song "Come Together" after meeting Leary.

L-R John Lennon, Timothy Leary, Yoko Ono

 Johns Hopkins is one of the sites of a national multisite randomized, placebo-controlled trial of psilocybin for major depressive disorder. 

The study was supported by philanthropic donors The Steven and Alexandra Cohen Foundation, Tim Ferriss, Matt Mullenweg, Craig Nerenberg, Blake Mycoskie, and Dave Morin; as well as by grants from the Riverstyx Foundation and the National Institute on Drug Abuse (T32DA007209, R01DA003889, K23DA035915).

References

Psilocybin treatment for major depression effective for up to a year for most patients - ScienceBlog.com

It isn't easy being green

"It isn't easy being green."   Kermit, the frog

Why are some potato chips green? are some potato chips green?  

 This is how poisonous green crisps are - and why you still find them in your packet

Few people will happily eat the green crisp - but here's the amount you'd have to eat to get ill, and what causes them.

Why are some potato chips green? — Tasting Table

Sunlight: Optimize Health and Immunity (Light Therapy and Melatonin)

Melatonin acts in many ways to maintain your health.  Most of you use it to help fall asleep, however, it has many important other functions to maintain good health.  Melatonin is produced in the pineal gland. There are receptors (ipRGCs) in the eye, intrinsically photosensitive retinal ganglion cells that are sensitive to infrared radiation. These retinal photoreceptors (nonvisual) send signals to the pineal gland which suppresses melatonin release.

There is another source for melatonin production, mitochondrion. Melatonin is produced as part of the mitochondrial oxidative chemistry.  Melatonin serves to ' cool down' mitochondrial overheating. This pathway for NIR penetrates the skin and enters mitochondria stimulating melatonin release. Thus there are two separate paths for melatonin, 1.pineal gland 2. intracellular mitochondria.  

Sunlight: Optimize Health and Immunity (Light Therapy and Melatonin)

Melatonin and the circadian rhythm play a pivotal role in rest, good health, and eliminating oxidative stress.  The video by Medcram (Robert Seheult, M.D., UC Riverside School of Medicine

Melatonin and the Optics of the Human Body

https://doi.org/10.32794/mr11250016

Goldie Hawn Opens Up About Her Childhood Depression & The Importance of ...

The Covid pandemic may be somewhat better, however, our children are still in recovery mode. The best way to deal with childhood depression is to discuss it with them. Ask how they are feeling.  

Goldie Hawn developed "Mind Up", a course for children about mental health.. This course is inexpensive and gives guidance and a curriculum for assisting children develop mental health.

Hobby Tool | Find New Activities to Replace Gaming

In the world of addiction therapy, most psychiatrists treat addiction as an obsessive-compulsive personality disorder.  OCD can be difficult to treat, and there are some psychoactive drugs now available to treat OCD.  Many of these drugs are SSRI'S and carry significant side effects. The use of SSRI drugs in children also carry other significant side effects

Most parents and physicians prefer to not put children or teens on psychoactive drugs, except in the most severe types of depression, when other options fail.  While it is challenging to treat OCD it is possible to transfer their form of gaming addiction to other forms of entertainment, or activity.  Teens often have sports activities, tennis, running, baseball or football. The neurochemical response to any addiction is a release of endorphins, running in particular. ( Endorphins, dopamine and serotonin are all related to mood elevation.  What is the difference between endorphins and dopamine in your brain? While endorphins are neurotransmitters that help you to cope with pain and stress, dopamine is a mood-boosting neurotransmitter that is released after you reach a goal.)

In this way, dopamine is involved in the reward circuit in your brain and helps to motivate you toward tasks (in contrast, low dopamine would also be de-motivating). Higher endorphins can actually lead to higher dopamine production; in this way, endorphins and dopamine are not mutually exclusive but are actually connected in the system that promotes action toward rewards and the good feelings that result.

In other words, you might feel motivated to participate in a marathon because of your dopamine reward system, which is further reinforced by the endorphins that are released during the actual act of participating in the race. In this way, endorphins are the quicker-acting "feelings" while dopamine is the longer-acting afterglow.

Need new activities to replace gaming? Use our hobby tool. Contains 70+ different ideas with 12 filters from which to select new hobbies

Our most recent edition of Health Train Express discussed Behavioral addiction to online social networking and its association with emotion regulation deficits.

Most parents and others recognize that their children are missing from the dinner table or refuse to participate in normal family activities.  They linger far into the night with their bedroom doors closed.  In some cases, they may be gaming alone or have a virtual social network to play games with friends they know already or have never met from other countries.

In previous generations, many parents wanted to know who their children hang out with.  Today, such is not the case.  Parents rarely know with whom their children socialize.  Back in the day mothers would insist on meeting the 'friends' and also their parental units to either give approval or suggest they find other friends.

Many parents from prior generation(s) are internet incompetent, however, today's young parents grew up in the internet age and are knowledgeable about its pitfalls.

Parent Guides from ConnectSafely

Is a handy guide for parents with information about many internet gaming sites, such as Snapchat, Instagram,  Roblox, Tiktok, Amazon Parent Dashboard, Amazon Fire TV. Discord, Cyberbullying Messenger, Messenger for Kids, developed by Facebook allows parents the ability to control their kid's messenger contracts.

One important tool is Google Family Link which allows monitoring and permissions remotely from a parent's smartphone or computer.  It requires an app on the child's device and the parent's device. Other software such as parental blocking on a home Wi-Fi router can help as well, but many social networks and games can be accessed via cell phone without internet.

Top Questions from Parents

1. What is Family Link? 

Family Link is an app from Google that allows you to set-up, manage and monitor a Google account and Android device for your child so even young children can take advantage of the benefits of having a smartphone or tablet. 

2. What does Family Link do? 

The app gives you the ability to manage what apps your kids can use and when they can use them, what websites they can visit, and when they can use the device. Parents can set a device’s “bedtime” so that it can’t be used for anything except phone calls during specific hours of the day or night. 

3. What do I need to set up a Family Link account? 

You need a compatible Android smartphone or tablet for your child (find details on this webpage) and either an Android or Apple phone or tablet for yourself to manage your child’s account. You can manage some of your child’s account settings from a web browser, but need an Android device for some features and settings. You’ll also need to be in the U.S., and have your own Google account. 

4. What are the minimum and maximum ages of kids who can use Family Link? 

The app doesn’t have a minimum age. It’s up to parents to decide when their child is ready to have a managed smartphone. For Family Link users, Google will notify both the parent and the child before the child’s 13th birthday, “to encourage a family conversation around when the child will be ready to take control over their own account and device.” The child has the option to transition to a regular account or remain under parent management up until their 18th birthday. 

5. Why should my family use Family Link? 

There are a great many benefits to smartphones and tablets, even for very young children. We can’t list them all, but they include the ability to make calls and send and receive texts and emails with family members, the ability to use educational apps or games, the ability to take and share pictures, track health and fitness data, and much more. Also, it’s possible to configure your child’s phone so that it securely reports its location to you, which means you know where the phone is and, if the phone is with your child, where the child is as well. Of course, you could give your child a device without Family Link but then you wouldn’t have the ability to manage the apps they use, the sites they visit, and the times they’re using it, and be able to monitor how your child is using the phone. Family Link helps your child learn how to responsibly use their device while giving parents extra peace of mind. 

6. Who can manage my child’s account? 

By default, it’s just the person who sets up the account but the family manager can add another family member to serve as a second parent who can manage and monitor the child’s device. 

7. What should I say to my child before installing Family Link? 

It is always a good idea to have a discussion with your child before allowing them to use a device and before using any monitoring or device management tool. Remind your child about their responsibility to use the device appropriately and to take good care of the device. Explain any family ground rules and policies, and talk with them about the features in Family Link so they understand what information you can monitor and how you will be able to manage what they can do with their device. If you elect to limit the apps and sites they use, explain how they can ask permission if they come across an app or site that they would like you to add.

Authors notes:

The situation is not hopeless, and there are credible solutions to protect children from exploitation. As the reader can see Facebook has "Facebook for Kids", Tiktok has Privacy settings, 

Hobby Tool | Find New Activities to Replace Gaming