Archivi del mese: aprile 2012

Hta, Balduzzi: necessario migliorare le valutazioni sulle tecnologie sanitarie

Le ricerche e le valutazioni in materia di Hta (Health technology assessment), cioè la valutazione di tutte le tecnologie compresi i farmaci, i dispositivi medici e le procedure, devono essere «sempre più orientate ad obiettivi prioritari di sanità pubblica», indicando come «prioritari e decisivi i fondi per la ricerca, ma anche il sistema delle regole nazionali che in prospettiva si auspica possano diventare sempre più europee». È quanto ha sottolineato il ministro Balduzzi intervenendo al Consiglio informale dei Ministri della Salute dell’Unione europea in corso a Horsens, in Danimarca.

Il Ministro ha ricordato che l’Hta ha bisogno di «un dialogo precoce tra governi e produttori, di regole più certe e verificabili nella loro applicazione, di una maggiore condivisione e di informazioni scientifiche indipendenti», permettendo di evitare «duplicazioni e comportamenti opportunistici». Il ministro Balduzzi ha proposto due soluzioni: «migliorare la qualità dei reporting attraverso procedure standardizzate e migliorare la trasparenza dei trial clinici attraverso l’accesso ai dati di base degli studi (protocollo iniziale, valutazione dei Comitati etici, verbali dei Comitati di gestione dello studio, dati individuali, naturalmente nel rispetto delle regole europee sulla privacy), così da consentire a tutta la comunità scientifica un controllo accurato dei dati».

Live & Learn

Source: Daily Inspiration & Motivation

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Live & Learn




Source: headlikeanorange – A Southern Sea Lion chases a Gentoo Penguin

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Live & Learn

OK.  Time to fess up.  Are you one of the eight?

  • “Internet addiction affects one in eight Americans.”
  • “Studies have shown that addicts (to internet) have 10%-20% surface area brain damage.”
  • “2012 Survey of American Women found that 34% check their smartphone before getting out of bed, 21% wake up in the middle of the night to check Facebook, 27% check Facebook while on the toilet.”
  • “Students who tried to disconnect for 24 hours: It felt like some sort of withdrawal; I most likely have an addiction; I really panicked; Media is my drug.”
    See infographic below for additional statistics and information:

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Live & Learn

Yes, the output of yet another one of my personal “lab tests”…

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Using Social Media to Improve Healthcare Quality: Part 1

“Many patients are already online, and the next generations of patients and caregivers will conduct more and more of their daily activities through social media.”
– Neil Seeman, CEO, Health Strategy Innovation Cell

Our two-part guide to current practice and future promise in using social media to benefit patients is for the social media novice and initiated alike. It’s part of a suite of interactive resources produced by The Change Foundation in partnership with the Health Strategy Innovation Cell at Massey College, University of Toronto, to help healthcare organizations better understand the potential and limitations of social media, and to prompt them to use these tools to capture and improve the patient experience.

Part 1, Introduction and Key Issues in the Current Landscape, reports on: how healthcare organizations are using social media; the link to quality improvement; leading practices, opportunities and limitations; and issues such as privacy, data control, ethics, and return on investment.

Read the report

How Doctors and Patients Do Harm

Just how broken is the United States health care system? Dr. Otis Brawley, chief medical officer for the American Cancer Society, paints a grim picture in his new book “How We Do Harm: A Doctor Breaks Ranks About Being Sick In America’’(St. Martin’s Press).

If the title alone doesn’t clue you in, the reader quickly discovers that Dr. Brawley is determined to make everyone as uncomfortable as possible about the flaws, inconsistencies and inequities that are rampant in American medical care. The book, written with Paul Goldberg, a journalist, begins with a frightening tale of a poor woman who for so long went untreated for breast cancer that her whole breast literally falls off at home. She arrives at the hospital carrying it in a plastic bag, clinging to the naïve hope that it might be reattached. Dr. Brawley treated the woman at Grady Hospital in Atlanta, which happens to be the largest hospital in the United States, as well as the safety-net hospital for poor and uninsured patients in the area.

Dr. Brawley says it makes him furious when he hears “politicians and pundits” assert that American health care is the best in the world. The statement may be true for the rich, he says, but “it’s not a great place to be sick if you are poor and uninsured and want consistent, basic care.”

“I have seen enough to conclude that no incident of failure in American medicine should be dismissed as an aberration,” he writes. “Failure is the system.”

But as you nod your head in agreement, be warned that Dr. Brawley doesn’t place all the blame on insurance companies, hospitals and doctors. He also blames patients who have bought into the notion that more care — more treatment, more screening, more scans, more drugs — is better care. Many Americans, particularly wealthier ones, he says, are “gluttonous” in their consumption of health care resources and often use them unwisely.

I recently spoke with Dr. Brawley about the problems in American medicine, how both doctors and patients can be greedy and why he became such a “loudmouth.” Here’s our conversation.

Q.What prompted you to write this book?
A.I started looking at my career, listening to the discussions going on about health care reform and health care costs being exorbitant. A lot of people didn’t seem to realize that in a lot of the discussion, we’re talking about human beings who are suffering because of lack of health care, and sometimes we’re suffering because of overuse of health. People are so focused on fears about rationing of health care. The talk should not be about rationing health care but about rational health care. So much of what we do in health care is irrational.
Q.Can you describe an experience you’ve had with irrational health care?
A.There was a man with colon cancer who went to a wonderful hospital with a wonderful reputation. He got surgery and was referred to a medical oncologist who has a wonderful reputation as a doctor to the rich and famous in Atlanta. That medical oncologist started giving him chemotherapy and two other expensive drugs. When this man lost his insurance, the oncologist basically dropped him, and the guy ended up being seen by me at the county hospital. A doctor who is training with me to be an oncologist immediately realizes that this guy is getting a chemotherapy regimen for colon cancer that we stopped using about 15 years ago. His medical oncologist was practicing the best medicine of the late 1980s, but we were in 2006. The other drugs he was being prescribed were totally unnecessary. But the doctor could get a substantial markup and make a substantial amount of money by selling them. The oncologist had known just enough to be greedy and prescribe drugs he can make money off of, but he didn’t know enough to prescribe the chemotherapy that would have given the patient a much better chance of surviving his cancer.

I’ve seen that so many times, where doctors really have failed to evolve and failed to learn as the profession and the scientific evidence have changed over time.

Q.But in reading the book, you don’t just blame doctors for being greedy. You blame patients for being gluttonous. Can you explain?
A.Another patient of mine had early colon cancer. Three doctors had told her she should not get chemotherapy. She decided she wanted it, and she went doctor-shopping until she found a doctor who would give it to her. Her insurance had no way to object to her getting this inappropriate chemotherapy because privacy laws prevent disclosing the stage of the disease to the insurance company. She was referred to me by a relative who was concerned about what she was doing. She readily admitted that she had three different medical opinions that said she should not get chemotherapy, but she wanted chemotherapy. So a doctor made $10,000 off that six months of chemotherapy, and she got an increased risk of leukemia for the rest of her life, not to mention losing her hair and everything else, with no scientific evidence that the treatment reduced her risk of the colon cancer coming back.

I blame patients, I blame doctors, I blame hospitals, I blame drug companies, I blame insurance companies. Our health care system is messed up because the system is designed to fail, and everybody is responsible for health care failing as it is now.

Q.The story about the woman whose breast fell off was horrible. What were you trying to tell us with that example?
A.We so frequently talk about breast cancer almost as if it’s a boutique disease or trendy. I feel some people have forgotten how terrible this disease can be. This lady – I saw a lot of things in her background that were lessons for society about what we need to do if we want to defeat breast cancer. When she realized she had something growing in her breast, she had insurance, but logistics having to do with her job and child care and a little bit of denial kept her from going to the doctor and getting this thing diagnosed and treated when it was likely curable. Later on, when she wanted to see a doctor, she couldn’t because her insurance had gotten so expensive that she had to drop it. If she had come in when she first found this thing 9 or 10 years earlier, I probably could have cured it, and it would have cost about a tenth of what we spent when she was uninsured and receiving free care from the hospital. She lived for about two years after I met her. That’s a failure of medicine to educate people.
Q.In the book, you talk about a conversation with a hospital marketing executive who talks about drumming up business with free prostate cancer screenings at a mall health fair. How did that affect you?
A.That was the beginning of Otis Brawley becoming a loudmouth in the prostate cancer screening debate. We’re making promises to patients and making them think we know things we don’t know and making money off of them. There is a subtle little corruption in medicine. We’re selling chemo to people who don’t need it, giving prostate screening when it might save lives, but we make them think it definitely does, and then I see a lady whose breast is falling off who couldn’t afford to see a doctor when she wanted to see one.
Q.Is there any hope that things might improve someday?
A.I am trying to get folks, through this book, to talk a little more about rational use of health care and realize that we are actually hurting people with overtreatment. Health care needs to be consumed in a wiser way that is much more concerned about allegiance to the science. We need to be more concerned about the welfare of our patients. There was a recent report, the 45 tests we do too much, that I was thrilled to see. People are starting to realize that we need to be a little wiser in our use of health care.

U.S. consumers turn to Facebook, Twitter for healthcare answers

Information found on social networks often leads to second opinions, survey shows

Computerworld – A third of U.S. consumers now use social media sites such as Facebook and Twitter to seek medical information and track and share symptoms. They’re also using the sites to vent about doctors, drugs, treatments, medical devices and health plans.

The survey of 1,040 U.S. consumers was put together by consulting firm PricewaterhouseCoopers (PwC) and includes data from a separate survey of healthcare and pharmaceutical executives on how social media is used in their business strategies.

Not unexpectedly, young adults rely on social networks for healthcare information far more than older Americans. The survey found that more than 80% of those between the ages of 18 and 24 said they’re likely to share health information through social media channels — and nearly 90% said they would trust information found there.

By comparison, less than half (45%) of those surveyed between the ages of 45 and 64 said they’re likely to share health information via social media.

The PwC report showed that four in 10 consumers have used social media to find health-related consumer reviews of treatments or doctors; one in three have sought information related to other patients’ experiences with their disease; and one in four have posted comments about their health experience.

“The power of social media for health organizations is in listening and engaging with consumers on their terms,” Kelly Barnes, U.S. Health Industries leader at PwC, said in a statement. “Social media has created a new customer service access point where consumers expect an immediate response.”

Seventy-two percent of those surveyed said they would use social networks for scheduling doctor visits and nearly half said they would expect a response within a few hours after doing so.

When asked whether information on social networks would affect their health decisions, 45% said it would play in role in whether to get a second opinion; 41% said it would affect their choice of a specific doctor, hospital or medical facility; and 34% said it would affect any decision to take a certain medication.

PwC’s report found that consumer activity on social media sites dwarfs that of healthcare organizations such as hospitals, insurance and pharmaceutical companies. Social media, the report notes, is changing the nature of healthcare interaction, and “health organizations that ignore this virtual environment may be missing opportunities to engage consumers,” Barnes said.

Community sites that allow people to weigh in on various medical and healthcare issues had 24 times more social media activity than corporate sites, according to PwC. That shows how much room to grow corporate sites have.

“Health organizations have an opportunity to use social media as a way to better listen, participate in discussions and engage with consumers in ways that extend their interaction beyond a clinical encounter,” Barnes said. “Savvy adopters are viewing social media as a business strategy, not just a marketing tool.”

Medical Device Reprocessing Challenges: A Q&A with ECRI Institute’s Chris Lavanchy

By Kelly M. Pyrek

Chris Lavanchy, engineering director of the Health Devices Group at ECRI Institute, has extensive experience working with sterile processing departments and provides his insights regarding the imperatives of proper medical device reprocessing.

Q: How significant would you say device-related infections and adverse events are these days, and what is contributing to these so-called “never events”? What are some ways to combat them?
A: Device-related infections are a continuing concern and every year we hear of a few incidents where a large group of patients may have been exposed to improperly reprocessed instruments. Probably the most notable examples are the reports we hear related to flexible endoscopes – these often become headlines. I believe several things contribute to these events. First, flexible endoscopes are complex, delicate devices that cannot be reprocessed as readily as many conventional instruments, and as a result the reprocessing steps also tend to be more manually-intensive, complex, and consequently more error prone. Endoscope reprocessing typically takes place adjacent to the care areas and not in the central sterile department where processes are generally more carefully monitored and managed. Also, because flexible endoscopes are expensive, most hospitals run with a lean inventory, so when demand for the endoscopes is high, technicians handling the reprocessing are sometimes subjected to pressure from clinicians to do the reprocessing more quickly. This can lead to shortcutting procedures. We recommend several ways to help combat problems with improperly reprocessed flexible endoscopes. For example have the reprocessing technicians managed by the central sterile department and require well documented reprocessing procedures for each specific endoscope model. Periodic reassessment of technician competence combined with annual review of procedures can also be helpful. When changes to reprocessing protocols are made they should be reviewed by leadership in the central sterile department and reviewed with technicians. Finally, hospitals using older reprocessing machines should consider the purchase of newer systems that can eliminate all or some of the manual cleaning needed.

Q: Medical devices and instruments are evolving so quickly, and so the demand for knowing how to reprocess these devices is escalating as well – what suggestions do you have for keeping pace with these developments?

A: This is an ongoing challenge. The designs of instruments have become increasingly more complex and more challenging to reprocess. One way to manage the concern better is to require that any instrument being purchased not be accepted unless the vendor provides specific, adequately detailed reprocessing instructions. Central sterile department leadership should ideally be to weigh in on selection of new instruments or at least be able to review the equipment documentation before they are used. It is not unusual to hear from central sterile departments that the first time they became aware that an instrument had been purchased was when it appeared in their department for reprocessing.  This was at one time common, but should never be allowed to occur today.

Q: What are clinicians and manufacturers’ shared roles when it comes to reducing the potential for device-related problems that can jeopardize patient outcomes?

A: One of the best strategies to overcome some of the device-related problems we’ve been discussing is for hospitals to encourage collaboration between purchasing and central sterile department leadership when discussing the purchase of new instruments from manufacturers. Too often little thought is given to the reprocessing stage of the instrument use cycle when equipment is being acquired. By involving central sterile departments in the process, manufacturers will perhaps more quickly see that ease of reprocessing is an important customer selection factor and give more attention to providing information about reprocessing when marketing their products.
Q: What are some of the common problems posed by endoscopes?

A: In the reprocessing arena, endoscopes are problematic. One of the things we have seen over the years is that it is critical to ensure that sterile processing personnel have the appropriate instructions for cleaning that specific endoscope. Endoscopes vary tremendously in their design and it is especially important if you are using an automated endoscope reprocessor, to have the appropriate adapters for that endoscope. One of the key messages for technicians is that they need device-specific reprocessing instructions. Reprocessing protocols should be documented somewhere and they should be something that is accessible to the person performing the reprocessing tasks.

Q: What are some of the specific problems you are seeing?
A: With regard to endoscope reprocessing, we continue to hear about horrible situations where many patients may have been affected by improper reprocessing. It’s such a recurrent problem that this topic continues to land on our top 10 technology hazards list. Through our accident investigation services we often gain unique insight into the root cause of such reprocessing failures . Sometimes it’s because there has been a change to the process without the appropriate oversight. These incidents tend to createhigh visibility situations where hundreds, thousands or tens of thousands of patients are notified that they may have been exposed to contaminated instruments. For example, a facility  switched to a different liquid chemical germicide for use in their automated endoscope reprocessor but failed to  adjust the unit’s settings for the new indicated operating temperature .   In another incident repairs were made to AERs and the facilities failed to to verify that the fluids going into the system are maintained at the required temperature. These things are particularly important because you can buy the best endoscope reprocessor, you can have the best technician handling the scopes, but if the oversight isn’t there, if you don’t have the appropriate processes, checks and balances in place, then it’s very easy to run into serious problems.
Q: What can infection preventionists do to assist sterile processing departments?

A: Infection preventionists can help by periodically checking with sterile processing technicians to make sure that they are aware that the manufacturers’ instructions exist, that they know how to find them, and are in fact using those instructions and applying them to the process correctly. It’s a bit burdensome, perhaps, but it’s probably the only way they can ensure that things are being done properly — especially with staff turnover being so high in healthcare facilities.
Q: What do you believe to be manufacturers’ responsibility?

A: For at least the last 10 years, the FDA  has specifically emphasized the need for medical device manufacturers to provide at least one viable method for reprocessing a reusable medical device. They can specify a high-level disinfection or sterilization method, or whatever is applicable, but the reality is, the more options that the vendor provides for reprocessing, the better it is for the hospital. In some cases, what they’re asking the hospital to do may not be practical. What we advise hospitals to do when they are buying medical instruments and equipment, is to review the reprocessing information that is available from t he manufacturer and consider that in their purchasing decisions. I’ve been to some hospitals where the reprocessing technicians first became aware that they were being given a new instrument to reprocess when it was presented to them dirty from the OR. That is just not the way to do things. Ideally, the central sterile department should be involved in the overall purchasing decision so that these personnel would understand what the requirements are for reprocessing that new device being considering for purchase. I think the awareness of device-related reprocessing issues is definitely being raised, and the FDA workshops and the AAMI/FDA summit have been helpful in getting the word out that there are instruments whose cleanability was a secondary consideration in their design. For example, at the FDA/AAMI summit someone showed a suction probe that had been cut open and how it would be virtually impossible to remove the debris. Fortunately I think it is a relatively rare thing today for an instrument to be designed like that, but the more that this concern is publicized, the more likely it is that manufacturers will ensure there is very diligent consideration of proper design for cleanability as products are being developed.

HTA in Integrated Care for a Patient Centered System, Bilbao, June 25-27, 2012

We are delighted to invite you to Bilbao in June 2012 for the 9th Annual Meeting of Health Technology Assessment International (HTAi).

Health care systems are facing challenges such as multiple entry points, inappropriate use of costly and scarce resources, waiting lists, and poor communication of information between institutions and health care practitioners.

Many countries around the world face a growing elderly population, and health technology and health systems have led to a reduction in mortality rates from certain diseases, which have become chronic. This is putting increased pressure on institutions and health care practitioners to provide medical care in the most cost-effective way. To address this issue, the concept of \”integrated care\” has emerged as a response to these challenges.

New technological solutions are being developed parallel to integrated health care: Telemedicine, point-of-care devices and ICTs generate new challenges for health technology assessment. There are experiences in motion which can be shared and discussed, and methodological approaches which can serve as core models for tailored interventions in different contexts.

We are planning a high quality scientific meeting which will allow health care practitioners, researchers, policy makers, industry representatives, consumer and patient organizations and other stakeholders to explore and share recent approaches for HTA to deal with these challenges.

The choice of Bilbao in the Basque Country in northeastern Spain as the venue for this prestigious conference in 2012 affords delegates from all over the world a unique opportunity to come together in this welcoming city with a great social and industrial life and to enjoy its culture and social heritage.

We are proud to be hosting this conference on behalf of HTAi, and look forward to meeting you in Bilbao.

In our mother tongue we will warmly tell you:


(Welcome to Bilbao!)

Dr José Asua
Chair of the Local Organizing Committee.
Director of Knowledge Management and Health Assessment of the Ministry of Health and Consumer Affairs of the Basque Country.

Rosa Rico-Iturrioz
Co-chair of the Local Organizing Committee.
Head of Osteba, Ministry of Health and Consumer Affairs.

Iñaki Gutiérrez-Ibarluzea
Head of the Secretariat of the Local Organizing Committee.
Knowledge Manager of Osteba, the Basque Office for HTA. Ministry of Health and Consumer Affairs.

UnitedHealth riduce i costi riducendo l’ospedalizzazione


Growth In Health Costs Limited As Americans Avoid Hospital Stays

By Jay Hancock

APRIL 19TH, 2012, 1:50 PM

Americans continued to seek moderate amounts of medical care in the first quarter, helping insurer UnitedHealth Group beat profit expectations amid signs of continued restraint in health-care spending.

In an early look at medical-cost trends for 2012, the nation’s biggest private insurer said today that an increase in outpatient treatments from January through March was partly offset by a lack of growth in hospital stays.  The Minnetonka, Minn. company is considered a bellwether for healthcare spending, as well as for the managed care sector, as the first major insurer to report quarterly earnings.

Treatment volume is ”tracking right in line with our expectations, which is to say we saw a modest increase in utilization,” Dan Schumacher, UnitedHealth’s chief financial officer, said on a conference call with investors. “Outpatient is the place where we see the most increase, and on the inpatient side we actually continue to see that very restrained. Our hospital bed days are actually flat to down in each of our businesses.”

The insurer’s expected 2012 cost increase for medical treatment, which includes price hikes from doctors and hospitals, as well as changes in how much care members seek, remains at 6 percent, UnitedHealth said.

Growth in the demand for care fell sharply after the economy tanked in 2008, and analysts have wondered when it would pick up as a recovery took hold.  UnitedHealth’s results from its 36 million members suggest: Not yet.

Many analysts pointed to the economic slump as an explanation, saying financially pinched families have avoided seeking care. These analysts expected medical visits to pick up as the economy improved. At the same time, however, employers and insurers have aggressively sought to contain costs by making workers pay larger deductibles and nudging them to get high-quality, less-expensive care.

Other factors influencing the 2012 cost trends are continued consolidation among hospitals and doctors, which gives them greater power to raise prices, and the expiration of patents on blockbuster drugs such as Pfizer’s Lipitor, which allows patients and health plans to buy cheaper generics, according to consultants PricewaterhouseCoopers.

In today’s UnitedHealth results, flat or declining hospital stays stood out as a powerful brake on cost increases, said Thomas Carroll, who follows the company’s stock for Stifel Nicolaus, an investment firm.

“What is positive are [UnitedHealth’s] comments around inpatient utilization — that it is still low,” Carroll said. “As you know, inpatient is the biggest piece of the health-care cost pie. The low utilization in inpatient is likely offsetting higher outpatient” trends and price increases by hospitals, he said.

UnitedHealth earned $1.4 billion in the first quarter, a 3 percent increase from results in the same period last year. Revenue was $27.3 billion, much of which includes sales from UnitedHealth’s non-insurance businesses. UnitedHealth’s profit of $1.31 a share exceeded the average estimate of $1.17 per share from Wall Street analysts, as compiled by Bloomberg News.


Cardiologi, Cina e Richard Smith @Richard56

Richard Smith, già Editor del British Medical Journal, propone tre considerazioni a margine del World Congress of Cardiology, tenutosi in Cina.

  1. Half of Chinese doctors and 70% of Chinese cardiologists smoke.
  2. At World Congress of Cadiology session on prevention in emerging eceonomies has 2 chairs,3 speakers, and 3 in the audience.
  3. Insertions of stents in China are increasing 30% a year since 2000. But there’s little attention to prevention.

Poco interesse nella prevenzione! O pochi interessi! Scegliete voi (n.d.r.)


Global Health and Development Topic of TEDx Event at HSPH

April 13, 2012

tedx students (tedx_students.jpg)Student government representatives Melissa Shive, MPH ’12, and Syed Kashif Mahmood, MPH ’14, introduced the event.

Students and other members of the Harvard School of Public Health (HSPH) community gathered in the Leadership Studio in Kresge to watch a global simulcast from Berlin sponsored by TEDx, an offshoot of the popular TED Conferences, on April 5, 2012. Afterwards, alumna Meghna Chakrabarti, SM ’01, co-host of Radio Boston on WBUR, led an HSPH panel in a discussion of the themes raised by the speakers. One of the topics on everyone’s minds was how to move ahead with the global health and development agenda in an era when funding is drying up.

In his opening remarks, Dean Julio Frenk observed that the large investments in global health seen in recent years may be coming to a close. Donor countries are pulling back on investments in the face of their own fiscal crises. But now is not the time to cut back, he said. Investments in health, which have led to successes such as the global eradication of smallpox, show concrete results not only in lives saved but in contributions to economic growth.

HSPH student government representatives Syed Kashif Mahmood, MPH ’14, and Melissa Shive, MPH ’12, introduced the TEDx simulcast. One of the Berlin speakers, Jeff Chapin, a mechanical engineer and product designer at IDEO, spoke about designing easy to assemble latrines and handwashing stations in Cambodia. He described giving up preconceived notions he had about the project and learning to listen to the local people’s concerns. Sven Giegold, a member of the European Parliament, spoke about how collective action helped bring about broader adoption of energy from solar, wind, and biomass in Germany.

A video documentary played during the event showed a group of kids in a poor neighborhood in India who took it upon themselves to make sure that all babies received polio inoculations. They created the first-ever map of the neighborhood and documented every household with the zealous preciseness of public health researchers.

International development consultant Theo Sowa called for more African women to be included in the conversations being had about them. She recalled attending a conference on women and HIV/AIDS that did not include a single woman speaker. People always talk about African women as victims, and that’s a problem: “People don’t ask victims for solutions,” she said.

Melinda Gates, co-chair of the Bill & Melinda Gates Foundation, closed the simulcast by making a passionate case for including contraception on the global health agenda. It has the potential to save hundreds of thousands of women’s lives around the world, particularly in countries like Nigeria, where just 10 percent of the population uses birth control, she said. “We can insist that all families have the opportunity to learn about contraceptives, and have access to the full variety of methods so they can decide which one is right for them. This is the clear goal: universal access to the birth control that women want. To achieve that goal, rich and poor governments alike must make birth control a priority,” she said.

Speaking after the simulcast, Dean Frenk said that the language of development must change from that of assistance to that of global solidarity and “co-responsiblity for shared problems.” The mindset that everyone’s problems affect everyone else is an argument against cutbacks to programs that are achieving results, he said.

Michael Chu, senior lecturer of business administration at Harvard Business School, and Jennifer Leaning, Francois-Xavier Bagnoud professor of the practice of health and human rights at HSPH, spoke about the power of the world’s bottom four billion as both a market and a political force that we ignore at our peril. “The way that the world can change for the better rests on our ability to listen and empower people to take charge of their own lives,” Leaning said. “When people are shown that they are cared about, that creates a power that leads to change.”

Learn more and watch video of the Berlin simulcast. Watch video of HSPH panel discussion.

– Amy Roeder

photo: Aubrey LaMedica

Time management

Il tempo costituisce una delle risorse realmente scarse. Per i manager o coloro che si atteggiano a tali, la gestione del tempo è diventata una delle priorità. Ho trovato simpatiche, ironiche e curiose le risposte di James Altucher a un lettore del suo blog che gli chiedeva quali sono i segreti della “gestione del tempo”. Sentite un po’:

  • Non guardate la TV
  • Non fate cena (per vivere non è necessario. E diventa difficile dormire quando il vostro stomaco cerca di digerire un antipasto di granchio, pastasciutta, bistecca, dessert e vino)
  • Non parlate con nessuno a meno che non sia veramente necessario. Il silenzio è il miglior modo di risparmiare tempo
  • Non viaggiate per fare riunioni
  • Io non partecipo a riunioni. Il mio criterio è: se non ho almeno il 10% di probabilità di avere un compenso X per partecipare a una riunione, non ci vado. In questo modo elimino circa il 90% delle riunioni. E così sono più felice.
  • Alzatevi prima di tutti. Io mi sveglio alle 4:30 di mattina. Vuol dire almeno 3 ore di silenzio. Poiché non ceno e non guardo la TV posso andare a letto presto.


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Labels: tempo management