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Speech Therapist in Los Angeles
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Valuable Services of a Speech Therapist in Los Angeles

Every parent needs a normal development timeline for their children thus when speech problems arise, they may be thrown into a state of confusion. As a parent, you will probably identify that something is amiss when at three years of age, your child seems slow at speaking and understanding what others are saying. On the flip side of it, you could also have difficulty making sense of his or her speech. However, there is no need for alarm since speech problems among babies have been corrected by specialists from time immemorial. This read is a summary of a thorough analysis of this subject to help you have all you need to know about speech problems in children. For those in California, I recommend you see a speech therapist Los Angeles based provider, in case you feel your child needs help. 

 

The possibility of a Child Developing Speech Problems.

Findings from Speech Pathology Australia can help us find out the probability of American children having speech problems since both are developed countries. According to the organization, one in seven children has a communication disability. This umbrella term entails various problems such as difficulty in voicing, understanding, and reading and writing which inherently affects the speech of a child. Such statistics are worrying since a considerable chunk of adults are likely to have speech problems if the situation is not mitigated early enough. Therefore, you have to be on the watch out for any signs of speech difficulties in your child.
 

How to Identify Speech Problems in Children

Any competent speech therapist Los Angeles has to offer, will tell you that parents are the first individuals to note whether their child has speech abnormalities. The typical red flags include not keeping up with their peers when talking and not understanding or communication their needs well. The speech therapists give a list of the various conventional indications that your child has speech issues.

  • People provide a lower prediction of the child’s age due to his or her speech.
  • The child makes inappropriate moves and other mistakes during play.
  • Other children tease the child when they play because of how he or she talks.
  • The Child finds reading and writing burdensome.
  • You and others have trouble understanding the young one.

The role of the Parent

As a parent, you need to have some expectations about how your child should behave speech wise at a given age. If you feel there is inconsistency at any point, then you should seek speech therapy immediately. In this regard, at 18 months, the child should be able to utter about ten names of familiar objects within his or her environment. At two years, the baby should be able to ask for something using two-word combinations. By age three, he or she should follow two-part instructions. At age four, the child constructs whole sentences and pesters you with questions. When he or she attains five years, they should be able to think before answering questions and give coherent responses to why and when questions.
 

Services Offered at a Speech Therapist

When you walk into the premises of a speech therapist Los Angeles based provider, you will be given guidance and assistance in various fields of communication. The therapist will assess your child and prescribe a schedule for treatment of the speech issue. Their services range from pronunciation difficulties, comprehension problems, stuttering, voicing, swallowing, reading and writing issues, social skills and listening problems. I highly recommend that you visit a speech therapist in the Los Angeles area, when you feel your child needs attention since often you may not have the expertise to identify all the speech problems that need to be addressed.

In summary, giving your child speech therapy when he or she deserves one is the most significant gift you could offer them. When they grow up with such ailments, they find themselves in awkward situations which will derail their performance in the academic as well as the employment world. For instance, people who lisp may not get employed in jobs that involve giving instructions. More so, many children with speech problems battle with isolation from an early stage. This state can lead to a broken social life in the future. Everyone deserves to be happy, and it all starts at the early stages of life. 

CVS Health eyes kidney patients for next expansion into care
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CVS Health eyes kidney patients for next expansion into care

A customer exits a CVS Health Corp. pharmacy in La Vista, Nebraska.

CVS Health is now planning to treat kidney failure patients, as the national drugstore chain continues to branch deeper into monitoring and providing care.

The company said Wednesday it will offer home dialysis for patients through its Coram business, and it is working with another unspecified company to develop a new device for that. A CVS spokeswoman declined to name the company or disclose how much CVS is spending on the venture.

The companies will start a clinical trial of their device this year.

CVS Health will begin its expansion into kidney care with a program that helps identify chronic kidney disease early. It will then connect those patients with nurses for training and nutritional counseling to help delay the need for dialysis, a process that filters and cleans blood.

Coram specializes in care delivered at a patient’s home and infusion therapy, which involves medication delivered through a needle or catheter.

Woonsocket, Rhode Island-based CVS Health Corp. has been broadening its reach beyond drugstores for years. It also runs a pharmacy benefit management business and is spending $69 billion to buy the insurer Aetna. It also has been expanding care offered through its more than 9,800 locations.

CVS Health operates 1,100 clinics in its stores. It does blood draws for diabetes patients and helps monitor chronic conditions like high blood pressure at certain stores. The company also has started testing vision and hearing aid centers and is talking about selling more medical equipment or offering nutritionists to counsel customers.

Company leaders have said they aren’t planning to replace doctors. Instead, they want to use their national reach to supplement the care patients already receive from a physician.

Surgeon General Jerome Adams urges Americans to carry overdose antidote
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Surgeon General Jerome Adams urges Americans to carry overdose antidote

 

The nation’s chief doctor wants more Americans to start carrying the overdose antidote naloxone to help combat the nation’s opioid crisis and save lives.

U.S. Surgeon General Dr. Jerome Adams is expected to speak about the new public health advisory Thursday morning at the National Rx Drug Abuse & Heroin Summit in Atlanta.

In a news release, Adams said he hopes those who are at risk — as well as their friends and family members — will keep the antidote on hand and learn how to use it.

“Each day we lose 115 Americans to an opioid overdose — that’s one person every 12.5 minutes,” Adams said in a statement. “It is time to make sure more people have access to this lifesaving medication, because 77 percent of opioid overdose deaths occur outside of a medical setting and more than half occur at home.”

More than 42,000 Americans suffered fatal opioid overdoses in 2016, his statement said.

Naloxone can restore a person’s breathing after it is injected or sprayed in the nostrils, quickly bringing overdose victims back from near-death.

The drug, which, is often referred to by the brand name Narcan, is available over the counter in most states and is regularly used by first responders across the country. A two-dose pack of Narcan is among many options available and the drug is increasingly covered by insurance, according to The Network for Public Health Law, a nonprofit that helps government agencies.

As of July 2017, all 50 states have passed laws improving naloxone access, the nonprofit said.

Maine’s Republican Gov. Paul LePage has been one of the most outspoken opponents of the push, arguing that naloxone doesn’t treat addiction and merely discourages people from seeking treatment by essentially offering a safety net if they do overdose.

Proponents, however, argue that greater access to naloxone doesn’t draw people to illegal drug use or foster an addiction.

“To manage opioid addiction and prevent future overdoses, increased naloxone availability must occur in conjunction with expanded access to evidence-based treatment for opioid use disorder,” Adams said in a statement.

Adams’ recommendation for more people to possess naloxone comes a month after Philadelphia’s health department urged residents to do the same.

Prior to his current role, Adams had been Indiana’s health commissioner, where he promoted needle-exchange programs aimed at stemming the spread of diseases among intravenous drug users.

Opioid addiction costs employers $2.6 billion a year for care
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Opioid addiction costs employers $2.6 billion a year for care

 

A new report shows large employers spent $2.6 billion to treat opioid addiction and overdoses in 2016, an eightfold increase since 2004. More than half went to treat employees’ children.

The analysis released Thursday by the nonpartisan Kaiser Family Foundation finds such spending cost companies and workers about $26 per enrollee in 2016.

Employers have been limiting insurance coverage of opioids because of concerns about addiction. The report finds spending on opioid prescriptions falling 27 percent from a peak in 2009.

Researchers analyzed insurance claims from employers with more than 1,000 workers. Most are self-insured, meaning they assume the financial risk.

Workers share the costs. Steve Wojcik of the National Business Group on Health says for every $5 increase, employers typically cover $4 and pass $1 to workers.

105112385-GettyImages-622247700.1910x1000.jpg
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Facebook Building 8 explored data sharing agreement with hospitals

The exploratory effort to share medical-related data was led by an interventional cardiologist called Freddy Abnousi, who describes his role on LinkedIn as “leading top-secret projects.” It was under the purview of Regina Dugan, the head of Facebook’s “Building 8” experiment projects group, before she left in October 2017.

Facebook’s pitch, according to two people who heard it and one who is familiar with the project, was to combine what a health system knows about its patients (such as: person has heart disease, is age 50, takes 2 medications and made 3 trips to the hospital this year) with what Facebook knows (such as: user is age 50, married with 3 kids, English isn’t a primary language, actively engages with the community by sending a lot of messages).

The project would then figure out if this combined information could improve patient care, initially with a focus on cardiovascular health. For instance, if Facebook could determine that an elderly patient doesn’t have many nearby close friends or much community support, the health system might decide to send over a nurse to check in after a major surgery.

The people declined to be named as they were asked to sign confidentiality agreements.

Facebook provided a quote from Cathleen Gates, the interim CEO of the American College of Cardiology, explaining the possible benefits of the plan:

“For the first time in history, people are sharing information about themselves online in ways that may help determine how to improve their health. As part of its mission to transform cardiovascular care and improve heart health, the American College of Cardiology has been engaged in discussions with Facebook around the use of anonymized Facebook data, coupled with anonymized ACC data, to further scientific research on the ways social media can aid in the prevention and treatment of heart disease—the #1 cause of death in the world. This partnership is in the very early phases as we work on both sides to ensure privacy, transparency and scientific rigor. No data has been shared between any parties.”

Health systems are notoriously careful about sharing patient health information, in part because of state and federal patient privacy laws that are designed to ensure that people’s sensitive medical information doesn’t end up in the wrong hands.

To address these privacy laws and concerns, Facebook proposed to obscure personally identifiable information, such as names, in the data being shared by both sides.

However, the company proposed using a common cryptographic technique called hashing to match individuals who were in both data sets. That way, both parties would be able to tell when a specific set of Facebook data matched up with a specific set of patient data.

The issue of patient consent did not come up in the early discussions, one of the people said. Critics have attacked Facebook in the past for doing research on users without their permission. Notably, in 2014, Facebook manipulated hundreds of thousands of people’s news feeds to study whether certain types of content made people happier or sadder. Facebook later apologized for the study.

Health policy experts say that this health initiative would be problematic if Facebook did not think through the privacy implications.

“Consumers wouldn’t have assumed their data would be used in this way,” said Aneesh Chopra, president of a health software company specializing in patient data called CareJourney and the former White House chief technology officer.

“If Facebook moves ahead (with its plans), I would be wary of efforts that repurpose user data without explicit consent.”

When asked about the plans, Facebook provided the following statement:

“The medical industry has long understood that there are general health benefits to having a close-knit circle of family and friends. But deeper research into this link is needed to help medical professionals develop specific treatment and intervention plans that take social connection into account.”

“With this in mind, last year Facebook began discussions with leading medical institutions, including the American College of Cardiology and the Stanford University School of Medicine, to explore whether scientific research using anonymized Facebook data could help the medical community advance our understanding in this area. This work has not progressed past the planning phase, and we have not received, shared, or analyzed anyone’s data.”

“Last month we decided that we should pause these discussions so we can focus on other important work, including doing a better job of protecting people’s data and being clearer with them about how that data is used in our products and services.”

Facebook has taken only tentative steps into the health sector thus far, such as its campaign to promote organ donation through the social network. It also has a growing “Facebook health” team based in New York that is pitching pharmaceutical companies to invest its ample ad budget into Facebook by targeting users who “liked” a health advocacy page, or fits a certain demographic profile.

Incyte tumbles after combo therapy with Merck fails study
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Incyte tumbles after combo therapy with Merck fails study

 

Incyte‘s shares sank more than 20 percent on Friday after its experimental cancer drug failed to bolster the effectiveness of Merck‘s blockbuster Keytruda to treat skin cancer patients.

The failure is a big blow for Incyte, which has strung deals with major drugmakers to test its immunotherapy epacadostat in combination with their cancer drugs in separate trials.

Guggenheim analyst Tony Butler noted the data suggests epacadostat provided no additional benefit above Keytruda alone. “We assume the probability of success of other studies with epacadostat is zero.”

Epacadostat, a so-called IDO inhibitor, works by blocking an enzyme that protects tumors from the immune system, reported promising clinical data last year.

The development also weighed on stocks of other drugmakers testing combination cancer treatments. Shares of NewLink Genetics tumbled 39 percent, while those of Nektar Therapeutics were down 8 percent.

Incyte’s study was evaluating a combination of epacadostat and Keytruda in patients with metastatic melanoma compared with those who were on Keytruda monotherapy.

Keytruda is approved to treat several forms of cancer, including lung cancer and advanced melanoma, and is a PD-1 or PD-L1 inhibitor that blocks a mechanism tumors use to evade detection.

Keytruda competes with Bristol-Myers Squibb‘s Opdivo. The companies are looking to expand the reach of these drugs by combining them with other therapies.

Incyte has already signed deals with Bristol-Myers and AstraZeneca to test epacadostat.

William Blair analyst Katherine Xu said the result was surprising and the failure will make things difficult for the cause of IDO inhibitors.

Merck and Incyte said the study’s second main goal of overall survival was also not expected to reach a statistical significance.

Incyte is currently testing its Jakafi as a treatment for graft versus host disease, a medical complication of transplants from a donor. It is also awaiting an FDA decision for baricitinib, an eczema drug it is developing with Eli Lilly.

Incyte shares were down 17 percent at $68, while Merck was down about 0.5 percent.

Knee surgery for seniors is costly and usually a waste
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Knee surgery for seniors is costly and usually a waste

 

The most common knee surgery performed on people over 65 is repair of torn meniscus cartilage. The procedure is costly, at up to $10,000 a patient — and it’s also usually a waste, if not outright harmful.

 

“It’s known that this procedure is often done without strong evidence; I don’t think it’s well known that this is one of the most common surgeries in the U.S.,” said Martin Makary, a professor of health policy at Johns Hopkins Medicine in Baltimore and author of a recent study in the Journal of the American Medical Association Surgery. “We not only described it, we looked at it in a population every American pays for (through Medicare). That’s a price tag and a context I’m not sure people have really calculated.”

That giant waste of money could be better spent on other treatments, from something as simple as Advil to more sophisticated courses of physical therapy that will give most patients better results, researchers at Johns Hopkins Medicine say.

The problem is that there are two kinds of meniscus tears, said David Altchek, an attending orthopedic surgeon at New York’s Hospital for Special Surgery and the medical director for the New York Mets. Only one of the two tears, the much less common one, responds to surgery, Altchek said.

Arthroscopic procedures for acute injuries are fine and are often done in conjunction with physical therapy to rebuild strength in the joint. These are mostly done on younger patients, who get hurt doing everything from playing basketball to misstepping off a commuter train. The issue with seniors is that their meniscal injuries are more often the result of wear and tear, and they often or even usually coincide with osteoarthritis, Altchek said.

Indeed, the cartilage that wears out in seniors is a different kind of tissue than what is damaged in acute injuries — the cartilage that bothers older patients is usually articular cartilage, while younger patients injure meniscal cartilage.

Articular cartilage is usually found on the surface of bones in the knee joint, and when it wears out, it produces a duller ache. Meniscal cartilage is more like a pad between joints and can produce a sharper pain, especially when it’s injured all at once rather than over time.

Incyte-Merck trial failure deals blow to cancer immunotherapy hopes
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Incyte-Merck trial failure deals blow to cancer immunotherapy hopes

 

Incyte hoped epacadostat, in conjunction with Keytruda, would fight cancer more effectively than Keytruda alone. But epacadostat failed to stop the progression of cancer, and it hasn’t helped overall survival. The disappointing trial caused Incyte stock to drop more than 19 percent on Friday; Merck shares were down near 3 percent, though that merely matched the selloff in the stock market.

“We are disappointed that this study did not confirm the efficacy of epacadostat in combination with KEYTRUDA in patients with unresectable or metastatic melanoma,” said Dr. Steven Stein, chief medical officer of Incyte, in a release. “We remain dedicated to transforming the treatment of cancer and will continue to explore how IDO1 inhibition and other novel mechanisms can potentially improve outcomes for patients in need.”

After halting the melanoma study, Incyte wants to test epacadostat with other types of cancer. Dr. Jason Luke, an oncologist at the University of Chicago, believes the Incyte study examined a patient sample that was too broad. Only patients with T cell-inflamed tumors react to immunotherapy at all. Patients without T cell-inflamed tumors don’t have a natural immune response against cancer. IDO inhibitors won’t make any difference.

“This is why we need to select those patient that have an immune response,” said Luke. For patients that have the natural immune response, epacadostat still might be effective. Unfortunately, this is the minority of cancer patients.

Doctors can use RNA-based sequencing to test if a patient would be a prime candidate for immunotherapy. Although the Incyte and Merck press release mentions lung cancer, Luke said IDO inhibitors might help this minority of patients with any type of cancer.

Dr. Roy Herbst, a Yale University oncologist, believes there is no one-size-fits-all cancer solution. “You have to personalize immunotherapy,” he said. “You need to know who will benefit from drug A and who will benefit from drug B.”

The more research that goes into immunotherapy, the more doctors will understand how best to treat patients. Combining different medications, like Merck and Incyte were trying to do, could improve treatment in the future.

Even with the trial failure, “That’s all the interest right now,” Herbst said.

More from Modern Medicine:

Knee surgery for seniors is costly, and usually a waste of time

Scientists on verge of universal flu vaccine


New Alzheimer’s blood test could detect disease decades in advance

How Mega-Mergers Are Changing the Business of Medical Care
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How Mega-Mergers Are Changing the Business of Medical Care

 

Dr. Mark J. Werner, a consultant for the Chartis Group, which advises medical practices, emphasized that convenience of care didn’t equal quality or, for that matter, less expensive care.

“None of the research has shown any of these approaches to delivering care has meaningfully addressed cost,” Dr. Werner said.

Critics of retail clinics argue that patients are given short shrift by health professionals unfamiliar with their history, and may be given unnecessary prescriptions. But researchers say neither has been proved in studies.

“The quality of care that you see at a retail clinic is equal or superior to what we see in a doctor’s office or emergency department,” said Dr. Ateev Mehrotra, an associate professor of health care policy and medicine at Harvard Medical School, who has researched the retail clinics. “And while there is a worry that they will prescribe antibiotics to everybody, we see equal rates occurring between the clinics and doctor’s offices.”

Still, while the retail clinics over all charge less, particularly compared with emergency rooms, they may increase overall health care spending. Consumers who not long ago would have taken a cough drop or gargled with saltwater to soothe a sore throat now pop into their nearby retail clinic for a strep test.

Frustration with the nation’s health care system has fueled a lot of the recent partnerships. Giant companies are already signaling a desire to tackle complex care for people with a chronic health condition like diabetes or asthma.

“We’re evolving the retail clinic concept,” said Dr. Troyen A. Brennan, the chief medical officer for CVS. The company hopes its proposed merger with Aetna will allow it to transform its current clinics, where a nurse practitioner might offer a flu shot, into a place where patients can have their conditions monitored. “It requires new and different work by the nurse practitioners,” he said.

Dr. Brennan said CVS was not looking to replace patients’ primary care doctors. “We’re not trying to buy up an entire layer of primary care,” he said.

But people will have the option of using the retail clinic to make sure their hypertension or diabetes is well controlled, with tests and counseling provided as well as medications. The goal is to reduce the cost of care for what would otherwise be very expensive conditions, Dr. Brennan said.

If the company’s merger with Aetna goes through, CVS will initially expand in locations where Aetna has a significant number of customers who could readily go to CVS, Dr. Brennan said.

UnitedHealth has also been aggressively making inroads, adding a large medical practice in December and roughly doubling the number of areas where its OptumCare doctors will be to 75 markets in the United States. It is also experimenting with putting its MedExpress urgent care clinics into Walgreens stores.

Big hospital groups are also eroding primary care practices: They employed 43 percent of the nation’s primary care doctors in 2016, up from 23 percent in 2010. They are also aggressively opening up their own urgent care centers, in part to try to ensure a steady flow of patients to their facilities.

HCA Healthcare, the for-profit hospital chain, doubled its number of urgent care centers last year to about 100, according to Merchant Medicine. GoHealth Urgent Care has teamed up with major health systems like Northwell Health in New York and Dignity Health in San Francisco, to open up about 80 centers.

“There is huge consolidation in the market right now,” said Dr. Jeffrey Le Benger, the chief executive of Summit Medical Group, a large independent physician group in New Jersey. “Everyone is fighting for the primary care patient.” He, too, has opened up urgent care centers, which he describes as a “loss leader,” unprofitable but critical to managing patients.

Eva Palmer, 22, of Washington, D.C., sought out One Medical, a venture-backed practice that is one of the nation’s largest independent groups, when she couldn’t get in to see a primary care doctor, even when she became ill. After paying the annual fee of about $200, she was able to make an appointment to get treatment for strep throat and pneumonia.

“In 15 minutes, I was able to get the prescriptions I needed — it was awesome,” Ms. Palmer said.

Patients also have the option of getting a virtual consultation at any time.

By using sophisticated computer systems, One Medical, which employs 400 doctors and health staff members in eight major cities, allows its physicians to spend a half-hour with every patient.

Dr. Navya Mysore joined One Medical after working for a large New York health system, where “there was a lot of bureaucracy,” she said. She now has more freedom to practice medicine the way she wants and focus more on preventive health, she said.

By being so readily available, One Medical can reduce visits to an emergency room or an urgent care center, said Dr. Jeff Dobro, the company’s chief medical officer.

As primary care doctors become an “increasingly endangered species, it is very hard to practice like this,” he said.

Hospital CEO forced to pay hackers in bitcoin now teaches others
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Hospital CEO forced to pay hackers in bitcoin now teaches others

 

“By 10:30 that night we had shut down every single computer that we had and all our servers,” Long recalled about the Thursday night in January. “By midnight we successfully shut off every computer in the organization and started from scratch. It’s surreal.”

By 4 a.m. on Friday, Long and his team had recruited Indianapolis-based cybersecurity firm Pondurance to identify the cause and scope of the attack and eradicate the imminent threat.

Pondurance co-founder Ron Pelletier said the first priority was to contain the intrusion and evaluate what was affected. Together with the FBI, which was called in to help pinpoint the origin of the attack, Pondurance experts determined that there was no easy way to erase the encrypted data from Hancock’s system and replace it with clean data from the backup system.

Taking into consideration the flu outbreak and the snowstorm, Long made the executive decision to buy the decryption keys from the hackers. Late Friday night, Hancock bought the keys by transferring four bitcoin.

Bitcoin’s was selling above $13,500 that day, bringing the estimated total Hancock paid to about $55,000.

“Criminal organizations now are treating this like a business,” Pelletier said. “They’re going to plan, they’re going to make sure they understand how they’re going to execute and then they’re going to set out and see where they can execute.”

Cybercriminals typically use the fourth quarter of the year to seek out “low-hanging fruit” and plan their attack, Pelletier said. Then, in the first quarter, particularly between February and April — a time Pelletier has come to refer to as “breach season” due to the uptick of cyber incidents — they put their plan into action.

“Hancock is one organization of many in this period that this happened to,” Pelletier said.

While the investigation into Hancock’s attack is ongoing, none of the network’s patient data appears to have been stolen, which Pelletier said was an indication that this particular group saw ransomware as a more effective way of getting paid.

“If you think about the numbers of breaches that have occurred in general, [it’s] millions and millions of records,” Pelletier said. “The dark web becomes a supply and demand issue at some point — I can try to monetize PHI [personal health information] by selling it on the dark web, or I can probably make maybe less, but a more expedited payment if I do something like ransomware.”