Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Saturday, October 21, 2023

I Am Having Major Network Issues => Use davidgmore@gmail.com To Contact Me If Needed!

 It is a lovely spring day in Sydney - far away from the horrors of the world!

David.

Monday 10am - Issues seem to be resolved!

D.

Friday, October 20, 2023

It Really Seems Like A Lot Has Happened With ChatGPT In A Year!

Spotted this this week:

Incredibly smart or incredibly stupid? What we learned from using ChatGPT for a year

As the tool becomes less of a curiosity and more a part of daily life, fans are finding clever uses – and discovering limitations

Matthew Cantor

@CantorMatthew

First published on Fri 13 Oct 2023 00.00 AEDT

Next month ChatGPT will celebrate its first birthday – marking a year in which the chatbot, for many, turned AI from a futuristic concept to a daily reality.

Its universal accessibility has led to a host of concerns, from job losses to disinformation to plagiarism. Over the same period, tens of millions of users have been investigating what the platform can do to make their lives just a little bit easier.

Upon its release, users quickly embraced ChatGPT’s potential for silliness, asking it to play 20 questions or write its own songs. As its first anniversary approaches, people are using it for a huge range of tasks. We’ve all heard about uses like crafting emails, writing student essays and penning cover letters. But with the right prompts, it can take on jobs that are more esoteric but equally useful in everyday life. Here are a few that might come in handy.

Jargon demystifier

You’re at a work meeting, and the accountants are talking about GAAP operating income for Q4 of FY22, the design people are panicked about kerning, and the CEO wants you to circle back to drill down on some pain points. On top of that, your British boss says your work is “quite good” but strangely doesn’t seem happy with it, while your US colleague claims everything anyone has ever done is amazing. Users say they’ve turned to ChatGPT for help as an intermediary, employing it to translate workplace jargon so everyone’s on the same page about the concerns you flagged, tnx.

This isn’t limited to the office: people have used ChatGPT to, for instance, translate a sleep study’s medical terminology, or help craft a legal opinion. It can serve as an intergenerational go-between: users have turned it into a gen Z slang translator (sample sentence from a description of a key historical event: “Titanic, flexing as the unsinkable chonk, sets sail with mad swag, a boatload of peeps, and the vibes of a 1912 rave”).

Pitiless critic

Sometimes you want a real critique of your work, a harsh assessment that your friends and family are too nice to provide. For some, ChatGPT is that critic (though whether the word “real” applies here is debatable). “I use ChatGPT to brutally audit where my copy is falling short of the target audience’s expectations,” a copywriter wrote on Reddit. Some have even found it can give decent (if imperfect) criticism of fiction writing, pointing out redundancies, missing characterization or weak imagery.

There are, of course, ethical questions about the use of ChatGPT in work and school settings. In response, some argue that asking it to be your critic, and learning from its feedback, is a way to improve your writing without letting it put words in your mouth.

It’s not always an easy task: what it gives you depends entirely on how you structure the prompt. Some users find it tough to find the language to “convince” it to be harsh enough. And you’ll get more appropriate feedback if you give it a detailed task – “give me feedback” might not help as much as “I’m writing an essay for college – tell me whether it’s well-structured and clear”.

Robot with feelings

Maybe you don’t want ChatGPT to be mean – maybe you want the opposite. Users have asked ChatGPT for help being nicer in their work emails, especially when they’re secretly fuming. “I write to it: please make me sound like less of an asshole,” said one user.

Sous chef

It’s dinnertime and there’s stuff in the kitchen – but you have no idea what to do with a half-eaten yogurt, a leftover chicken leg, a bag of flour and some forgotten tomatoes on the verge of becoming truly upsetting. Users report that ChatGPT has helped them create impressive meals out of what they have, or come up with ideas based on what’s around and a specified grocery budget. Many users report being pleased with the results, though some recipes sound perhaps too creative: garbanzo bean and cheddar cheese soup, a peanut butter and Nutella quesadilla, and a “carrot and grape salad with muesli crunch” (based on what’s in my own kitchen).

ChatGPT invents an odd recipe. Photograph: ChatGPT/Screenshot

Last month, OpenAI, the tool’s developer, added an image-recognition feature that makes this task even easier – instead of having to list ingredients, users can take photos of the food in their cabinets and ChatGPT will come up with recipes.

Results have been mixed. Beyond the fact that the bot has no taste buds, some users have expressed safety concerns, saying ChatGPT may, for example, convince inexperienced chefs to undercook meat.

Whiteboard interpreter

Following the update allowing ChatGPT to “see”, users have found its interpretation skills to be alarmingly impressive. In a clip making the rounds, an AI developer, Mckay Wrigley, shows it a hand-drawn flowchart on a whiteboard, which it’s able to turn into code that Wrigley runs – and it works. The platform can even tell that the green arrows indicate the steps should be reordered. So you can stop beating yourself up for never having learned to code.

Speedy summarizer

ChatGPT can act as your personal SparkNotes, condensing large quantities of information into small ones – whether that information is in the form of articles, meeting notes or book chapters. Combined with the right browser plugin, it can even summarize entire YouTube videos so you don’t have to listen to an insufferable Ted Talker.

Here is the full link text:

https://www.theguardian.com/technology/2023/oct/12/chatgpt-uses-writing-recipes-one-year

Certainly we are seeing all sorts of ideas on how to use this AI. I, for one, would not have expected how fast we have moved!

David.

 

Thursday, October 19, 2023

This Looks Like Very Good News Indeed Given How Many Sepsis Kills!

 

This appeared last week:

Sepsis treatment on next stage of clinical trials across hospitals throughout the country

By Nicholas Finch

6:31PM October 12, 2023

Australian scientists are developing a new treatment for deadly sepsis, and are moving onto the next phase of clinical trials across the country.

The Florey Institute of Neuroscience and Mental Health discovered that patients administered with sodium ascorbate showed signs of improved organ functions across the body, and needed less medical assistance in restoring blood pressure.

The results were positive enough for researchers to investigate the effects of sodium ascorbate outside of sepsis treatment. Potential benefits include assisting in open heart surgery, ­treating a subarachnoid haemorrhage or traumatic brain injury, and acting as an immune stimulant for immunocompromised patients.

The Florey Institute successfully tested the chemical on an unresponsive patient in 2020, then trialled it from then until 2022 with 30 patients at Melbourne’s Austin Hospital.

The results of the study have been published in the journal Critical Care, which found that patients administered with the drug showed improved kidney function, reduced requirements for blood pressure-maintaining drugs, and reduced multi-organ dysfunction.

The next phase of clinical trials will involve 300 patients over 1 to 1.5 years.

The World Health Organisation said in 2020 that sepsis was responsible for 11 million deaths every year. Austin Hospital’s director of intensive care research, Rinaldo Bellomo, said that its extremity and speed makes sepsis the biggest killer in intensive care units across the world.

“People may not appreciate how big a problem sepsis is,” Professor Bellomo told The Australian. “Your kidneys don’t work, your lungs don’t work, your circulation malfunctions, your liver malfunctions, and your chance of dying is around 20 per cent. And this is a much bigger risk than having a heart attack, which is the sort of thing that people immediately understand and recognise.”

Lots more here:

https://www.theaustralian.com.au/science/sepsis-treatment-on-next-stage-of-clinical-trials-across-hospitals-throughout-the-country/news-story/83078700609111051f0126d92ff4e160

Given the lethality of sepsis every 1% improvement matters.

We can only hope for more soon!

David.

Tuesday, October 17, 2023

Ozempic Seems To Be Getting A Lot Of Attention. Care Is Required With On-Line Sales And Marketing At Least!

Fads are a commonly seen manifestation in the health sector.

It could be argued to latest biggie is semaglutide (Ozempic). The drug was introduced as a treatment for Type 2 diabetes but it is the powerful weigh-loss effects that have been noticed in the overweight rich world – which now has a shortage and which has the drug selling in such quantities that it is having a real impact on the Danish GDP! (Yes it is not cheap!)

This is a useful review of what is going on!

Possible Ozempic side effects investigated by Australian drug regulator

By Aisha Dow and Henrietta Cook

October 10, 2023 — 11.22am

Australia’s medicine regulator is investigating several reports of intestinal obstructions in patients using the diabetes turned weight-loss drug Ozempic, in a step that could lead to a change to the drug’s product information.

Ozempic, which has been in short supply since Hollywood stars and influencers boosted its reputation as a quick weight-loss solution, has already been associated with several potential complications, including pancreatitis, diarrhoea, nausea and low blood sugar.

Gary Wittert, an endocrinologist from the University of Adelaide, said these and other possible side effects should serve as a reminder that Ozempic was a medication “intended to treat serious disease”.

“It’s not meant to be thrown around to lose a few kilograms here or there.”

Last month, the US drug regulator, the Food and Drug Administration (FDA), updated Ozempic’s labelling to recognise that cases of a gastrointestinal disorder called ileus have been reported following use of the drug.

Ileus stops the bowel from working normally to move waste out of the body.

Australia’s Therapeutic Good Administration (TGA) confirmed it had also received three reports of intestinal obstructions and one case of “ileus paralytic”, though a spokesman stressed that there may be no link between these events and the medicine.

The TGA is investigating the issue to see if local updates are required to the drug’s product information.

Prescriptions for Ozempic have exploded in recent years in Australia and around the world, in a trend linked to its growing reputation as a fat-burning drug, and off-label prescribing of the medicine designed as a treatment for type 2 diabetes.

A weight-loss version of the drug, called Wegovy, has not yet been made available in Australia.

Wittert said when Ozempic was properly prescribed for type 2 diabetes, it was a life-saving medication for many people. He said it could also be extremely beneficial for patients whose health and quality of life are being harmed by obesity.

“I use it to treat people with diabetes who have got significant obesity and significant obesity-related comorbidities, and it changes their lives completely. And it’s been extremely frustrating, and sometimes distressing for people, to find that they can’t get it… because it’s being used inappropriately,” he said.

Wittert said Ozempic worked on at least three parts of the body. It works on the gut, slowing gastric emptying, which may help explain cases of ileus.

He said it also works on the pancreas and has been linked to rare cases of pancreatitis. Finally, he said it works on the brain to decrease appetite.

Since 2020, 91 cases of pancreatitis following the use of Ozempic, otherwise known as semaglutide, have been reported to the TGA.

“It is important to note that reporting of an adverse event to the TGA or publication in the DAEN does not necessarily mean that a causal link with the medicine is established,” a TGA spokesman said.

Dr Terri-Lynne South, chair of the obesity management group with the Royal Australian College of General Practitioners, said gastrointestinal side effects such as nausea and vomiting were the most common side effects of Ozempic. Other patients reported constipation or diarrhoea, she said.

South said although the class of drugs that Ozempic belongs to had been around for quite a while, they were still learning about the long-term impacts of Ozempic, which was first developed about a decade ago.

A spokesperson for Novo Nordisk, the company behind Ozempic, said patient safety was a top priority for the company and it worked closely with the FDA and TGA “to continuously monitor the safety profile of our medicines”.

More here

https://www.smh.com.au/national/possible-ozempic-side-effects-investigated-by-australian-drug-regulator-20231009-p5easx.html

With popularity comes all sorts of problems and potential misuse.

Amazingly there are even counterfeit injector pens (it is usually a weekly injection).

https://www.novonordisk-us.com/media/news-archive/news-details.html?id=166119

What with some misuse, counterfeit injectors and really significant side-effects my feeling is this is a drug to be used by experts for patients with diabetes and those at risk of developing it! (which leaves out the Hollywood set etc.)

Having an on-line free for all will end badly and as for it being flogged by on-line drug peddlers as is now happening I reckon regulatory intervention is well overdue. Could give telehealth a very bad name unfairly and do some real harm!

David.


Sunday, October 15, 2023

Adoption Of The Voice Has Failed But Health System Improvements Must Proceed!

Australia has voted on the Indigenous Voice To Parliament:

‘The Australian people always get it right’: Deputy prime minister

Deputy Prime Minister Richard Marles says the government will continue its work on reconciliation and closing the gap despite the defeat of the Voice to parliament referendum.

“Obviously for those of us who are supporting the Yes campaign, it wasn’t the night we hoped for, and I am disappointed, but the Australian people always get it right, and we absolutely accept this result,” he said on ABC’s Insiders this morning.

“But I don’t take last night as any vote against reconciliation, and I think both sides of the argument made that clear, even in their comments after the result last night, nor do I take this as a vote against a will, on the part of the Australian people, to see a closing of the gap in social disadvantage which affects Indigenous Australians.

“To close the gap, and from the government’s point of view, obviously that is now our focus. The Australian people have asked us to do this in a different way. We hear that and we’ll do that and we will now look at how we can work harder.”

Marles said the government had of course weighed up the issues when it became clear the Coalition decided against supporting the Voice, but they always believed it was best to press on.

“Did we understand that it was more difficult? Of course we did. But we didn’t go to the election saying, ‘We will take this to the Australian people so long as Peter Dutton agrees’,” he said.

Here is the link:

https://www.smh.com.au/politics/federal/voice-referendum-results-live-updates-australia-rejects-constitutional-change-pm-says-government-will-accept-result-20231014-p5ec9o.html?post=p55bgp#p55bgp

In the end it wasn’t even close with the NO vote fining up at close to 60%

It seems clear that despite this overall rejectionist sentiment there are a great number of health related initiatives (including Digital Health development) that need to continue and be further evolved..

The physical and mental health of many of the First Australians is simply unconscionable and an outcome of the failed referendum must surely be to make sure the efforts at consultation with and health support of this population are accelerated and not reduced.

The sad thing is that after a gazillion reports we all know what needs to be done and what resources are required. The time for actual delivery has now arrived, as we put to failed referendum behind us and move forward in a positive way! I wonder will our Governments step up?

David.

AusHealthIT Poll Number 718 – Results – 15 October, 2023.

 Here are the results of the poll.

Should The Prescriber Be Able To Decide If A Script Is Good/Valid For Either 30 or 60 Days?

Yes                                                                              4 (15%)

No                                                                              21 (78%)

I Have no Idea                                                            2 (7%)

Total No. Of Votes: 27

A clear outcome that I really do not understand! If the prescriber can’t decide on the script duration just who can?

Any insights on the poll are welcome, as a comment, as usual!

A poor number of votes. And also a very clear outcome even if I don’t understand it! 

2 of 27 who answered the poll admitted to not being sure about the answer to the question!

Again, many, many thanks to all those very few who voted! 

David.

Thursday, October 12, 2023

Given The Health Divide Between Indigenous And Non-Indigenous Australiana The Referendum Needs Some Commentary!

This appeared least week:

Indigenous voice to parliament: ‘Out here’ in the APY Lands, early death the great divide

Exclusive

By Greg Bearup

Feature writer, The Weekend Australian Magazine

3:44PM October 7, 2023

Out here, the houses are overflowing with kids and cousins. The cost of fuel and fresh food is eye-watering.

Teachers out here use a device called a Soundfield to amplify their voices so kids can hear through the gunk in their infected ears.

If you were born and raised out here in the Anangu Pitjantjatjara Yankunytjatjara Lands in the remote northwest corner of South Australia, the odds are you’ll be dead before you’re 55. A Torrens University study found that out here they have the highest rate of “premature mortality” in Australia. Out here is out of kilter with the rest of this healthy and wealthy country. Some argue the voice will divide us, but this nation is already divided.

The Anangu live in small communities on their traditional lands in the foothills of the spectacular Musgrave Ranges – it’s softly stunning, like an Albert Namatjira watercolour. Two thousand people are spread across an area the size of Germany 1200km from Adelaide, speaking either Pitjantjatjara or Yankunytjatjara. As a result of this extreme isolation, traditional culture is still deeply etched into the fabric of life. It’s pretty much a dry community, apart from occasions when grog is smuggled in. There’s a vibrant arts sector, the community is strong and there are some wonderful, committed whitefellas working with the Anangu to bring about change.

But on just about every social measure the folk of the APY Lands are the most disadvantaged people in Australia.

And so you’d reckon that out here they’d be clamouring for a voice in Canberra to address these myriad ailments. But despite this poverty of outcomes, or possibly because of it, there’s uncertainty about the referendum and an understandable distrust, an ingrained wariness, of anything that has the sniff of coming their way from whitefellas “over east”.

I first talked to the chair of Ernabella Arts, Anne Thompson, about the voice when I was visiting the APY lands in early September. She was deeply sceptical. “No one has really ever listened to Anangu in the past. Why now? What’s gunna change?”

She said she would need to be convinced about what the voice would do for her people before she’d vote yes. At that time she was leaning heavily towards no.

However, I spoke to Thompson again a few days ago when she was visiting Sydney for an exhibition and she is now more enthusiastic about voting yes. “I don’t think it’s gunna bring peace, but I am gunna vote yes, probably.” She says the voice will not fix all their problems, but First Nations people should be recognised. “We want to be respected.”

When I first spoke to the previous chair, famed artist Alison Milyika Carroll, she said she didn’t really know anything about the referendum and that “maybe” she would vote yes. A few days ago she told me people have been talking a lot about the voice. “Everybody is saying they are gunna say yes. Everyone in the arts centre and everyone in the community, they are all saying yes. People have been talking a lot. (A few) still (say) no, but most say yes.”

Old versus young

Rueben Burton, director of the Pitjantjatjara Yankunytjatjara Education Committee, has the same view as Anne Thompson, that whitefellas never listen. He says programs are foisted on the APY Lands from afar without any consultation, then the locals are blamed when those programs fail. But he reckons this is a chance for his mob to finally be heard.

Burton says the great challenge for his people is integrating the kids into the Western world – giving them opportunities for further education and good jobs – while maintaining a hold over traditional culture and language.

“My understanding about the voice … is to educate the government people to recognise the importance of Anangu (knowledge),” he says. “Maybe one day the voice can help us get the things that Anangu (need) … we want to say this is how we want to change things. We should be saying ‘This is how you do it’. I’m a supporter of the yes.”

Vastly more here:

https://www.theaustralian.com.au/nation/indigenous/indigenous-voice-to-parliament-out-here-in-the-apy-lands-early-death-the-great-divide/news-story/a288c5e93c9b6aa5a170151126f2477a

As noted above, there is a vote on Saturday that proponents suggest, if carried, will do good things for indigenous health! If that outcome is even probable, on that basis alone, it has to be supported. The state of indigenous health is really a national shame IMVHO and must be addressed in all ways possible!

My concern, and it is obvious, is that there have been efforts on the health front forever, and pretty much zero progress forever too!

If I could believe the Voice would really make a difference, then you have won me hands down! My only concern is that it might not turn out to be true. Nevertheless, some good people seem to be sure it will really help and on that basis I am in!

Time will tell if I have been conned or not, but I hope not.

My other worry is that I would rather not embed unproven solutions in our constitution and so I favour a legislated Voice initially and then a move to the constitution after we know it works!

But what would I know?

David.

Tuesday, October 10, 2023

The ADHA Spins The Wheel Again But Does Not Seem To Come Up With Much!

 This appeared last week:

Roundup: ADHA names new board chair and more briefs

By Adam Ang

September 29, 2023 04:16 AM

ADHA appoints new board chair

The Australian Digital Health Agency has assigned Lyn McGrath to their board's chair. 

McGrath has been a non-executive member of the ADHA Board for over seven years. She has also served as chair of the agency's Audit and Risk Committee.

She will be replacing Dr Elizabeth Deveny, who has been with the organisation since its inception. 

"It's with great enthusiasm that I take up the role of Chair of the [ADHA] Board. I look forward to continuing to advance the national digital health agenda and building on the momentum that has already been achieved under Dr Deveny's leadership," McGrath said about her three-year appointment, which begins on 29 September. 

Other stories follow here:

https://www.healthcareitnews.com/news/anz/roundup-adha-names-new-board-chair-and-more-briefs

The old chair has been in place since 2016, and the main feature I have noticed in that period is that the ADHA Board is a secret organisation that does not tell anyone outside what it is doing or what its plans other than in the usual glossy puff-pieces we see every year or two.

Pity those affected by its actions (most of us) do not see any minutes etc. of the meetings and are not asked to comment from time to time on how things are going!

Seems to be typical of the way bureaucracy works these days.

Rather sad I reckon.

David.