Newborn Butterfly Project Non-Surgically Corrects Infant Ear DeformitiesNEW YORK (February 27, 2015) -- A team of researchers from Weill Cornell Medical College and NewYork-Presbyterian/Weill Cornell Medical Center has improved a non-surgical procedure that safely and effectively corrects newborn ear deformities in just two weeks -- a drastically shorter period of time than previously reported.
In their study, published today in the Journal of Plastic and Reconstructive Surgery, the researchers demonstrate how a rigid plastic mold can be used to reshape deformed ears -- softening the curves and re-contouring the cartilage -- when applied to newborn infants' ears within the first few weeks of their lives. They also discovered that the pain-free and non-invasive procedure could effectively transform the ear shape in 14 days, compared to the six to eight weeks doctors have historically advised.
"This research represents a breakthrough in how we treat ear deformities," said lead author Dr. Melissa Doft, a clinical assistant professor of plastic surgery at Weill Cornell Medical College and an assistant attending surgeon at NewYork-Presbyterian/Weill Cornell. "Through innovation, we have an opportunity to truly make a difference in children's lives, helping to decrease the bullying that many children with ear deformities face and eliminating the need for invasive surgical correction later in life."
The investigators' findings are based on the outcomes of procedures that Dr. Doft, in collaboration with pediatricians, audiologists and parents, conducted on about 100 newborns (and 158 ears) using the Becon EarWell Infant Ear Correction System between 2010 and 2013 at NewYork-Presbyterian/Weill Cornell. Infants from the newborn nursery were referred directly to Dr. Doft in the first few days of their lives, when ears are characterized by greater plasticity. The investigators found that the process was nearly fail-proof, with a 96 percent success rate, and attributed these outcomes to the young age at which they initiated intervention.
While ear correction is typically cosmetic, early intervention and ear molding with the EarWell is often covered by insurance because it's considered a congenital deformity. Dr. Doft dubbed her research the Newborn Butterfly Project because abnormal ears are coaxed through a natural metamorphosis, similar to how a caterpillar becomes a butterfly.
Ear deformities and ear molding
Fifteen to 20 percent of all children are born with an ear deformity, which includes constriction, a missing fold, a deep conchal bowl or an obtuse angle. Of these deformities, 30 percent are expected to self-correct, but there is no scientific way to know which ones will improve. Infants are born with high levels of estrogen in their bloodstreams, which peaks at day three of life. This elevated estrogen increases the ear cartilage's plasticity, allowing the ear to be molded into the correct position.
While ear molding has been taking place for centuries, the technique has traditionally been less effective in correcting deformities. Until recently, physicians had advised new parents to use dental paste, feeding tubes and paper tape to make a hodge-podge of a mold that could reshape their baby's ears. However, this placed the onus of shaping the ear on the baby's parents, who can be overwhelmed with caring for a small child. The makeshift mold also wiggled and shifted so the ear was not continuously being folded into the correct position, elongating treatment times. The EarWell device, released five years ago, changed things, Dr. Doft said.
"The EarWell is a little cradle that holds the ear in the perfect position so the parents do not have to do anything," Dr. Doft said. "They just leave it on and do not even have to think about it. It applies pressure to the ear to conform to a more natural anatomy 24/7."
Once estrogen levels return to normal -- when infants are about six weeks old -- using non-surgical means to fix deformities becomes less reliable, causing infants with ear abnormalities to wait and have ear surgery later in life. Many children have the surgery, called otoplasty, later in their childhood, but like all surgeries, it comes with pain and some risk, including infection, hematoma and anesthesia-related complications. With otoplasty, there's also a 20 percent chance that the deformity will reoccur if the stiches break. The EarWell's higher success rate and pain-free process may make it a more attractive option for parents.
"The fact that non-surgical ear molding is more successful than surgical correction is noteworthy," Dr. Doft said, adding that there are some things -- like changes to the soft curves of the ear or certain ridges -- that can be much better corrected with molding.
Ease of use
The procedure is pain-free, does not impact children's ability to hear and does not affect parents' ability to breast-feed. "The device is perforated, so the babies can hear perfectly fine. You can breast-feed with it. The only limitation is that you need to try not to get it wet because of the adhesive that sticks onto the baby's skin," Dr. Doft said. "Otherwise, you just treat it as if the baby is wearing little earmuffs."
In the patients who participated in the study, Dr. Doft placed the EarWell within the first six weeks of life, sometimes when the child was still in the newborn nursery. The investigators monitored the patients throughout treatment, which lasted 14 days on average (between nine and 42 days), and reviewed outcomes over two years. The study authors also surveyed parents at the time of placing the EarWell, immediately after treatment, and again at six and 12 months.
Prior to treatment, 73 percent of parents said that they believed the deformity would lead to "severe psychological harm," Dr. Doft said. "If you look at the research, that worry makes sense," she said, citing the prevalence of stories in the news on the bullying and teasing of children who have abnormal ears. "They're definitely affected by it."
If more people knew about -- and took advantage of -- this option, Dr. Doft said, future surgical intervention and psychological trauma could be avoided. "With doctors, healthcare professionals and parents working together," Dr. Doft said, "we are able to produce outcomes that can only happen during a short time-window in newborn infants' lives -- something we have never been able to achieve before."
Study co-authors include Anthony N. LaBruna, Ashutosh Kacker and Jennifer I. DiPace from Weill Cornell Medical College. At the time of the study, co-authors Shawn Diamond was a medical student at Weill Cornell and Alison Goodkind was an undergraduate student at Barnard College.NewYork-Presbyterian/Weill Cornell Medical Center
NewYork-Presbyterian/Weill Cornell Medical Center, located in New York City, is one of the leading academic medical centers in the world, comprising the teaching hospital NewYork-Presbyterian and Weill Cornell Medical College, the medical school of Cornell University. NewYork-Presbyterian/Weill Cornell provides state-of-the-art inpatient, ambulatory and preventive care in all areas of medicine, and is committed to excellence in patient care, education, research and community service. Weill Cornell physician-scientists have been responsible for many medical advances -- including the development of the Pap test for cervical cancer; the synthesis of penicillin; the first successful embryo-biopsy pregnancy and birth in the U.S.; the first clinical trial for gene therapy for Parkinson's disease; the first indication of bone marrow's critical role in tumor growth; and, most recently, the world's first successful use of deep brain stimulation to treat a minimally conscious brain-injured patient. NewYork-Presbyterian Hospital also comprises NewYork-Presbyterian/Columbia University Medical Center, NewYork-Presbyterian/Morgan Stanley Children's Hospital, NewYork-Presbyterian/Westchester Division, York-Presbyterian/The Allen Hospital, and NewYork-Presbyterian/Lower Manhattan Hospital. The hospital is also closely affiliated with NewYork-Presbyterian/Hudson Valley Hospital and NewYork-Presbyterian/Lawrence Hospital. NewYork-Presbyterian is the #1 hospital in the New York metropolitan area, according to U.S. News & World Report, and consistently named to the magazine's Honor Roll of best hospitals in the nation. Weill Cornell Medical College is the first U.S. medical college to offer a medical degree overseas and maintains a strong global presence in Austria, Brazil, Haiti, Tanzania, Turkey and Qatar. For more information, visit www.nyp.org and weill.cornell.edu.Weill Cornell Medical College
Weill Cornell Medical College, Cornell University's medical school located in New York City, is committed to excellence in research, teaching, patient care and the advancement of the art and science of medicine, locally, nationally and globally. Physicians and scientists of Weill Cornell Medical College are engaged in cutting-edge research from bench to bedside aimed at unlocking mysteries of the human body in health and sickness and toward developing new treatments and prevention strategies. In its commitment to global health and education, Weill Cornell has a strong presence in places such as Qatar, Tanzania, Haiti, Brazil, Austria and Turkey. Through the historic Weill Cornell Medical College in Qatar, the Medical College is the first in the U.S. to offer its M.D. degree overseas. Weill Cornell is the birthplace of many medical advances -- including the development of the Pap test for cervical cancer, the synthesis of penicillin, the first successful embryo-biopsy pregnancy and birth in the U.S., the first clinical trial of gene therapy for Parkinson's disease, and most recently, the world's first successful use of deep brain stimulation to treat a minimally conscious brain-injured patient. Weill Cornell Medical College is affiliated with NewYork-Presbyterian Hospital.
Saturday, February 28, 2015
Infant Ear Deformities
Tuesday, February 17, 2015
Salt Lake Vocal Artists to perform at national ACDA conference
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| Salt Lake Vocal Artists |
A former Mormon Tabernacle Choir member described the Salt Lake Vocal Artists performance as "enthusiastic" and "professional grade."
Under the baton of Dr. Brady Allred, the A Cappella choir will perform February 23, 2015 at 7:30 p.m. at the First Baptist Church, 777 South 1300 East, Salt Lake City. The performance, called "The Singing Heart," will also include Ko Matsushita and the Metropolitan Chorus of Tokyo.
Later that week the two choirs will perform at the American Choral Directors Association (ACDA) national conference in Salt Lake City. The ACDA conference program will include a half dozen songs by the Salt Lake Vocal Artists, including three that were commissioned for the choir.
I Cannot Dance, composed by Canadian Larry Nickel, includes a solo by Jennifer Williamson.
I cannot dance O' Lord,
Unless You lead me
If You want me to leap joyfully,
Let me see You dance and sing
The choir uses Singing Bowls from Crystal Tones in their performance of Eriks Esenvalds' Stars. The bowls add magic to a beautiful performance of Esenvalds' music and lyrics adapted from a poem by Sara Teasdale (1920). Latvian Ešenvalds is one of the most sought-after choral composers working today.
Alone in the night
On a dark hill
With pines around me
Spicy and still,
Another piece, beautifully performed by the choir, is Alleluia by American composer Jake Runestad. An online description of the music says: "Through history, the singing of 'alleluia' has served as an outward celebration as well as an introspective prayer of praise,... The work begins with a rhythmic declaration of joy and builds intensity through metric changes, tonal shifts, glissandi, and hand clapping. This lively exultation soon gives way to a reverent meditation with soaring melodic lines and lush harmonies. The dancing rhythms from the beginning return with a gradual build in intensity as one’s praises rise to the sky. Click to hear the choir's performance of Alleluia.
Organized under the direction of Dr. Brady Allred in 2010, the Salt Lake Vocal Artists has become the first professional-level touring and recording choir within the Salt Lake Choral Artists organization. This mixed-voice choral ensemble varies in size depending on the project from 16 to 40 auditioned singers and performs a diverse repertoire ranging from the Renaissance to the 21st Century.
In its premiere season, the SL Vocal Artists were honored with an invitation to participate in the 42nd Tolosa Choral Contest in October 2010. After a successful concert tour of the Basque region of Spain, the SLVA competed against renowned choirs from all over the world and were awarded First Prize in all four categories they entered, as well as the special Audience Prize.
To conclude only its second season, the SL Vocal Artists were one of only 25 choirs and the only American choir to perform at the World Choral Symposium in Argentina following a two week concert tour of the country in July and August. They also traveled by invitation to Italy in September to compete in the Arezzo International Choral Competition where they won 5 first prizes, and as a featured choir for the Concordia Vocis music festival in Cagliari, Sardinia, Italy.
In addition to debuting at the national ACDA conference in February, the choir will travel in June 2015 to Aachen, Germany as the featured international choir for the Chor Biennale and to The Netherlands for additional concerts with the choirs of Dion Ritten.
Prior to resigning in October 2010, Dr. Allred served as the Director of Choral Studies at the University of Utah, where he conducted the award-winning University of Utah Singers and the A Cappella Choir. Facebook page https://www.facebook.com/SLVocalArtists
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| Brady Allred and Stefan Kaltenbock |
Boosting Kid’s Self-Esteem through Yoga!
by Teresa Anne Power
February is International Self-Esteem Month, and one way to enhance the self-worth of children is through the practice of yoga. Yoga can not only help build a child's esteem and motivation but also their over-all health and well-being.
The National Association for Self-Esteem (NASE) defines self-esteem as "the experience of being capable of meeting life's challenges and being worthy of happiness." Self-esteem is not about looks or clothing but instead what you think about yourself internally.
Children today are faced with challenges not only from our fast-paced technological society but also from peer pressure, bullying, competition, and demands from school and extra-curricular activities. How children view themselves personally can have a huge impact on their confidence, and in turn how they handle situations such as the above where their self-esteem is tested.
We need to develop in our youth a healthy self-esteem characterized by
- Tolerance
- Respect for others
- Integrity
- Responsibility for their own actions
- Self-motivation and
- Feeling worthy of happiness
Children who have healthy self-esteem trust their own being to be life affirming, constructive, and responsible. Yoga can build self-worth by promoting a positive outlook, reducing anxiety, and focusing the mind to bring clarity and perspective.
One great posture for kids to try is the Flamingo Pose. This yoga posture helps with focus and concentration, while at the same time building confidence and self-esteem in children as they learn to balance on one leg.
When a child has the foundation of healthy self-esteem, he or she can be better prepared to face the trials and challenges of life with a sense of capability to overcome and work through them.
Teresa Anne Power, avid yoga practitioner for over 30 years, is a leading authority on children's yoga, and the best-selling author of The ABCs of Yoga for Kids. Also available in Spanish, and soon in French and Italian, her book has won multiple awards including, but not limited to, The Mom's Choice Award, Family Choice Award, Living Now Book Award, Moonbeam Children's Book Award, and National Best Books Award. Since, Power has recently released The ABCs of Yoga for Kids 2015 Calendar, and a new interactive yoga DVD, Yoga Adventures with Down Dog.
Power has appeared on both local and national television, and has had articles published in USA Today Magazine, Yogi Times, Violet magazine, and The Palisadian-Post. She currently writes articles about children's health and fitness on Examiner.com.
For the past 10 years, Power has taught young children yoga in schools, yoga studios, and local organizations, helping thousands of kids develop a healthy attitude towards their body. Power has also spoken at numerous libraries, schools, yogastudio, and school conferences. In addition, she volunteers her yoga expertise, and works with Children's Bureau, Pathways, Connections with Children and the Neighborhood Youth Association. Additionally, Power is a keynote speaker and teaches children's yoga training workshops. A graduate of University of Southern California, she earned her J.D. from Pepperdine University School of Law and has a California Real Estate Broker's License. In 2002, she completed a yoga training program with Indigo Yoga.
She resides in Pacific Palisades, California.
Website: http://www.abcyogaforkids.com/
Twitter: https://twitter.com/abcyogaforkids
The ABCs of Yoga for Kids is available for purchase at Amazon, Barnes & Noble, The Chopra Center, and many other bookstores and yoga studios.
Opinion: Tennessee Medicaid Expansion’s Bad Priorities
Medicaid Expansion's Bad for State Taxpayers
By Sean Parnell |
| Sean Parnell |
On its face, expansion might appear to be a no-brainer. The federal government will pay for all of the expansion cost for the first few years, and 90 percent afterwards. The expansion would undoubtedly help reduce the number of people who are considered uninsured, which is probably a good thing.
But once you get past the pro-expansion talking points, things look far less rosy. In fact, getting on the expansion bandwagon is almost certain to end up in disaster.
Consider the high level of federal funds involved. The federal government normally covers about 65 percent of what Tennessee pays for its Medicaid program. Getting 90 percent covered for people made newly eligible under an expansion is obviously a better deal than that.
That 90 percent share, however, is not carved in stone. In fact, in past budgets both the Republican Congress and President Obama himself have suggested the federal government's share under the expansion should be reduced.
When that happens (and the federal budget deficits that loom in the next couple of years pretty much guarantee it's a matter of when, not if), Tennessee will have to make some pretty terrible choices. The same is true of the 10 percent or more Tennessee will definitely have to come up with once the federal match drops; that money has to come from somewhere.
What kind of choices will Tennessee have to make to fund its share of the expansion, whatever percentage it ends up being? Raising taxes to cover the shortfall is one obvious option. Perhaps the state will impose an income tax – fightin' words for many Tennesseans.
Another option would be to reduce funding for other items in the state budget. Education would be the obvious place to take from, given K–12 and higher education spending currently consume just under half of Tennessee's general funds.
Another option would be to reduce state funding for those currently on Medicaid, primarily poor, single mothers and their children, plus the elderly, and instead protect spending for the expansion population, primarily able-bodied childless men, more than one-third of whom have criminal backgrounds.
This rather cruel choice would make great sense in financial terms, because the way the federal match works, cutting poor women, children, and the elderly loses less funding for the state than cutting childless, able-bodied males. For every $100 the state spends on its traditional Medicaid population, it receives $186 in federal funds, whereas for every $100 it spends on the expansion population, it receives $900. That's a huge incentive for the state to cut funding for low-income mothers, children, and old people.
And although lowering the number of uninsured may seem a good thing, it does little to provide more access to care. Medicaid badly underpays doctors and hospitals, causing many of them to refuse to accept more than a small number of patients covered under the program.
Gov. Haslam should focus his energies on getting real reform for his state's Medicaid program, starting with pushing for block grants that give him and the legislature the flexibility they need to craft solutions that work in Tennessee instead of satisfying the whims of politicians and bureaucrats in Washington, DC.
Sean Parnell (sparnell@heartland.org) is managing editor of Health Care News.
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