Is the Person Exposing You to Radiation Qualified?

ST. PAUL, Minn., Feb. 27- Every day in the United States, tens of thousands of patients are exposed to ionizing radiation through radiation therapy, CT scans, x rays, mammograms, and other medical imaging and therapeutic procedures. Patients need to have confidence that the technologists caring for them have the credentials and qualifications to safely administer radiation, and that the equipment they are using is properly calibrated and maintained to deliver radiation safely and within the proper dose parameters.

These imaging procedures are key to making correct diagnoses of injuries and disease processes. Radiation therapy procedures are an important weapon in treating cancer. But, along with its life-saving capacity, ionizing radiation can cause harm to patients when used improperly. Too much radiation and the patient may suffer debilitating injury or death, as today's testimony before the U.S. House of Representatives' Energy and Commerce Committee's Subcommittee on Health has documented.

Responsibility for assuring balance between the amount of radiation used and the costs and benefits of its use lies with the physicians, the radiation oncologists, the equipment manufacturers, the radiation physicists, and the technologists who interact directly with the patients and who operate the equipment that delivers the radiation. Being fully qualified to perform their role in this team of professionals requires that the individuals have been appropriately educated in the fundamental concepts of radiation -- including its biological effects -- and how to achieve positive benefits and avoid or mitigate negative effects.

"For technologists, that means a formal educational program that covers both the underlying concepts of radiation physics and its application for medical uses," according to Michael DelVecchio, B.S., R.T.(R)(ARRT), president of the American Registry of Radiologic Technologists. "This includes both classroom work and hands-on education in clinical settings."

Completion of the educational program is followed by application for certification by a national organization specializing in medical imaging and/or radiation therapy, according to DelVecchio. Certification organizations evaluate the applicant's education (including successful completion of specified clinical competencies), compliance with ethics standards related to patient care, and passing a comprehensive examination that covers both principles of radiation and application to imaging or therapy.

"Initial certification alone, however, is not sufficient for assuring ongoing qualifications," DelVecchio notes. Although the concepts of radiation learned in the educational program may remain relevant for decades, the technology of how it is used changes rapidly. "This means that technologists must continue to update their qualifications on an ongoing basis," he adds. Continuing education relevant to their practice is an essential requirement for technologists and is a requirement for maintaining the registration of certification.

"While no medical error is acceptable," DelVecchio asserts, "they do occur. They can result from lack of knowledge and education in some cases. But errors may also result from behavior that lacks the appropriate ethical grounding, which is also essential to assuring ongoing qualifications. Measured by an appropriate standard of ethics, individuals can demonstrate that they have internalized a set of guidelines that reflect the best interests of the patient."

Answering the question -- Is the person exposing you to radiation qualified? -- is a matter of both initial and ongoing evaluation and monitoring of qualifications. Certification programs such as those administered by the American Registry of Radiologic Technologists are important elements in providing the quality of care that all patients and their loved ones should expect.

The American Registry of Radiologic Technologists promotes high standards of patient care by recognizing individuals qualified in medical imaging, interventional procedures, and radiation therapy. Headquartered in St. Paul, Minn., ARRT evaluates, certifies, and annually registers more than a quarter-of-a-million radiologic technologists across the United States.

How Much Will Your Surgery Cost? Hospitals Can't Tell You

WASHINGTON, Feb. 3 - Patients are the losers in both the Democratic and Republican versions of the health care reform bills. Proposed health care reform won't help patients find out how much health care costs before they get care and many hospitals aren't set up to help.


A new research paper from The Healthcare Blue Book (healthcarebluebook.com) entitled Surgery Pricing Secrets: The Challenges Patients Face, shows that it is almost impossible to get prices ahead of time if a patient plans to have surgery in a hospital.


Healthcare Blue Book researchers found that:

-- It took three times as many phone calls and four times as long to get
pricing information from a hospital.
-- Hospitals would not provide guaranteed prices and price ranges often
varied by more than 100%.
-- ASCs were more likely to discount prices for cash customers;
regardless of the patient's financial status.
-- Facility fees are 3-4 times higher in a hospital than in an ASC.


Healthcare Blue Book researchers contacted hospitals and ambulatory care centers (ASCs) in three markets: Raleigh-Durham, NC; Denver, CO; and Portland, OR. Hospitals and ASCs were asked to provide the costs of an anterior cruciate ligament surgery of the knee for a patient without health insurance.


Queries were primarily about facility fees, but researchers also asked respondents about other fees associated with the surgery.


It's almost certain health care expenditures, which totaled about $2.5 trillion in 2009, will continue to climb by at least 6% a year. Hospital costs are 31% of the total according to the Centers for Medicare and Medicaid Services. So what are health care consumers going to do?


The Healthcare Blue Book, an Internet content provider, offers a free consumer guide to fair pricing for healthcare treatments and services for local markets at www.healthcarebluebook.com.


"One of the main tenets of successful healthcare reform will be patients taking more responsibility for finding out what their care costs as they make treatment decisions," said Dr. Jeffrey Rice, Healthcare Blue Book CEO, and white paper author. "But until hospitals are able to provide exact pricing, managing out of pocket costs for both insured and self-pay patients is almost impossible."

Peanut Butter Dipping Helps Kids Eat More Veggies

WASHINGTON, Oct. 31 - This week at the Obesity Society 27th Annual Meeting, new data was presented showing that adolescents deemed "vegetable resistant," who don't eat vegetables at all, significantly increased both the amount and variety of vegetables they ate when they were served with one of America's favorite foods -- peanut butter. Raw carrots, celery, and broccoli were provided either with or without peanut butter for dipping and those not provided peanut butter, did not improve vegetable intake.

"We measured what they ate and were excited to see that even those who reported not eating vegetables, who are the most challenging group, ate a greater variety of vegetables with the peanut butter," said Dr. Craig Johnston, Instructor at the Behavioral Research Center at Baylor College of Medicine, at the USDA-ARS Children's Nutrition Research Center in Houston, Texas who conducted the study.

Vegetable intake has been shown to be beneficial against the development of many chronic diseases, but consumption in adolescents is well below recommended levels and strategies to increase intake in adolescents are limited.

Peanut butter was paired with vegetables in this study, because it is a nutrient-rich comfort food loved by kids and adults alike. In fact, it was well received and readily consumed by the students in this study all of whom are Mexican-American.

The adolescents are part of a treatment group in a successful weight loss program in schools that is funded by the United States Department of Agriculture-Agricultural Research Service (USDA-ARS). Though some believe peanut butter would be associated with increased energy intake, the study has demonstrated significant weight loss that is maintained over time.

In the United States, over two-thirds of the nuts eaten are peanuts and peanut butter. Peanut butter provides over 15 key nutrients and is offered in Women, Infant, and Children (WIC) packages because of its protein, nutrient content, and affordability. Numerous studies have also shown that peanuts and peanut butter reduce the risk of chronic disease when eaten in small amounts daily and that they can help in weight management and keeping you satisfied.

Pairing vegetables with peanut butter is an effective, simple strategy for children and adolescents, which helps build positive eating habits and increases vegetable intake. Eating more vegetables with increased variety, by providing them with healthy, nutrient-rich foods like peanut butter may contribute to healthier lifestyles and chronic disease reduction.

The Peanut Institute is a non-profit organization that supports nutrition research and develops educational programs to encourage healthful lifestyles. Learn more about peanuts and health at www.peanut-institute.org

New Survey Reveals Even After 12 Years of Living With Depression Adults Still Struggle Due to Lack of Basic Information

Expert Panel Offers Three-Step Plan to Guide People Toward Recovery of Depression

INDIANAPOLIS, Oct. 14 - A new survey of 2,001 adults living with depression revealed that despite being diagnosed for an average of 12 years, many unknowingly took actions that could have sabotaged their chances of getting well.(i) Furthermore, on average, it took about six years for respondents to seek diagnosis from a health care professional, suggesting these adults may have been coping with depression for as long as 18 years.(i)

Depression, which includes a variety of symptoms,(ii) is a highly treatable illness,(iii) but it can become more difficult to treat the longer it goes undiagnosed or undertreated.(iv) The survey showed that among those who waited six months or more to be diagnosed, 69 percent reported they delayed diagnosis because they lacked knowledge about depression or lacked basic facts about available depression treatments and where to go for help.(i) Additionally, among those who wanted more information about depression treatment at the time of diagnosis, 64 percent said they wanted to know what it means to "get well."(i) Surprisingly, 91 percent have been prescribed an antidepressant for depression, but among them, just seven percent felt very knowledgeable about all basic aspects of the treatment.(i)

The survey is part of a new depression educational program called Missing Pieces, which was developed by leading mental health experts and supported by Eli Lilly and Company to help people identify the information they need to better understand depression. Overall, the survey demonstrated that many adults with depression are engaging in unhealthy behaviors that may jeopardize recovery,(i) such as:

-- Nearly three in five (57 percent) of those who delayed seeking a
diagnosis felt they could manage their own depression symptoms.(i)
-- Among respondents who had taken antidepressants for depression, nearly
half (47 percent) did not discuss when it might be necessary to change
medications with their doctor, despite the fact that they were still
experiencing depressive symptoms.(i)
-- Among those who have stopped taking antidepressants, about two in five
(41 percent) did so without telling their doctor.(i)

-- More than 70 percent (71 percent) noted that talk therapy should
always be part of a depression treatment plan, yet only 22 percent
were currently enrolled in talk therapy.(i)


"The survey strongly suggests that many people living with depression are unaware or are 'missing pieces' of vital information that may be preventing them from getting well," said Dr. Susan Kornstein, professor of psychiatry and obstetrics and gynecology at Virginia Commonwealth University. "Depression needs to be treated by a health care professional.(iii) To increase the likelihood of recovery from depression, it's important that people with depression have a comprehensive treatment plan that may include medications, psychotherapy and lifestyle changes.(iii,v) The goal is to help them to recovery."(iv)

Three-Step Action Plan

The survey revealed key areas of information that people with depression are missing. In response,

The Missing Pieces expert panel recommends three simple steps to help guide people from diagnosis to recovery of depression:

Step One: Two Week Rule for Diagnosis of Depression

Current American Psychiatric Association guidelines state that adults experiencing at least five of the symptoms of depression for two consecutive weeks, and at least one of them is depressed mood or loss of interest, they should talk to a health care professional.(ii) Additional symptoms of depression can also include feelings of guilt or worthlessness, thoughts of death or suicide, restlessness, trouble concentrating or making decisions, fatigue, lack of energy and changes in weight or sleep patterns.(ii) Additional symptoms of depression may include pain, irritability and anxiety.(ii)

Step Two: Six Week Rule for Seeing Improvement in Depression Symptoms

To get fully well, it is important to address all of the symptoms of depression.(iv,vi) Experts recommend that individuals on any type of treatment plan for depression who are unsatisfied with their level of improvement should consider consulting with their doctor about making changes to their treatment plan.

Step Three: Managing Your Depression Treatment Plan When Feeling Better

If an individual has found a depression treatment plan that is addressing many of their depression symptoms, they should continue on that treatment for at least another four to nine months to help prevent the return of their symptoms. Some individuals will also need long-term maintenance treatment to help prevent future episodes of depression.(vii,viii)

In addition to this three-step plan, Missing Pieces offers an educational Web site, found at www.MissingPiecesProgram.com, which provides more survey details and in-depth information about depression. The Missing Pieces program was driven by a multi-disciplinary expert panel that helped shape the development of all educational materials including the national survey and Web site content:

-- Dr. Susan Kornstein, professor of psychiatry and obstetrics and
gynecology at Virginia Commonwealth University
-- Dr. Sally Edwards, family practice doctor at Woodinville Primary Care
in Seattle, Washington
-- Dr. W. Clay Jackson, clinical assistant professor of psychiatry at the
University of Tennessee College of Medicine

-- Dr. Thomas Wise, professor of psychiatry, George Washington University
School of Medicine

About the Survey

The Missing Pieces survey was conducted online within the United States by Harris Interactive® on behalf of Eli Lilly and Company from April 23 to May 7, 2009 among 2,001 U.S. adults ages 18 and older who have been diagnosed with depression. Results were weighted as needed to the U.S. adult population diagnosed with depression. Propensity score weighting was also used to adjust for respondents' propensity to be online. No estimates of theoretical sampling error can be calculated. Full methodology is available through Harris Interactive. Patient input garnered from the survey played a pivotal role in shaping all Missing Pieces materials.

About Harris Interactive

Harris Interactive is a global leader in custom market research. With a long and rich history in multimodal research, powered by our science and technology, we assist clients in achieving business results. Harris Interactive serves clients globally through our North American, European and Asian offices and a network of independent market research firms. For more information, please visit www.harrisinteractive.com.

Medication Adherence: Important Factor in the Treatment of Postmenopausal Osteoporosis

DENVER, Sept. 14- Amgen Inc. today announced the presentation of data highlighting the links between medication satisfaction, adherence to therapy and fracture risk reduction among women with postmenopausal osteoporosis. The data were presented at the 31st annual meeting of the American Society for Bone Mineral Research (ASBMR).

"These data enhance our understanding of why many women discontinue treatment with current osteoporosis therapies, suggesting that convenience, effectiveness and side effects are important factors," said David Macarios, executive director for Global Health Economics at Amgen. "This new research reinforces the view that poor adherence can lead to negative outcomes including fractures, more frequent hospital admissions and higher medical costs."

Impact of Treatment Satisfaction (Perceived Benefits, Convenience, Side Effects) on Persistence with Postmenopausal Osteoporosis Therapy (Abstract No. SA0317)

Data collected from the Prospective Observational Scientific Study Investigation Bone Loss Experience (POSSIBLE US(TM)) study showed that women who were less satisfied with their osteoporosis therapy were more likely to discontinue or switch their therapy compared to women who were more satisfied.(i) The prospective registry study enrolled 5,015 patients, the majority of whom were using an oral bisphosphonate at the time of study entry, and used the self-administered Treatment Satisfaction Questionnaire for Medication every six months to measure patient satisfaction with convenience, perceived effectiveness and side effects of therapy.

In this study, in which women self-reported their adherence to therapy, 25 percent (n=2402) reported discontinuation of their initial therapy within the first study year and an additional 7 percent reported that they switched from their initial therapy to another therapy. Women who were less satisfied with the convenience of their treatment were approximately 39 percent (adjusted HR 0.72) more likely to discontinue or switch their initial therapy, and women who were less satisfied with the effectiveness of their treatment were approximately 25 percent (adjusted HR 0.80) more likely to discontinue or switch. Furthermore, among women reporting moderate or severe treatment side effects, those who were less satisfied with treatment were 61 percent (adjusted HR 0.62) more likely to discontinue or switch.

Comorbidities, Bone Loss and Concomitant Medication Use in European Postmenopausal Women: POSSIBLE EU (Abstract No. MO0339)

Amgen also reported preliminary findings from a similar longitudinal cohort study, the Prospective Observational Scientific Study Investigating Bone Loss Experience in Europe (POSSIBLE EU ), designed to describe the characteristics and management of postmenopausal women (N = 3,403) receiving bone loss medication in 5 countries in the European Union (France, Germany, Italy, Spain and the UK). Data were collected via physician-completed questionnaires at study entry and at 3-month intervals for 1 year.

Interim analysis showed that at study enrollment, the majority (84 percent) of patients were receiving oral bisphosphonate therapy and the largest proportion (31 percent) of patients received 5 or more concomitant medications. Upper gastrointestinal (GI) problems were common in this population, particularly in patients who switched bone loss medication at baseline. In this European population, comorbid conditions and the use of multiple medications were common. POSSIBLE EU analyses are ongoing exploring the association between patient characteristics, treatment satisfaction and adherence.

Impact of Adherence to Osteoporosis Medication on Risk of Fracture (Abstract No. SA0368) and Association Between Adherence to Osteoporosis Medication and Inpatient Stays and Medical Services Costs (Abstract No. SU0387)

Two retrospective analyses were conducted from a study that examined the impact of medication adherence on risk of fracture, hospitalization and healthcare costs among women initiating osteoporosis medication. The two analyses used medical and pharmacy claims from 32,573 women who initiated treatment on alendronate, risedronate, teriparatide, ibandronate or raloxifene in a large U.S. health plan. One analysis showed that patients with low adherence had a 20.4 percent higher risk of fracture than did patients with high adherence (p<0.0001).(ii)

A second analysis found that patients with low adherence had a 31.2 percent higher probability of a hospital stay (p<0.001) and 11.4 percent higher mean medical costs (p=0.001) versus patients with high adherence, even after adjusting for other important patient characteristics such as comorbidities, prior fracture history, and hospitalizations.(iii) The mean monthly medical costs were significantly higher for low-adherence ($507) vs. high-adherence ($405) patients.

Fracture is one of the most common health events suffered by postmenopausal women with osteoporosis.(iv) Globally, one woman in three over 50 years of age will experience a fracture in her lifetime.(3) A woman who has broken a bone as a result of osteoporosis has more than an eight-out-of-ten chance of breaking another bone.(v) Half of women who break a hip, a life changing event, will permanently need assistance to walk.(vi)

Osteoporosis: Impact and Prevalence

Often referred to as the "silent epidemic," osteoporosis is a global problem that is increasing in significance as the population of the world both increases and ages. The World Health Organization (WHO) has recently identified osteoporosis as a priority health issue along with other major non-communicable diseases.

The economic burden of osteoporosis is comparable to that of other major chronic diseases; for example, in the U.S., the costs associated with osteoporosis-related fractures are equivalent to those of cardiovascular disease and asthma.(vii) (viii) (ix) It has been reported that osteoporosis results in more hospital bed-days than stroke, myocardial infarction or breast cancer.(x)

About Amgen

Amgen discovers, develops, manufactures and delivers innovative human therapeutics. A biotechnology pioneer since 1980, Amgen was one of the first companies to realize the new science's promise by bringing safe and effective medicines from lab, to manufacturing plant, to patient. Amgen therapeutics have changed the practice of medicine, helping millions of people around the world in the fight against cancer, kidney disease, rheumatoid arthritis, and other serious illnesses. With a deep and broad pipeline of potential new medicines, Amgen remains committed to advancing science to dramatically improve people's lives.

Home-Spun or Hard Fact?

Fast-Food Family Planning May Contribute to High Levels of Unintended Pregnancies

NEWBURY, England,- Women's health experts are warning that old wives' tales and ignorance about modern contraceptive options could be fuelling Britain's high levels of unintended pregnancy, following new research into contraception myths by pollster Opinion Health.(1)

Fast-foods and store cupboard staples were often suggested as methods of contraception women had heard of.(1) Coca-cola, kebabs, chocolate bars or wrappers, crisp packets and chewing gum were proposed as contraceptives and one in five women questioned mentioned a kitchen cupboard staple as a possible option, with eating garlic or using bread, cling film or even chicken skin as a barrier method given as alternatives.(1)

These myths are compounded by a lack of general understanding of even the most popular methods of contraception. The survey revealed that half of women hold the false belief that oral contraceptive use over an extended period of time can cause infertility(1) and nearly 10 percent of women think that it always takes a number of years to regain fertility after discontinuation of The Pill.(1) In fact, no matter how long The Pill is taken for, the effects are fully reversible and it is possible to get pregnant straight away in the absence of other forms of contraception.(2)

The survey also highlighted that there is a myth that oestrogen is only present in combined oral contraceptive pills in order to disguise the taste(1) when in fact the combined pill was designed to have the combination of oestrogen and progestogen to offer protection from pregnancy and shorter lighter periods. Surprisingly, those questioned who were using oral contraception often showed a lower level of knowledge about The Pill than those not using it.

These and other myths - ranging from the ridiculous to the concerning - are held by women across all ages, according to the research.

Dr Annie Evans, Women's Health Specialist at the Bristol Sexual Health Centre, commented: "It is not surprising that this survey has uncovered how widespread contraceptive myths still are in this country, given that Britain continues to have the highest unintended pregnancy rate in Europe*,(3) with as many as 50% of births being unintended.(4) It is vital that women are made aware of the facts, using the credible sources of information available to them."

Despite the accurate information available to women online, in the media and from their healthcare professionals, over a third of women mistakenly believe that the greatest risk of getting pregnant whilst using the combined contraceptive pill is to miss a pill in the middle of the pack.(1) The truth is that missing the first and last pills of the pack pose the greatest risk of getting pregnant.(2)

Dr Anne Szarewski, Associate Specialist at the Margaret Pyke Centre commented: "Combined oral contraceptive pills are the most widely prescribed contraceptive option, but they are particularly plagued by myths. Many women are unaware that they even contain oestrogen and progestogen, both of which play different but important roles. It is vital that women of all ages are aware of the facts, to have a full understanding of their contraception and so avoid the distress of an unintended pregnancy."


Other myths exposed by the survey include:

- One in six women believed that the contraceptive pill is effective as
soon as a woman starts taking it (increasing to one in three in
the 18-20 age group).(1) Whilst this is closer to the truth than other
tales, it is only if the first pill is taken on the first day of the
menstrual cycle.

- Some believe that using combined oral contraceptives will protect them
against HIV, when in fact only condoms will protect you against HIV.

- Some believe that if a woman is not using contraception she is safe
from getting pregnant if she only has sex on her period. In fact, there
is still the possibility of becoming pregnant during your period if you
have sex without using contraception.(5)


The results from this survey also show that, contrary to popular belief, older women believe more myths than younger women. The importance of sex education is also underlined, with those women that have received it showing a better understanding of the facts about contraception, and in particular, about combined oral contraceptives.

The more credible sources of accurate information that there are made available to women, the better chance there is of dispelling these outdated myths. Balanced, factual information about a range of contraceptive options can be found on the comprehensive new website http://www.contraception.co.uk which was recently launched by leading contraception manufacturer Bayer Schering Pharma.

Children with severe Milk Allergy can Safely Drink Milk

Some children with a history of severe milk allergy can safely drink milk and consume other dairy products every day, according to research led by the Johns Hopkins Children’s Center and published in Journal of Allergy and Clinical Immunology.

Investigators followed up with a subset of children who were part of an earlier Hopkins Children’s-led study published in 2008 in which patients allergic to milk were given increasingly higher doses of milk over time. For many of them, continuous exposure to milk allergens – the proteins that trigger bad reactions – slowly and gradually retrained their immune systems to better tolerate the very food that once sent those systems into overdrive.

The follow-up of 18 children ages 6 to 16 whose severe milk allergies had eased or disappeared found that all children were able to safely consume milk at home, and that reactions, while common, were generally mild and grew milder and milder over time. The follow-up varied from three to 17 months, depending on how long it took patients to increase their milk intake.

These findings also suggest that regular use of milk and dairy foods may be needed for children to maintain their tolerance.

“We now have evidence from other studies that some children once successfully treated remain allergy-free even without daily exposure, while in others the allergies return once they stop regular daily exposure to milk,” says Robert Wood, M.D., the study’s senior investigator and director of Allergy & Immunology at Hopkins Children’s. “This may mean that some patients are truly cured of their allergy, while in others the immune system adapts to regular daily exposure to milk and may, in fact, need the exposure to continue to tolerate it,” he adds.

After up to 17 months of at-home consumption, 13 of the 18 children who could tolerate increasingly higher doses were asked to return to the clinic for milk-drinking tests. Of the 13, six showed no reaction after drinking 16,000 mg (16 ounces) of milk, twice the highest tolerated dose during the initial study. Seven children had reactions at doses ranging from 3,000 mg to 16,000 mg. The reactions ranged from oral itch to hives, to sneezing to mild abdominal pain, but none was serious. One child developed cough requiring medications.

Investigators also continued to follow three children who could not tolerate doses higher than 2,540 mg (2.5 ounces) – the cutoff set by the investigators at the beginning of the follow-up – which made them ineligible to continue the at-home part of the study. All three continued to drink milk daily with minimal reactions, and two of the children were eventually able to increase their consumption beyond 2,540 mg.

Sensitivity to milk was also measured with traditional skin prick testing, which showed gradual decreases in reactions over time. Seven children had no reactions at eight to 15 months of follow-up. Blood levels of milk IgE antibodies slowly decreased over time too, another sign of better tolerance to milk. At the same time, a different type of antibody, IgG4 – one that signals immunity to a particular allergen – went up over time, a maker of improved tolerance.

Children and their parents also kept daily logs of milk and dairy consumption and recorded symptoms, such as hives, abdominal pain, sneezing and cough. During the first three months, consumption of milk triggered reactions 49 percent of the time, with some children experiencing as few as two reactions for every 100 doses of milk consumed. The figure dropped to 23 percent in the subsequent three months, and some children had no reactions at all.

Milk allergy is the most common type of food allergy. Three million U.S. children have food allergies, according to the Centers for Disease Control and Prevention.

Co-investigators in the study include Satya Narisety, Robert Hamilton and Elizabeth Matsui, of Hopkins; Justin Skripak of the Mt. Sinai School of Medicine; and Pamela Steele and A. Wesley Burks of Duke University.

The research was funded by the National Institutes of Health.

Dr. Wood receives funding support from Genentech, manufacturer of Xolair, for the treatment of allergic asthma. He serves on the advisory board of the Food Allergy and Anaphylaxis Network.