The Michigan Daily - michigandaily.com
Monday, April 1, 2013 - 5A
The Michigan Daily - michigandailycom Monday, April 1, 2013 - 5A
Chronic conditions
focus of new effort
UMHS looks to
improve palliative
medicine
By MOLLY BLOCK
Daily StaffReporter
With the scope of innova-
tive medical procedures and
treatments available today,
the average life expectancy of
Americans has increased dra-
matically. According to the Cen-
terforDisease Control, however,
nearly half of U.S. adults live
with chronic disease. Palliative
medicine works to help patients
combat these chronic, incurable
diseases.
The newly-formed Adult Pal-
liative Medicine Program at the
University of Michigan Health
System was created to provide
care for chronic diseases based
on interdisciplinary collabora-
tion and the training of doctors
in palliative medicine.
Adam Marks, associate direc-
tor of the UMHS Palliative and
Supportive Care Clinic, sees this
new initiative as building a bet-
ter future for America's aging
population.
"The overall goal of palliative
care is to reduce the symptom
burden and to improve the qual-
ity of life for those living with
chronic, incurable disease,"
Marks said. "The Adult Pallia-
tive Medicine Program, in addi-
tion to providing these services
to patients and their families,
also provides training for the
next generation of palliative
medicine providers."
Another important aspect
of the program is the oversight
steering committee, which will
include representatives from
multiple medical disciplines
and schools at the University
and will enhance the quality of
patient care. Raymond Yung,
chief of geriatric and palliative
medicine at the Medical School,
said this new structure will also
boost UMHS's reputation.
"The main goal is to create
the structure that will enhance
both coordination and national
reputation of clinical education
research for the adult hospice
and palliative medicine pro-
gram at the University," Yung
said.
Built on the spirit of collabor-
ative care, the oversightcommit-
tee for the program is comprised
of a wide array of representa-
tives from the internal medicine
department, including geri-
atric and palliative medicine,
oncology, radiology and general
medicine; the family medicine
department; the School of Nurs-
ing; the School of Social Work;
and the College of Pharmacy.
The program combines pal-
liative care specialists, nurses
and social workers from within
the hospital system, and differ-
ent schools at the University.
"It's beyond departments,"
Yung said. "It's across depart-
ments and across schools
because the School of Nursing,
the School of Pharmacy and the
School of Social Work are all
involved."
The program creates an aca-
demic home for the Hospice and
Palliative Medicine Fellowship
Program, a one-year program
to teach physicians the clinical
skills needed to treat palliative
conditions.
Phillip Rodgers, an assistant
professor in family medicine,
said the collaborative nature
of the program is particularly
important because palliative
patient care often requires
knowledge in multiple special-
ties. For example, he noted that
many patients are in need of
psychological care.
"What has grown over time
in the palliative medicine divi-
sion is that patients and families
have needs across their physical
domains of health - their psy-
chological domains that are in
interpersonal issues with fam-
ily members who are touched
by illness, and spiritual needs,"
Rodgers said.
The program has begun to
look into community engage-
ment as their next overarching
task, Rodgers said.
"In addition to the over-
sight steering committee, we
are in the process of convening
a community board to advise
the steering committee," Rod-
gers said. "What this group is
charged with is setting the stra-
tegic direction of the program."
UMHS and its physicians
have strong relationships with
patient care facilities in the
community - specifically Arbor
Hospice in Ann Arbor - but this
new program opens the door to
strengthen these relationships
in addition to increasing future
community outreach opportu-
nities, Rodgers said.
"Because we've been focused
primarily on building the pro-
graminternally, we haven't done
as much community outreach as
we would like," he said. "But it's
one of our strategic goals for the
new program."
NOAH BERGER/AP
A worker cleans up damage at a Walmart in San Jose, Calif., after a motorist drovethrough a store entrance and began assaulting
shoppers on Sunday.
Four injured in auto
crash at Wal-Mart
Driver assaulted
customers after
hitting Calif. store
SAN JOSE, Calif (AP) - Four
people were hurt Sunday when a
driver crashed his vehicle into a
Wal-Mart and then assaulted cus-
tomers inside, officials said.
Investigators have not deter-
mined how fast the driver -
described as a male in his 30s
- was going at the time of the
crash but the car went about 10
to 20 feet into the store in San
Jose. About 70 people were inside
at the time, police Officer Albert
Morales said.
After the crash at around 11:15
a.m., the unidentified driver got
out of his vehicle and used a blunt
object to attack people, Morales
said. The driver was arrested
when officers arrived.
One person suffered what
Morales described as serious inju-
ries. He did not know the extent
of the injuries to the three other
people but said they were not life-
threatening. One of the injured
included a store employee.
Customer Sharon Kaye told the
San Jose Mercury News the driv-
er sideswiped her car as he made
several runs around the parking
lot before driving between poles
at the entrance and crashing into
the store.
"At first, I thought I may have
done something to anger him
while driving," she said. "But then
I realized he was out to get into
the store."
After the crash, the entrance to
the Wal-Mart was roped off with
yellow police tape, and workers
put up large boards covering the
automatic doors where the car
had entered.
A Wal-Mart spokeswoman told
the Mercury News that the store
remained shut down for sev-
eral hours, and an employee was
among those hurt.
"We're obviously very con-
cerned about the associate who
was injured," spokeswoman Kory
Lundberg said.
Egyptian TV satirist
questioned by police
AHN YOUNG-JOON/AP
South Korean Army soldiers patrol along a barbed-wire fence near the border village of Panmunjom in Paju, South Korea Sun-
day. North Korea threatened Saturday to shut down a border factory complex that's the last major symbol of cooperation.
N. Korea says nukes
part of nation's 1 e'
Leader: Korean
Peninsula is in a
"state of war"
SEOUL, South Korea (AP) - A
top North Korean decision-mak-
ing body issued a pointed warn-
ing Sunday, saying that nuclear
weapons are "the nation's life"
and will not be traded even for
"billions of dollars."
The comments came in a
statement released after North
Korean leader Kim Jong Un pre-
sided over the plenary meeting
of the central committee of the
ruling Workers' Party. The meet-
ing, which set a "new strategic
line" calling for building both a
stronger economy and nuclear
arsenal, comes amid a series of
near-daily threats from Pyong-
yang in recent weeks, including a
vow to launch nuclear strikes on
the United States and a warning
Saturday that the Korean Penin-
sulawas ina "state of war."
Pyongyang is angry over annu-
al U.S.-South Korean military
drills and a new round of U.N.
sanctions that followed its Feb. 12
nuclear test, the country's third.
Analysts see a full-scale North
Korean attack as unlikely and say
the threats are more likely efforts
to provoke softer policies toward
Pyongyang from a new govern-
ment in Seoul, to win diplomatic
talks with Washington that could
get the North more aid, and to
solidify the young North Korean
leader's image and military cre-
dentials athome.
North Korea made reference to
those outside views in the state-
ment it released through the
official Korean Central News
Agency following the plenary
meeting.
North Korea's nuclear weap-
ons are a "treasure" not to be
traded for "billions of dollars,"
the statement said. They "are
neither a political bargaining
chip nor a thing for economic
dealings to be presented to the
place of dialogue or be put on
the table of negotiations aimed
at forcing (Pyongyang) to dis-
arm itself," it said.
North Korea's "nuclear
armed forces represent the
nation's life, which can never be
abandoned as long as the impe-
rialists and nuclear threats exist
on earth," the statement said.
North Korea has called the
U.S. nuclear arsenal a threat to
its existence since the 1950-53
Korean War, which ended in a
truce, not a peace treaty, leaving
the peninsula still technically at
war. Pyongyangjustifies its own
nuclear pursuit in large part on
that perceived U.S. threat.
While analysts call North
Korea's threats largely brink-
manship, there is some fear
that a localized skirmish might
escalate. Seoul has vowed to
respond harshly should North
Korea provoke its military.
Naval skirmishes in disputed
Yellow Sea waters off the Kore-
an coast have led to bloody bat-
tles several times over the years.
Attacks blamed on Pyongyang
in 2010 killed50 South Koreans.
The plenary statement also
called forstrengtheningthemor-
ibund economy, which Kim has
put an emphasis on in his public
statements since taking power
after the death of his father, Kim
Jong II, in late 2011. The United
Nations says two-thirds of the
country's 24 million people face
regular food shortages.
Opposition
claims Morsi is
intimidating critics,
private media
CAIRO (AP) - Egypt's most
popular television satirist, who
every week skewers the Islamist
president and hard-line clerics
on his Jon Stewart-style show,
was released on bail Sunday but
could face charges of insulting
the country's leader and Islam.
Bassem Youssef is the most
prominent critic of President
Mohammed Morsi to be called in
for questioning in recent weeks,
in what the opposition says is a
campaign to intimidate critics
amid wave after wave of politi-
cal unrest in deeply polarized
Egypt.
Arrest warrants have been
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issued for five prominent anti-
government activists accused of
instigatingviolence.
Deputy chief prosecutor Has-
san Yassin denied the nearly
five-hour interrogation was part
of an intimidation campaign and
said his department was enforc-
ing the law and seeking to estab-
lish some guidelines on freedom
of expression.
"The prosecution is the pro-
tector of social rights and we
work on implementing the law.
... There must be guidelines for
those working in the media to
observe so as not violate the
law," Yassin told The Associated
Press.
Morsi last week accused pri-
vate media of fanning violence
and argued that it was being
used for political aims.
But Yassin denied that the
prosecutor's office was operat-
ing at the behest of the presi-
dency to go after Morsi's critics,
saying it has also interrogated
and sentenced Islamists. Morsi
appointed the chief prosecu-
tor late last year despite an out-
cry from many in the judiciary
who accused him of trampling
on their right to choose the top
prosecutor.
A court ruling last week
declared Morsi's appointment
void, a verdict he will likely
appeal.
"There is no contact between
us and the presidency.... Just like
we moved against someone who
insults Christianity, we moved
against someone who is accused
of insulting Islam," he said.
Youssef is the host of the
weekly political satire show
known for his skits lampoon-
ing Morsi and Egypt's newly
empowered Islamist political
class. But he also mocks the
opposition and the media.
t