Executives at pharmaceutical company Eli Lilly have condemned the Trump administration's proposal to consider ways to import prescription drugs from abroad, calling for regulatory reforms instead, reports The Hill . Executives said the concept of importing drugs from other countries, even in limited circumstances, is worrisome. The U.S. Department of Health and Human Services (HHS) recently announced it is creating a working group to study how the United States could import pharmaceuticals from abroad as a way to fight steep price increases for drugs that are produced by one manufacturer and that are not protected by patents or exclusivities. HHS Secretary Alex Azar, who used to oversee Lilly's U.S. division, argues that importing drugs could increase competition and discourage manufacturers from implementing extreme price jumps just to make a profit. David Ricks, Lilly's chairman and CEO, said he supports expanding access to prescription drugs and keeping prices affordable. But he said importing drugs is not the solution, and pressed for regulatory reforms instead. Ricks said he is planning for a policy change, and noted he is open to changing the Medicare drug rebate structure — something currently under criticism by Azar, who thinks rebates provide an incentive for higher drug prices.

A study from the Center for Retirement Research at Boston College is the first to document how often adult children in their 60s and 70s increasingly take care of their older parents, reports Kaiser Health News . The researchers estimated that 10 percent of adults ages 60 to 69 whose parents are living serve as caregivers, as do 12 percent of adults age 70 and older. The team analyzed data from 80,000 interviews between 1995 and 2010 for the Health and Retirement Study. They found approximately 17 percent of adult children care for their parents at some point in their lives, and the probability of doing so increases with age. Boston College's Alice Zulkarnain notes later-life caregiving comes with significant challenges, with such assistance exerting strain on older bodies. University of Pittsburgh Professor Richard Schulz also warns of emotional stress, saying, "If older caregivers have health problems themselves and become mentally or emotionally stressed, they're at a higher risk of dying." Furthermore, older caregivers can be more socially isolated than younger caregivers, and they face the risk of depleting hard-earned savings with no possibility of replacing them by resuming employment.

CBS News reports that Walt Disney is offering to pay full tuition for hourly employees who want to earn a college degree, finish high school, or learn a new skill. As many as 80,000 hourly workers in the United States could be eligible for the program, which pays upfront tuition for employees taking online classes starting this fall. The entertainment giant initially plans to invest $50 million into the "Disney Aspire" program and up to $25 million a year after that. The program includes a network of schools and offers a range of degrees and disciplines. Disney joins other large corporations that have started paying tuition for workers. Walmart, for example, plans to offer workers the chance to get a college degree at three universities via online programs. Starbucks, meanwhile, partners with Arizona State University to offer tuition coverage for U.S. workers earning an undergraduate degree.

The U.S. Food and Drug Administration (FDA) has contracted the National Academies of Sciences, Engineering, and Medicine (NASEM) to help advance development of evidence-based guidelines for appropriate opioid analgesic prescribing for acute pain, reports Regulatory Focus . FDA Commissioner Scott Gottlieb said NASEM will undertake a study and disclose its findings, starting with identification and prioritization of "procedures and conditions associated with acute pain for which opioid analgesics are commonly prescribed and where evidence-based clinical practice guidelines would help inform prescribing practices." He noted analyses "suggest that the first prescription for many common, acute indications could typically be for many fewer pills." NASEM also will examine current opioid analgesic prescribing guidelines to investigate how they were developed, detect any gaps, and outline studies needed to generate evidence. Gottlieb said the guidelines would differ from corresponding work by the Centers for Disease Control and Prevention as it would be indication-specific and based on evidence taken from assessments of clinical practice and pain treatment. NASEM also will organize meetings and public workshops to engage various stakeholders who can contribute on existing guidelines and on emerging evidence or specific policy issues related to the development and availability of opioid analgesic prescription guidelines.

A study published in the Journal of the American Geriatrics Society determined older adults receiving physical therapy (PT) services while in the emergency department (ED) for a fall experienced fewer fall-related repeat visits, reports EurekAlert . The researchers analyzed Medicare claims data to examine differences in 30-day and 60-day ED repeat visit rates among seniors who visited the ED for a fall and underwent PT there, and compared them to older adults who did not receive PT services in the ED following a fall. ED-based PT services include getting information, diagnosis, and referral for follow-up PT care after discharge. Receiving PT services in the ED during an initial visit for a fall was associated with a lower chance of revisiting ED for another fall within 30 and 60 days. Geriatric care experts have previously recommended screening senior ED visitors for high fall risk and referring them, when appropriate, to physical therapists or other healthcare team members. However, the researchers say older adults who go to the ED for a fall seldom receive the kind of examination and referral for PT services they require. They also suggest EDs could play a role in reducing fall-related ED revisits by primarily connecting people treated for a fall to appropriate follow-up care. "In our sample, only 3.2 percent of older adults who had a fall-related ED visit received PT services during that visit," the team notes.

Michelle Memran's documentary portrait of playwright María Irene Fornés, "The Rest I Make Up," was filmed over 15 years as she battled Alzheimer's disease, reports the New Yorker . Despite her inevitable decline, Fornés remains exalted as an artist, and celebrates the very nature of the life of an artist as an continuous act of creation in itself. When filming originally began, Memran had no specific project in mind, but the playwright's worsening memory loss and cessation of writing eventually led to an Alzheimer's diagnosis. As the film chronicles, the erosion of Fornés' short-term memory does not impact the power and emotional heft of her immediate observations and interpretations. Memran is quite aware of the ethical controversy of filming Fornés in a state of increasing disability. Fornés specifies her desire to present herself fully and frankly to the camera. "I prefer not to hide anything," she says. "If you expose anything about you ... you are a freer person." Fornés never loses the awareness of her performative presence. "The camera, to me, is my beloved ... and I give everything I have to a camera," she notes.

Wisconsin-based Three Square Market, which has implanted microchips to track willing employees and assist them in their activities, will soon unveil a body heat-driven microchip for people with dementia that incorporates global-positioning system (GPS) and voice recognition technology, reports CNBC . Three Square Market President Patrick McMullan says the company will be ready to beta test the GPS tracking chip early next year and pursue product approval from the Food and Drug Administration. Three Square Market started developing the chip in 2017, around the time it branched out from self-service kiosks into microchips, smart city, and medical error mitigation solutions. "It's not only GPS, it's not only voice activation, it's working on monitoring your vital signs," McMullan says. "And there are different medical institutions that obviously want that. It's going to tell my ... doctor's office I have an issue." Three Square Market CEO Todd Westby argues that the company is making the issue of advanced medical implants acceptable, "or brought it to the forefront where people are now talking about it and looking at the benefits it can do for a person."

Care communities in the eastern Netherlands are pioneering an approach to dementia treatment that combines relaxation, childhood memories, sensory aids, soothing music, family structure, and other tools to heal, calm, and nurture residents, reports the New York Times . Simulated trips in buses or on beaches create a gathering point for residents, and the shared experience lets them converse about past trips and take a small vacation from their daily lives. "In the '80s, clients were treated like people in a hospital," says former occupational therapist Ilse Achterberg. She helped pioneer "snoezel" rooms, which feature light, aroma, massage, and sound therapy, and let participants relax and access emotions that are often impeded in stressful clinical settings. Although caregivers and academics believe such environments help people with dementia cope better, clear proof of their long-lasting effectiveness is rare. However, Katja Ebben with the Vitalis Peppelrode community in Eindhoven says she has observed that with the newer techniques, beneficiaries require less medication and fewer physical restraints. Residents in many Dutch communities have their own rooms, which they are encouraged to consider their own domain. There frequently is a communal living room and a kitchen, where residents help with chores.

A Gartner survey found over 66 percent of employees worldwide say they have to consult with multiple bosses to get their jobs done, and nearly as many waste significant time waiting for guidance from senior leaders, reports the Wall Street Journal . Bosses currently manage nine direct reports on average, up from five in 2008, which can spread leaders so thin that they have little idea of what their employees are doing. Only about 35 percent of employees polled by Gartner in 2017 say their manager understands their day-to-day work. "Managers are less likely to provide good feedback and coaching when they don't understand what that employee's workflow is," says Gartner's Brian Kropp. Roxanne Allen, formerly with American Express, notes the modern office environment keeps managers' priorities in flux, and their employees are expected to remain open to fast-changing roles and business needs. "To be perceived as anything else is a career killer," she warns. Allen recommends that "Managers should set clear goals, learn to clearly communicate their priorities, and know the work their employees are performing so that mindless 'never minds' are unnecessary and overloading never happens. Alignment starts at the top." Meanwhile, Babson College Professor Rob Cross says people with deeply rooted identities as high-performing employees are especially vulnerable to collaborative overload.

A study by the AARP Public Policy Institute found 70 percent of seniors with dementia prescribed dementia medications took them long-term despite a shortage of clinical evidence supporting their benefit beyond 12 months, reports Healio . "It doesn't seem to be widely known that such treatments have limited efficacy," says the AARP Public Policy Institute's Elizabeth A. Carter. "Given that long-term use of dementia drugs could have financial and health implications ... we wanted to examine real-world prescribing patterns." Generally, 50.7 percent of the study sample were prescribed a dementia drug within one year of their diagnosis and 70 percent of seniors with dementia were prescribed drugs for 13 months or longer. Eleven percent received treatment with dementia drugs for one month or less, and 19 percent were treated for between two and 12 months. Of the 36,000 enrollees in the sample who initiated medication treatment for dementia, 58 percent were prescribed cholinesterase inhibitors, 33 percent were prescribed cholinesterase inhibitors and memantine, and 8 percent were prescribed memantine only. Sixteen percent also were prescribed cholinesterase inhibitors or memantine without an accompanying diagnosis of dementia on the insurance claim. Subjects taking cholinesterase inhibitors and memantine together had the highest total drug costs, with an average of $151 per month and more than $4,800 over the decade-long study period. Alone, the costs for memantine averaged $200 monthly and $3,163 over the study period, but the costs were considerably lower for cholinesterase inhibitors, averaging $59 monthly and $997 total. Some individuals took dementia medication for up to 10 years, costing as much as $18,000 per person.