Personalizing health care: feasibility and future implications

Considerable variety in how patients respond to treatments, driven by differences in their geno- and/ or phenotypes, calls for a more tailored approach. This is already happening, and will accelerate with developments in personalized medicine. However, its promise has not always translated into improvements in patient care due to the complexities involved. There are also concerns that advice for tests has been reversed, current tests can be costly, there is fragmentation of funding of care, and companies may seek high prices for new targeted drugs. There is a need to integrate current knowledge from a payer’s perspective to provide future guidance. Multiple findings including general considerations; influence of pharmacogenomics on response and toxicity of drug therapies; value of biomarker tests; limitations and costs of tests; and potentially high acquisition costs of new targeted therapies help to give guidance on potential ways forward for all stakeholder groups. Overall, personalized medicine has the potential to revolutionize care. However, current challenges and concerns need to be addressed to enhance its uptake and funding to benefit patients

The Elusive Muse : Understanding Musical Giftedness

Many labels exist to outline musical giftednessor aspects of it; a profusion resulting from differentepistemological positions, disagreements, and theconsiderable complexity of the issue. In this chapter,musical giftedness as a sub-cultural attribute is discussedas well as the problems inherent in attributionby consensus procedures. Based on available researcha conceptual model of musical giftedness is outlinedbased on domain generality and domain specificity,thus proposing an understanding of musical giftednessas a set of core skills and sets of key skills, particularfor specific domains. The question of heredity isbrought to the fore as is the significance of accumulatedpractice over time. Differences between the developmentof Western Classical musicians and popularmusicians are demonstrated. Recent research on giftednessidentification is also discussed followed by aconcluding overview of potential research pitfalls asthe understanding of musical giftedness continues tobe explored