Sex & Violence – News Syndication

posted by AndrewW on Aug 31

Story By: by Jordan Rau

Expensive technologies like proton beam therapy and hot chemo baths are among the reasons America’s health care spending is rising at an unsustainable clip and making the federal deficit so hard to tame.

But two of the nation’s top health care economists are expressing doubts that accountable care organizations — one of Obama administration’s most-hyped mechanisms to save money — will be able to overcome the medical system’s lust for the new new thing.

Established through last year’s health law, ACOs are networks of doctors and hospitals that would collaborate to provide quality care at lower cost, with the motivation of keeping a share of the savings they deliver to Medicare and private insurers. Medicare has been working for months to get the program running by next year.

In a paper delivered last week at a Federal Reserve Bank of Kansas City symposium in Jackson Hole, Wyo., Harvard’s Katherine Baicker and Amitabh Chandra warned that ACOs may not want to rein in the use of expensive technologies that haven’t been proved superior to old-fashioned approaches, since the new stuff is often a major lure for patients.

They write:

[W]e do not know how well ACOs will sidestep cost-ineffective technologies, particularly if the latest shiny innovation increases market share. The viability of ACOs will depend on the receptiveness of physicians to capitated payments — some specialists will see their incomes fall and are unlikely to take these cuts quietly. While their concerns may not resonate with patients, they might if providers claim that valuable care is being withheld. Designers of ACOs are therefore keenly interested in measuring ACO performance and patient satisfaction, but current quality measures only capture truly negligent care.

The authors also warn that even if ACOs do achieve savings by performing fewer procedures, “some of the savings from lower quantities may be offset with higher prices as ACOs exert market power” by charging more to private insurers.

Their paper has the relatively snappy title of “Aspirin, Angioplasty, and Proton Beam Therapy: The Economics of Smarter Health Care Spending.” It’s the latest argument that’s been made about the need to limit the use of fancy technology, as political accusations of “death panels” have receded for the moment.

But the Harvard professors are bleak that fixing most of America’s wasteful health spending, including that on iffy technology, will be enough. They conclude:

The U.S. has yet to wrestle with the question of public policy priorities in a world of scarce resources: even with perfect productive efficiency, we cannot cover all services for all people. … By first ensuring that health care resources are used more productively, we will be in a much better position to move towards spending the “right” amount on health.

Originally Published On: www.npr.org – Original Article Here

posted by AndrewW on Aug 30

Story By: by Phil Galewitz

Insurance is a top priority for Rabbi Craig Ezring.

When Rabbi Craig Ezring’s annual health insurance costs soared 38 percent this year to a whopping $18,636, he did more than just complain.

He went looking for a young wife.

For several years, the Boca Raton, Fla., rabbi had been getting coverage through a small corporation he formed with his wife. When she died four years ago, he thought the cost of his insurance coverage would drop. Instead it rose.

That’s partly because Ezring, 56, had a heart bypass surgery a couple of years ago. Nonetheless, he said he’s still quite healthy, and does ballroom and Latin dancing twice a week.

When he got his latest health insurance bill in August, Ezing said he almost had a heart attack.

An insurance broker told him his small business insurance rate is based on the age of the owner of the company. So, Ezring posted on his blog that he was looking for a younger woman who wouldn’t mind marrying him to help him get cheaper coverage.

“Give some thought to the possibility of marrying me … a good insurance plan is all I ask,” he wrote. “Okay there maybe one or two other things I ask for, but sadly, right now insurance has become a top priority.”

Ezring, a rabbi at several nursing homes and assisted living facilities in South Florida, said he’s had a few “comical offers” of marriage in response to his plea, including one asking if he wanted to move to South Carolina.

Ezring said his insurer, UnitedHealthcare, has been good to him: The company makes sure he gets services he needs and can see the doctors he wants. But with the latest rate hike, he feels like he’s working mostly just to afford his health coverage. He’s shopped for other policies, but other companies won’t offer him coverage.

When told that Florida Gov. Rick Scott, who vehemently opposes the federal health overhaul, is only paying about $400 a year for his state-subsidized health insurance, Ezring chuckled. “It would be lovely if everyone could pay that amount for really good insurance,” he said.

Originally Published On: www.npr.org – Original Article Here

posted by AndrewW on Aug 29

It’s a common belief that women take fewer risks than men, and that adolescents always plunge in headlong without considering the consequences. But the reality of who takes risks when is actually a bit more complicated, according to the authors of a new paper which will be published in the August issue of Current Directions in Psychological Science, a journal of the Association for Psychological Science. Adolescents can be as cool-headed as anyone, and in some realms, women take more risks than men.

A lot of what psychologists know about risk-taking comes from lab studies where people are asked to choose between a guaranteed amount of money or a gamble for a larger amount. But that kind of decision isn’t the same as deciding whether you’re going to speed on the way home from work, wear a condom, or go bungee jumping. Research in the last 10 years or so has found that the way people choose to take risks in one domain doesn’t necessarily hold in other domains.

“The typical view is that women take less risks than men, that it starts early in childhood, in all cultures, and so on,” says Bernd Figner of Columbia University and the University of Amsterdam, who cowrote the paper with Elke Weber of Columbia University. The truth is more complicated. Men are willing to take more risks in finances. But women take more social risks—a category that includes things like starting a new career in your mid-thirties or speaking your mind about an unpopular issue in a meeting at work.

It seems that this difference is because men and women perceive risks differently. That difference in perception may be partly because of how familiar they are with different situations, Figner says. “If you have more experience with a risky situation, you may perceive it as less risky.” Differences in how boys and girls encounter the world as they’re growing up may make them more comfortable with different kinds of risks.

Adolescents are known for risky behavior. But in lab tests, when they’re called on to think coolly about a situation, psychological scientists have found that adolescents are just as cautious as adults and children. The difference between the lab and the real world, Figner says, is partly the extent to which they involve emotion. In an experiment where adolescents’ emotions got triggered strongly (with a gambling task in which they made stepwise decisions of increasing risk and got immediate feedback on how good or bad they were doing, a situation much closer to real-world incremental or dynamic risk decisions), they looked very different from children and adults and took bigger risks, just as observed in real world settings.

Emotion can affect decisions about risk-taking in all age groups, not just adolescents, Figner says. And the emotion doesn’t necessarily have to be triggered from the decision situation itself even, for example. if you’re angry about an argument, you might later drive too fast on the highway.

“Ultimately we would like to provide knowledge with our research that people can use to make decisions that are more beneficial for them in the long term,” Figner says. The goal isn’t to avoid risk, of course—stepping out the front door in the morning increases your chance of getting run over by a bus. But by understanding when and how people decide to take risks, he hopes to help people make risky decisions that they won’t regret, either immediately after they have made them, or years later.

—

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posted by AndrewW on Aug 29

Story By: by Marilyn Werber Serafini

Republican presidential candidate Texas Gov. Rick Perry speaks to supporters in Greenville, S.C. on Aug. 20.

Just a few weeks into his campaign, Texas Gov. and presidential candidate Rick Perry isn’t talking a whole lot about health care, except to criticize President Obama for last year’s law. And he’s not considered a health care expert. But he’s is passionate on one point: Fixing the nation’s health care system must include a major reform of the medical malpractice system.

In 2009, Perry and fellow GOP presidential competitor Newt Gingrich wrote in a Washington Post op-ed that Texas has successfully controlled health care costs, and at the same time has improved quality by enacting tort reforms in 2003. “Fewer frivolous lawsuits have attracted record numbers of doctors to the state as medical malpractice insurance premiums dropped by half,” they wrote.

They also mention Christus Health, a large Catholic nonprofit system with a significant presence in Texas, which reduced its liability defense payments from about $100 million in 2003 to $2.3 million last year. The savings went to expanding health-care services in low-income communities.

The 2003 law Perry enacted capped non-economic damages — court awards for pain and suffering – at $250,000 per defendant. There is no cap on economic damages, such as medical expenses.

Republicans and physicians have long argued that massive court awards make it difficult for doctors to obtain malpractice insurance coverage at affordable prices – or at all — and that they increase health care costs by prompting them to practice defensive medicine. Consumer advocates and trial lawyers, though, have countered that capping awards infringes on the rights of individuals to be properly compensated, that the caps don’t do much good in holding down costs.

Perry wrote in an op-ed in the Washington Examiner in 2009: “In 2003, I declared the medical liability crisis an emergency item, and the legislature responded, passing sweeping reforms that protected the patient …. We ended the practice of allowing baseless, but expensive, lawsuits to drag on indefinitely, requiring plaintiffs to provide expert witness reports to support their claims within four months of filing suit or drop the case.”

But Jon Greenberg of New Hampshire Public Radio today debunked some of Perry’s claims on tort reform on the Politifact website: “The wholesale transformation that Perry describes is not backed up by the numbers. Perry said Texas has 21,000 more doctors thanks to tort reform. That’s flat out wrong. Texas has only about 13,000 more doctors in the state and the historic trends suggest that population growth was the driving factor. We rate his statement False.”

What else might “Perrycare” have to offer Americans? “Rick Perry believes the best way for the federal government to improve health care is to stimulate job creation so more Americans are covered by employer-sponsored health plans,” according to his campaign website. “Creating jobs will also reduce the strain on public safety net programs like Medicaid, saving taxpayer dollars.”

Originally Published On: www.npr.org – Original Article Here

posted by AndrewW on Aug 29

New, York, NY—July 28, 2011—A new study co-authored by Columbia Engineering professor Kartik Chandran and recently published in the journal, Environmental Science & Technology, shows that reducing nitrogen pollution generated by wastewater treatment plants can come with "sizable" economic benefits, as well as the expected benefits for the environment.

Chandran was one of five scientists from around the U.S. who worked on the study, along with James Wang of NOAA’s Air Resources Laboratory and formerly of Environmental Defense Fund (EDF); Steve Hamburg, Chief Scientist for EDF; Donald Pryor of Brown University; and Glen Daigger of CH2M Hill, a global environmental engineering firm based in Englewood, Colorado.

The study found that adding available technology to the existing infrastructure at a common type of wastewater treatment plant could create a trifecta of reductions in aquatic nitrogen pollution, greenhouse gas pollution, and energy usage. It also found that creating an emissions crediting system for the wastewater treatment sector could make the addition of new technologies much more affordable.

"As wastewater permits on wastewater treatment plants become more and more restrictive, the resultant increased capital and operating costs can pose quite a burden to utilities and municipalities," said Chandran, associate professor of earth and environmental engineering. "Our study shows that, if the reduced emissions associated with well-designed and operated biological nitrogen removal operations can be used to earn CO2 credits, then this could be a big benefit both for the utilities from a cost perspective and for the environment from water quality and air quality perspectives."

The majority of wastewater treatment plants already have systems to reduce ammonia levels in effluent, but pay relatively little attention to overall nitrogen pollution reduction, especially in the form of nitrous oxide (N2O), a potent greenhouse gas. Using emissions credits to address the problem could create an economic incentive of up to $600 million per year for U.S. plants to reduce nitrogen pollution, with the added benefit of up to $100 million per year in electricity savings if they do so.

"Recent N2O monitoring studies conducted by Columbia Engineering and research groups across the globe have found that meeting wastewater treatment objectives actually decreases biogenic N2O emissions," added Chandran. "So designing and adopting better process technologies for improving water quality could actually have a significant impact on reduced N2O emissions."

"Our study shows that there’s a win-win-win situation out there waiting to be realized," said James Wang, the chief author of the paper. "The creation of an emissions trading market could provide the needed incentive for wastewater treatment plants to adopt technologies that would reduce climate pollution, help clean up our waterways, and even save energy and money."

Chandran’s research focuses primarily on biological nitrogen removal from wastewater, sustainable water sanitation and hygiene (WASH), and developing new technologies for resource recovery and reuse from waste. His team recently created the first protocol to measure nitrous oxide (a greenhouse gas 300 times more potent than CO2). Using the protocol, his Columbia Engineering group developed the first nationwide database of N2O emissions from wastewater treatment plants. The database has now been adopted by the U.S. Environmental Protection Agency as the standard to estimate N2O emissions from wastewater treatment plants. Chandran is also working towards developing and implementing "energy-positive" wastewater treatment technologies that will produce energy rather than consume it at some of the largest wastewater utilities in the U.S.

Chandran was recently awarded a $1.5 million project grant from the Bill & Melinda Gates Foundation to develop a revolutionary new model in water, sanitation, and energy. Working with his partners Dr. Ashley Murray, founder and director of Waste Enterprisers, and Dr. Moses Mensah, a chemical engineering professor at Kwame Nkrumah University of Science and Technology, Chandran is developing an innovative technology to transform fecal sludge into biodiesel and create the "Next-Generation Urban Sanitation Facility" in Accra, Ghana.

posted by AndrewW on Aug 29

During the last prolonged warm spell on Earth, the oceans were at least four meters—and possibly as much as 6.5 meters, or about 20 feet—higher than they are now.

Where did all that extra water come from? Mainly from melting ice sheets on Greenland and Antarctica, and many scientists, including UW-Madison geoscience assistant professor Anders Carlson, have expected that Greenland was the main culprit.

But Carlson’s new results, published July 29 in Science, are challenging that assertion, revealing surprising patterns of melting during the last interglacial period that suggest that Greenland’s ice may be more stable—and Antarctica’s less stable—than many thought.

"The Greenland Ice Sheet is melting faster and faster," says Carlson, who is also a member of the Center for Climatic Research in the Nelson Institute for Environmental Studies. But despite clear observations of that fact, estimates of just how much the ice will melt and contribute to sea level rise by the end of this century are highly varied, ranging from a few centimeters to meters. "There’s a clear need to understand how it has behaved in the past, and how it has responded to warmer-than-present summers in the past."

The ice-estimation business is rife with unknown variables and has few known physical constraints, Carlson explains, making ice sheet behavior—where they melt, how much, how quickly—the largest source of uncertainty in predicting sea level rises due to climate change. His research team sought a way to constrain where ice remained on Greenland during the last interglacial period, around 125,000 years ago, to better define past ice sheet behavior and improve future projections.

The researchers analyzed silt from an ocean-floor core taken from a region off the southern tip of Greenland that receives sediments carried by meltwater streams off the ice sheet. They used different patterns of radiogenic isotopes to identify sources of the sediment, tracing the silt back to one of three "terranes" or regions, each with a distinct geochemical signature. The patterns of sedimentation show which terranes were still glaciated at that time.

"If the land deglaciates, you lose that sediment," Carlson explains. But to their surprise, they found that all the terranes were still supplying sediment throughout the last interglacial period and thus still had some ice cover.

"The ice definitely retreated to smaller than present extent and definitely raised sea level to higher than present" and continued to melt throughout the warm period, he adds, but the sediment analysis indicates that "the ice sheet seems to be more stable than some of the greater retreat values that people have presented."

The team used their results to evaluate several existing models of Greenland ice sheet melting during the last interglacial period. The models consistent with the new findings indicate that melting Greenland ice was responsible for a sea level rise of 1.6 to 2.2 meters—at most, roughly half of the minimum four-meter total increase.

Even after accounting for other Arctic ice and the thermal expansion of warmer water, most of the difference must have come from a melting Antarctic ice sheet, Carlson says.

"The implication of our results is that West Antarctica likely was much smaller than it is today," and responsible for much more of the sea level rise than many scientists have thought, he says. "If West Antarctica collapsed, that means it’s more unstable than we expected, which is quite scary."

Ultimately, Carlson says he hopes this line of research will improve the representation of ice sheet responses to a warming planet in future Intergovernmental Panel on Climate Change (IPCC) reports. Temperatures during the last interglacial period were similar to those expected by the end of this century, and present-day temps have already reached a point that Greenland’s glaciers are melting.

—

 Follow U.S. News Science on Twitter.

posted by AndrewW on Aug 29

Work by University of Cincinnati researchers to create a sensor that provides fast feedback related to the presence and levels of heavy metals—specifically manganese—in humans is published in the August issue of the prestigious international journal, Biomedical Microdevices.

Described in the article is the development of a low-cost, disposable lab-on-a-chip sensor that detects highly electronegative heavy metals more quickly than current technology generally available in health-care settings. It’s envisioned that the new UC sensor technology will be used in point-of-care devices that provide needed feedback on heavy-metal levels within about ten minutes.

It’s expected that the sensor will have potential for large-scale use in clinical, occupational and research settings, e.g., for nutrition testing in children.

The new sensor is environmentally friendly in that its working electrode is made of bismuth vs. the more typical mercury, and it’s child friendly in that it requires only a droplet or two of blood for testing vs. the typical five-milliliter sample now required.

Explained one of the researchers, UC’s Ian Papautsky, “The conventional methods for measuring manganese levels in blood currently requires about five milliliters of whole blood sent to a lab, with results back in 48 hours. For a clinician monitoring health effects by measuring these levels in a patient’s blood—where a small level of manganese is normal and necessary for metabolic functions—you want an answer much more quickly about exposure levels, especially in a rural, high-risk area where access to a certified metals lab is limited. Our sensor will only require about two droplets of blood serum and will provide results in about ten minutes. It’s portable and usable anywhere.”

Papautsky, UC associate professor of electrical and computer engineering, is co-author of the Biomedical Devices-published research, “Lab-on-a-Chip Sensor for Detection of Highly Electronegative Heavy Metals by Anodic Stripping Voltammetry.” Other co-authors are Erin Haynes, assistant professor of environmental engineering; William Heineman, distinguished research professor of chemistry; and just-graduated electrical and computer engineering doctoral student Preetha Jothimuthu, just-graduated chemistry doctoral student Robert Wilson, and biomedical engineering undergraduate research co-op student Josi Herren.

FIRST FIELD TEST OF SENSOR EXPECTED IN 2012 IN MARIETTA, OHIO

One specific motivation for developing the sensor was an ongoing project by UC’s Erin Haynes, who is studying air pollution and the health effects of manganese and lead in Marietta, Ohio. Manganese is emitted in that area because it is home to the only manganese refinery in the United States and Canada. Preliminary results from UC’s Mid-Ohio Valley Air Pollution Study (M.A.P.S.) found elevated levels of manganese in Marietta residents when compared to those who live in other cities.

HOW THE UC SENSOR WORKS

The new UC sensor uses a technology called anodic stripping voltammetry that incorporates three electrodes: a working electrode, a reference electrode and an auxiliary electrode.

A critical challenge for such sensors is the detection of electronegative metals like manganese. Detection is difficult because hydrolysis, the splitting of a molecule into two parts by the addition of a water molecule, at the auxiliary electrode severely limits a sensor’s ability to detect an electronegative metal.

To resolve this challenge, the UC team developed a thin-film bismuth working electrode vs. the conventional mercury or carbon electrode. The favorable performance of the bismuth working electrode combined with its environmentally friendly nature means the new sensor will be especially attractive in settings where a disposable lab-on-a-chip is wanted.

In addition, the UC team also optimized the sensor layout and working-electrode surface to further reduce the effects of hydrolysis and to boost the reliability and sensitivity in detecting heavy metals. The new sensor layout better allowed for its functioning, which consists of taking of a blood serum sample, stripping out the heavy metal and then measuring that heavy metal.

posted by AndrewW on Aug 28

Ago 17, 2011
| Publico<!– | 0 comentarios –>

Los resultados obtenidos gracias a una nueva técnica de datación utilizada en varias rocas de origen lunar indican que el satélite tiene unos 200 millones de años menos de lo que se estimaba hasta ahora. Los investigadores responsables del estudio, cuyos resultados han sido publicados hoy en la revista Nature, han asegurado que, o bien la Luna terminó de formarse mucho después de lo que se pensaba o las actuales teorías sobre su formación deben ser revisadas.

posted by AndrewW on Aug 28

Story By: by Marilyn Werber Serafini

Republican presidential candidate Texas Gov. Rick Perry speaks to supporters in Greenville, S.C. on Aug. 20.

Just a few weeks into his campaign, Texas Gov. and presidential candidate Rick Perry isn’t talking a whole lot about health care, except to criticize President Obama for last year’s law. And he’s not considered a health care expert. But he’s is passionate on one point: Fixing the nation’s health care system must include a major reform of the medical malpractice system.

In 2009, Perry and fellow GOP presidential competitor Newt Gingrich wrote in a Washington Post op-ed that Texas has successfully controlled health care costs, and at the same time has improved quality by enacting tort reforms in 2003. “Fewer frivolous lawsuits have attracted record numbers of doctors to the state as medical malpractice insurance premiums dropped by half,” they wrote.

They also mention Christus Health, a large Catholic nonprofit system with a significant presence in Texas, which reduced its liability defense payments from about $100 million in 2003 to $2.3 million last year. The savings went to expanding health-care services in low-income communities.

The 2003 law Perry enacted capped non-economic damages — court awards for pain and suffering – at $250,000 per defendant. There is no cap on economic damages, such as medical expenses.

Republicans and physicians have long argued that massive court awards make it difficult for doctors to obtain malpractice insurance coverage at affordable prices – or at all — and that they increase health care costs by prompting them to practice defensive medicine. Consumer advocates and trial lawyers, though, have countered that capping awards infringes on the rights of individuals to be properly compensated, that the caps don’t do much good in holding down costs.

Perry wrote in an op-ed in the Washington Examiner in 2009: “In 2003, I declared the medical liability crisis an emergency item, and the legislature responded, passing sweeping reforms that protected the patient …. We ended the practice of allowing baseless, but expensive, lawsuits to drag on indefinitely, requiring plaintiffs to provide expert witness reports to support their claims within four months of filing suit or drop the case.”

But Jon Greenberg of New Hampshire Public Radio today debunked some of Perry’s claims on tort reform on the Politifact website: “The wholesale transformation that Perry describes is not backed up by the numbers. Perry said Texas has 21,000 more doctors thanks to tort reform. That’s flat out wrong. Texas has only about 13,000 more doctors in the state and the historic trends suggest that population growth was the driving factor. We rate his statement False.”

What else might “Perrycare” have to offer Americans? “Rick Perry believes the best way for the federal government to improve health care is to stimulate job creation so more Americans are covered by employer-sponsored health plans,” according to his campaign website. “Creating jobs will also reduce the strain on public safety net programs like Medicaid, saving taxpayer dollars.”

Originally Published On: www.npr.org – Original Article Here

posted by AndrewW on Aug 28

Story By: by Jordan Rau

Is that MRI for back pain necessary?

Back surgery is one of the best documented examples of expensive medical treatments that drive up health care costs while not always helping patients, and sometimes even hurting them.

And the latest Medicare data show that doctors frequently order MRI back scans for patients who haven’t tried recommended treatments such as physical therapy. An MRI often prompts surgery.

In 2009, 32 percent of Medicare patients with lower back pain who received a spine MRI at a hospital outpatient imaging center hadn’t tried a more conservative — and cheaper — treatment than surgery, according to data published on Medicare’s Hospital Compare website this month.

Among 2,088 hospitals where Medicare had enough data to evaluate, Regions Hospital in St. Paul, Minn., had the highest rate: 64 percent of the 329 patients that got scans in 2009 hadn’t received prior treatments first.

According to the Hospital Compare data, the hospitals with the next highest rates in 2009 were:

To be sure, high MRI rates aren’t proof the hospitals are jumping the gun (or the scan) on patients. It’s possible that doctors who referred to these places tended to have more patients who warranted prompt scans on clinical grounds. And hospitals like to note that they don’t control many of the doctors who order these tests.

Nonetheless, this is one of only two measures of potential imaging overuse that Medicare publishes and that has been endorsed as valid by the National Quality Forum, which does rigorous screenings of health care quality measures with the participation of medical providers. (The other NQF-endorsed measure of potential imaging overuse that Medicare publishes is double chest CT scans.)

And there’s evidence — such as in this recent study — that patients receiving back scans are more likely to end up getting spinal surgery. Spine surgeries are a rapidly growing cost to Medicare, and there are widespread concerns that some spine surgeons are too eager to perform these lucrative surgeries, egged on by financial conflicts of interest.

The Medicare data show that at 9 of 10 hospitals, at least 25 percent of the patients who received back MRIs hadn’t tried a more conservative treatment first.

Among states, Minnesota had the highest average rate of MRI back scans without prior interventions, at 41 percent. Wyoming was second, followed by Arkansas, West Virginia, Utah and Montana. The state with the lowest rate was Delaware, at 26 percent, followed by Florida, New Jersey, California and New York.

These results are intriguing because many of the states with the highest rates of possibly premature MRIs, such as Minnesota and Utah, are frequently cited by folks at the Dartmouth Atlas and elsewhere for their cost-effective care. Some of the states with the lowest rankings, such as New Jersey and New York, are often cited as places where doctors and hospitals perform too many procedures.

If you want to look up your hospital’s back scan rate, go to Hospital Compare. Enter your city and state or zip code, select your hospital and then select the “Use of Medical Imaging” tab on the left. Note that many hospitals didn’t do a sufficient number of MRIs for Medicare to do a valid analysis.

Originally Published On: www.npr.org – Original Article Here