Five years after it exploded into a political conflagration over “death panels,” the issue of paying doctors to talk to patients about end-of-life care is making a comeback, and such sessions may be covered for the 50 million Americans on Medicare as early as next year.
Bypassing the political process, private insurers have begun reimbursing doctors for these “advance care planning” conversations as interest in them rises along with the number of aging Americans. People are living longer with illnesses, and many want more input into how they will spend their final days, including whether they want to die at home or in the hospital, and whether they want full-fledged life-sustaining treatment, just pain relief or something in between. Some states, including Colorado and Oregon, recently began covering the sessions for Medicaid patients.
But far more significant, Medicare may begin covering end-of-life discussions next year if it approves a recent request from the American Medical Association, the country’s largest association of physicians and medical students. One of the A.M.A.’s roles is to create billing codes for medical services, codes used by doctors, hospitals and insurers. It recently created codes for end-of-life conversations and submitted them to Medicare.
The Centers for Medicare and Medicaid Services, which runs Medicare, would not discuss whether it will agree to cover end-of-life discussions; its decision is expected this fall. But the agency often adopts A.M.A. recommendations, which are developed in meetings attended by its representatives…and discussion with bible-thumping populist idjits is useless as ever. Why waste the time?…
The water system in Reserve, Garyville and Mount Airy has tested positive for a potentially deadly brain-eating amoeba, the state Department of Health and Hospitals said…Officials say the Naegleria fowleri amoeba was found in samples taken from St. John the Baptist Parish’s Water District No. 1, which serves 12,577 people in those east bank communities.
There are no known cases of illness from the amoeba. But officials warned residents to take precautions against getting water in their nasal passages, which is how the amoeba can move to the brain…
“Families can take simple steps to protect themselves from exposure to this amoeba, the most important being to avoid allowing water to go up your nose while bathing or swimming in a pool,” state health officer Jimmy Guidry. “It is important to remember that the water is safe to drink; the amoeba cannot infect an individual through the stomach.”
The St. John public school system has ordered water fountains turned off at all schools and was taping them up, school system spokeswoman Jennifer Boquet said.
Water District No. 1 was sampled as part of the state’s surveillance program and was found to be out of compliance for maintaining minimum disinfectant levels set to control the Naegleria fowleri amoeba. The state imposed higher disinfectant levels after a 4-year-old boy Mississippi boy contracted the amoeba during a visit to St. Bernard Parish and died.
St. John is now under an emergency order to perform a 60-day free chlorine burn on the water system, in which the water lines are infused with free chlorine. That is a stronger, faster-acting disinfectant than the normal infusion of chloramines, a combination of chlorine and ammonia.
Shouldn’t change the look and smell of Louisiana drinking water a whole boatload. When I lived in New Orleans it was usual to fill your bathtub with water green enough to look like a celebration rehearsal for St.Patrick’s Day.
The amoeba may not kill you; but, the crap the state of Louisiana adds to what passes for drinking water might.
Looking at couples over the first nine years of marriage, the study found:
• More frequent marijuana use by husbands and wives (two-to-three times per month or more often) predicted less frequent intimate partner violence (IPV) perpetration by husbands.
• Husbands’ marijuana use also predicted less frequent IPV perpetration by wives.
• The relationship between marijuana use and reduced partner violence was most evident among women who did not have histories of prior antisocial behavior.
The study’s lead author is Philip H. Smith, PhD, a recent doctoral graduate of the UB School of Public Health and Health Professions and now associate research scientist in the Department of Psychiatry at Yale University.
It is based on research data collected by lead investigator Kenneth Leonard, PhD, director of the UB Research Institute on Addictions. The study was supported by a grant from the National Institute on Alcohol Abuse and Alcoholism to Leonard and a grant to Smith from the National Institute on Drug Abuse.
Exactly the sort of scientific research that can benefit society and law. Guaranteed to be ignored by the overwhelming majority of our lawmakers – and the idjits who vote for them.
Still, the important part is that scientists are unrelenting in their curiosity, the quest for knowledge regardless of opposition from Philistines.
States that have legalized medical marijuana tend to experience an unexpected benefit — fewer overdose deaths from narcotic painkillers…
Access to medical marijuana is associated with 25 percent fewer prescription drug overdose deaths each year compared to states where medical pot is illegal, according to findings published Aug. 25 in JAMA Internal Medicine.
What’s more, states that pass medical marijuana laws see their overdose death rates decrease dramatically in the years immediately afterward…
The study authors believe that people suffering from chronic pain tend to rely on medical marijuana when they have that option, which reduces the risk of addiction and overdose that accompanies use of narcotic medications.
The study used data from the U.S. Centers for Disease Control and Prevention to determine the prescription painkiller overdose death rate for each state between 1999 and 2010, and then took into account whether and when each state had passed a medical marijuana law…
Critics are trying hard to come up with rationales that support continued reliance on the profitable trade in prescription painkillers – and don’t confront idjit ideology that says cannabis is the Antichrist.
Overdose deaths from prescription painkillers have skyrocketed over the past two decades, increasing 118 percent between 1999 and 2011, according to the CDC.
The agency estimates that every day 113 people die from drug overdoses in the United States, and another 6,700 land in the emergency room from an overdose…
States’ overdose death rates decline an average 20 percent in the first year following the passage of a medical marijuana law, the researchers found. By the second year, overdose death rates on average decline 25 percent, and as much as 33 percent by five years after legalization of medical pot.
Medical marijuana laws also are associated with a more dramatic decrease in overdose death rates than other means commonly used to tackle prescription drug abuse, the study noted.
There is no reason for Congressional opposition to medical marijuana other than it may cut down contributions from amoral corporations chartered to profit from pain and illness.
Creeps like Mitch McConnell and Erik Paulsen may as well take their contributions directly from the drug cartels instead of the painkiller producers. Cut out the middleman.
Joycelyn Elders – Surgeon General forced to resign by Republican backwardness, Democrat cowardice
Conduct an Internet search for “masturbation,” and you will find hundreds, if not thousands, of slang phrases for the act. This proliferation of slang phrases suggests people want to talk about masturbation, but are uncomfortable about doing so directly. Using comedic terms provides a more socially acceptable way to express themselves.
So before we talk any more about it, let’s normalise it a bit. Masturbation, or touching one’s own genitals for pleasure, is something that babies do from the time they are in the womb. It’s a natural and normal part of healthy sexual development.
According to a nationally representative US sample, 94% of men admit to masturbating, as do 85% of women. But societal perspectives of masturbation still vary greatly, and there’s even some stigma around engaging in the act. Related to this stigma are the many myths about masturbation, myths so ridiculous it’s a wonder anyone believes them.
They include: masturbation causes blindness and insanity; masturbation can make sexual organs fall off; and masturbation causes infertility.
In actual fact, masturbation has many health benefits…And there are plenty of additional benefits from orgasms generally, including reduced stress, reduced blood pressure, increased self-esteem, and reduced pain…
Talking about masturbation also has benefits. Promoting sex-positive views in our own homes and in society, including around masturbation, allows us to teach young people healthy behaviours and attitudes without stigma and shame.
Parents and guardians who feel embarrassed or need extra guidance to do this should seek out sex-positive sources of information, like ones from respected universities.
Or you could be truly stupid and talk to a priest or listen to some politician who worries about offending 14th Century sexual mores a heckuva lot more than supporting educated reason.
A pilot lost control of a passenger plane after his artificial arm became detached as he was coming in to land, an accident report has said.
The Flybe flight from Birmingham, with 47 passengers on board, was approaching Belfast City Airport in gusty conditions on 12 February…It landed heavily but no-one was hurt and the plane was not damaged.
The pilot said he would be more cautious in future about checking his attachment, according to the report.
In a statement, Flybe said the senior captain was one of its “most experienced and trusted pilots”, and the safety of passengers and crew had not been compromised in any way…
While he had thought about getting his co-pilot to take control, the time available and the challenging conditions meant his best course of action was to move his right hand from the power levers on to the yoke to regain control.
“He did this, but with power still applied and possibly a gust affecting the aircraft, a normal touchdown was followed by a bounce, from which the aircraft landed heavily,” the report found.
The AAIB reported that the captain had said that in future he would be more cautious about checking the attachment on his prosthesis as he may have dislodged the latching mechanism.
He also said he would brief his co-pilots about the possibility of a similar event and that they should be ready to take control at any time.
Could’ve been worse. Might have been a lumberjack operating a chainsaw.
Every day, 22 veterans take their own lives. That’s a suicide every 65 minutes. As shocking as the number is, it may actually be higher.
The figure, released by the Department of Veterans Affairs in February, is based on the agency’s own data and numbers reported by 21 states from 1999 through 2011. Those states represent about 40% of the U.S. population. The other states, including the two largest (California and Texas) and the fifth-largest (Illinois), did not make data available.
Who wasn’t counted?
People like Levi Derby, who hanged himself in his grandfather’s garage in Illinois on April 5, 2007. He was haunted, says his mother, Judy Casper, by an Afghan child’s death. He had handed the girl a bottle of water, and when she came forward to take it, she stepped on a land mine…
Derby was not in the VA system, and Illinois did not send in data on veteran suicides to the VA…
Combat stress is just one reason why veterans attempt suicide. Military sexual assaults are another. Psychologist Craig Bryan says his research is finding that military victims of violent assault or rape are six times more likely to attempt suicide than military non-victims.
More than 69% of all veteran suicides were among those 50 and older. Mental-health professionals said one reason could be that these men give up on life after their children are out of the house or a longtime marriage falls apart. They are also likely to be Vietnam veterans, who returned from war to a hostile public and an unresponsive VA. Combat stress was chalked up to being crazy, and many Vietnam veterans lived with ghosts in their heads without seeking help…
Then, Ronald Reagan issued an executive order denying unemployment compensation to VietNam-era vets “who decided not re-enlist”.
“There’s probably a tidal wave of suicides coming,” says Brian Kinsella, an Iraq war veteran who started Stop Soldier Suicide, a nonprofit group that works to raise awareness of suicide. Between October 2006 and June 2013, the Veterans Crisis Line received more than 890,000 calls. That number does not include chats and texts.
Though there is a tradition among conservatives to consider all war as patriotic, there is no matching correlation with the cost of war. This is especially true of the Neo-Cons with “con” standing for both conservative and confederate. They love sending folks off to war – without the least consideration for the cost of war.
At best, they count the cost of war in dollar$ and cent$ for hardware. At worst – more typical – they consider the cost in human lives as collateral damage when it comes to the “other side” and some kind of inherent weakness outside of combat casualties on “our side”. Sit down and have a couple of beers with Dick Cheney and you’ll see what I mean. Metaphorically or otherwise.
So, Bush and Cheney sent our military off to foreign lands with bigger and better hardware. Many came back with bigger and much worse cases of PTSD than the VietNam vets sent off by Johnson and Nixon. Neither group of stinking politicians included plans to pay for the cost of their wars. Neither group considered the damage done to our military men and women as part of that cost – anyway.
RTFA to add another jot of sadness to your day. Beaucoup examples of the overlooked and forgotten.
Photo from 1983. Things haven’t gotten any better.
Nationwide, 25% of military families – 620,000 households – need help putting food on the table, according to a study by Feeding America, a network of 200 food banks.
“The results are alarming,” says Bob Aiken, chief executive officer of Feeding America. “It means that people in America have to make trade-offs. They have to pick between buying food for their children or paying for utilities, rent and medicine.”
One in seven Americans – 46 million people – rely on food pantries and meal service programs to feed themselves and their families, the study found…
Linda Patterson, executive director of Lorton Community Action Center, says stereotypes of the people who need food assistance are misleading.
“The people who come here are hard workers. They are employed. They are the school bus drivers, the lab techs in doctors offices, receptionists, the janitors who clean the floor of your children’s school,” Patterson says. “They just can’t make ends meet because some kind of crisis has hit them.”
The Hunger in America study found that of people who use food banks:
• 26% are black, 20% are Hispanic, 43% are white and 11% are other.
• 33% of households have at least one family member with diabetes.
• 65% of households have a child under 18 or someone 60 or older…
In the past year, food banks have increased their focus on healthy foods. The study found that 79% of people who use food banks report purchasing inexpensive, unhealthy food just to have enough to feed their families…
“The people who come to us for help are coming more regularly,” says Allison Majewski of the Capital Area Food Bank. “We aren’t a one-time emergency stop anymore. We are a staple for them, so it’s very important that we make these healthy foods available.”
Last time I read about anyone in Congress trying to live on a food stamp budget it was a couple of Democrats and one Republican. They may have lasted a week.
Everyone else was away at fund-raising banquets.
States that aren’t expanding Medicaid are leaving a total of $423 billion in federal funds on the table over the next decade.
States do have to spend a bit of their own money to get the federal dollars. While the federal government covers the full cost of Medicaid expansion through 2016, states have to kick in a small portion (5 percent) beginning in 2017. The state’s contribution ultimately rises to 10 percent by 2020.
The Urban Institute, who crunched the numbers behind this map, finds that the states currently not expanding Medicaid would have to spend $31.6 billion over the next decade if they opt-in. That is definitely real money — but also less than a tenth of the amount they’re losing out on by passing up the expansion.
Almost all these states have Republican governors and Republican-conrolled legislatures. Proving once again idjits elect idjits – or liars.
As for sloganeering — it’s obvious Republicans have as much concern for people needing healthcare as they do for people needing jobs. Lots of talk – but, won’t do a damned thing to help out.
A study published in the July issue of Cognitive Science determined that children who are not exposed to religious stories are better able to tell that characters in “fantastical stories” are fictional — whereas children raised in a religious environment even “approach unfamiliar, fantastical stories flexibly.”
In “Judgments About Fact and Fiction by Children From Religious and Nonreligious Backgrounds,” Kathleen Corriveau, Eva Chen, and Paul Harris demonstrate that children typically have a “sensitivity to the implausible or magical elements in a narrative,” and can determine whether the characters in the narrative are real or fictional by references to fantastical elements within the narrative, such as “invisible sails” or “a sword that protects you from danger every time.”
However, children raised in households in which religious narratives are frequently encountered do not treat those narratives with the same skepticism. The authors believed that these children would “think of them as akin to fairy tales,” judging “the events described in them as implausible or magical and conclude that the protagonists in such narratives are only pretend.”
And yet, “this prediction is likely to be wrong,” because “with appropriate testimony from adults” in religious households, children “will conceive of the protagonist in such narratives as a real person — even if the narrative includes impossible events…”
This conclusion contradicts previous studies in which children were said to be “born believers,” i.e. that they possessed “a natural credulity toward extraordinary beings with superhuman powers. Indeed, secular children responded to religious stories in much the same way as they responded to fantastical stories — they judged the protagonist to be pretend.”
The researchers also determined that “religious teaching, especially exposure to miracle stories, leads children to a more generic receptivity toward the impossible…
Then, they grow up and vote.