News on 28 - 3 January 2016
28 December 2015
Preparing for the End
It’s not a lot of money: $86 for a 30-minute conversation with your doctor. That’s the amount Medicare decided this year to pay physicians for talking with patients about the medical choices they would make if they become so sick they are unable speak for themselves.
But that $86 payment marks a watershed in a long-running, controversial debate over whether doctors should encourage patients to discuss the care they would and wouldn’t want at the end of life. For years, the idea of reimbursing doctors for such “advance care planning” conversations – originally proposed as part of the Affordable Care Act – had been castigated by conservative Republicans as a vehicle for establishing “death panels.”
But in 2014, I wrote that the tide was changing, as more patients, doctors and even some private insurers were seeing value in discussions about interventions like feeding tubes or ventilators. Whether patients would want every possible measure to keep them alive or whether they would want pain relief and comfort care, many liked being able to specify beforehand, partly to save family members the angst of having to decide. Later that year, a national nonpartisan panel recommended advance care planning discussions as part of a sweeping report on end-of-life care.
In July 2015, Medicare proposed covering end-of-life conversations, and after a public comment period, the proposal was adopted. Starting in January, doctors, nurse practitioners and other medical professionals can be reimbursed for face-to-face meetings with patients, as well as any relatives or caregivers patients want to include. There is no limit on the number of meetings, and because private insurance companies often follow Medicare’s lead, advance care planning is on track to become a regular part of medical care. – PAM BELLUCK
http://www.nytimes.com
29 December 2015
Worry Warriors Unite
Anxiety — and its extended family members “stress” and “worry” — cast long shadows over much of my reporting in 2015, as I looked at adolescent and young adult behavior, and the growing research area of human-animal interactions. New job title this year? “Chief Anxiety Correspondent” — extensive professional and personal experience.
There was lots of bad news about anxiety (to accompany all the bad news to be anxious about). But there was surprisingly good news, too, as researchers found an upside to being a worry warrior.
On college campuses, mental health centers are being overrun with students whose most common diagnosis is now anxiety, outnumbering depression. Longtime therapists note a generational shift among students, who seem less able to withstand the normal buffeting of life away from home. The centers are increasingly offering group sessions to address social anxiety and test anxiety, and to teach students more coping skills. Petting playful therapy dogs is also a popular stress-busting activity during finals week at many universities.
But do animals really alleviate stress and anxiety? The research about long-term effects is equivocal at best. Nonetheless, there is a growing belief that companion animals can be a source of comfort, particularly for people with depression and anxiety. As a result, many college students who say they have mental health disabilities are successfully petitioning to keep pets in their dormitory rooms — dogs, cats, guinea pigs, snakes — with mixed results for other residents.
It turns out that anxiety can be contagious at home, too. Researchers found that math-anxious parents, who struggled mightily to help their children with homework, wound up contributing to their children’s escalating math anxiety. And the news, of course, added another element to parental anxiety: guilt.
But researchers found that as people waited for test results, worrying and anxiety turned out to be reasonably excellent strategies. Compared with their composed colleagues, the anxiety-ridden were better prepared if the news was bad and more elated if the news was good. At long last, two cheers for us! – JAN HOFFMAN
http://www.nytimes.com
30 December 2015
Dad Speaks The Truth And Gets Silent Treatment From Daughter
DEAR
ABBY: My daughter, a single parent, has a 27-year-old son who has
assaulted her several times. He has never worked and has been in trouble
with the law because of drugs. Recently, she called me to ask if she
and her son could spend the night with me. (They live 160 miles away.) I
told her that because of his past behavior it wasn't a good idea.
She
was very offended and said I would "never see her son again." After
sending me several hurtful emails, she's no longer speaking to me,
despite the fact that I have always taken care of her and listened to
her problems about her son.
I
deserve an apology -- which I won't receive. But I feel bad about the
situation. How do I fix it without apologizing myself? -- DAD WITH A
DILEMMA IN FLORIDA
DEAR
DAD: Because you know an apology from your daughter won't be
forthcoming, don't expect one. Considering the fact that your grandson
has a tendency to be violent, I don't blame you for not wanting him in
your home. So stand pat. Your daughter will start talking to you again
as soon as she needs something from you. Of that, I am sure.
Dear Abby
http://news.yahoo.com
Tornadoes and severe weather hit the Southeast, West and Midwest
At
least 42 people were killed across seven states since Wednesday
following days of severe weather, including flash floods in Illinois and
tornadoes in Texas.
The
Marion County, Illinois, Sheriff's Office said five people were killed
Saturday as a major storm system brought flash flooding and blizzard conditions to parts of the United States.
In
central Missouri, eight have died in Saturday flooding incidents,
officials said. Missouri Gov. Jay Nixon has declared a state of
emergency because of the heavy rain.
Two deaths were reported in Alabama, 10 were reported in Mississippi, six were killed in Tennessee and one died in Arkansas.
Two deaths were reported in Alabama, 10 were reported in Mississippi, six were killed in Tennessee and one died in Arkansas.
In Garland, a suburb of Dallas, eight people died Saturday when an EF-4 tornado touched down, the National Weather Service Fort Worth survey team said. EF-4 tornados bring winds over 165 mph.
Three others died in Collin County, police said.
The
same tornado that struck Garland hit the neighboring town of Rowlett,
where it weakened to an EF-3, meaning its winds were over 135 mph, the
NWS Fort Worth survey team said. Twenty-three people were injured and 39
homes were "totally destroyed," City Manager Brian Funderburk said
today. (GMA)
Yahoo News
http://news.yahoo.com
When Ebola Is Cured but Not Over
 |
Before he contracted Ebola, Dr. Ian Crozier
had two blue eyes. After he was told he was cured of the disease, his
left eye turned green.
Credit
Emory Eye Center
|
Months after Dr. Ian Crozier thought he was cured of Ebola, his doctors were horrified — and fascinated — to find that his left eye was teeming with the virus. It was a fierce, painful infection that blinded the eye for weeks and even changed its color from blue to green. But with careful treatment, Dr. Crozier’s sight, and his eye color, gradually returned.
Dr. Crozier, who was infected while taking care of Ebola patients in Sierra Leone, called his eye trouble “an odd canary in this coal mine.” His case was an early warning that Ebola can lurk undetected in parts of a recovered patient’s body. The disease infected more than 28,000 people, killing more than 11,000 of them, in Guinea, Sierra Leone and Liberia. Lingering eye problems are not uncommon among survivors.
In October, another survivor fell mysteriously ill again, nine months after her recovery. Pauline Cafferkey, a Scottish nurse also infected while volunteering in Sierra Leone, had a severe case of meningitis caused by the virus’s lingering in her nervous system. She again recovered.
Certain parts of the body — the eye, the testes, the central nervous system — are “immune-privileged” sites, meaning they are off limits to the body’s natural defenses, the immune system. But if a virus like Ebola manages to invade those sites, immune privilege can backfire.
Doctors have long known that Ebola could lurk in the testes, but until the recent epidemic, they did not realize how long it could hang on. A report published in October said that a male survivor in Liberia had infected a female sexual partner six months after his own illness. Another study published in October found that genetic material from the virus was still present in some men’s semen nine months after they were infected. The possibility of sexual transmission is suspected in a few recent cases that have popped up in West Africa after the epidemic was thought to have been over. There is still much to be learned about Ebola. – DENISE GRADY
Dr. Crozier, who was infected while taking care of Ebola patients in Sierra Leone, called his eye trouble “an odd canary in this coal mine.” His case was an early warning that Ebola can lurk undetected in parts of a recovered patient’s body. The disease infected more than 28,000 people, killing more than 11,000 of them, in Guinea, Sierra Leone and Liberia. Lingering eye problems are not uncommon among survivors.
In October, another survivor fell mysteriously ill again, nine months after her recovery. Pauline Cafferkey, a Scottish nurse also infected while volunteering in Sierra Leone, had a severe case of meningitis caused by the virus’s lingering in her nervous system. She again recovered.
Certain parts of the body — the eye, the testes, the central nervous system — are “immune-privileged” sites, meaning they are off limits to the body’s natural defenses, the immune system. But if a virus like Ebola manages to invade those sites, immune privilege can backfire.
Doctors have long known that Ebola could lurk in the testes, but until the recent epidemic, they did not realize how long it could hang on. A report published in October said that a male survivor in Liberia had infected a female sexual partner six months after his own illness. Another study published in October found that genetic material from the virus was still present in some men’s semen nine months after they were infected. The possibility of sexual transmission is suspected in a few recent cases that have popped up in West Africa after the epidemic was thought to have been over. There is still much to be learned about Ebola. – DENISE GRADY
http://www.nytimes.com
Malaysian actress Tiffany Leong dies of cancer at 30
"Tiffany left us peacefully this afternoon. We would like to ask everyone to give us some time to see to her funeral. Thank you for your understanding, and please pray for her," said her family in a post on her official Facebook page.
The Mediacorp artiste was diagnosed with multiple endocrine neoplasia (MEN syndrome) in 2013, and she was later confirmed to have early-stage liver cancer, reported Channel 8. She had 60 per cent of her liver removed, and returned to work late last year.
Leong was admitted to a hospital in Kuala Lumpur on Saturday, Channel 8 added.
Condolence messages poured in after news of Leong’s death broke.
“She was young, knowledgeable, talented, beautiful, humble, kind,
friendly, hardworking and had many positive qualities. I got to know her
as a good actress with depth as we filmed Priceless Wonder, and I liked
her immensely. She had studied about working behind the scenes, but was
later persuaded to get in front of the camera, thanks to her good
looks. I sincerely wished her a bright future,” wrote Singapore actress
Xiang Yun in a Facebook post
By channelnewsasia
http://www.channelnewsasia.com
Rare 'corpse flower' blooms in Australia
A 2m-tall flower, known for its pungent odour which has been likened to rotting flesh, has bloomed in Australia.
About two weeks ago the plant's famously pungent flower began to grow, before finally opening on Monday.
Matt Coulter, a horticulture curator at the garden, said the flower's "rotten fish smell" was overpowering.
"When I opened the door this morning it almost knocked me over, it was so strong," he said.
Mr Coulter, who has been tending the flower for the last eight years, said he was ecstatic that it had flowered for the first time.
"It's fantastic. I didn't think it would ever flower," he said.
"It comes from [the Indonesian island of] Sumatra, so we've been keeping it warm in winter and cool in summer, and keeping the humidity high.
The corpse flower cannot self-pollinate and its stench attracts sweat bees and carrion beetles that live on animal carcasses.
In the wild, these animals will carry the plant's pollen to other corpse flowers.
Queues of visitors have been lining up to see - and smell - the flower at Mount Lofty Botanic Garden since it began opening on Monday.
The flower will last for just 48 hours before it collapses in on itself.
Other flowers have been grown in botanical gardens around the world, attracting visitors when they bloom.
By BBC
http://www.bbc.com
