Health – Page 26 – artdiamondblog.com

Sweden Shows ObamaCare Will Cause Health Care Delays and Rationing

(p. A11) President Obama has declared the Affordable Care Act a success–a reform that is “here to stay.” The question remains, however: What should we expect to come out of it, and do we want the effects to stay? If the experiences of Sweden and other countries with universal health care are any indication, patients will soon start to see very long wait times and difficulty getting access to care.
. . .
Rationing is an obvious effect of economic planning in place of free-market competition. Free markets allow companies and entrepreneurs to respond to demand by offering people what they want and need at a better price. Effective and affordable health care comes from decentralized innovation and risk-taking as well as freedom in pricing and product development. The Affordable Care Act does the opposite by centralizing health care, minimizing or prohibiting differentiation in pricing and offerings, and mandating consumers to purchase insurance. It effectively overrides the market and the signals it sends about supply and demand.
Stories of people in Sweden suffering stroke, heart failure and other serious medical conditions who were denied or unable to receive urgent care are frequently reported in Swedish media. Recent examples include a one-month-old infant with cerebral hemorrhage for whom no ambulance was made available, and an 80-year-old woman with suspected stroke who had to wait four hours for an ambulance.
Other stories include people waiting many hours before a nurse or anyone talked to them after they arrived in emergency rooms and then suffering for long periods of time before receiving needed care. A 42-year-old woman in Karlstad seeking care for meningitis died in the ER after a three-hour wait. A woman with colon cancer spent 12 years contesting a money-saving decision to deny an abdominal scan that would have found the cancer earlier. The denial-of-care decision was not made by an insurance company, but by the government health-care system and its policies.

For the full commentary, see:
PER BYLUND. “OPINION; What Sweden Can Teach Us About ObamaCare; Universal public health care means the average Swede with ‘high risk’ prostate cancer waits 220 days for treatment.” The Wall Street Journal (Fri., April 18, 2014): A11.
(Note: ellipsis added.)
(Note: the online version of the commentary has the date April 17, 2014.)

Research on Dogs that Benefits Both Humans and Dogs

“Erica Moore examined Akyra, a shih tzu, in August before the dog was enrolled in Penn Vet’s canine mammary tumor program. She had surgery there.” Source of caption and photo: online version of the NYT article quoted and cited below.

(p. D6) Akyra’s mammary glands were riddled with tumors, including one the size of a golf ball. She would be hard to place in a home, and the medical care she needed would be expensive. The tumors could be cancerous.

“When my husband called and said they were going to leave one of the dogs behind because she had mammary tumors, I said, ‘No, you’re not!’ ” said Bekye Eckert, 49, a dog lover who lives outside Baltimore and has cared for several animals with mammary cancer.
Ms. Eckert arranged for Akyra to be enrolled in an innovative program at the University of Pennsylvania, where veterinary oncologists are learning about the progression of human breast cancer by treating mammary tumors in shelter dogs.
. . .
Generally, two sets of tumor samples are taken from each dog, one for the pathology lab and one for Dr. Troyanskaya to use for molecular analysis. Astrid, for example, had tumors in seven mammary glands that were mostly benign. The largest proved to be malignant.
Such a large set of samples is a gold mine for Dr. Troyanskaya, who is looking for changes in the expression of a specific gene or group of genes, or pathways linking groups of genes as the tumor becomes malignant.
. . .
In the meantime, stray dogs are getting free cancer treatment that makes it easier to find them permanent homes, and they are promised care for any recurrence. More than 100 dogs have been through the program; several have been adopted by women who also survived breast cancer.
For Akyra, there was good news. She had surgery in August, and veterinarians removed the large tumor and three smaller lesions. The pathology report gave her a clean bill of health: None were cancerous. She was adopted by Beth Gardner, a relocation consultant in Devon, Pa.

For the full story, see:
RONI CARYN RABIN. “By Treating Dogs, Answers About Breast Cancer.” The New York Times (Tues., April 1, 2014): D6.
(Note: ellipses added.)
(Note: the online version of the commentary has the date MARCH 31, 2014, and has the title “From Dogs, Answers About Breast Cancer.”)

Re-Use of Plastic Bags Increases E. Coli Infections

(p. A13) Though reducing plastic-bag use might be good for the environment, encouraging the re-use of plastic bags for food-toting may not be so healthy for humans. After San Francisco introduced its ban on non-compostable plastic bags in large grocery stores in 2007, researchers discovered a curious spike in E. coli infections, which can be fatal, and a 46% increase in deaths from food-borne illnesses, according to a study published in November 2012 by the University of Pennsylvania and George Mason University. “We show that the health costs associated with the San Francisco ban swamp any budgetary savings from reduced litter,” the study’s authors observed.
Affirming this yuck factor, a 2011 study from the University of Arizona and Loma Linda University found bacteria in 99% of reusable polypropylene bags tested; 8% of them were carrying E. coli. The study, though it mainly focused on plastic bags, also looked at two cotton reusable bags–and both contained bacteria.
Bag-ban boosters counter that consumers just need to wash their bags and use separate bags for fish and meat. If only my washing machine had a “reusable bag vinegar rinse cycle.” A paltry 3% of shoppers surveyed in that same 2011 study said they washed their reusable bags. Has anybody calculated the environmental impact of drought-ravaged Californians laundering grocery bags?

For the full commentary, see:
JUDY GRUEN. “Becoming a Bagless Lady in Los Angeles.” The Wall Street Journal (Sat., March 8, 2014): A13.
(Note: the online version of the commentary has the date March 7, 2014.)

The 2012 study mistakenly labelled above as “published” is:
Klick, Jonathan and Wright, Joshua D., Grocery Bag Bans and Foodborne Illness (November 2, 2012). U of Penn, Inst for Law & Econ Research Paper No. 13-2. Available at SSRN: http://ssrn.com/abstract=2196481 or http://dx.doi.org/10.2139/ssrn.2196481

The 2011 article mentioned above, is:
Williams, David L., Charles P. Gerba, Sherri Maxwell, and Ryan G. Sinclair. “Assessment of the Potential for Cross-Contamination of Food Products by Reusable Shopping Bags.” Food Protection Trends 31, no. 8 (Aug. 2011): 508-13.

Solitary Swimming Helps Creativity and Problem-Solving

(p. 5) Ms. Nyad has spent a lifetime in the water, chasing an elusive mark in marathon swimming, and she has written about the exhilarating out-of-body experience she has when powering through long distances. The medium makes it necessary to unplug; the blunting of the senses by water encourages internal retreat. Though we don’t all reach nirvana when we swim, swimming may well be that last refuge from connectivity — and, for some, the only way to find the solitary self.
. . .
For better or worse, the mind wanders: We are left alone with our thoughts, wherever they may take us. A lot of creative thinking happens when we’re not actively aware of it. A recent Carnegie Mellon study shows that to make good decisions, our brains need every bit of that room to meander. Other research has found that problem-solving tends to come most easily when our minds are unfocused, and while we’re exercising. The neurologist Oliver Sacks has written books in his head while swimming. “Theories and stories would construct themselves in my mind as I swam to and fro, or round and round Lake Jeff,” he writes in the essay “Water Babies.” Five hundred lengths in a pool were never boring or monotonous; instead, Dr. Sacks writes, “swimming gave me a sort of joy, a sense of well-being so extreme that it became at times a sort of ecstasy.” The body is engaged in full physical movement, but the mind itself floats, untethered. Beyond this, he adds, “there is all the symbolism of swimming — its imaginative resonances, its mythic potentials.”
Dr. Sacks describes a sublime state that is accessible to all, from his father, with his “great whalelike bulk,” who swam daily and elegantly until 94 years of age, to the very young. . . .
. . .
I asked Dara Torres, who has logged countless training hours for her five Olympics, what she thinks about when she’s swimming. “I’m always doing five things at once,” she told me by phone (at the time, she was driving a car). “So when I get in the water, I think about all the things that I have to do. But sometimes I go into a state — I don’t really think about anything.” The important thing, she says, is that the time is yours. “You can use it for anything. It depends where your head is at — it’s a reflection of where you are.”
The reflection of where you are: in essence, a status update to you, and only you. The experience is egalitarian. You don’t have to be a great swimmer to appreciate the benefits of sensory solitude and the equilibrium the water can bring.

For the full commentary, see:
Justin Gillis. “BY DEGREES; Freezing Out the Bigger Picture.” The New York Times (Tues., FEB. 11, 2014): D3.
(Note: ellipses added.)
(Note: the online version of the commentary has the date FEB. 10, 2014.)

Some Geographical Clusters Are Due to Chance (It Is Not Always a Miracle, When Good, Or the Environment, When Bad)

David J. Hand. Source of photo: online version of the NYT article quoted and cited below.

(p. 12) Your latest book, “The Improbability Principle,” aims to prove that extremely improbable events are in fact commonplace. Can you explain that a bit? Things like roulette wheels coming up in strange configurations or the same lottery numbers hitting two weeks in a row are clearly very rare events, but if you look at the number of lotteries and the number of roulette wheels, then you realize that you should actually expect these sorts of things to happen. I think within the statistical community people accept this. They’re aware of the impact of the law of truly large numbers.
. . .
You also write that geographical clusters of people with diseases might not necessarily be a result of environmental issues. It could just be a coincidence. Well, they could be due to some sort of pollution or infectious disease or something like that, but you can expect clusters to occur just by chance as well. So it’s an interesting statistical problem to tease these things out. Is this a genuine cluster in the sense that there’s a cause behind it? Or is it a chance cluster?

For the full interview, see:
Chozick, Amy, interviewer. “‘The Wonder Is Still There’; The Statistician David J. Hand on Eerie Coincidences and Playing the Lottery.” The New York Times Magazine (Sun., FEB. 23, 2014): 12.
(Note: ellipsis added; bold in original.)
(Note: the online version of the interview has the date FEB. 21, 2014, and has the title “David J. Hand’s Lottery Tips.”)

Hand’s book is:
Hand, David J. The Improbability Principle: Why Coincidences, Miracles, and Rare Events Happen Every Day. New York: Scientific American/Farrar, Straus and Giroux, 2014.

If Lack of Focus and Poverty Go Together, Which Is the Cause and Which the Effect?

Source of book image: http://www.scientificamerican.com/sciam/cache/file/BF860CC7-371A-46BB-8ACCECD4289565A8.jpg

Are the poor poor partly because they concentrate less, or do they concentrate less partly because they are poor? Samantha Power discusses one of her favorite books of 2013:

(p. C11) In “Scarcity,” Sendhil Mullainathan and Eldar Shafir offer groundbreaking insights into, among other themes, the effects of poverty on (p. C12) cognition and our ability to make choices about our lives. The authors persuasively show that the mental space–or “bandwidth”–of the poor is so consumed with making ends meet that they may be more likely to lose concentration while on a job or less likely to take medication on time.

For the full article, see:
“12 Months of Reading; We asked 50 of our friends–from April Bloomfield to Mike Tyson–to name their favorite books of 2013.” The Wall Street Journal (Sat., Dec. 14, 2013): C6 & C9-C12.
(Note: the online version of the article has the date Dec. 13, 2013.)

The book that Power praises is:
Mullainathan, Sendhil, and Eldar Shafir. Scarcity: Why Having Too Little Means So Much. New York: Times Books, 2013.

Regulators Forbid Doctor from Curing Dentist’s Pelvic Pain

“Dr. Daniel Davidson, an Idaho dentist, has pelvic pain so severe that he cannot sit, and can stand for only limited periods.” Source of caption and photo: online version of the NYT article quoted and cited below.

(p. A18) After visiting dozens of doctors and suffering for nearly five years from pelvic pain so severe that he could not work, Daniel Davidson, 57, a dentist in Dalton Gardens, Idaho, finally found a specialist in Phoenix who had an outstanding reputation for treating men like him.

Dr. Davidson, whose pain followed an injury, waited five months for an appointment and even rented an apartment in Phoenix, assuming he would need surgery and time to recover.
Six days before the appointment, it was canceled. The doctor, Michael Hibner, an obstetrician-gynecologist at St. Joseph’s Hospital and Medical Center, had learned that members of his specialty were not allowed to treat men and that if he did so, he could lose his board certification — something that doctors need in order to work.
The rule had come from the American Board of Obstetrics and Gynecology. On Sept. 12, it posted on its website a newly stringent and explicit statement of what its members could and could not do. Except for a few conditions, gynecologists were prohibited from treating men. Pelvic pain was not among the exceptions.
Dr. Davidson went home, close to despair. His condition has left him largely bedridden. The pain makes it unbearable for him to sit, and he can stand for only limited periods before he needs to lie down.
“These characters at the board jerked the rug out from underneath me,” he said.

For the full story, see:
DENISE GRADY. “Men With Pelvic Pain Find a Path to Treatment Blocked by a Gynecology Board.” The New York Times (Weds., December 11, 2013): A18.
(Note: the online version of the story has the date December 10, 2013.)

AquaBounty Has Waited More than 17 Years for FDA Approval

“The Enviropig Scientists at the University of Guelph, in Canada, developed these pigs to produce more environmentally friendly waste than conventional pigs. But the pigs were killed because the scientists could not get approval to sell them as food.” Source of caption and photo: online version of the NYT article quoted and cited below.

(p. 4) If patience is a virtue, then AquaBounty, a Massachusetts biotech company, might be the most virtuous entity on the planet.

In 1993, the company approached the Food and Drug Administration about selling a genetically modified salmon that grew faster than normal fish. In 1995, AquaBounty formally applied for approval. Last month, more than 17 years later, the public comment period, one of the last steps in the approval process, was finally supposed to conclude. But the F.D.A. has extended the deadline — members of the public now have until late April to submit their thoughts on the AquAdvantage salmon. It’s just one more delay in a process that’s dragged on far too long.
The AquAdvantage fish is an Atlantic salmon that carries two foreign bits of DNA: a growth hormone gene from the Chinook salmon that is under the control of a genetic “switch” from the ocean pout, an eel-like fish that lives in the chilly deep. Normally, Atlantic salmon produce growth hormone only in the warm summer months, but these genetic adjustments let the fish churn it out year round. As a result, the AquAdvantage salmon typically reach their adult size in a year and a half, rather than three years.
. . .
We should all be rooting for the agency to do the right thing and approve the AquAdvantage salmon. It’s a healthy and relatively cheap food source that, as global demand for fish increases, can take some pressure off our wild fish stocks. But most important, a rejection will have a chilling effect on biotechnological innovation in this country.
. . .
Then there’s the Enviropig, a swine that has been genetically modified to excrete less phosphorus. Phosphorus in animal waste is a major cause of water pollution, and as the world’s appetite for meat increases, it’s becoming a more urgent problem. The first Enviropig, created by scientists at the University of Guelph, in Canada, was born in 1999, and researchers applied to both the F.D.A. and Health Canada for permission to sell the pigs as food.
But last spring, while the applications were still pending, the scientists lost their funding from Ontario Pork, an association of Canadian hog farmers, and couldn’t find another industry partner. (It’s hard to blame investors for their reluctance, given the public sentiment in Canada and the United States, as well as the uncertain regulatory landscape.) The pigs were euthanized in May.
The F.D.A. must make sure that other promising genetically modified animals don’t come to the same end. Of course every application needs to be painstakingly evaluated, and not every modified animal should be approved. But in cases like AquaBounty’s, where all the available evidence indicates that the animals are safe, we shouldn’t let political calculations or unfounded fears keep these products off the market. If we do that, we’ll be closing the door on innovations that could help us face the public health and environmental threats of the future, saving countless animals — and perhaps ourselves.

For the full commentary, see:
EMILY ANTHES. “Don’t Be Afraid of Genetic Modification.” The New York Times, SundayReview Section (Sun., March 10, 2013): 4.
(Note: ellipses added.)
(Note: the online version of the commentary has the date March 9, 2013.)

Emily Anths, who is quoted above, has written a related book:
Anthes, Emily. Frankenstein’s Cat: Cuddling up to Biotech’s Brave New Beasts. New York: Scientific American / Farrar, Straus and Giroux, 2013.

Patent Allows Mechanic to Profit from Invention to Ease Births

“With Jorge Odón’s device, a plastic bag inflated around a baby’s head is used to pull it out of the birth canal.” Source of caption and photo: online version of the NYT article quoted and cited below.

(p. A1) The idea came to Jorge Odón as he slept. Somehow, he said, his unconscious made the leap from a YouTube video he had just seen on extracting a lost cork from a wine bottle to the realization that the same parlor trick could save a baby stuck in the birth canal.

Mr. Odón, 59, an Argentine car mechanic, built his first prototype in his kitchen, using a glass jar for a womb, his daughter’s doll for the trapped baby, and a fabric bag and sleeve sewn by his wife as his lifesaving device.
. . .
(p. A4) In a telephone interview from Argentina, Mr. Odón described the origins of his idea.
He tinkers at his garage, but his previous inventions were car parts. Seven years ago, he said, employees were imitating a video showing that a cork pushed into an empty bottle can be retrieved by inserting a plastic grocery bag, blowing until it surrounds the cork, and drawing it out.
. . .
With the help of a cousin, Mr. Odón met the chief of obstetrics at a major hospital in Buenos Aires. The chief had a friend at the W.H.O., who knew Dr. Merialdi, who, at a 2008 medical conference in Argentina, granted Mr. Odón 10 minutes during a coffee break.
The meeting instead lasted two hours. At the end, Dr. Merialdi declared the idea “fantastic” and arranged for testing at the Des Moines University simulation lab, which has mannequins more true-to-life than a doll and a jar.
Since then, Mr. Odón has continued to refine the device, patenting each change so he will eventually earn royalties on it.
. . .
Dr. Merialdi said he endorsed a modest profit motive because he had seen other lifesaving ideas languish for lack of it. He cited magnesium sulfate injections, which can prevent fatal eclampsia, and corticosteroids, which speed lung development in premature infants.
“But first, this problem needed someone like Jorge,” he said. “An obstetrician would have tried to improve the forceps or the vacuum extractor, but obstructed labor needed a mechanic. And 10 years ago, this would not have been possible. Without YouTube, he never would have seen the video.”

For the full story, see:
DONALD G. McNEIL Jr. “Promising Tool in Difficult Births: A Plastic Bag.” The New York Times (Thurs., November 14, 2013): A1 & A4. [National Edition]
(Note: ellipses added.)
(Note: the online version of the story has the date November 13, 2013, and has the title “Car Mechanic Dreams Up a Tool to Ease Births.”)

“Pretty Cool” Cochlear Implant: “It Helps Me Hear”

“The cochlear implant.” Source of caption and photo: online version of the WSJ commentary quoted and cited below.

(p. A15) . . . , three pioneering researchers– Graeme Clark, Ingeborg Hochmair and Blake Wilson –shared the prestigious Lasker-DeBakey Award for Clinical Medical Research for their work in developing the [cochlear] implant. . . . The award citation says the devices have “for the first time, substantially restored a human sense with medical intervention” and directly transformed the lives of hundreds of thousands.
I’ve seen this up close. My 10-year-old son, Alex, is one of the 320,000 people with a cochlear implant.
, , ,
“What’s that thing on your head?” I heard a new friend ask Alex recently.
“It helps me hear,” he replied, then added: “I think it’s pretty cool.”
“If you took it off, would you hear me?” she asked.
“Nope,” he said. “I’m deaf.”
“Cool,” she agreed. Then they talked about something else.
Moments like that make me deeply grateful for the technology that allows Alex to have such a conversation, but also for the hard-won aplomb that lets him do it so matter-of-factly.

For the full commentary, see:
Denworth, Lydia. “OPINION; What Cochlear Implants Did for My Son; Researchers who were just awarded the ‘American Nobel’ have opened up the world of sound to the deaf.” The Wall Street Journal (Fri., Sept. 20, 2013): A15.
(Note: ellipses, and bracketed word, added.)
(Note: the online version of the article has the date Sept. 19, 2013.)