Saturday, September 27, 2014

Living During an Age of Anxiety: A Reading List | Longreads Blog

When I am wracked with anxiety, I make a list of everything that is stressing me. These lists have included "transportation plans for this weekend," "living at home," "Sandy [my dog] dying," "getting props for the play" and "editing articles for The Annual." I don't write solutions. Sometimes, there are no solutions, or the solutions are not immediate, which makes me worry even more. Just writing down what weighs on my mind helps.

The act of writing moves these things out of my head, where they take up space in my subconscious, and makes them tangible and coherent. These lists are a part of my self-care routine—a routine I adopted when I suffered from a particularly nasty bout of depression in college. I use this ritual today, and I do other things too: I eat three meals every day; I get enough sleep at night; I read to relax; I take my medications; I clean my room; I listen to music or to podcasts; I call my friends; I sleep some more.

Here's another list: four authors who write about their experiences with anxiety, its roots and its bedfellows.

Finding Risks, Not Answers, in Gene Tests -

Jennifer was 39 and perfectly healthy, but her grandmother had died young from breast cancer, so she decided to be tested for mutations in two genes known to increase risk for the disease.

When a genetic counselor offered additional tests for 20 other genes linked to various cancers, Jennifer said yes. The more information, the better, she thought.

The results, she said, were "surreal." She did not have mutations in the breast cancer genes, but did have one linked to a high risk of stomach cancer. In people with a family history of the disease, that mutation is considered so risky that patients who are not even sick are often advised to have their stomachs removed. But no one knows what the finding might mean in someone like Jennifer, whose family has not had the disease.

It was a troubling result that her doctors have no idea how to interpret.

Such cases of frightening or confusing results are becoming more common because of a big recent change in genetic testing for cancer risk. Competing companies have hugely expanded the array of tests they offer, in part because new technology has made it possible to sequence many genes for the same price as one or two. Within the next year, at least 100,000 people in the United States are expected to undergo these tests. The costs, about $1,500 to $4,000, are covered by some, but not all, insurers.

The new tests build on the success of earlier ones for inherited risks of breast, ovarian and colon cancer, which can give people options for prevention, like getting screened more often, taking a drug to lower breast cancer risk, or having their breasts or ovaries removed.

But some doctors worry that the newer tests for up to 30 genes may open a can of worms, because the ability to find mutations has outpaced the understanding of what they mean. In some cases, tests find cancer-associated mutations for which there are no preventive measures, and the patient is left with a bleak prognosis.

Some genes were included "because they could be tested, not necessarily because they should be," said Dr. Kenneth Offit, chief of clinical genetics at Memorial Sloan Kettering Cancer Center in New York. He said that the testing companies are "rushing headlong into this era," and that "individuals are getting results we're not fully educated to counsel them on."

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Friday, September 26, 2014

Health care in Canada—how is the system performing? | CIHI

Your Health System is a web tool for the health sector and general public. It provides comparable, interactive data so that hospitals, regions, provinces and territories can compare how they measure up on 37 indicators related to

  • Access
  • Quality of care
  • Patient safety
  • Emerging health trends across the country

Tuesday, September 23, 2014

Health Researchers Will Get $10.1 Million to Counter Gender Bias in Studies -

In an effort to begin addressing persistent gender bias in laboratory research, the National Institutes of Health announced Tuesday that it will distribute $10.1 million in grants to more than 80 scientists studying a diverse array of subjects, including drug addiction, fetal development, migraines and stroke.

The researchers will use the additional funds to include more human participants — generally women — in clinical trials and to ensure that their laboratory animals, even cell lines, are representative of both genders. The money also will be used to analyze gender differences in the resulting data, officials said.

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Sunday, September 21, 2014

After Surgery, Surprise $117,000 Medical Bill From Doctor He Didn’t Know -

Before his three-hour neck surgery for herniated disks in December, Peter Drier, 37, signed a pile of consent forms. A bank technology manager who had researched his insurance coverage, Mr. Drier was prepared when the bills started arriving: $56,000 from Lenox Hill Hospital in Manhattan, $4,300 from the anesthesiologist and even $133,000 from his orthopedist, who he knew would accept a fraction of that fee.

He was blindsided, though, by a bill of about $117,000 from an "assistant surgeon," a Queens-based neurosurgeon whom Mr. Drier did not recall meeting.

"I thought I understood the risks," Mr. Drier, who lives in New York City, said later. "But this was just so wrong — I had no choice and no negotiating power."

In operating rooms and on hospital wards across the country, physicians and other health providers typically help one another in patient care. But in an increasingly common practice that some medical experts call drive-by doctoring, assistants, consultants and other hospital employees are charging patients or their insurers hefty fees. They may be called in when the need for them is questionable. And patients usually do not realize they have been involved or are charging until the bill arrives.

The practice increases revenue for physicians and other health care workers at a time when insurers are cutting down reimbursement for many services. The surprise charges can be especially significant because, as in Mr. Drier's case, they may involve out-of-network providers who bill 20 to 40 times the usual local rates and often collect the full amount, or a substantial portion.

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