A company in Boulder, CO is offering a genetic test to determine what kind of sport your child is most genetically suited for. For $149, with the swab of a cheek your child will know if he or she would be best at speed and power sports like sprinting or football, or endurance sports like distance running, or a combination of the two.
These seems like a terrible idea to me. First of all you are possibly pigeon-holing your child into a specific sport when he or she could excel at any number of activities. Secondly, this is frighteningly a reminder of our eugenics past. Where will this drive for genetic advanage stop?
Also as many of the Dr.'s in this article point out. Everything we know about genetics is pointing less and less to the isolation of certain genes causing certain traits and more towards a combination of genetic and environment causes.
Seems like a new snake oil salesman if you ask me.
Saturday, November 29, 2008
Thursday, November 27, 2008
http://news.aol.com/article/poll-rates-most-and-least-ethical-jobs/259161?icid=100214839x1214058528x1200860973
Why is it that every year nurses are voted the most ethical of professions? I will be very proud and pleased to explain it to you.
The philosophy and understand standing of ethics in healthcare is taught directly from the first day of nursing school. While we are learning the biology and science of medicine we are constantly reminded of the ramifications of what could go wrong given a situation. This concept is driven into our head at every turn and the answers on every multiple-choice question. In addition, the instructors also boost our pride at every opportunity by glorifying the profession and reminding us that we are the patient advocate. Our primary purpose in life is to protect the patient from harm and to educate them because we have better bedside manners.
This is not the case in every culture I have found however. Specifically in some east Indian cultures I have come to learn that nurse is our one of the bottom respected professions. As a matter of fact lower than a housekeeper, janitor, maid. For whatever reason having to care for the old and sick is not respected. I have run into this discrimination many times in my career and now do not take offense by this. I view it as an opportunity to engage more fiercely with that family member or patient that usually is not getting the appropriate emotional care they deserve as a human being.
I plan to use my law degree in the area of advocacy within the court systems. Although I do this every day through communication and facilitation, I know there are some patients who get caught up in the legal system with no appropriate representation. I have been complemented many times on this natural ability. A recent manager of mine once stated on my review, “I always want you on my side and God help me if I am up against you on a patient issue.”.
Why is it that every year nurses are voted the most ethical of professions? I will be very proud and pleased to explain it to you.
The philosophy and understand standing of ethics in healthcare is taught directly from the first day of nursing school. While we are learning the biology and science of medicine we are constantly reminded of the ramifications of what could go wrong given a situation. This concept is driven into our head at every turn and the answers on every multiple-choice question. In addition, the instructors also boost our pride at every opportunity by glorifying the profession and reminding us that we are the patient advocate. Our primary purpose in life is to protect the patient from harm and to educate them because we have better bedside manners.
This is not the case in every culture I have found however. Specifically in some east Indian cultures I have come to learn that nurse is our one of the bottom respected professions. As a matter of fact lower than a housekeeper, janitor, maid. For whatever reason having to care for the old and sick is not respected. I have run into this discrimination many times in my career and now do not take offense by this. I view it as an opportunity to engage more fiercely with that family member or patient that usually is not getting the appropriate emotional care they deserve as a human being.
I plan to use my law degree in the area of advocacy within the court systems. Although I do this every day through communication and facilitation, I know there are some patients who get caught up in the legal system with no appropriate representation. I have been complemented many times on this natural ability. A recent manager of mine once stated on my review, “I always want you on my side and God help me if I am up against you on a patient issue.”.
http://news.yahoo.com/s/ap/20081119/ap_on_he_me/med_artificial_heart
Please see the above article in which a young girl was kept alive on a heart machine for over 100 days while waiting for heart transplant. The machine is approximately the size of a photocopier and pumps the blood through the body.
In light of our discussions recently in regards to the donation prosthetic process and lack of available organs, I am thrilled to see this successful piece of medical technology. I feel it is only a short matter of time when we are able to produce medically sufficient man-made organs. I believe that going further with stem cell research and DNA transfer will only expedite the process.
Jennifer B.
Please see the above article in which a young girl was kept alive on a heart machine for over 100 days while waiting for heart transplant. The machine is approximately the size of a photocopier and pumps the blood through the body.
In light of our discussions recently in regards to the donation prosthetic process and lack of available organs, I am thrilled to see this successful piece of medical technology. I feel it is only a short matter of time when we are able to produce medically sufficient man-made organs. I believe that going further with stem cell research and DNA transfer will only expedite the process.
Jennifer B.
Monday, November 24, 2008
Save the Cord - Non-Controversial Source of Stem Cells
Cord blood is blood left in the umbilical cord or placenta after childbirth that is said to be a non controversial source of stem cells. Cord blood banking seems like a promising way to ensure that stem cells will be available for future medical use, partly because the procedure is easy and non-invasive, and it does not interfere with the childbirth process in any way. Women who choose to preserve cord blood have the option of donating their cord blood to a public bank, or paying to store it in a private bank for later use exclusively within their own family.
In the case of private banks, when a donor or immediate family member has a disease that requires a stem cell transplant, cord blood from a newborn bay in the family may be the best treatment option, as it will be a perfect match for the donor and has a 1 in 4 chance of being a perfect match for a siblings.
Unlike bone marrow transplants, which require a perfect match, cord blood transplants only require 3/6 Human Leukocyte Antigens (HLAs) to match. Cord blood is unique in this respect because it is the “youngest” source of stem cells and, thus, readily accepted in to a recipient’s system.
Save the Cord Foundation (www.savethecordfoundation.org) is a non-profit organization that was started by co-founders Charis Ober and Anne Sarabia. Both women graduated from the University of Arizona, and worked in the biotech and pharmaceutical industries before starting the foundation. They were motivated to start the foundation after visiting a public cord blood bank in Tucson, AZ, and meeting children with leukemia and sickle cell anemia whose lives had been saved with cord blood donations. Save the cord aims to make the collection of cord blood the standard of care in hospitals across the nation, and to make public cord blood banks a national priority.
Cord blood seems like a promising solution for stem cells. Are there any mothers contributing to this blog who have donated or preserved their cord blood? If not, did you know about the option at the time of giving birth? Thanks for any input!
In the case of private banks, when a donor or immediate family member has a disease that requires a stem cell transplant, cord blood from a newborn bay in the family may be the best treatment option, as it will be a perfect match for the donor and has a 1 in 4 chance of being a perfect match for a siblings.
Unlike bone marrow transplants, which require a perfect match, cord blood transplants only require 3/6 Human Leukocyte Antigens (HLAs) to match. Cord blood is unique in this respect because it is the “youngest” source of stem cells and, thus, readily accepted in to a recipient’s system.
Save the Cord Foundation (www.savethecordfoundation.org) is a non-profit organization that was started by co-founders Charis Ober and Anne Sarabia. Both women graduated from the University of Arizona, and worked in the biotech and pharmaceutical industries before starting the foundation. They were motivated to start the foundation after visiting a public cord blood bank in Tucson, AZ, and meeting children with leukemia and sickle cell anemia whose lives had been saved with cord blood donations. Save the cord aims to make the collection of cord blood the standard of care in hospitals across the nation, and to make public cord blood banks a national priority.
Cord blood seems like a promising solution for stem cells. Are there any mothers contributing to this blog who have donated or preserved their cord blood? If not, did you know about the option at the time of giving birth? Thanks for any input!
Sunday, November 23, 2008
Why Discussing Limiting Medicare Benefits for the Elderly Is Worthwhile
While browsing the opinion section of the New York Times, I came across an interesting editorial about limiting benefits for senior citizens in order to make health care more effective. The article, by Daniel Callahan, can be found here: http://newoldage.blogs.nytimes.com/2008/11/13/heart-surgery-how-old-is-too-old. Callahan, in essence, argues that we should limit expensive treatment given to the elderly in order to cut costs upon the Medicare system and avoid otherwise necessary increases in taxes.
Callahan succinctly explains the burdens levied upon the Medicare system by expensive treatments for the elderly. While I believe some will find that assessing life-saving treatments as “burdensome” or perhaps “wasteful,” as Callahan certainly implies, the cold numbers are extremely persuasive. And they should at the very least not be overlooked. So let’s examine the numbers. The Medicare program cost $429 billion in 2007, and has a 7% annual cost increase. Thus, by 2017, it should cost $884 billion. Most importantly, by 2017, the Medicare program will be bankrupt.
Now, how do expensive treatments for the elderly factor in? While Old age itself is certainly not a barrier to coverage. In fact, the average age of those undergoing heart surgery, organ transplantation, kidney dialysis, and cancer treatment is continually rising, Callahan explains. Essentially, science is finding ways of keeping the sick or weak alive longer. It is important not to forget that just a few decades ago, the methods used to keep people alive were not even dreamed of. Significantly, not only are people staying alive longer, but many elderly people are opting for expensive, aggressive treatments, even when the likelihood of success is dismal. I personally do not blame anyone for this decision; if your life is on the line, wouldn’t you opt to try to extend it? But the fact remains: people aren’t likely to simply roll over and die. If treatment is available, they’ll want it.
Thus, the effect on the system is significant. Callahan writes that the average Medicare recipient has to spend between $5,000 and $10,000 for treatment not covered by the program. Doctors are becoming reluctant to take on elderly patients because they are often poorly reimbursed. Out of pocket costs for drugs and co-payments are expected to jump anywhere from 31 to 60 percent in 2009 alone. Therefore, if I interpret the numbers correctly, it seems that not only is the system going bankrupt, but recipients are facing significant price increases or will have to pay out-of-pocket because the system itself cannot afford to treat them.
In light of these numbers, Callahan argues that limiting benefits based on age should be done, because it is not likely that the other possible fix (raising taxes) will be seriously considered in the near future. I thought the most important part of Callahan’s argument was the simple fact that he acknowledges that age-based rationing will not be accepted. Thus, I think he effectively removes that contention from the argument. However, his point is that we can’t completely factor out cost and age from the equation. Congress has refused to allow Medicare to take costs into account in its coverage decisions. But should it play some role? Should age? Callahan’s answer is emphatically yes. I agree with Callahan’s sentiment that our society “can not, and should not, promise open-ended, progress-driven medical care that is indifferent to costs.” Because in the real world, age does matter. It matters in that there are more and more elderly people undergoing expensive care, putting increasing burdens on a system that is already on the brink of collapse. This is a practical way to save money. This is not a proposal to eliminate access to benefits for the elderly altogether. It's a proposal that cuts extremely expensive treatments that likely either won't work or won't work for long. And freeing up cash helps the system. And, although now I am editorializing, I wonder: at the end of the day, what is better? A functioning system that, admittedly has its flaws and is imperfect? Or no system whatsoever? I say an imperfect system.
Keep in mind, age isn’t the only factor. Likelihood of success, cost, and patient wishes should all weigh in. Perhaps a government-regulated healthcare system would solve ALL of these problems? But we’re not there yet, and I think it is important to try to make our system work until we get there. I think Callahan’s point is that we need to consider solutions that may not be popular or pleasant, not because they will ultimately be implemented, but because they are often realistic and therefore, a reasonable starting point to formulate serious solutions.
Callahan succinctly explains the burdens levied upon the Medicare system by expensive treatments for the elderly. While I believe some will find that assessing life-saving treatments as “burdensome” or perhaps “wasteful,” as Callahan certainly implies, the cold numbers are extremely persuasive. And they should at the very least not be overlooked. So let’s examine the numbers. The Medicare program cost $429 billion in 2007, and has a 7% annual cost increase. Thus, by 2017, it should cost $884 billion. Most importantly, by 2017, the Medicare program will be bankrupt.
Now, how do expensive treatments for the elderly factor in? While Old age itself is certainly not a barrier to coverage. In fact, the average age of those undergoing heart surgery, organ transplantation, kidney dialysis, and cancer treatment is continually rising, Callahan explains. Essentially, science is finding ways of keeping the sick or weak alive longer. It is important not to forget that just a few decades ago, the methods used to keep people alive were not even dreamed of. Significantly, not only are people staying alive longer, but many elderly people are opting for expensive, aggressive treatments, even when the likelihood of success is dismal. I personally do not blame anyone for this decision; if your life is on the line, wouldn’t you opt to try to extend it? But the fact remains: people aren’t likely to simply roll over and die. If treatment is available, they’ll want it.
Thus, the effect on the system is significant. Callahan writes that the average Medicare recipient has to spend between $5,000 and $10,000 for treatment not covered by the program. Doctors are becoming reluctant to take on elderly patients because they are often poorly reimbursed. Out of pocket costs for drugs and co-payments are expected to jump anywhere from 31 to 60 percent in 2009 alone. Therefore, if I interpret the numbers correctly, it seems that not only is the system going bankrupt, but recipients are facing significant price increases or will have to pay out-of-pocket because the system itself cannot afford to treat them.
In light of these numbers, Callahan argues that limiting benefits based on age should be done, because it is not likely that the other possible fix (raising taxes) will be seriously considered in the near future. I thought the most important part of Callahan’s argument was the simple fact that he acknowledges that age-based rationing will not be accepted. Thus, I think he effectively removes that contention from the argument. However, his point is that we can’t completely factor out cost and age from the equation. Congress has refused to allow Medicare to take costs into account in its coverage decisions. But should it play some role? Should age? Callahan’s answer is emphatically yes. I agree with Callahan’s sentiment that our society “can not, and should not, promise open-ended, progress-driven medical care that is indifferent to costs.” Because in the real world, age does matter. It matters in that there are more and more elderly people undergoing expensive care, putting increasing burdens on a system that is already on the brink of collapse. This is a practical way to save money. This is not a proposal to eliminate access to benefits for the elderly altogether. It's a proposal that cuts extremely expensive treatments that likely either won't work or won't work for long. And freeing up cash helps the system. And, although now I am editorializing, I wonder: at the end of the day, what is better? A functioning system that, admittedly has its flaws and is imperfect? Or no system whatsoever? I say an imperfect system.
Keep in mind, age isn’t the only factor. Likelihood of success, cost, and patient wishes should all weigh in. Perhaps a government-regulated healthcare system would solve ALL of these problems? But we’re not there yet, and I think it is important to try to make our system work until we get there. I think Callahan’s point is that we need to consider solutions that may not be popular or pleasant, not because they will ultimately be implemented, but because they are often realistic and therefore, a reasonable starting point to formulate serious solutions.
Friday, November 21, 2008
America Shrugs at Being Fat
The fattest city in America has just been named, and apparently it "shrugs" at that moniker. This makes me think long and hard about how a city in America, a country so weight-obsessed, can be as nonchalant about being called The Fattest. Professor Pasquale's lecture about image-obsession reminded me of how beauty throughout history has been paralleled with wealth. Huntington, West Virginia, the aforementioned unhealthiest city in America, also has a poverty level worse than the national average. With the economy in the state it is, will the future of America's health suffer as dramatically as the stock market? And if so, how will the health care system adapt? The economy is sickening the hospitals in the U.S. Decline in elective procedures and admissions, and patients who cannot pay for care have left hospitals in an economic slump. Poor times call for cheap measures, for sure. Kentucky Fried Chicken's $10 Challenge is no help. A KFC commercial challenged a family in a grocery store to put together a dinner for $10 or less that was comparable to the KFC $9.99 7-piece value meal. Access to health seems to be as big of an issue as access to health care.
Huntington leads the nation in a half dozen other ailments too, including diabetes, heart disease, and tooth loss. I wonder how a city that is so evidently health-poor can just not seem to care? When did being healthy become associated with being rich? When did health become a luxury? Americans pine after having the newest thing, and despite the economic situation, people will keep shopping. KMart reinstated layaway just in time for the holidays. But people don't seem to want to spend that money on healthier foods -- the apathy is there, and it doesn't seem to be going anywhere. Not even the mayor of the fattest town in America seems to want to do anything about it.
In Mauritania, fatter women are considered beautiful. Young girls in rural areas are forcefed until they vomit in order to attain this goal. This, on a continent with with 50% of the population living below the poverty line, seems reflective of the trend that wealth equals beauty. In India, even in the most rural areas, the poorest of women wear a piece of jewelry because that represents her beauty. However, even with America's economy plummeting as it has, that desire for beauty in the U.S. seems to fade. Priorities change, and rightly so, but the desire to preserve one's health, the most basic human instinct, has seemed to vanish from the American psyche. One would think being called the fattest city in the entire country would be a wakeup call, but when the reaction is no more than a shrug, I worry.
Huntington leads the nation in a half dozen other ailments too, including diabetes, heart disease, and tooth loss. I wonder how a city that is so evidently health-poor can just not seem to care? When did being healthy become associated with being rich? When did health become a luxury? Americans pine after having the newest thing, and despite the economic situation, people will keep shopping. KMart reinstated layaway just in time for the holidays. But people don't seem to want to spend that money on healthier foods -- the apathy is there, and it doesn't seem to be going anywhere. Not even the mayor of the fattest town in America seems to want to do anything about it.
In Mauritania, fatter women are considered beautiful. Young girls in rural areas are forcefed until they vomit in order to attain this goal. This, on a continent with with 50% of the population living below the poverty line, seems reflective of the trend that wealth equals beauty. In India, even in the most rural areas, the poorest of women wear a piece of jewelry because that represents her beauty. However, even with America's economy plummeting as it has, that desire for beauty in the U.S. seems to fade. Priorities change, and rightly so, but the desire to preserve one's health, the most basic human instinct, has seemed to vanish from the American psyche. One would think being called the fattest city in the entire country would be a wakeup call, but when the reaction is no more than a shrug, I worry.
Thursday, November 20, 2008
Please Make Me Look White?
An issue was raised in class a couple weeks ago regarding the trend that in an effort to appear more white, Asians were demanding plastic surgery. I’ve often questioned this idea and wondered if it wasn’t instead a misperception perpetrated by the media.
Consider for example the argument which posits that the reason Asians flock to plastic surgeons for double eyelid blepharoplasty is to achieve larger, rounder, Caucasian eyes. It seems like a post hoc argument to me (hearkening back to the LSAT, it’s a necessary but not sufficient condition). Associating the rise in blepharoplasty procedures with the rise in Western media influence is certainly plausible, but it’s not an entirely sound argument.
I’m not discounting the fact that the media plays an enormous role in shaping perceptions of beauty, but I think that it’s just as important to look to the underlying evolutionary basis (that crosses cultural lines) behind plastic surgery trends. Obviously there’s much interplay between these two, but when it comes to this debate I often see the focus on the aforementioned cultural imperialist notion rather than on evolutionary reasons.
It seems almost universal that humans are drawn to big eyes—notice our penchant for babies, puppies, and kittens. Big eyes are associated with youthfulness, as evidenced by the popularity of brow lift procedures in older American woman seeking to “open up” their eyes. And seeing that there are almost four billions Asians in the world there are obviously those with varying eye sizes.
After college, I lived in Taiwan for a couple years and traveled extensively throughout Asia. I met a few people with plastic surgery, but none would say that getting their eyes done made them look more Caucasian. In fact, the surgery allowed them to look more like other Asians who had relatively larger eyes. Naturally occurring double eyelids are prevalent in those from the southern part of China and Southeast Asia, and to a lesser extent (but not uncommon) in Northern Chinese, Koreans, and Japanese.
Another issue that is often discussed is the fixation with skin lightening. Again, I’m wary of the media’s conclusions that it’s just another example of Asians desiring to look more Caucasian. Throughout the centuries in Asia, dark skin has been frowned upon because of its association with toiling under the sun and menial labor—thus, the reason fair skin is generally desirable.
I just had to throw it out there, but there are plenty of other reasons Asians prefer bigger eyes or lighter skin and it may be due to reasons other than trying to look like their Western counterpart. It’s more likely that their reasons for doing so are more similar to the reason Westerners prefer bigger eyes.
When two cultures collide there’s bound to be misperceptions. As someone who embodies both Asian and American cultures and has lived on both sides of the world, I think it’s important to take what you read with a grain of salt-- there are obvious reasons which needn’t be mentioned here why the Western media’s portrayal of the East is skewed (as with the East’s portrayal of the West).
Ellie
Subscribe to:
Posts (Atom)