Is getting a second opinion worth it?

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Second opinions often sought but value is not yet proven

By Michelle Andrews
KHN

Dye with Yes, No and Maybe of the three visible sidesActress Rita Wilson, who was diagnosed with breast cancer and underwent a double mastectomy recently, told People magazine last month that she expects to make a full recovery “because I caught this early, have excellent doctors and because I got a second opinion.”

When confronted with the diagnosis of a serious illness or confusing treatment options, everyone agrees it can be useful to seek out another perspective. Even if the second physician agrees with the first one, knowing that can provide clarity and peace of mind.

A second set of eyes, however, may identify information that was missed or misinterpreted the first time. A study that reviewed existing published research found that 10 to 62 percent of second opinions resulted in major changes to diagnoses or recommended treatments.

Another study that examined nearly 6,800 second opinions provided by Best Doctors, a second-opinion service available as an employee benefit at some companies, found that more than 40 percent of second opinions resulted in diagnostic or treatment changes.

But here’s the rub: While it’s clear that second opinions can help individual patients make better medical decisions, there’s little hard data showing that second opinions lead to better health results overall. Continue reading

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Hunger stalks millions of US seniors

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In sunlit paradise, seniors go hungry

By Sarah Varney
KHN

NAPLES, Fla.— It wasn’t until the Maffuccis found themselves living on cups of coffee, and coffee alone, that they finally called a food pantry for help.

The couple had sold their suburban New Jersey home where they had raised three children and set out to pursue the glossy dream of an easy-going retirement in sunny southwest Florida.

But Mina and Angelo Maffucci quickly ran out of money—overtaken by illness, bad luck and an economic crisis that claimed their Florida dream home to foreclosure. They soon found themselves staring at an empty cupboard.

“You open up the closet and all we had was coffee,” said Angelo Maffucci, 82, who had been a drywall installer in New Jersey. “I never thought we would be down on our hands and knees like that, but it happened fast.”

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Angelo and Mina Maffucci pose for a portrait in the kitchen of their son’s apartment, where they’ve been living for about five years — since they lost their house. (Photo: Ariel Min/PBS NewsHour)

While the U.S. economy adds jobs and the financial markets steadily improve, a growing number of seniors are having trouble keeping food on the table.

In 2013, the most recent data available, 9.6 million Americans over the age of 60 —or one of every six older men and women—could not reliably buy or access food at least part of the year, according to an analysis from researchers at the University of Kentucky and the University of Illinois. Continue reading

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Nudging students to make healthier choices

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applesBy Tara Bostock
Public Health – Seattle and King County

It turns out that encouraging students to make healthier choices in the lunchroom can be accomplished affordably and without a major overhaul of the cafeteria.

Research shows that small changes like making the salad bar the highlight of the lunchroom, displaying fruit in attractive baskets, or placing healthy foods by the cash register can influence what students select to eat.

In Washington State, the Kent School District is leading the way by changing their cafeterias to

How the Kent School District is bringing behavioral economics principles to their lunchrooms.

encourage students to pick healthier foods. With the help of funding from the Community Transformation Grant, the District partnered with the Cornell Center for Behavioral Economics in Child Nutrition Programs to run a pilot program reaching over 6,000 students in six secondary school cafeterias.

The goal: to increase the number of students choosing healthy foods like fruit, vegetables, white milk, or healthy entrées. And the District saw positive changes.

How does behavioral economics work in the lunchroom?

Continue reading

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New efforts to keep the mentally ill out of jail

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BrainBy Michael Ollove
Stateline

Paton Blough has served multiple jail terms as a result of mental illness.

He said his various offenses included brandishing a shotgun, reckless endangerment, destruction of civic property, spitting on a police officer, being a public nuisance and threatening a public official.

Never was he charged with being mentally ill. That isn’t a crime, after all. But there was no doubt about why he had ended up in jail.

Blough, 38, has had bipolar disorder since his late teens. At times delusions convinced him of a worldwide conspiracy against him involving police officers, former President George W. Bush and Nazi ghosts.

“Can you imagine if we had two million people locked up for having a heart condition? Well guess what? We have two million people locked up with a health condition called mental illness.”

“Can you imagine if we had two million people locked up for having a heart condition?” Blough, whose last arrest was six years ago, said in a telephone interview last week from his home in Greenville, South Carolina. “Well guess what? We have two million people locked up with a health condition called mental illness.”

In many places, police, judges and elected officials increasingly are pointing out that a high proportion of people in jail are mentally ill, and that in many cases they shouldn’t be there. In recent years, many cities and counties have tried to reduce those numbers by training police to deal with mental health crises, creating mobile mental health units to assist officers, and establishing mental health support centers as an alternative to jail, among other measures.

In King County, Washington, a combination of ACT teams, supportive housing and intensive community-based treatments has resulted in a 45 percent reduction in jail and prison bookings among those participating. 

Continue reading

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Medicaid expansion helps cut rate of older, uninsured adults from 12 to 8 percent

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ACA health reform logoBy Michelle Andrews
KHN

The health law’s expansion of Medicaid coverage to adults with incomes over the poverty line was key to reducing the uninsured rate among 50- to 64-year-olds from nearly 12 to 8 percent in 2014, according to a new analysis.

“Clearly most of the gains in coverage were in Medicaid or non-group coverage,” says study co-author Jane Sung, a senior strategic policy adviser at the AARP Public Policy Institute, which conducted the study with the Urban Institute.

Under the health law, adults with incomes up to 138 percent of the federal poverty level ($16,243 for one person in 2015) are eligible for Medicaid if a state decides to expand coverage. Twenty-seven  states  had done so by the end of 2014.

The study found the uninsured rate for people between age 50 and 64 who live in states that haven’t expanded Medicaid was twice as high—11 percent—as for those who live in states that have done so.

More than 2 million people between 50 and 64 gained coverage between December 2013 and December 2014, according to the study. Continue reading

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At-home walking program group support helps people with poor leg circulation | Reuters

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Running shoes full shotGroup sessions that teach and encourage people with poor circulation in their legs to walk regularly on their own improves mobility and prevents its loss, according to a new study.

The findings suggest that supervised activity is not essential for peripheral artery disease (PAD) patients, and doctors and other healthcare providers should not rule out at-home programs, said the study’s lead author.

Source: At-home walking program group support helps people with poor leg circulation | Reuters

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53 people in 9 states sickened after eating raw tuna

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305px-Hiroshige_Bowl_of_SushiA salmonella outbreak likely linked to raw tuna has sickened 53 people in nine states, health officials said Thursday.

Most of the cases – 31 – are in California, officials at the California Department of Public Health said. Other affected states include Arizona, Illinois, Mississippi, New Mexico, South Dakota, Virginia, Washington and Wisconsin.

Source: News from The Associated Press

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The gray areas of assisted suicide

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When J.D. Falk was dying of stomach cancer in 2011, his wife says doctors would only talk about death in euphemisms. (Photo: courtesy of Hope Arnold)

By April Dembosky, KQED

SAN FRANCISCO — Physician-assisted suicide is illegal in all but five states. But that doesn’t mean it doesn’t happen in the rest. Sick patients sometimes ask for help in hastening their deaths, and some doctors will hint, vaguely, how to do it.

This leads to bizarre, veiled conversations between medical professionals and overwhelmed families.

Doctors and nurses want to help but also want to avoid prosecution, so they speak carefully, parsing their words. Family members, in the midst of one of the most confusing and emotional times of their lives, are left to interpret euphemisms.

Doctors and nurses want to help but also want to avoid prosecution, so they speak carefully, parsing their words.

That’s what still frustrates Hope Arnold. She says throughout the 10 months her husband J.D. Falk was being treated for stomach cancer in 2011, no one would talk straight with them.

“All the nurses, all the doctors,” says Arnold. “everybody we ever interacted with, no one said, ‘You’re dying.’”

Until finally, one doctor did. And that’s when Falk, who was just 35, started to plan. He summoned his extended family. And Hope made arrangements for him to come home on hospice. Continue reading

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Fast currents, frigid temps make local water dangerous this time of year

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From the Washington State Department of Health

Mountain Stream

Cold and fast waters can be a recipe for drowning and state health officials remind folks that even though the calendar says it’s close to Memorial Day, water temperatures are frigid and river flows are swift.

Springtime river flow is high and swift from rain and snow melt and can easily overwhelm the strongest swimmer.

Many Washingtonians wait for hot weather to dip their toes into lakes, rivers, and the ocean surf, but other people brave the frosty waters and hop into boats, inner tubes, and other floating equipment in search of a late-spring water adventure.

Being unprepared for the freezing water temperatures or the swift flow of the waters can lead to tragedy. Continue reading

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Most enrolled in exchange plans satisfied with premiums, cost sharing and provider networks, survey finds

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Affordability Remains Significant Concern for Many in Non-Group Plans

ACA health reform logoFollowing the Affordable Care Act’s second open enrollment period, most people enrolled in marketplace plans report being satisfied with a wide range of their plan’s coverage and features, finds a new Kaiser Family Foundation survey of people who buy their own health insurance.

A large majority (74%) of those in marketplace plans rate their coverage as excellent or good, the survey finds.

Most (59%) also say their plan is an excellent or good value for what they pay for it, though the share rating the value as “excellent” declined somewhat from 23 percent last year to 15 percent in the current survey.

Majorities also say they are “very” or “somewhat” satisfied with seven different features of their plans, including:

  • Their choice of primary-care doctors (75%), hospitals (75%) and specialists (64%);
  • What they have to pay out of pocket for doctor visits (73%), prescription drugs (70%) and annual deductible (60%);
  • And their monthly premiums (65%).

To learn more go here.

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Planning on going on a cruise? Check in here first.

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Screen Shot 2015-05-21 at 11.20.45 AMThe independent investigative journalism website ProPublica has set up a webpage where you can search a database of over 300 cruise ships that make port in the U.S., where you are able to see their health and safety records going back as far as 2010, as well as their current position and deck plans.

To search the database, go here.

 

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Washington state ranked 11th in the nation for senior health

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Washington MapWashington state ranks 11th in the nation for senior health, ahead of Maryland but behind Maine, and up from its 15th-place ranking last year, according to a senior health assessment conducted each year by the UnitedHealth Foundation.

Vermont was rated number 1 in the nation, followed by New Hampshire, Minnesota, Hawaii and Utah. West Virginia. The Oklahoma, Arkansas, Kentucky, Mississippi and Louisiana came in at the bottom of the list.

The rankings, which appear in the foundatio’ns “America’s Health Rankings Senior Report,” are based on 35 measures of health, which include such factors as availability and quality of health care services, health behaviors, community and environmental amenities, and state health care policies.

Among Washington’s Strengths were:

  • Low prevalence of physical inactivity
  • High enrollment in the Supplemental Nutrition Assistance Program
  • Low prevalence of full-mouth tooth extraction

Among the state’s weaknesses were:

  • High prevalence of chronic drinking • Low prescription drug coverage
  • High prevalence of falls

Highlights:

  • In the past year, hip fractures decreased 21% from 6.7 to 5.3 hospitalizations per 1000 Medicare beneficiaries.
  • In the past 2 years, home health care increased 17% from 73.2 to 85.5 home health care workers per 1000 adults aged 75 and older.
  • In the past 2 years, preventable hospitalizations decreased 15% from 46.4 to 39.3 discharges per 1000 Medicare beneficiaries.
  • In the past year, obesity increased 6% from 25.6% to 27.0% of adults aged 65 and older.
  • In the past year, poverty increased 5% from 7.8% to 8.2% of adults aged 65 and older.
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Facing death but fighting the aid-in-dying movement

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Stephanie Packer (Photo by Stephanie O’Neill / KPCC)

By Stephanie O’Neill
Southern California Public Radio

Stephanie Packer was 29 when she found out she has a terminal lung disease.

It’s the same age as Brittany Maynard, who last year was diagnosed with terminal brain cancer. Maynard, of northern California, opted to end her life via physician-assisted suicide in Oregon last fall.

Maynard’s quest for control over the end of her life continues to galvanize the “aid-in-dying” movement nationwide, with legislation pending in California and a dozen other states.

But unlike Maynard, Packer says physician-assisted suicide will never be an option for her.

“Wanting the pain to stop, wanting the humiliating side effects to go away – that’s absolutely natural,” Packer says. “I absolutely have been there, and I still get there some days. But I don’t get to that point of wanting to end it all, because I have been given the tools to understand that today is a horrible day, but tomorrow doesn’t have to be.”

A recent spring afternoon in Packer’s kitchen is a good day, as she prepares lunch with her four children.

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The Packer family gathers in the kitchen to cook dinner. From left: Jacob, 8; Brian Sr. ; Brian Jr., 11; Savannah, 5; Scarlett, 10; and Stephanie. (Photo by Stephanie O’Neill / KPCC)

“Do you want to help?” she asks the eager crowd of siblings gathered tightly around her at the stovetop.

“Yeah!” yells 5-year-old Savannah.

“I do!” says Jacob, 8.

Managing four kids as each vies for the chance to help make chicken salad sandwiches can be trying. But for Packer, these are the moments she cherishes. Continue reading

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