Wednesday, October 17, 2012
After Decades in Institutions, a Bumpy Journey to a New Life
By RACHEL L. SWARNS
The New York Times
Originally published September 29, 2012
Here are some excerpts:
Once viewed as outcasts to be shunned and isolated in institutions, hundreds of Georgia’s most disabled citizens are taking their first tentative steps back into society. Their fledgling journeys, marked by uncertainty, jubilation and some setbacks, are unfolding as officials embark on an ambitious plan to profoundly reshape the lives of the cognitively and physically impaired.
It is a new strategy for Georgia, one of several states responding to mounting pressure from the Justice Department, which in recent years has threatened legal action against states accused of violating the civil rights of thousands of developmentally disabled people by needlessly segregating them in public hospitals, nursing homes and day programs.
Mississippi, which has nearly 2,000 developmentally disabled people living in its institutions, began moving dozens of them out this spring. Virginia, which reached a settlement with the Justice Department this year, expects to move more than 400 people out by the end of the 2016 fiscal year.
Here in Georgia, about 360 developmentally disabled patients have left state hospitals over the past two years, health officials say, moving mostly into small group homes that house four people each. About 400 more will leave over the next three years, nearly emptying the state’s institutions of people with severe mental disabilities, autism and dementia.
Advocates for the disabled are hailing the move as akin to the demise of racial segregation. For the first time, people who have spent decades in hospital wards will live in the community, have some say in their day-to-day activities and get the opportunity to meet and mingle with their neighbors.
“Everybody has a right to live in the world,” said Pat Nobbie, deputy director of the Georgia Council on Developmental Disabilities, who supports the shift.
The entire story is here.
Tuesday, October 16, 2012
Former City Official’s Blog Chronicled His Fall From Grace and Plans for Suicide
By RUSS BUETTNER
The New York Times
Originally published October 7, 2012
After years of using his blog to settle scores with journalists, former fellow city officials and even his own father, Russell A. Harding began his final post with an unsettling mix of humility and humor.
“While you read this try and hear the Doors playing in the background for the right feel,” he wrote. “Just kidding, trying to lighten the mood.”
“Well, this is my last post,” he added. “I am hoping and praying that by the time you read this I have not botched this suicide attempt.”
By the time the 3,000-word post, “The End,” was posted on Sept. 30, Mr. Harding, 48, had taken his own life.
His body was found by the police at his apartment in Dobbs Ferry, N.Y., on Saturday, Sept. 29, apparently two days after he had committed suicide. A friend of Mr. Harding’s called the police there, and said he had received a letter that made him “concerned about his friend’s welfare,” Dobbs Ferry Police Sgt. Manuel Guevara said.
The entire story is here.
The Jumper Squad
By WENDY RUDERMAN
The New York Times
Originally published October 5, 2012
ON a concrete ledge off the upper deck of the George Washington Bridge, more than 200 feet above the swift and leaden Hudson River that November night, the two detectives gingerly approached the despondent man as he contemplated jumping.
The plunge, at a speed of more than 60 miles per hour, would surely kill him.
Detectives Marc Nell and Everald Taylor, tethered to the bridge and to their rescue truck with nylon harnesses and heavy rope, knew to resist the urge to pull the man to safety. It was not time yet.
“Tell me your name,” Detective Nell said, tapping into the emotional and psychological arsenal that he had acquired in training. “Talk to me.” “Think of your family.”
Sometimes the detectives do most or all of the talking. It does not always matter. What the detectives are probing for is not necessarily conveyed in words. They are looking for an opening. A moment of doubt.
“Once you see that light, you see their facial expression change, their body posture change, and you think: ‘Oh, I got them. O.K., they are not going anywhere,’ ” Detective Nell said. “It’s like when a boxer gets that shot and he knows that the opponent is wobbly and he just keeps going at that same spot.”
In this case, Detectives Nell and Eddie Torres, a third officer who had joined the rescue, did what they refer to as the Grab. They seized the man, pulling him off the ledge and over a guardrail.
Each year, the Police Department receives hundreds of 911 calls for so-called jumper jobs, or reports of people on bridges and rooftops threatening to jump. So far this year, that number is on track to surpass last year’s total, 519.
The entire story is here.
Thanks to Ed Lundeen for this story.
Monday, October 15, 2012
Letting Patients Read the Doctor’s Notes
By PAULINE W. CHEN, M.D.
The New York Times
Originally published on October 4, 2012
Here are some excerpts:
This patient’s experience, like those of so many others who have tried to obtain their medical records, came to mind this week when I read about the long-awaited results of a study in which patients were given complete access to their doctors’ notes. The findings, published in the Annals of Internal Medicine, do more than shed light on what patients want. They make our current ideas about transparency in the patient-doctor relationship a quaint artifact of the past.
Since 1996, when Congress passed the Health Insurance Portability and Accountability Act, or HIPAA, patients have had the right to read and even amend their own records.
In fact, few patients have ever consulted their own records. Most do not fully grasp the extent of their legal rights; and the few who have attempted to exercise them have often found themselves mired in a parallel universe filled with administrative regulations, small-print permission forms, added costs and repeated delays.
(cut)
For one year, the study, aptly called OpenNotes, allowed over 13,000 patients from three medical centers — the Beth Israel Deaconess Medical Center in Boston, the Geisinger Health System in Danville, Pa., and the Harborview Medical Center in Seattle — to have complete access to one part of their medical records, the notes that doctors wrote about them. Within days of seeing their doctors, patients received an e-mail inviting them to read the doctor’s signed note on a secure patient Web site. Two weeks before their return visit, patients received a second e-mail inviting them again to review their doctor’s note from the previous encounter.
After a year, almost all the patients were enthusiastic about the OpenNotes initiative.
Surprisingly, so were the majority of doctors.
The entire article is here.
The research from the Annals of Internal Medicine is here.
The New York Times
Originally published on October 4, 2012
Here are some excerpts:
This patient’s experience, like those of so many others who have tried to obtain their medical records, came to mind this week when I read about the long-awaited results of a study in which patients were given complete access to their doctors’ notes. The findings, published in the Annals of Internal Medicine, do more than shed light on what patients want. They make our current ideas about transparency in the patient-doctor relationship a quaint artifact of the past.
Since 1996, when Congress passed the Health Insurance Portability and Accountability Act, or HIPAA, patients have had the right to read and even amend their own records.
In fact, few patients have ever consulted their own records. Most do not fully grasp the extent of their legal rights; and the few who have attempted to exercise them have often found themselves mired in a parallel universe filled with administrative regulations, small-print permission forms, added costs and repeated delays.
(cut)
For one year, the study, aptly called OpenNotes, allowed over 13,000 patients from three medical centers — the Beth Israel Deaconess Medical Center in Boston, the Geisinger Health System in Danville, Pa., and the Harborview Medical Center in Seattle — to have complete access to one part of their medical records, the notes that doctors wrote about them. Within days of seeing their doctors, patients received an e-mail inviting them to read the doctor’s signed note on a secure patient Web site. Two weeks before their return visit, patients received a second e-mail inviting them again to review their doctor’s note from the previous encounter.
After a year, almost all the patients were enthusiastic about the OpenNotes initiative.
Surprisingly, so were the majority of doctors.
The entire article is here.
The research from the Annals of Internal Medicine is here.
The Ups and Downs of Electronic Medical Records
By MILT FREUDENHEIM
The New York Times
Originally published October 8, 2012
The case for electronic medical records is compelling: They can make health care more efficient and less expensive, and improve the quality of care by making patients’ medical history easily accessible to all who treat them.
Small wonder that the idea has been promoted by the Obama administration, with strong bipartisan and industry support. The government has given $6.5 billion in incentives, and hospitals and doctors have spent billions more.
But as health care providers adopt electronic records, the challenges have proved daunting, with a potential for mix-ups and confusion that can be frustrating, costly and even dangerous.
Some doctors complain that the electronic systems are clunky and time-consuming, designed more for bureaucrats than physicians. Last month, for example, the public health system in Contra Costa County in California slowed to a crawl under a new information-technology system.
The entire story is here.
Sunday, October 14, 2012
Mirrored Morality: An Exploration of Moral Choice in Video Games
By Andrew J. Weaver, Ph.D., and Nicky Lewis, M.A.
CYBERPSYCHOLOGY, BEHAVIOR, AND SOCIAL NETWORKING
Volume 15, Number 11, 2012
DOI: 10.1089/cyber.2012.0235
Abstract
This exploratory study was designed to examine how players make moral choices in video games and what effects these choices have on emotional responses to the games. Participants (n = 75) filled out a moral foundations questionnaire (MFQ) and then played through the first full act of the video game Fallout 3. Game play was recorded and content analyzed for the moral decisions made. Players also reported their enjoyment of and emotional reactions to the game and reflected on the decisions they made. The majority of players made moral decisions and behaved toward the nonplayer game characters they encountered as if these were actual interpersonal interactions. Individual differences in decision making were predicted by the MFQ. Behaving in antisocial ways did increase guilt, but had no impact on enjoyment.
(cut)
Discussion
As moral choices are increasingly utilized as plot devices in video games, they present a unique opportunity to examine the underlying factors involved in moral decision making. This exploratory study indicates that moral decisions in games largely play out the same way that moral judgments in real-world interactions would. The suspension of disbelief that has long been a feature of fictional entertainment consumption occurred in this game context as well, with players often interacting with nonplayer characters as if they were real people, experiencing the same emotions (e.g., guilt) that they would feel in actual interpersonal interactions. In this study, we found that not only did most players avoid antisocial behavior, but they cited moral considerations for their behavior. Although a subset of the sample did describe their choices in strategic terms, moral disengagement was not typical in this context when a player was given moral agency.
The entire paper can be found here.
CYBERPSYCHOLOGY, BEHAVIOR, AND SOCIAL NETWORKING
Volume 15, Number 11, 2012
DOI: 10.1089/cyber.2012.0235
Abstract
This exploratory study was designed to examine how players make moral choices in video games and what effects these choices have on emotional responses to the games. Participants (n = 75) filled out a moral foundations questionnaire (MFQ) and then played through the first full act of the video game Fallout 3. Game play was recorded and content analyzed for the moral decisions made. Players also reported their enjoyment of and emotional reactions to the game and reflected on the decisions they made. The majority of players made moral decisions and behaved toward the nonplayer game characters they encountered as if these were actual interpersonal interactions. Individual differences in decision making were predicted by the MFQ. Behaving in antisocial ways did increase guilt, but had no impact on enjoyment.
(cut)
Discussion
As moral choices are increasingly utilized as plot devices in video games, they present a unique opportunity to examine the underlying factors involved in moral decision making. This exploratory study indicates that moral decisions in games largely play out the same way that moral judgments in real-world interactions would. The suspension of disbelief that has long been a feature of fictional entertainment consumption occurred in this game context as well, with players often interacting with nonplayer characters as if they were real people, experiencing the same emotions (e.g., guilt) that they would feel in actual interpersonal interactions. In this study, we found that not only did most players avoid antisocial behavior, but they cited moral considerations for their behavior. Although a subset of the sample did describe their choices in strategic terms, moral disengagement was not typical in this context when a player was given moral agency.
The entire paper can be found here.
Saturday, October 13, 2012
Fake Peer Reviews, the Latest Form of Scientific Fraud, Fool Journals
By Josh Fischman
The Chronicle of Higher Education
Originally published September 30, 2012
Scientists appear to have figured out a new way to avoid any bad prepublication reviews that dissuade journals from publishing their articles: Write positive reviews themselves, under other people's names.
In incidents involving four scientists—the latest case coming to light two weeks ago—journal editors say authors got to critique their own papers by suggesting reviewers with contact e-mails that actually went to themselves.
The glowing endorsements got the work into Experimental Parasitology, Pharmaceutical Biology, and several other journals. Fake reviews even got a pair of mathematics articles into journals published by Elsevier, the academic publishing giant, which has a system in place intended to thwart such misconduct. The frauds have produced retractions of about 30 papers to date.
"I find it very shocking," said Laura Schmidt, publisher in charge of mathematics journals at Elsevier. "It's very serious, very manipulative, and very deliberate."
The entire story is here.
The Chronicle of Higher Education
Originally published September 30, 2012
Scientists appear to have figured out a new way to avoid any bad prepublication reviews that dissuade journals from publishing their articles: Write positive reviews themselves, under other people's names.
In incidents involving four scientists—the latest case coming to light two weeks ago—journal editors say authors got to critique their own papers by suggesting reviewers with contact e-mails that actually went to themselves.
The glowing endorsements got the work into Experimental Parasitology, Pharmaceutical Biology, and several other journals. Fake reviews even got a pair of mathematics articles into journals published by Elsevier, the academic publishing giant, which has a system in place intended to thwart such misconduct. The frauds have produced retractions of about 30 papers to date.
"I find it very shocking," said Laura Schmidt, publisher in charge of mathematics journals at Elsevier. "It's very serious, very manipulative, and very deliberate."
The entire story is here.
91 Are Charged With Fraud, Billing Millions to Medicare
By REUTERS
Originally published October 4, 2012
Ninety-one people including doctors, nurses and other medical professionals were charged criminally after an investigation of Medicare fraud that involved $430 million in false billing in seven cities, officials said on Thursday.
It was the government’s second big raid in recent months after a similar investigation in May involving $452 million in possible fraud in Medicare, the health program for the elderly and disabled.
(cut)
The investigation is part of an effort by the Obama administration to find health care savings.
The entire story is here.
Friday, October 12, 2012
May Doctors Help You to Die?
By Marcia Angell
The New York Review of Books
Published on October 11, 2012
On November 6, Massachusetts voters will decide whether a physician may provide a dying patient with medication to bring about a faster, easier death if the patient chooses. On the ballot will be a Death with Dignity Act that reads:
If this ballot initiative passes, it will be binding, and Massachusetts will join Oregon, which implemented a virtually identical statute in 1998, and Washington, which did the same in 2009, as the only states where voters approved this form of physician-assisted dying, sometimes called aid-in-dying. (These terms are favored by proponents over the older term, physician-assisted suicide, because they distinguish it from the typical suicide in which someone with a normal life expectancy chooses death over life. Here the patient is near death from natural causes anyway, and chooses the timing and manner of an inevitable death.) Montana, through a 2009 decision by its Supreme Court, not a voter referendum, also permits physician-assisted dying.
The entire review is here.
The New York Review of Books
Published on October 11, 2012
On November 6, Massachusetts voters will decide whether a physician may provide a dying patient with medication to bring about a faster, easier death if the patient chooses. On the ballot will be a Death with Dignity Act that reads:
It is hereby declared that the public welfare requires a defined and safeguarded process by which an adult Massachusetts resident who has the capacity to make health care decisions and who has been determined by his or her attending and consulting physicians to be suffering from a terminal disease that will cause death within six months may obtain medication that the patient may self administer to end his or her life in a humane and dignified manner. It is further declared that the public welfare requires that such a process be entirely voluntary on the part of all participants, including the patient, his or her physicians, and any other health care provider or facility providing services or care to the patient.
If this ballot initiative passes, it will be binding, and Massachusetts will join Oregon, which implemented a virtually identical statute in 1998, and Washington, which did the same in 2009, as the only states where voters approved this form of physician-assisted dying, sometimes called aid-in-dying. (These terms are favored by proponents over the older term, physician-assisted suicide, because they distinguish it from the typical suicide in which someone with a normal life expectancy chooses death over life. Here the patient is near death from natural causes anyway, and chooses the timing and manner of an inevitable death.) Montana, through a 2009 decision by its Supreme Court, not a voter referendum, also permits physician-assisted dying.
The entire review is here.
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