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When It Comes To Happiness, Time Trumps Money, Study Suggests

(Amanda/Flickr)

(Amanda/Flickr)

By Joshua Eibelman
CommonHealth Intern

What do you value more: your money or your time?

A new study by researchers at the University of British Columbia suggests that those who place a greater value on their time, rather than their money, are happier.

Among the study’s 4,600 participants, there was an almost even split between those who prefer money and those who put a higher value on their time.

While the participants’ median age ranged from 20-45, older people tended to value time over money, possibly because over the years, their priorities shifted, and they feel greater satisfaction from quality time with friends and family, researchers found.

The study, published in the journal Social Psychological and Personality Science, looked at what kinds of trade-offs people were willing to make to achieve “happiness.” For instance, participants were asked whether they would prefer a higher paying job farther from home or a lower paying job closer to home.

College students surveyed at the University of British Columbia were asked various questions about what fields of study and jobs they’d choose and how they would prioritize time commitments versus potential salaries.

Participants were told that they’d been admitted to two graduate programs and had to decide between a higher starting salary with more more work hours, or a lower salary with fewer hours, the study said.

Those who are willing to make trade-offs in favor of time, the study found, tend to be happier. Interestingly, researchers report, “These findings could not be explained by materialism, material striving, current feelings of time or material affluence, or demographic characteristics such as income or marital status.”

Happiness was measured though a number of self-reporting tools and questions about the number of positive emotions people feel in a day, said lead researcher Ashley Whillans, a doctoral student in social psychology at the University of British Columbia.

Whillans likened preferences for either time or money as “personality characteristics.” Continue reading

Opinion: What A Cancer Cure ‘Moon Shot’ Might Look Like

During his final State of the Union address, President Obama announced a new national effort to cure cancer. He said Vice President Joe Biden, who lost his 46-year-old son to cancer last year, would lead the effort. (Evan Vucci/AP)

During his final State of the Union address, President Obama announced a new national effort to cure cancer. He said Vice President Joe Biden, who lost his 46-year-old son to cancer last year, would lead the initiative. (Evan Vucci/AP)

In his final State of the Union address Tuesday night, President Obama called for a historic new effort to find a cure for cancer, a “moon shot.”  

“For the loved ones we’ve all lost, for the family we can still save, let’s make America the country that cures cancer once and for all,” Obama said in naming Vice President Joe Biden to lead the effort. 

So what might such a massive endeavor look like? Here, Barrett Rollins, M.D., Ph.D., chief scientific officer at the Dana-Farber Cancer Institute, offers his vision:

President Obama’s call for a new national effort against cancer — a “moon shot” — comes at a most opportune time. Cancer research has advanced significantly and now genomic analysis of tumors can reveal the specific DNA changes that drive cancer growth.

Our patients at Dana-Farber/Brigham and Women’s Cancer Center and Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, through the Profile research project, are benefiting from this — using the powerful technique of next-generation sequencing, scanning more than 300 cancer-related genes in every patient’s tumor to look for abnormalities. In a growing number of cases, the DNA changes can be targeted by precision therapies such as designer drugs that block overactive growth pathways. Often it will take combinations of targeted drugs to halt cancer progression, and many studies of these combinations are underway.

At the same time, there’s enormous promise in the field of immunotherapy. We’ve learned how to boost the body’s natural defenses against cancer and how to remove the molecular “brakes” that cancer cells exploit to hide from immune soldier cells and hinder their attack on tumors. Drugs that help the immune system fight cancer are coming quickly to the market, and there is promising research on related strategies such as cancer vaccines and genetic manipulation of immune cells to recognize cancer cells in the body. Continue reading

Analysis: Controversy Over CDC’s Proposed Opioid Prescribing Guidelines

OxyContin pills are arranged at a pharmacy in Montpelier, Vt. in this 2013 file photo. Opioid drugs include OxyContin. (Toby Talbot/AP)

OxyContin pills are arranged at a pharmacy in Montpelier, Vt. in this 2013 file photo. Opioid drugs include OxyContin. (Toby Talbot/AP)

Updated at 3 p.m.

By Judy Foreman

The U.S. Centers for Disease Control and Prevention recently came out with controversial proposed guidelines for opioid prescribing through a process that critics say may harm pain patients and is based on relatively low-grade evidence.

One of those critics is Cindy Steinberg, national director of policy and advocacy for the U.S. Pain Foundation, a patient advocacy group which receives funding from opioid manufacturers. Steinberg said in an interview and in emails that she’s worried the guidelines may negatively impact patients suffering with severe pain. “I am concerned that if these guidelines go forward as they are now written, they will lead to further restrictions on access to opioids for people with unremitting pain who truly need them and take them responsibly,” she said.

Dr. Jane Ballantyne, president of the non-profit Physicians for Responsible Opioid Prescribing (PROP), which is part of a larger group involved in the guidelines process, said in a telephone interview that the worry about limited access to opioids for chronic pain patients is a “very legitimate fear.” But, she added: “We don’t want to reduce access for people already dependent on opioids. The guidelines are designed to not have so many people dependent on opioids in the future…”

Ballantyne said that the new guidelines are similar to previous guidelines with two key exceptions: lower dose limitations and the recommendation that, for acute pain not related to major surgery or trauma, opioids should be prescribed for only three days.

The month-long period for public comment on the proposed guidelines will be over Jan. 13.

A major concern of some critics is the lack of solid evidence backing up the guidelines, which give recommendations on prescribing practices; they include when to start opioids, how to establish treatment goals, how to discuss risks and benefits, recommended limitations on drug doses, duration of treatment and other issues. Continue reading

Mass. Wants To Be Home To Nation’s Leading Cluster Of Digital Health Companies

Massachusetts government leaders and the state’s health care and technology sectors have announced a new partnership. The goal is to make the Bay State home to the nation’s leading cluster of digital health companies. WBUR’s Curt Nickisch reports the announcement shows political and industry will, but little money, at least not yet.

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Mass. Launches Partnership Aimed At Boosting Digital Health Sector

Gov. Charlie Baker speaks at a press conference at Boston Children's Hospital Thursday announcing a new public-private partnership to boost the state's digital health care sector. (Greta Jochem for WBUR)

Gov. Charlie Baker speaks at a press conference at Boston Children’s Hospital Thursday announcing a new public-private partnership to boost the state’s digital health care sector. (Greta Jochem for WBUR)

Updated 5:40 p.m.

BOSTON — If you own a smartphone and use it to track your steps, count calories, check your blood pressure or monitor your health savings account, you’re helping to build the digital health sector. A recent Goldman Sachs report says the sector will grow to $32 billion within a decade.

A new public-private partnership announced Thursday aims to make sure much of that growth is in the Bay State, where leaders argue the elements are already in place.

“Massachusetts has a wealth of capabilities,” Boston Children’s Hospital CEO Sandy Fenwick said at a press conference Thursday announcing the new digital health initiative — a wealth of knowledge and talent, Fenwick added, in biotech, pharma and technology.

Fenwick has been part of a two-year working group, formed by the Massachusetts Competitive Partnership (MAPC), that included the leaders of area companies, hospitals and universities. MAPC reached out to Gov. Charlie Baker, members of his cabinet, Boston Mayor Marty Walsh and House Speaker Robert DeLeo to form the public side of this joint venture after deciding that digital health offered the best potential for job growth in the tech sector.

On the private side, MAPC has a four-part plan.

1. Financing: Startups in Massachusetts routinely complain they can’t find financing, and the numbers show they’re right.

(Source: MAPC)

(Source: MAPC)

No firm dollar amount has been pledged yet. Vertex CEO Jeff Leiden, who led the working group for MAPC, says there will be an announcement about several innovative strategies and an investment commitment within the next six months.

2. Standard Agreements: All the software and tech licensing agreements as well as sponsored research agreements used in the state’s digital health initiative will use standard language. MAPC says MIT, Harvard, Northeastern, UMass and Partners HealthCare have agreed to use the agreements, which may be a first for academic institutions in the U.S.

3. Mentoring: There are lots of stories about young entrepreneurs getting advice from CEOs in Silicon Valley while standing in line at the coffee shop. Massachusetts may not get quite that loose, but MAPC is planning a speakers series that would give startups access to CEOs for support and guidance.

4. Space: MAPC will work with the state and MassChallenge, a nonprofit that runs a competition and programs for startups, to create a digital health innovation accelerator. Mayor Walsh says the city is working to help the project find space.

The Right Mix Of People

Startups will have the opportunity to test ideas in hospitals and other health care settings around the state, something Jacqueline Thong, who launched Klio Health here, which helps those with chronic conditions track symptoms and treatments, says will be invaluable.

Continue reading

Lost In Translation: How Foreign-Speaking Patients Suffer Without Medical Interpreters

Hospitals take different approaches to support people with low English-speaking ability. In this 2004 photo, medical interpreter Carmen Diaz interprets for Spanish-speaking patient at Temple University Hospital in Philadelphia. (Bradley C. Bower/AP)

Hospitals take different approaches to support people with low English-speaking ability. In this 2004 photo, medical interpreter Carmen Diaz interprets for Spanish-speaking patient at Temple University Hospital in Philadelphia. (Bradley C. Bower/AP)

By Dr. David Scales

When I met Mr. Y., he was sitting up in bed, sweating and breathing quickly. An elderly, Russian-speaking man, he was admitted to the cardiology ward at a large hospital where I was working. His blood pressure was dangerously high and he struggled to breathe. His fear was instantly apparent in his wide blue eyes. Panting, he told us that he had liver pain, pointing to just below the ribs on his right side.

It’s unusual for patients to complain about liver pain. In broken English, Mr. Y. explained that it began after starting new blood pressure medications a few months ago. But his chest X-ray told a different story. His lungs were drowning in fluid — the likely reason why he was so out of breath — and that couldn’t have been caused by the medications he was so worried about. Having already perused his laboratory results, his condition seemed like a straightforward case of heart failure, but I quickly realized admitting Mr. Y. would be linguistically and culturally complex.

I needed to understand what made him so short of breath, and why he thought his medications caused the problem. But no in-person interpreter was available for another hour and a half. The telephone interpreting service at this hospital was designed to be accessible — the interpreter can be paged from any hospital telephone and should call back. Yet, no one had called back after my two attempts. I imagined they were busy interpreting for other patients. In the meantime, Mr. Y. continued to pant and sweat, leaning forward in bed to help his breathing.

Reluctantly, I asked his adult daughter if she would interpret for me. She agreed, but was clearly reticent; her hesitance and discomfort apparent as she stumbled over questions about her father’s recent urinary and bowel habits. While I speak no Russian, I became suspicious of misunderstandings when she interpreted my question about previous “heart failure” as “infarkt,” which sounds like a medical term for a heart attack.

“Family members may struggle to interpret accurately when family or cultural expectations are upset by medically routine, but personally embarrassing questions.”

I know of studies showing patients suffer when clinicians do not use interpreters or use untrained, informal interpreters like family members. I learned this during medical interpreter training and in my own experience volunteering as an Arabic interpreter with Iraqi refugees in New Haven and Syrian refugees in Jordan. As was the case with Mr. Y.’s daughter, family members may struggle to interpret accurately when family or cultural expectations are upset by medically routine, but personally embarrassing questions.

As a trained interpreter myself, it is painful and frustrating when good interpreter services are not available. But it isn’t just a dearth of interpreters — it’s also a lack of time that presents challenges to providing good care to non-English speakers. If I had a leisurely day I could have waited or returned, but on an adrenaline-fueled day on call, waiting for the interpreter was not possible. I had to balance my limited time with Mr. Y. against preparing for the three other patients I expected to be admitted at any minute. Worried this would be my only chance to hear his story, I put my interpreter training aside.

Long waits for in-person interpreters, an unreliable telephone interpreting system and the pressure of three other sick patients waiting to be admitted put both my resident and me in the uncomfortable position of just “getting by.” I had enough information to treat his illness but not enough time to understand how he connected his liver pain to his new medications.

Interpreters are easier to obtain with better technology. One analysis points out that physicians tend not to use interpreters much in the system I was using. It’s where the patient speaks to the interpreter over the phone then passes the phone to the physician for interpretation. Advancements in technology to two handsets and videophones now bring the telephone interpreter into the room with my patients and me. Some studies show these technological improvements have increased the use of interpreters by physicians. In one small study, placing a dual-handset phone at every patient’s bedside led to a fourfold increase in the use of telephone interpreter services without a decline in demand for in-person services. Continue reading

1 In 6 Mass. Residents Put Off Health Care This Year To Avoid Costs, Survey Finds

A new survey of Massachusetts residents finds that about one in six did not get health care they said they needed in 2015 because of the cost.

The survey from the state’s Center for Health Information and Analysis (CHIA) highlights a trend showing more people have high-deductible plans in which insurance covers less care and patients pay more out of pocket. Continue reading

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Elder Hunger: New Efforts To Combat Surprisingly Common Malnutrition Among Seniors

Meals on Wheels, a national home-delivery meals program, has helped some seniors manage their dietary needs as rates of malnutrition among the elderly population rises. (Jeff Gentner/AP)

Meals on Wheels, a national home-delivery meals program, has helped some seniors manage their dietary needs as rates of malnutrition among the elderly population rises. (Jeff Gentner/AP)

By Nell Lake

After her stroke, a 95-year-old woman in New York State found that she could no longer taste her food. She was also unable to feel hunger, so she didn’t know when she was supposed to eat. As a result, the woman began losing weight, grew weak and wasn’t getting the nutrients she needed.

Enter Meals on Wheels, a national home-delivered meals program established by the 1965 Older Americans Act. The woman (who asked that her name not be used) began receiving meals at her home five days a week. This, she says, helped her remember to eat regularly. Her weight improved, and so did her general health.

Malnutrition like hers is surprisingly common. Six percent of the elderly who live at home in the United States and in other developed countries are malnourished, according to a 2010 study in the Journal of the American Geriatric Society. The rate of elder malnutrition doubles among those in nursing homes, where it is 14 percent, according to the same study.

And rates skyrocket among elderly populations in rehabilitation facilities and hospitals: Various measures show an astonishing one third to one half of seniors are malnourished upon being admitted to the hospital.

“Malnutrition is a serious and under-recognized problem among older adults,” says Nancy Wellman, a nutritionist and instructor at Tuft University’s Friedman School of Nutrition Science and Policy.

It’s not a new problem. But growth in the elderly population, and concerns about healthcare costs, have helped renew efforts by nutritionists and other advocates to establish screenings for malnutrition in medical settings, and to improve interventions that can prevent or reverse the issue.

Nutrition Complexities

Most basically, malnutrition means not getting enough nutrients for optimal health. In older adults, the causes are complex, experts say. Illness, disability, social isolation, poverty — often a combination of these — can all contribute to malnutrition. An older person may become malnourished because she has trouble chewing or swallowing. The medications she takes may suppress appetite. She may be unable to get to a grocery store. She may live alone, be depressed, or simply be uninterested in eating.

It’s important to know, says Connie Bales, a dietician and faculty member at Duke University Medical Center, that obese and overweight seniors can be malnourished, too. Eating too many calories doesn’t necessarily mean you’re getting the right nutrients for maintaining muscle and bone. “One can be quite malnourished, yet not be skinny,” Bales says.

High Costs 

Whatever the cause, malnutrition leads to further trouble. It increases older adults’ risk of illness, frailty and infection. Malnourished people visit the doctor and are admitted to the hospital more often, have longer hospital stays and recover from surgery more slowly.

The association between malnutrition and hospitalization goes both ways, say Wellman and other experts: The sick are more likely to become malnourished, and the malnourished are more likely to get sick. Continue reading

A Tale Of 2 Hospital Visits: How The Cost Of Care Can Vary Dramatically Depending On Where You’re Treated

After receiving almost the exact same care at two different hospitals, a patient we're calling Nancy was stunned when she received both bills on the same day. (AP file photo)

After receiving almost the exact same care at two different hospitals, a patient we’re calling Nancy was stunned when she received both bills on the same day. (AP file photo)

The stomach cramp and nausea began one hot Friday evening in August, midway through a vacation on Martha’s Vineyard. The next morning, nearly doubled over in pain, a patient who we’ll call “Nancy” walked gingerly into the emergency room at Martha’s Vineyard Hospital.

Nancy is a 55-year-old former nurse who would prefer not to use her real name because she works with the hospitals in this story.

Even Nancy, who spends hours every day focused on health care costs, would gasp when she saw the bill for this visit.

In the ER, a doctor poked at Nancy’s tender belly and took blood for tests and a urine sample. The doctor ordered a CT scan of Nancy’s abdomen and pelvis, using contrast. It showed bulges, inflammation and thickening in Nancy’s colon. The diagnosis: uncomplicated diverticulitis. Nancy filled a prescription for an antibiotic, took some Advil, and felt better after a few days on a clear liquid diet.

Five weeks later, the diverticulitis monster invaded Nancy’s intestines again. This time she went to an urgent care center closer to home, run by Beth Israel Deaconess Medical Center (BIDMC). A doctor there ordered the same single CT scan of the abdomen and pelvis, again with contrast.

Nancy says the care she received at both places was great. But a month later, when she received the bills and her insurance company’s explanation of benefits for both visits on the same day, she was stunned.

The explanation of benefits show Blue Cross had paid Martha’s Vineyard Hospital almost seven times what it paid BIDMC’s urgent care center for the same CT scan — $3,888.76 vs. $574.97. Continue reading

How Much Is That Eye Exam? Study Probes The Elusive Quest For Health Care Prices

Let’s say you’re having trouble reading this. The words are a little fuzzy. You might need glasses or a new prescription. So you call to make an appointment for an eye exam and ask how much the visit will cost. You’re going to pay for the appointment because your insurance plan has a deductible that you haven’t met.

Seems like a simple question, but be prepared: There’s a good chance you won’t get a simple answer.

“Sometimes people were downright rude,” says Barbara Anthony, senior fellow in health care at the Pioneer Institute. “Other times, staff said they weren’t allowed to give price information over the phone.” (Click the audio player above for Anthony’s interview with WBUR’s Bob Oakes.)

The Pioneer Institute called the offices of 96 dentists, ophthamologists, dermatologists and gastroenterologists (the doctors who perform colonoscopies) last month, asking for the price of five basic services.

0812_pioneer-prices

The results show that prices vary widely. But getting the information wasn’t easy. Continue reading

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