Racial gaps in access to robotic prostate surgery -Prostate Cancer ...

? Prostate Cancer news ? Jan 05, 2013

Minority and Medicaid cancer patients are less likely to have their prostates removed at hospitals that use robot-assisted surgery, according to a new study that stops short of suggesting the robotic technique represents better care.

?People who are poor - frequently Hispanic, African American or black, and Medicaid patients - tend to get what is considered to be less high-quality care than those who are middle class and wealthy,? said Dr. Otis Brawley, chief medical and scientific officer of the American Cancer Society.

But Brawley, who wasn?t involved in the new study, also said there is no evidence that removing a prostate with a robot is better than the old-fashioned way, with ?open? surgery that requires an incision across a man?s stomach.

Those are two of several treatment options available for prostate cancer, including radiation as well as active surveillance, also known as watchful waiting.

The American Cancer Society estimates approximately 250,000 men were diagnosed with prostate cancer in 2012, and about 28,000 died from it.

Despite a lack of evidence showing its superiority, robot-assisted prostate removal has become the predominant method since being approved by the U.S. Food and Drug Administration in 2000, according to the researchers, led by Dr. Simon Kim at the Mayo Clinic in Rochester, Minnesota.

Robotic surgical tools allow doctors to operate through small incisions with the aid of a tiny video camera, an approach that is considered less invasive but also tends to be more expensive.

Kim and his colleagues write in The Journal of Urology that evidence does exist to show that black patients are already less likely to get radiation or to have their prostates removed, but there is less data on whether they and other minorities have equal access to robot-assisted prostate removal.

For the study, Kim?s group used two national databases to compare the differences between the approximately 20,500 cancer patients who had their prostates removed at hospitals offering robotic surgery, and the 9,500 who had their surgery at hospitals without robots between 2006 and 2008.

Overall, the researchers found, the proportion of all prostate removals shifted from about 56 percent taking place at hospitals with robots in 2006 to 76 percent in 2008.

They also found that hospitals offering robotic surgery removed more than four times the number of prostates as other hospitals during that time.

That?s important because hospitals that remove more prostates tend to report better patient outcomes after surgery.

In addition, black patients were 19 percent less likely to have their surgery at a hospital using robots compared to white patients, and Hispanic patients were 23 percent less likely.

Medicaid patients were also 30 percent less likely to go to a hospital offering robotic surgery, compared to patients with private insurance.

Dr. Michael Barry, who was not involved in the new research but has studied prostate cancer treatment and outcomes, pointed out that the new work shows a gap in who is able to access the hospitals that perform the greatest number of prostate removals.

?The issue here is not access to robot (surgery) but high-volume hospitals,? said Barry, a clinical professor of medicine at Boston?s Harvard Medical School.

The study authors, who were not available for comment by press time, similarly conclude that gaps in access to robotic surgery hospitals may also indicate limited access to high-volume hospitals.

?More effective health care policies focusing on incentives to provide better access for minorities or for patients primarily insured by Medicaid may reduce disparities in access to high volume hospitals with robotic surgery,? they write.

SOURCE: The Journal of Urology, online December 18, 2012.

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Disparities in Access to Hospitals with Robotic Surgery for Patients with Prostate Cancer Undergoing Radical Prostatectomy

Results

Overall 20,424 (68.5%) patients were surgically treated with radical prostatectomy at hospitals with robotic surgery, while 9,413 (31.5%) underwent radical prostatectomy at hospitals without robotic surgery. There was a marked increase in radical prostatectomy at hospital adopters from 55.8% in 2006 and 70.7% in 2007 to 76.1% in 2008 (p Conclusions

Although there was a rapid shift of patients who underwent radical prostatectomy to hospitals with robotic surgery from 2006 to 2008, black and Hispanic patients or those primarily insured by Medicaid were less likely to undergo radical prostatectomy at such hospitals.

###
Simon P. Kim, Nilay D. Shah, Stephen A. Boorjian, Christopher J. Weight, Jon C. Tilburt, Leona C. Han, R. Houston Thompson, Quoc-Dien Trinh, Maxine Sun, James P. Moriarty, R. Jeffrey Karnes
The Journal of Urology - 18 December 2012 (10.1016/j.juro.2012.09.033)

Provided by ArmMed Media

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Source: http://www.health.am/cr/more/to-robotic-prostate-surgery/

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Anti-Aging Truths you must not Ignore!!! - Food Fitness Life Love

Almost everyone dreads the ageing attack when they hit 40. This is the time when they try out different techniques to retard or slow down the ageing process. Unfortunately, most of these attempts fail. Don?t get disheartened. There are many anti-aging secrets which have been given a green signal by experts and have worked really well for many.

Nutritional Needs

It is important to understand your nutritional needs and choose the right type of foods. This will help you maintain super soft, smooth, and glowing skin. Understand that at any given age, you require boosting your body and supply your skin with certain vital nutrients. Make sure you have fresh fruits and vegetables as snacks instead of processed or manufactured ?fast foods?. Avoid rush during meals. You should give enough time to digest your food properly to avoid burden on your body leading to unnecessary wear and tear. This can cause premature aging!

Clean and Moisturize

You must use a gentle daily cleanser to keep your skin squeaky clean. Don?t use a washcloth that could pull and tear at the skin. Understand that the skin needs to be cleansed with your fingers using gentle, circular motions. Strictly avoid stretching the delicate eye area. Moisturize the skin daily as the process could protect it from the effects of wind, pollution, and sun. It also helps in retaining the natural moisture of the skin.

Sunscreen

It is not easy to resist the warmth of sun during cold months. But hours under the sun will tan your skin and inflict gradual damage only to make it dull and thin. This also results in premature aging overtime. Apply sunscreen as part of your daily routine. It is highly advisable to use moisturizers which have sunscreen in them. If you are worried of not getting adequate sunlight exposure, it is advisable to get about 15 minutes of sun exposure each day. This will provides you with requisite vitamin D for your body to stay healthy.

Choose Anti-aging Products with Care

It may be tough for you to choose high quality anti-aging products. Here are some tips you can follow as a guide:

? The product you buy should have natural or organic ingredients.

? Don?t use products with many chemicals.

? Do not buy products with fragrances as fragrance contain toxins which are harmful for your skin.

? Strictly avoid products with collagen. Researches have proved that it cannot penetrate the pores of the skin despite the claims from cosmetics manufacturers. Try using a product that stimulates collagen production within your own body.

? The product should contain powerful anti-oxidants that help fight free radicals. These free radicals are the main culprits that cause premature aging.

Following the above mentioned rules will help you prevent the onslaught of premature aging and continue to look young for years to come.

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Source: http://www.foodfitnesslifelove.com/beauty/anti-aging-truths-you-must-not-ignore/

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What Congress can learn from tribal elders

NGTV / Lion TV via PBS

UCLA Professor Jared Diamond has studied traditional cultures for decades, laying out his findings in the Pulitzer Prize-winning book "Guns, Germs and Steel" as well as "Collapse" and his just-published volume, "The World Until Yesterday."

By Alan Boyle

In the wake of a high-wire "fiscal cliff" performance that wasn't exactly their finest hour, members of Congress would do well to learn a lesson from the tribes of New Guinea and the Amazon: Listen to your elders. At least that's the lesson passed along by UCLA Professor Jared Diamond, the author of "The World Until Yesterday: What Can We Learn From Traditional Societies?"

Diamond documented the reasons why European invaders overwhelmed less technologically advanced cultures in his Pulitzer Prize-winning book, "Guns, Germs and Steel: The Fates of Human Societies." He laid out cautionary tales of social breakdown in the follow-up book, "Collapse: How Societies Choose to Fail or Succeed." In his newly published book, Diamond draws upon his decades of research in far-flung locales to lay out lessons for us less traditional types.

"Tribes constitute thousands of natural experiments in how to run a human society," he told a capacity crowd Thursday night during the kickoff of his international book tour at Town Hall Seattle.

---

Diamond says the useful findings from those experiments run a wide gamut, from the benefits of multilingualism to the right way to carry a baby ("vertically upright, facing forward"). But one of his biggest themes has to do with the way older people are treated, or mistreated. He noted that a Fijian friend was shocked to see how often America's?senior citizens are shunted aside by the younger generation. And although some traditional societies have their own quirks about dealing with the aged?? for example, strangling them when they become a liability?? Diamond agrees that American attitudes need an adjustment.

Penguin

"The World Until Yesterday" is the latest book from Jared Diamond, a geography professor at UCLA.

"The lives of the elderly constitute a disaster area of modern American society," the 75-year-old Diamond said in Seattle. "We can do better."

He'd like to see senior citizens restored to the roles they have always held in traditional societies, but in a modern-day context:?for example,?as baby-sitters in a world where both parents work, or as fonts for the kind of wisdom you can't get through a Web search. He'd even like to see age given more respect on Capitol Hill, where the median age is 57 in the House and 62 in the Senate.?That was the theme of my interview with Diamond on Thursday. Here's an edited version of the Q&A:

Cosmic Log: How would traditional societies deal with something like the fiscal cliff? What advice can you give to Congress for dealing with the kind of gridlock that we've seen?

Diamond:?"The unrealistic answer is to say that the only senators and House members who are permitted to vote on fiscal-cliff issues are those who are over the age of 70. That's not realistic. But the realistic idea is to say that we should give disproportionate weight to the opinions of older politicians who have experienced a much wider range of financial conditions than have the young members of Congress. That is to say, we should listen to people who have gone through the Great Depression, the bubbles of the '80s, the soaring interest rates of the '70s. They've seen a variety of conditions, whereas younger people have seen only recent conditions, and they don't realize that things can be different. That's what comes out of traditional societies.?

"Most traditional peoples talk about 'tribal elders.' The reality is that the leaders of traditional peoples are always the older people. And the reason is, it's good. They have lots of lifetime experience under very different conditions.

"The same also applies to modern societies:?Sometimes I'm asked to talk to hedge-fund groups. I'm struck by the fact that most of the people are in their 20s or 30s. There may be a few people in their 40s, and maybe a couple in their 50s. When you look at the statistics, about half of all hedge funds fail within the first five years, although many of them do spectacularly well for a couple of years. The reason is, the whiz kids are very good at algorithms that make money under good conditions. But they don't realize that conditions can be very different, that there are tough conditions ? soaring interest rates, financial setbacks. So they don't have the long perspective.?That's an example of how a long perspective is necessary for financial policy, just as it is for governing, for deciding about war and peace."

Q: Is there any institutional reform that can do that, or is it beyond modern society to get back to those ways?

A: "It's not beyond modern society, because if you look around at different modern societies?? and I'm talking about rich industrial societies?? some of them give a lot more deference and weight to older people than do others. The United States is an extreme in this respect. We are perhaps the modern rich society that has the biggest cult of youth. For example, when was the last time you saw a commercial with an 83-year-old raising a bottle of Coca-Cola? The Coke ads are all about 25-year-olds. That's our cult of youth. But in Europe, there is much more deference given to older people. In China, even more. In Japan, too, and in Mexico and Italy. So there's an area where the United States, in its own self-interest, can learn from the experience of its older people."

Q: I'm struck by one of the comments that a House Republican made during the fiscal-cliff deliberations, complaining about the "sleep-deprived octogenarians" in the Senate. ...

A: "Sure, but the octogenarians have had 80 years to see the advantages of taxes. Taxes are an investment, they're not money taken away from you. They're your own money that's being used for long-term purposes. Our taxes are paying for roads, they're paying for schools, they're paying for armed forces, they're paying for inspectors, they're paying for regulators. The more we put in, the more we get out. Now, this is not to deny that every government wastes some tax money. Nobody has figured out how to spend taxes in a way that there's no waste. But the basic mindset is that taxes bring benefits. The longer you live, the more you see those benefits."

Q: Is there an analog to taxation that has worked for traditional societies?

A: "There is, but it's not until you get to medium-to-large societies. Small traditional societies of a few dozen to a few hundred people really don't have anything like taxation. Once you get to a society of a few thousand people, where there's a chief?? big enough that you can't have a face-to-face discussion, but you've got to have a chief?? chiefs practice an early form of taxation. They require that the commoners turn over a fraction of their agricultural products to the chief. Part of that is used to support their own lifestyle, and part of that is also held in reserve to redistribute to the commoners in a time of famine. One could say that that's a precursor to state government taxation."

Q: Are there other things on your short list of lessons that could help break the societal gridlock we see today?

A:?"Another whole area that's open for discussion is the area of conflict resolution. The American system of conflict resolution in the courts is a system of determining right and wrong, with winners and losers. But in traditional societies, conflict resolution has a different goal. The goal is to achieve and maintain peace between people who are going to have to deal with each other for the rest of their lives. The society is small, so you know everybody. In the United States, a big society, if you have a traffic accident, the other person is likely to be someone you never saw before and will never see again. So who cares whether they're unhappy with the result? But the reality is that anybody who's been involved with the American civil or criminal justice system knows that its goal is not to achieve reconciliation. And the result is emotional agony, often for the rest of one's life.

"It's particularly sad when that agony involves divorcing spouses, or so often it involves brothers and sisters, or parents and children who end up suing each other in inheritance disputes. That's because when you use courts and lawyers, the goal is not to achieve emotional clearance, but the goal is to decide right and wrong. That is another big subject area?we could happily talk about for a few hours."

Q: Another big subject area would be how to deal with the emotional scars left by the string of mass shootings we've seen lately. Are there any lessons that can be drawn from traditional societies addressing that issue?

A:?"My one-liner there would be the balance between individual interests and communal interests. The United States' laws provide that if an individual wants a gun, that individual is going to have a gun, even if that is bad for society as a whole. Today I'm talking from Seattle, which is 100 miles from the Canadian border. Here we have a neighbor that is as affluent as the United States, but has a different balance ??with much more emphasis on communal interests and much less interest on individual rights. Among other things, Canadians do not feel that everybody should exercise their God-given right to carry a gun."

Think there's enough in what Diamond says to get a discussion going? Feel free to weigh in with your comments below.

More from Jared Diamond:

---

Alan Boyle is NBCNews.com's science editor. Connect with the Cosmic Log community by "liking" the log's?Facebook page, following?@b0yle on Twitter?and adding the?Cosmic Log page?to your Google+ presence. To keep up with Cosmic Log as well as NBCNews.com's other stories about science and space, sign up for the Tech & Science newsletter, delivered to your email in-box every weekday. You can also check out?"The Case for Pluto,"?my book about the controversial dwarf planet and the search for new worlds.

Source: http://cosmiclog.nbcnews.com/_news/2013/01/04/16354535-collapse-in-congress-lawmakers-should-learn-from-tribal-elders?lite

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RCA Mobile TV Tablet combines DTV with Dyle, arrives this spring for $299

The RCA DMT580D may not be memorably named, but the television-centric tablet stands out for other reasons: most notably, its combination of DTV and Dyle-powered mobile TV. RCA's toting its "Mobile TV Tablet" as, "the electronics industry's first dual-tuner mobile TV" -- making your on-the-go viewings of The View all the easier. Oh, and the other 130 mobile TV stations Dyle also offers certainly don't hurt; you'll be able to scoop up regular ol' digital TV signals using the tablet's telescoping antenna. It's essentially an upgrade to RCA's previous efforts in the TV-centric tablet market.

If the TV angle isn't enough for you, RCA promises a fully featured Android tablet otherwise: an 8-inch HD IPS screen, 802.11b/g/n WiFi capability, a Cortex A5 1GHz processor, 1GB of RAM, and 8GB of flash storage memory (expandable via MicroSD). Should you wish to capture the facial reactions you'll assuredly make during those daily View broadcasts, front-facing and rear cameras are also part of the equation, and the whole shebang weighs in at roughly 1.4 lbs. Around four hours of battery life are expected if you're going whole hog on the TV bit, which balloons to 10 if you're just surfing the web / playing Angry Birds / etc. At $299, you'd better be really into those television features -- the RCA Mobile TV Tablet arrives at retail "this coming spring."

Continue reading RCA Mobile TV Tablet combines DTV with Dyle, arrives this spring for $299

Filed under: Tablets, Software, HD, Mobile

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Source: http://www.engadget.com/2013/01/04/rca-mobile-tv-tablet-announcement/

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Bookmark Specific Gmail Pages for Quicker Access

Usually, you need to head to your Gmail inbox in order to compose a new message, view your drafts, or visit another part of your inbox. Lifehack.org notes that you can actually bookmark these pages for quicker access.

I generally pin my Gmail inbox to the side of my tab bar, but that isn't ideal for everyone?in fact, it's likely to distract you into constantly checking your email. So, if you try to keep your Gmail out of sight, Lifehack says you should add a few bookmarks?to things like like Compose, Drafts, Starred, or any other specific locations?to your bookmark bar so they're easily accessible in fewer clicks. It's an incredibly simple tip, but one that could be pretty helpful if you want to minimize both distractions and mouse clicks. (Of course, you could always do it from your address bar or from an app launcher too, if you want even more speed).

You can do this with other Google services, too. Hit the link for a few other handy but dead simple Gmail tricks.

Two Tips for Gmail Users to Manage Email More Efficiently | Lifehack

Source: http://feeds.gawker.com/~r/lifehacker/full/~3/EN5WxLRIST0/bookmark-specific-gmail-pages-for-quicker-access

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Azerbaijani Interior Minister visits military unit - Trend.Az

Azerbaijan, Baku, Jan. 3 / Trend I.Isabalayeva /

Interior Minister, colonel-general Ramil Usubov visited a military unit of Azerbaijani Internal Troops in Baku, the Interior Ministry press service said on Thursday.

The minister conveyed the greetings of the President, the Supreme Commander-in-Chief of the Armed Forces Ilham Aliyev to staff and acquainted himself with the service and living conditions of soldiers and officers, as well as the military training at the unit.

Usubov inspected the new helicopter pad, the on-going construction work in the hangar and gave instructions and recommendations expressing satisfaction with the work progress.

Usubov and the Deputy Interior Minister, Commander of Interior Troops, Zakir Hasanov, then joined staff and soldiers' parents at a dinner.

Do you have any feedback? Contact our journalist at agency@trend.az

Source: http://en.trend.az/news/society/2105042.html

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Face of the new Congress

WASHINGTON (AP) ? Politically, the 213th Congress that was sworn in Thursday won't be much of a change from the less-than-stellar 212th Congress it replaces: Democrats picked up a few seats in the House and Senate, but the balance of power is unchanged, with Republicans controlling the House and Democrats holding a majority in the Senate.

Yet a closer look finds that Congress is undergoing some of the changes that have altered the face of America in general, with women and minorities playing increasingly more prominent roles. Here's a breakdown.

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THE NUMBERS

The House has 233 Republicans and 200 Democrats. Each party should pick up one more seat when two vacancies are filled. Going into the election, the GOP edge was 242-193. Senate Democrats will have a caucus of 55, including two independents, Angus King of Maine and Bernie Sanders of Vermont. Republicans have 45. That's a pickup of two seats for Democrats.

___

WOMEN

The House will have 79 women, including 60 Democrats. At the end of the last session, there were 50 Democratic women and 24 Republican women. The new Senate will have 20 women members, an increase of three. That consists of 16 Democrats and four Republicans. The last Senate had 12 Democratic women and five Republicans.

___

FRESHMEN

With two vacancies to be filled, the House has 82 freshmen; 47 Democrats and 35 Republicans. As of the end of the last session, 87 of 103 freshmen were Republicans. The Senate will include 14 new faces, with nine Democrats and the independent King. Five are women. New senators include Brian Schatz, who was sworn in on Dec. 27 to fill the seat of the late Hawaii Democrat Daniel Inouye.

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AFRICAN AMERICANS

The House will have 40 African Americans, all Democrats. The number of Democrats is unchanged, although two Republicans will be gone: Allen West, R-Fla., lost his re-election bid, and Tim Scott, R-S.C., was appointed to fill the Senate seat of Jim DeMint, R-S.C., who is retiring. Scott will be the first black lawmaker in the Senate since Roland Burris, who retired in 2010 after filling the Illinois Senate seat of Barack Obama for almost two years.

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HISPANICS

The new House will have 33 Hispanics, with 25 Democrats and eight Republicans. That's up slightly from last year. The Senate will have three Hispanics: Democrat Robert Menendez of New Jersey, Republican Marco Rubio of Florida and Republican freshman Ted Cruz of Texas.

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OTHER MINORITIES

The new House will have nine Asian Americans, all Democrats. There are two American Indians: Tom Cole, R-Okla., and Ben Lujan, D-N.M.

___

OTHER FACTS

According to CQ Roll Call newspaper, the average age of House members in the 113th Congress is 57; the average age of senators is 62. It estimates that the House will include some 277 Protestants and Catholics, 22 Jews, two Muslims and two Buddhists. The Senate will have 80 Protestants and Catholics and 10 Jews. The House will have its first Hindu, Rep.Tulsi Gabbard, D-Hawaii. Senate freshman Mazie Hirono, also of Hawaii, will be the Senate's only Buddhist. Also for the first time, white men will be a minority among House Democrats.

Source: http://news.yahoo.com/face-congress-185123646.html

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