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Managing Incontinence After A Stroke - May Is Stroke Awareness Month
Approximately 800,000 people suffer a stroke in the United States each year, nearly three-quarters of which occur in people over 65 years old. On average, someone in the U.S. suffers a stroke every 40 seconds.
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Doctors And Nurses Facing Tough Choices
Doctors and nurses consider job security and the differences between primary care and specialties when choosing their career paths.
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Abortion Coverage Likely To Be Next Battle In House Health Reform Legislation
Abortion coverage could become the next "sticking point" in debates over health reform between the House leadership and conservative Democrats, the Los Angeles Times reports. During most of the battle over a health care overhaul, abortion-related issues have taken a "back seat" to clashes between House Energy and Commerce Committee Chair Henry Waxman (D-Calif.) and fiscally conservative Blue Dog Democrats over the cost of the House bill (HR 3200). However, reproductive health issues are increasingly coming into play, with some other conservative Democrats threatening to withdraw support for the bill if coverage of abortion services is not explicitly excluded from receiving federal funding. Rep. Bart Stupak (D-Mich.) and 18 fellow Democrats in June wrote a letter to House Speaker Nancy Pelosi (D-Calif.) stating that they "cannot support any health care proposal unless it excludes abortion from the scope of any government-defined or subsidized health insurance plan." According to the Times, Stupak has "vowed" to press Waxman to include restrictions on abortion coverage in the Energy and Commerce Committee"s version of the House bill. Abortion-rights supporter Rep. Louise Slaughter (D-N.Y.), chair of the House Rules Committee, opposes Stupak"s proposal. Slaughter spokesperson Vincent Morris said, "The starting point for Rep. Slaughter of the health care debate was protecting abortion rights."The Hyde Amendment currently prevents the use of federal Medicaid funds for abortion services. The reach of current law restrictions "grows murkier" if the government forms its own health insurance plan to compete with private insurers or creates a new market that allows the public to choose between various private plans, the Times reports. Both options are under consideration in Congress, and abortion-rights opponents fear that abortion services would be covered unless the language of the bill explicitly forbids it.Abortion-rights supporters argue that the bill would maintain the status quo, as insurance companies already are able to choose whether to cover abortion services. New government restrictions could mean that women seeking abortion coverage would have to choose a more expensive private plan rather than a lower-cost, government-subsidized option, according to abortion-rights advocates. Another concern, they say, is that insurers who currently cover abortion would discontinue that coverage to take advantage of government incentives. In a recent statement, the Planned Parenthood Federation of America said, "Opponents of women"s health and health care reform are exploiting health care reform as a way to push for unprecedented prohibitions on abortion coverage in the private marketplace."The Obama administration is attempting to remain neutral on the issue, the Times reports. White House press secretary Robert Gibbs recently said that "a benefit package is better left to experts in the medical field to determine how best and what procedures to cover." The House bill currently establishes a Health Benefits Advisory Committee to recommend which "essential benefits" should be covered under any government-supported insurance plan. In an interview with CBS News last week, President Obama said that he believes it is "appropriate for us to figure out how to just deliver on the cost savings and not get distracted by the abortion debate."According to the Times, the Obama administration"s silence on the issue is "precisely what worries" antiabortion-rights advocates. Rep. John Fleming (R-La.) said that Obama is "actually making an affirmative statement in favor of" federal funding for abortion services by not taking a stand on the issue (Oliphant, Los Angeles Times, 7/28).
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Fibromyalgia: Doctor Offers Unbiased Overview In New Book

As many as fifteen million American women suffer from a disabling medical condition known as fibromyalgia. In the medical community, sides have been drawn over whether fibromyalgia is a genuine syndrome or a catchall diagnosis based on vague clinical criteria. In The Fibromyalgia Controversy, M. Clement Hall, MD presents an unbiased overview of the fibromyalgia situation today and reviews the most up-to-date opinions and studies on this condition and its surrounding controversy. Fibromyalgia - affecting approximately five percent of the American population, mostly women - is characterized primarily by widespread pain, tender spots, decreased pain threshold, sleep disturbance, fatigue, and psychological distress. It is a chronic condition characterized by a pattern of vague symptoms that are difficult to diagnose and treat. The controversy among doctors is whether or not there is an actual disease that can be cured, rather than just a set of symptoms to manage. "Despite being recognized as a diagnosable disease by the American College of Rheumatology, the Food and Drug Administration and most insurers, fibromyalgia has not completely shed the stigma of being dismissed as "psychosomatic" by some in the medical establishment." noted the Sacramento Bee in a May 31, 2009 article on patients not being taken seriously by their doctors. There are few conditions about which the medical profession is so polarised One side argues, sometimes heatedly, that patients are masquerading - pretending a disability they know they do not have. The other side counters, with equal passion, that fibromyalgia sufferers are abused by a society that fails to give them the support they deserve while painfully suffering from this severely debilitating illness. In The Fibromyalgia Controversy, Dr. M. Clement Hall presents six fictional, though factually based, case studies of typical patients from differing socioeconomic backgrounds and describes the varying investigations, diagnoses, and treatments they have undergone. Each of these case studies represents a composite of many years of clinical practice rather than one specific patient. Collectively, they cover the range of experiences fibromyalgia patients are likely to have encountered. By taking this unique approach, Dr. Hall presents an objective overview of the fibromyalgia situation today in North America. Patients, family members, and physicians will see themselves reflected in the descriptions and will gain a broader understanding of this challenging illness. "While several books address the challenges of living with fibromyalgia... Hall"s is a uniquely objective account that surveys diagnosis, treatments, and the controversy surrounding the condition," says Rebecca Raszewski, University of Illinois at Chicago, in a Library Journal review. "Hall... delivers a balanced view... by presenting perspectives of skeptics who doubt whether fibromyalgia is a real medical condition - as well as comprehensive descriptions of the disorder and treatment options." By detailing the process by which clinicians make their diagnoses, explaining how those who think they may have fibromyalgia can make the most of their doctors" visits, discussing various treatments in current use (medication, physical therapy, diet modification, and alternative approaches such as massage or acupuncture), and looking at the historical record of various related disorders, Hall provides an unbiased, indispensable survey of data and views on this illness. Notes: The Fibromyalgia Controversy is a must read for sufferers, clinicians, and those interested in gaining insight about this heated dispute in the medical community and its long-term repercussions. About the Author: M. Clement Hall, MD (Toronto, Ontario, Canada), is the director of continuing education in the emergency department of Scarborough Hospital, and is the author of "Trauma Surgeon" among other works. Jennifer Kovach Prometheus Books


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