Wednesday, May 5, 2010
The artist, Adam Kuby, explains that he uses “…the body as a metaphor for the entire city…hop[ing] to identify those places in the landscape that are important to us as a community, drawing attention not only to the significance of each focal point but also to the interconnectedness of them to each other as well as to ourselves.” The 4 goals of the 35 foot tall needles are to:
create visual links to the “The Portland Plan,” the city's 25 year strategic planning effort happening now
help people connect their own individual bodies and individual health to the health of their city
spotlight the acupuncture profession and generate local & national press coverage
offer acupuncture demonstrations and treatments at various sculpture sites during the installation
City planners hope this instillation will stimulate public discourse about the Portland Plan, a guide for the city’s growth over the next 25 years. The Portland Plan ( HYPERLINK "http://www.portlandonline.com/portlandplan" www.portlandonline.com/portlandplan) examines the challenges we face around education, affordable housing, livability, and environmental sustainability and sets lofty goals to ensure that all these issues are addressed in future planning. The needles will be placed in areas that bring attention to the some of the city's most challenging problems, greatest assets, and enormous potential.
The first 5 needles, made out of super strong, high-tensile steel that is still light enough to be lifted manually, will be placed along the Willamette and the Columbia Rivers. The initial instillations draw attention to these ancient waterways as the reason for Portland's existence, while also pointing to specific challenges and opportunities they are facing today. You can learn more about the artist, the project and the location of all the needle installations at http://acuportland.org/.
Friday, March 5, 2010
A recent article in Lancet, a leading medical journal out of England, cites a spike in cesarean sections (c-section) over the last decade. The greatest rise was seen in China, where this surgery was performed in 46% of all deliveries. In Chinese culture, this spike is tied to an increase in wealth, a perception of modernity, and even a desire to have your child born on a “lucky” birthday. However, this rise in c-sections can be seen across the entire globe and over every socioeconomic class. Even in the United States the rate of c-sections has risen from 4.5% back in 1965 to 33% in 2007.
There are many reasons why this rise is happening. Research suggests that the natural contractions of the uterus are disrupted by the continual electronic monitoring of the baby as well as by the administration of epidurals early in the delivery. Women are rarely being advised of all their birthing options, perhaps because as medicine becomes more advanced a more casual attitude towards major surgeries is taking hold. It is easier to “go in” and get the baby then invest the time and energy in having a doula or other trained professional present to assist in a natural birth. One is also left to wonder whether insurance compensation practices pressure doctors to deliver in an efficient manner, as a long, drawn out delivery is still reimbursed as just “a delivery”.
It is important to realize that c-sections pose a great deal of risk to both the mother and the child. Mothers will have uterine scarring after the c-section that increases the future chances of infertility, ectopic pregnancies and placenta previa, a condition where the placenta develops across the cervix, increasing the risk of miscarriage. A higher rate of unexplainable fetal demise happens after week 34, late in the 3rd trimester, in women who have scarred uteruses. And the one proposed benefit of a c-section, protecting the pelvic floor and reducing future incontinence, seems over emphasized. Minimal differences exist 6 months postpartum and by age 50 no noticeable difference in the strength and function of the pelvic floor is detectable. Furthermore, this concern can be offset by regularly practicing simple pelvic floor exercises.
Babies, too, are put at risk when a c-section is performed. A recent study has shown that the normal infant mortality rate in the United States, 0.62 deaths per 1000 vaginal births, jumps 3 fold to 1.77 deaths per 1000 when a c-section is performed. While this is still considerably low, it is cause for concern. These deaths can be the result of something as simple as being cut during the procedure or as complicated as developing dyspnea, a breathing disorder, after they are born. Dyspnea can develop in weaker children who are unable to clear out the amniotic fluid in their lungs that would normally be pushed out by the natural physical compression of the lungs during vaginal birth. Children delivered via c-section have high levels of pain medicines in their systems, leaving them sleepy and uninterested in breastfeeding. These children often lose interest in breast-feeding and again if already weakened, can fail to thrive.
Cesarean sections are one example of the great strides modern medicine has made to save lives and avert emergencies. However, this is a major surgery that does come with serious risks, and anyone planning a family should evaluate the pros and cons prior to their delivery date.
Thursday, January 14, 2010
Spending on health care slowed in 2008, according to a government report released Tuesday. In fact, health spending grew more slowly than at any time in at least a half-century.
However, the annual health spending statistics published by the Department of Health and Human Services are a classic case of good news and bad news.
The good news: Health spending slowed down. Way down, said Anne Martin, one of the authors of the study published in the current issue of the policy journal Health Affairs.
"National health spending growth slowed in 2008 to 4.4 percent, the slowest rate of growth in the National Health Expenditure Accounts."
In other words, the slowest growth since the government has kept records.
The bad news: Health care still totaled $2.3 trillion in 2008. That's more than $7,600 per man, woman and child. Plus it still grew faster than the rest of the economy.
There's still more bad news, says Rick Foster, the chief actuary at HHS. A major reason health spending slowed is that with the bad economy, many people simply couldn't afford medical care.
"In many cases they lost their employee-sponsored health benefits at the same time they lost their jobs. So that meant that the cost of care was much much higher because they had to pay it out of pocket. So some people presumably scaled back on their purchases."
Analysts say that given the depth of the recession, the problems with health spending probably didn't get any better in 2009.