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The Morning Report provides a quick look at today’s medical news, research and features.  









Should docs make end-of-life decisions for patients?
The good news is that we are living longer.  The bad news is that the longer we live, the more likely it is that we will encounter significant health problems and develop an impaired decision-making capacity to make our own medical decisions. What happens if we survive our spouse, our children, or are otherwise estranged from family who may be able to make medical decisions for us?
As the number of incapacitated people increases, professional guardians are becoming more common.  These surrogate decision makers are appointed by a judge and often have no preexisting relationship with the patient. But the relationship may not always work out well for the patient.  Guardians are often reluctant to limit the level of medical care and choose the safer path of aggressive care rather than become involved with potential legal issues involved with end-of-life care.
Researchers suggest in the current issue of JAMA: Internal Medicine that while doctors may be able to help, they are also placed in a difficult position. Physicians are in a unique position to assist guardians with these difficult decisions and to collaborate with them to protect the rights and dignity of the vulnerable persons whom guardians represent,” according to the authors, led by Andrew B. Cohen, MD of the Yale School of Medicine. “However, physicians are often uncertain about whether guardians are empowered to withhold treatment and when their decisions require judicial review.”

Music therapy may help people with epilepsy
Music therapy might someday help people with epilepsy, a new study suggests. About 80 percent of epilepsy patients have temporal lobe epilepsy, in which seizures originate in the temporal lobe of the brain. Music is processed in the auditory cortex, located in the same region of the brain, which is why researchers from Ohio State University’s Wexner Medical Center wanted to study the connection.
The study authors said that the brains of epilepsy patients appear to react to music differently from the brains of people without the disorder. “We believe that music could potentially be used as an intervention to help people with epilepsy,” Christine Charyton, adjunct assistant professor and visiting assistant professor of neurology, said in an American Psychological Association (APA) news release. Charyton plans to present the research Sunday at the APA’s annual meeting in Toronto.
The researchers looked at how different types of music and silence were processed in the brains of 21 people with epilepsy. Whether listening to classical music or jazz, all of the participants had much higher levels of brain wave activity when listening to music, the study found.

Difficult for women in combat zones to get contraceptives
Next year, the military will officially lift restrictions on women in combat, the end of a process that may open up as many as 245,000 jobs that have been off limits to women. But women who deploy overseas may continue to face obstacles in another area that can have a critical impact on their military experience: contraception.
It’s not a minor issue. Rates of unintended pregnancy among women in the military are 50 percent higher than those of women in the general population. And because of strict federal rules, their insurance does not generally cover abortion.
Tricare, the health care plan for more than 9 million active and retired members of the military, covers most contraceptive methods approved by the FDA. Active-duty service members pay nothing out of pocket. Spouses and dependents of service members may face copayments in some instances. But all methods aren’t necessarily available at every military hospital and clinic, and overseas, for example, women may have difficulty getting refills of their specific type of birth control pill.
In a 2013 study, based on more than 28,000 responses to the 2008 Department of Defense health-related behaviors survey, researchers found that after adjusting for the larger concentration of young women in the military, the rate of unintended pregnancy among military women was 7.8 percent, compared with 5.2 percent among women in the general population.

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