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New Services Available through Local Libraries

Jefferson County Library and Port Townsend Public Libraries now offer three new and exciting free technological services: Microsoft IT Academy, the Library Now for Washington mobile app, and Kit Keeper – a software system allowing book clubs to reserve up to ten copies of the same book 12 months in advance.

“Libraries are no longer simply a collection of books in a physical space the customer must visit. Today we offer a myriad of services all centered on our core mission – free access to ideas and information for all people,” said Jefferson County Library director, Meredith Wagner at a recent public event. Whether you wish to become certified as a Microsoft Office Specialist to set you apart in the job market or reserve up to ten copies of the same book for your book club, new services are available through your library digitally, and most of these new services are free for library card holders.

Through partnership with Microsoft, the Washington State Library, a division of the Office of the Secretary of State, received funding from the legislature to offer the Microsoft IT Academy to libraries at no cost through June of 2015. Funds from the legislature pay for the non-discounted portion and Microsoft has discounted the remaining cost of these courses by approximately 90 percent Funding from the legislature will also cover the cost for the Washington State Library to partner with both Microsoft and the libraries in the project. The Washington Microsoft IT Academy will provide the people of Washington access without charge to a wide range of Microsoft online courses and learning resources through local public libraries.

The IT Academy offers three levels of technology courses: Basic digital literacy proficiencies, Microsoft Office training, and advanced skills for IT professionals. Participants can achieve certification following successful completion of a series of courses by testing at certification centers, or they may choose to complete selected courses without certification. The online courses are free to all library card holders – certification upon completion requires a fee. Training courses include the full range of Microsoft Office 2010 and 2013 products such as Word, Excel and PowerPoint, and also provide free training to prepare for a career in information technology through the Microsoft Technology Associate certification.

More detailed information on Microsoft IT Academy is available on the website for either library, or you can come to the front desk in Port Townsend or Port Hadlock to find out more about how to register for courses.

Jefferson County Library and Port Townsend Public Library have also both launched Library Now, a mobile app to put your library at your fingertips. From any mobile phone or tablet connected to the internet you can instantly reserve books, search the library catalog, check your account, and renew books. Funding for the Library Now app was provided by the Paul G. Allen Family Foundation, the Institute of Museum and Library Services, and the Washington State Library. For more information about Library Now visit sos.wa.gov/q/LibraryNow or contact either library directly.

Another new library service is for book clubs. Through new software called Kit Keeper, prepared book club kits containing ten copies of the same title can be reserved online by a book club representative with a valid library card up to 12 months in advance on either library’s website. Book club kits come in a plastic tote and are checked out for up to eight weeks, allowing plenty of time for books to be distributed and read by book club members.

For more information about these new services, visit www.jclibrary.info or call 360.385.6544 to reach Jefferson County Library, or www.ptpubliclibrary.org or 360.385.3181 to reach Port Townsend Public Library. Jefferson County Library is located at 620 Cedar Avenue in Port Hadlock, and Port Townsend Public Library is temporarily located at Mt. View Commons, 1925 Blaine Street in Port Townsend.

 

Growing Old with More and More People

The August 2014 issue of Voice contained a short article on “Demographics: U.S. State., County and Port Ludlow. I’d like to offer a different take on the information presented.

The article linked falling birth rates in most countries to a slowing population growth that might be detrimental to us seniors. That is, where will the nation get enough young people to support us old folks as health care and living costs mount, perhaps putting us in jeopardy of running out of money before we die? The article also implies that we are beginning to lick the global overpopulation problem with reduced birthrates. Let’s tackle the latter first as birth rates and immigration ultimately determine the size of the “65 year old plus” cohort.

In the article it said, “It (the world’s population) will not double even once in the current century, after having doubled twice in the last one.” This may give the impression that our growth is materially slowing. Not so, according to the UN Probabilistic Population Projections-2012 Revisions report. Yes indeed, many richer countries particularly those in Europe and Japan are experiencing lower birth rates and some developing countries with historically higher rates are seeing them ease some, but unfortunately not enough to blunt population momentum, which take decades to overcome. Demographers are also concerned that the giants in in Asia, namely China and India, are tending to reverse course, as growing prosperity in the middle class makes bigger families more affordable.

Here’s how the United Nations looks at the big picture: “Based on 1950-2010 demographic trends, there is an 80% probability that the world population will increase by 2.3 to 3.0 billion people between 2010-2050, and 0.6 to 2.6 extra billion in the second half of this century, leading to a world population in 2100 between 9.7 and 12.5 billion.” In that same report, a high-end projection of 16 billion (more than doubling our current estimate of nearly 7.3 billion people) is forecasted for century’s end with an unrealistic low-end projection of 6.5 billion. The most likely scenario appears to be a middle of the road 12.5 billion people by 2100.

With world-wide population pressures causing foreign turmoil, you can count on greater domestic advocacy to take in more war-torn immigrants; on the back of a million already legally admitted each year. Couple that with the prospect of a resurgent birth rate, what to do about the geriatric set may take a big back seat. While the recent Great Recession put a small dent in births with a dip below the replacement level of 2.1 births per 1000 residents, anecdotal information suggests a bounce back is occurring, as the economy picks up and Obamacare kicks in.

In 2009 U.S Census Bureau made a conservative forecast of slightly fewer than 400 million by 2050, which suggests our present estimated population of 318 million is right on track to reach that number, if not exceed it. Think about it: in less than forty years, America will add more people than currently living in the states of California, Texas, and New York combined.

Washington State’s Office of Financial Management estimates our state’s population to be nearly seven million with a forecast of roughly 8.8 million by 2040…with a growth rate continuing to be higher than the national average. In other words both our nation and state will continue to produce plenty of youngsters. That’s the good news, but the bad news is that Mother’s Nature is beginning to show the wear and tear of sustaining us.

As a result, water scarcity is becoming an alarming reality. For example, with each year that ticks by both the Columbia and Colorado River basins ground water levels are declining, putting future food production   in question. As we all know, many crops in California are in peril from three years of drought, the most serious in recorded history, with no optimistic weather forecasts. Already some food prices are beginning to re-inflate as shortages grow.

Just recently NASA released a study on ground water levels and officials found the losses “shocking.” Since 2004, researchers reported, “the Colorado River basin — the largest in the Southwest — has lost 53 million acre feet, or 17 trillion gallons, of water. That’s enough to supply more than 50 million households for a year, or nearly fill Lake Mead — the nation’s largest water reservoir — twice.” Remember this basin serves seven states as well as parts of Mexico and it takes decades for these deep-down aquifers to recharge from trickle down surface waters even with plentiful rains and flooding. All of this portends a new era of climate change attributed to human activity with an emerging clarity of the socio-economic consequences.

For now, it appears likely that government support of seniors will become a bigger economic and political struggle, as our numbers balloon from aging baby-boomers. With no let-up in lengthening longevity, the cost of our cohort will weigh much heavier on society than previously imagined. In my opinion, both the federal and state government will look for convenient exits, as they strategically shift tax dollars to prop-up a growing under-class of low skilled workers who are mired in low-wage jobs and poverty. Bottom line-what we (the 65year olds plus) have enjoyed in government benefits will slowly become a thing of the past.

It’s clear that America has a serious population growth problem, exacerbating another emerging dilemma of depleting natural resources in an era of climate change that technology alone can’t solve. Yes, there are effective common sense fixes, such as free family planning services and significantly lower immigration quotas, but they are locked up in a paralyzing social debate. The hang-up has been decades of public controversy over contraception, abortion and immigration fueled by intractable religious and political differences. Not to mention a Congress and Administration that wants more not less people for supposed economic benefit. As a result, futurists predict life in America will be “urban, dense and crowded.” And this may be coming to a neighborhood near you.

On a brighter note there will be plenty of well-off seniors from the hot and parched southwest wanting to relocate in cool, verdant Jefferson County, making it easier to sell our homes when the need arises, assuming of course no Great Recessions. Also, chances are good that we won’t have to worry about the enjoyment of grandchildren…they too will be ample.

W.J. Van Ry

For a more expansive discussion about America’s “Too Many People Problem”, go to www.elbowroomusa.org  and select Topics; “Population Primer”.
(posted 8/11/2014)

Know the Facts: Mammograms Do Save Lives

by Manfred Henne, MD, PhD, MS

A recent study by Canadian researchers published on February 11, 2014 in the British Medical Journal states that annual mammogram screening does not reduce breast cancer deaths.  The study also states that annual mammograms may lead to over-diagnosis or that cancers that were found may not have been life-threatening. This study has created great confusion for women and frustration for the medical community. 

The American Cancer Society’s website reports that this data differs from approximately a dozen other clinical trials that breast cancer screening experts use to make decisions about screening guidelines. These findings also differ from the consensus of most experts, including the U.S. Preventive Services Task Force, which has estimated that breast cancer screening reduces the relative risk of death by about 15 percent in women ages 40-59. 

The Canadian National Breast Screening Study followed 89,835 women for 25 years. The women were randomly assigned to the mammogram group or the control group. Those in the mammogram group had a mammogram every year for five years, while those in the control group were not screened. Women ages 40-49 in the mammogram group and women ages 50-59 in both groups also received annual clinical breast exams. Women ages 40-49 in the control group received one clinical breast exam, and typical care from their family doctor. After five years, women in the study received usual care by their regular doctors, which could include mammograms at their doctor’s direction.

The Canadian study findings show that during the screening period, a total of 666 cancers were found in the mammogram group versus 524 found in the control group. Most (484), but not all, of the cancers found in the mammogram group were found by the screening. Overall during the 25-year study period, about the same number of women, 3,250 in the mammogram group and 3,133 in the control group, were diagnosed with breast cancer. About the same number in each group, 500 in the mammogram group and 505 in the control group, died of breast cancer. Because more cancers were diagnosed by mammogram, but essentially the same number of women died of breast cancer, the study authors concluded that there had been over-diagnosis. They found that 22 percent of breast cancer cases detected through screening were over-diagnosed. They conclude that recommendations for annual breast cancer screening through mammograms be re-evaluated.

The Canadian study is only one study. Although this study did not find an advantage for mammogram screening, a number of other studies have. Experts in the field, including those at the American Cancer Society, say the findings of this study may be due to differences in the quality of the mammograms themselves, or problems with the study design. For instance, although mammograms are meant to find cancers that are too small to be felt, 68 percent of the cancers found in the mammogram group were big enough to be felt. The study design also may have influenced the results, as women who had signs and symptoms of breast cancer (such as a breast lump) were still allowed in the study mammogram group, even though screening is only meant to be used in women who don’t have signs or symptoms of the disease. Breast cancer diagnosed based on symptoms is likely to be at a more advanced stage and have worse survival than cancers found only with mammogram screening. In the study, the mammogram group included more women with symptoms of breast cancer than the control group; therefore, the study was less likely to show an advantage of mammograms.

It should also be noted that this study was initiated in 1980. At that point in time mammography equipment was relatively new. Technical advances have made great strides and the use of 3D mammography has made it possible to find cancers at very early stages when treatment options and outcomes are optimal. Two recent studies published in 2013 show that 3D mammography is 40-50 percent more accurate in finding invasive breast cancer. 

As a radiologist I receive notes from female patients on a regular basis thanking us for finding their cancer and saving their lives.  At InHealth Imaging we perform Low Radiation 3D Mammography on every patient because we believe it is the right thing to do.  We also provide results to each patient before they leave our office.  We also stress to patients that the risk of breast cancer goes up with age. That is why it is important to have an annual mammogram for comparison. The question I like to pose is this: if it is you, or someone you love, doesn’t it make sense to take a 20-minute exam, which is covered by insurance, once a year that really can save your life or their life?

The American Cancer Society continues to recommend that women age 40 and older should have a mammogram and clinical breast exam every year and should continue to do so for as long as they are in good health. The Society’s 12-person panel of experts regularly reviews all the scientific data on mammograms. Otis Brawley, MD, MPH, Chief Medical Officer of the American Cancer Society, has also said the Canadian study is one piece of information in a large volume of evidence that adds to the body of knowledge about breast cancer screening. For now, he said this new study will not change any of the American Cancer Society recommendations.

For additional information on the study or InHealth Imaging contact Dr. Henne at mhenne@inhealthimaging.com or 360/598-3141.