Dean of the Johns Hopkins University Public Health School, Dr. Michael J. Klag, ordered the school’s federally-funded online database of reproductive health literature reprogrammed to restore the word 'abortion' as a search term. Administrators had set POPLINE, the world’s largest database on reproductive health, with more than 360,000 records and articles on family planning, fertility and sexually transmitted diseases, to ignore abortion as a search term.
The move to censor abortion-related materials was met with harsh criticism from libraries trying to access the articles and women’s health advocates, according to UPI. POPLINE representatives said that the decision to do so was tied to their funding from the US Agency for International Development (USAID).
April 8, 2008
One in 4 Teen Girls Has a Sexually Transmitted Disease
More than 3 million teenaged girls have at least one sexually transmitted disease (STD), a new government study suggests. The most severely affected are African-American teens. In fact, 48 percent of African-American teenaged girls have an STD, compared with 20 percent of white teenaged girls. "What we found is alarming," Dr. Sara Forhan, from the U.S. Centers for Disease Control and Prevention, said during a teleconference Tuesday. "One in four female adolescents in the U.S. has at least one of the four most common STDs that affects women." "These numbers translate into 3.2 million young women nationwide who are infected with an STD," Forhan said. "This means that far too many young women are at risk of the serious health effects of untreated STDs, including infertility and cervical cancer."
March 31, 2008
Home bipolar disorder test causes stirs
Dr. John Kelsoe has spent his career trying to identify the biological roots of bipolar disorder. In December, he announced he had discovered several gene mutations closely tied to the disease, also known as manic depression. Then Kelsoe, a prominent psychiatric geneticist at the University of California, San Diego, did something provocative for the buttoned-down world of academic medical research: He began selling bipolar genetic tests straight to the public over the Internet last month for $399. His company, La Jolla-based Psynomics, joins a legion of startups racing to exploit the boom in research connecting genetic variations to a host of health conditions. More than 1,000 at-home gene tests have burst onto the market in the past few years. The proliferation of these tests troubles many public health officials, medical ethicists and doctors. The tests receive almost no government oversight, even though many of them are being sold as tools for making serious medical decisions. Health experts worry that many of these products are built on thin data and are preying on individuals' deepest anxieties.
Are you addicted to the Internet?
Excessive gaming, viewing online pornography, emailing and text messaging have been identified as causes of a compulsive-impulsive disorder by Dr Jerald Block, author of an editorial for the respected American Journal of Psychiatry. Block argues that the disorder is now so common that it merits inclusion in the Diagnostic and Statistical Manual of Mental Disorders, the profession's primary resource to categorise and diagnose mental illnesses. He says internet addiction has four main components:
· Excessive use, often associated with a loss of sense of time or a neglect of basic drives;
· Withdrawal, including feelings of anger, tension and/or depression when the computer is inaccessible;
· The need for better computers, more software, or more hours of use;
· Negative repercussions, including arguments, lying, poor achievement, social isolation and fatigue.
· Excessive use, often associated with a loss of sense of time or a neglect of basic drives;
· Withdrawal, including feelings of anger, tension and/or depression when the computer is inaccessible;
· The need for better computers, more software, or more hours of use;
· Negative repercussions, including arguments, lying, poor achievement, social isolation and fatigue.
Culture gap
Among newcomers to this nation - one in eight Americans is now foreign-born - mental illness can be an alien, stigmatizing term, and many immigrants from Latin America, Africa, and Asia are far more likely to talk initially about physical ailments than seek psychiatric services.
Over the past several years, top mental health specialists have begun a number of new initiatives to improve psychiatric care for immigrants. The Massachusetts Department of Mental Health, along with a team of researchers, are educating primary care doctors around the state about what physical symptoms might be signs of mental disorders.
Over the past several years, top mental health specialists have begun a number of new initiatives to improve psychiatric care for immigrants. The Massachusetts Department of Mental Health, along with a team of researchers, are educating primary care doctors around the state about what physical symptoms might be signs of mental disorders.
Gap in Life Expectancy Widens for the Nation
New government research has found “large and growing” disparities in life expectancy for richer and poorer Americans, paralleling the growth of income inequality in the last two decades.
Life expectancy for the nation as a whole has increased, the researchers said, but affluent people have experienced greater gains, and this, in turn, has caused a widening gap. One of the researchers, Gopal K. Singh, a demographer at the Department of Health and Human Services, said “the growing inequalities in life expectancy” mirrored trends in infant mortality and in death from heart disease and certain cancers.
Life expectancy for the nation as a whole has increased, the researchers said, but affluent people have experienced greater gains, and this, in turn, has caused a widening gap. One of the researchers, Gopal K. Singh, a demographer at the Department of Health and Human Services, said “the growing inequalities in life expectancy” mirrored trends in infant mortality and in death from heart disease and certain cancers.
Rising Health Costs Cut Into Wages
Recent history has not been kind to working-class Americans, who were down on the economy long before the word recession was uttered. The main reason: spiraling health-care costs have been whacking away at their wages. Even though workers are producing more, inflation-adjusted median family income has dipped 2.6 percent -- or nearly $1,000 annually since 2000.
Employees and employers are getting squeezed by the price of health care. The struggle to control health costs is viewed as crucial to improving wages and living standards for working Americans. Employers are paying more for health care and other benefits, leaving less money for pay increases. Benefits now devour 30.2 percent of employers' compensation costs, with the remaining money going to wages, the Labor Department reported this month. That is up from 27.4 percent in 2000.
Employees and employers are getting squeezed by the price of health care. The struggle to control health costs is viewed as crucial to improving wages and living standards for working Americans. Employers are paying more for health care and other benefits, leaving less money for pay increases. Benefits now devour 30.2 percent of employers' compensation costs, with the remaining money going to wages, the Labor Department reported this month. That is up from 27.4 percent in 2000.
The Myth of ‘Best In The World’
In international comparisons of health care, the infant mortality rate is a crucial indicator of a nation's standing, and the United States' position at No. 28, with seven per 1,000 live births—worse than Portugal, Greece, the Czech Republic, Northern Ireland and 23 other nations not exactly known for cutting-edge medical science—is a tragedy and an embarrassment. Much of the blame for this abysmal showing, however, goes to socioeconomic factors: poor, uninsured women failing to get prenatal care or engaging in behaviors (smoking, using illegal drugs, becoming pregnant as a teen) that put fetuses' and babies' lives at risk. You can look at 28th place and say, yes, it's terrible, but it doesn't apply to my part of the health-care system—the one for the non-poor insured.
McCain's stand on tobacco is put to test
Ten years ago, Senator John McCain took on the tobacco industry, saying he would never back down from legislation to regulate the industry. He also supported a $1.10-per-pack tax on cigarettes to fund programs to cut underage smoking. "I still regret we did not succeed," he said as recently as last October. Now, McCain's longtime effort to crack down on tobacco is being put to a new test. Within weeks, the Senate is expected to vote on legislation to allow the Food and Drug Administration to regulate tobacco. McCain agreed months ago to cosponsor the current bill with Senator Edward M. Kennedy, but McCain's policy adviser said the senator won't commit to voting for it until he sees the final legislation. McCain has also dropped his support for increasing cigarette taxes. Last year, McCain voted against legislation that would have used a 61-cents-per-pack tax to expand a children's health program. He told a television reporter earlier this year that he would have a "no new taxes" policy as president.
Clinton Details Premium Cap in Health Plan
Senator Hillary Rodham Clinton said in an interview on Wednesday that if elected president she would push for a universal health care plan that would limit what Americans pay for health insurance to no more than 10 percent of their income, a significant reduction for some families.
In an extensive interview on health policy, Mrs. Clinton said she would like to cap health insurance premiums at 5 percent to 10 percent of income. The average cost of a family policy bought by an individual in 2006 and 2007 was $5,799, or 10 percent of the median family income of $58,526, according to America’s Health Insurance Plans, a trade group. Some policies cost up to $9,201, or 16 percent of median income. The average out-of-pocket cost for workers who buy family policies through their employers is lower, $3,281, or 6 percent of median income, according to the Kaiser Family Foundation, a health research group.
In an extensive interview on health policy, Mrs. Clinton said she would like to cap health insurance premiums at 5 percent to 10 percent of income. The average cost of a family policy bought by an individual in 2006 and 2007 was $5,799, or 10 percent of the median family income of $58,526, according to America’s Health Insurance Plans, a trade group. Some policies cost up to $9,201, or 16 percent of median income. The average out-of-pocket cost for workers who buy family policies through their employers is lower, $3,281, or 6 percent of median income, according to the Kaiser Family Foundation, a health research group.
Women and Alcohol
Having more than one alcoholic drink per day increases a woman's chances for high blood pressure, stroke, some types of cancer, injury (e.g., motor vehicle crashes, violence), and suicide. Alcohol use, especially binge drinking (four or more drinks in about two hours), might also lead to an unplanned pregnancy, a sexually transmitted infection, or sexual assault. Some people, including pregnant women and women who might become pregnant, should not drink alcohol at all. Drinking alcohol during pregnancy is one of the top preventable causes of birth defects and developmental disabilities, known as fetal alcohol spectrum disorders (FASDs).
March 30, 2008
The Murky Politics of Mind-Body
Now a critical moment has been reached in a 15-year debate in statehouses and in Congress over whether treatment for problems like depression, addiction and schizophrenia should get the same coverage by insurance companies as, say, diabetes, heart disease and cancer.This month, the House passed a bill that would require insurance companies to provide mental health insurance parity. It was the first time it has approved a proposal so substantial.The bill would ban insurance companies from setting lower limits on treatment for mental health problems than on treatment for physical problems, including doctor visits and hospital stays. It would also disallow higher co-payments. The insurance industry is up in arms, as are others who envision sharply higher premiums and a free-for-all over claims for coverage of things like jet lag and caffeine addiction. Parity raises all sorts of tricky questions. Is an ailment a legitimate disease if you can’t test for it? A culture tells the doctor the patient has strep throat. But if a patient says, ‘‘Doctor, I feel hopeless,’’ is that enough to justify a diagnosis of depression and health benefits to pay for treatment? How many therapy sessions are enough? If mental illness never ends, which is typically the case, how do you set a standard for coverage equal to that for physical ailments, many of which do end?
March 24, 2008
Unequal Perspectives on Racial Equality
Social psychologists Philip Mazzocco and Mahzarin Banaji once asked white volunteers how much money would cover the "costs" of being born black instead of white. The volunteers guessed that about $5,000 ought to cover the lifetime disadvantages of being an average black person rather than an average white person, in the United States. By contrast, when asked how much they wanted to go without television, the volunteers demanded a million dollars.
Mazzocco and Banaji were taken aback: The average black person in America is 447 percent more likely to be imprisoned than the average white person, and 521 percent more likely to be murdered. Blacks earn 60 cents to the dollar compared with whites who have the same education levels and marital status. The black poverty rate is nearly twice the white poverty rate. Blacks tend to die five years earlier than whites; the infant mortality rate among black babies is nearly 1 1/2 times the rate among white babies. And because of long-standing patterns of inheritance, blacks and whites begin life with substantial disparities in family wealth.
March 20, 2008
Should Pharmacists be Required to Fill Prescriptions for Emergency Contraception?
Pharmacists asked the Illinois Supreme Court Tuesday to overturn a rule forcing them to dispense emergency contraception over their religious convictions. Gov. Rod Blagojevich's three-year-old edict requires pharmacists to fill orders for the so-called "morning-after pill." Taken within days of having sex, the pill can interfere with conception, which some pharmacists argue is the equivalent of abortion. . . . When Blagojevich introduced the rule, he said pharmacists had an obligation to fill all prescriptions despite any personal qualms. Someone in need of emergency contraception should always be able to get it, "No delays. No hassles. No lectures," he said then.
Jail 'not the solution' to drug crime
Convicted drug users should not be sent to prison because it does more harm than good, a report from the influential UK Drug Policy Commission will say tomorrow. Up to 65,000 prisoners in England and Wales are thought to be problem drug users and, of these, two-thirds are convicted of less serious crimes such as shoplifting and burglary. The commission believes these offenders should not be jailed. Although the report accepts that almost a third of heroin and crack users arrested admit to committing an average of one crime a day, it says that community treatment programmes would be more effective than prison.
Should High Risk Children Be Red Tagged?
Primary school children should be eligible for the DNA database if they exhibit behaviour indicating they may become criminals in later life, according to Britain's most senior police forensics expert. Gary Pugh, director of forensic sciences at Scotland Yard and the new DNA spokesman for the Association of Chief Police Officers (Acpo), said a debate was needed on how far Britain should go in identifying potential offenders, given that some experts believe it is possible to identify future offending traits in children as young as five. 'If we have a primary means of identifying people before they offend, then in the long-term the benefits of targeting younger people are extremely large,' said Pugh. 'You could argue the younger the better. Criminologists say some people will grow out of crime; others won't. We have to find who are possibly going to be the biggest threat to society.' Pugh admitted that the deeply controversial suggestion raised issues of parental consent, potential stigmatisation and the role of teachers in identifying future offenders, but said society needed an open, mature discussion on how best to tackle crime before it took place
How much sexual innuendo can an advertiser pack into 15 seconds?
Pfizer has always straddled a line marketing Viagra, insisting that the drug treats a serious medical condition, impotence, and deserves insurance coverage, while promoting the drug with wink-and-a-nod ads that have irritated regulators. In 2004, the Food and Drug Administration told the company to stop running ads that included the lines, “Remember that guy who used to be called ‘Wild Thing’? The guy who wanted to spend the entire honeymoon indoors?”
The ads come as Viagra is losing market share to other impotence drugs. Last year, Pfizer’s Viagra sales totaled $1.7 billion, including $800 million in the United States.
The ads come as Viagra is losing market share to other impotence drugs. Last year, Pfizer’s Viagra sales totaled $1.7 billion, including $800 million in the United States.
The Case for Another Drug War, Against Pharmaceutical Marketers’ Dirty Tactics
Our Daily Meds begins by illustrating the established drug-company practices that have led to this sorry juncture. There is the rigging of studies, so that to be deemed “effective” a drug need only perform better than a sugar pill. There are the promotional strategies that evade the need for F.D.A. warnings by, say, planting logos for the sexual enhancement drug Viagra and the antidepressant Wellbutrin on Nascar vehicles. There is the co-option of doctors and university researchers by aggressive, payola-dispensing drug company representatives. . . . But she moves to weightier matters in assessing the directions in which heavy drug dependence is leading Americans. First of all there are the business strategies that have created illnesses out of what used to be facts of life, labeled them as syndromes, and have hooked customers into long-term use of medication to cure them. . . . Second, there are the economics of creating chronic consumers for marginally necessary drugs. . . . Irate as she is that in a period (1980-2003) when Americans doubled what they spent on cars they increased their spending on prescription drugs by 17 times, Ms. Petersen steps back to consider the long-term consequences of this shift in consumption. She notes that the first generation of children raised in front of ubiquitous, sunny drug-company advertisements (which became legal in 1997) has acquired the notions that prescription pills fix everything, and that they are less dangerous than street drugs. Then, looking to the elderly, she points out that increasing numbers of drugs are accumulating in these patients, with little regard for the consequences.
Cutting Dosage of Costly Drug Spurs a Debate
When a drug can cost more than $300,000 a year, the right dose becomes a matter of public debate. The drug in question, Cerezyme, is used to treat a rare inherited enzyme deficiency called Gaucher disease. Some experts say that for most patients, as little as one-fourth the standard top dose would work, saving the health care system more than $200,000 a year per Gaucher patient. “It is economic malpractice to give a much higher dose of an expensive drug than is required,” said Dr. Ernest Beutler, an authority on Gaucher disease at the Scripps Research Institute. Some other Gaucher specialists argue otherwise, saying that skimping on the medicine could endanger patients. . . . [C]ritics say the company’s development costs were minimal, because the early work on the treatment was done by the National Institutes of Health, which gave Genzyme a contract to manufacture it. And analysts estimate the current cost of manufacturing the drug to be only about 10 percent of its price.
Student Stress and Suicide in India
In 2006, 5,857 students — or 16 a day — committed suicide across India due to exam stress. And these are just the official figures. Shimla superintendent of police (crime), Punita Bhardwaj, said incidents of children committing suicide because of examination stress often did not get reported as traumatized parents wanted to keep the issue under wraps.
Genes and Post-Traumatic Stress
Why is it that when a group of soldiers share a horrific battle experience, some are able to work through it and get on with their lives while others suffer the persistent anxiety, emotional numbness and bomb-blasted nightmares of post-traumatic stress disorder (PTSD)? The answer, researchers have long believed, is that an individual's response to trauma — whether in battle, or as result of a natural disaster, a violent crime or some other horror — depends not only on the intensity of that trauma but also on a complex interplay of past experiences and genetic factors. A new paper, published in the current issue of the Journal of the American Medical Association, provides remarkable support for this explanation and identifies a specific gene that influences susceptibility to PTSD.
March 16, 2008
Op-Ed on Hunger by Secretary General of the United Nations
The price of food is soaring. The threat of hunger and malnutrition is growing. Millions of the world's most vulnerable people are at risk. An effective and urgent response is needed.
The first of the Millennium Development Goals, set by world leaders at the U.N. summit in 2000, aims to reduce the proportion of hungry people by half by 2015. This was already a major challenge, not least in Africa, where many nations have fallen behind. But we are also facing a perfect storm of new challenges.
The first of the Millennium Development Goals, set by world leaders at the U.N. summit in 2000, aims to reduce the proportion of hungry people by half by 2015. This was already a major challenge, not least in Africa, where many nations have fallen behind. But we are also facing a perfect storm of new challenges.
Double jeopardy in Alzheimer's families
One parent with Alzheimer's disease is tough enough, but imagine the memory-robbing illness striking both parents - and knowing chances are high you'll get it, too. A study of more than 100 families for the first time gauges the size of that risk. . . . The study, appearing in March's Archives of Neurology, found more than 22 percent of the adult children of 111 couples with Alzheimer's had the disease themselves. Risk grew with age. Among offspring older than 60, more than 30 percent were affected. In those older than 70, nearly 42 percent had the disease.
Prior studies have found a 6 to 13 percent prevalence of the disease in the U.S. population older than 65.
Prior studies have found a 6 to 13 percent prevalence of the disease in the U.S. population older than 65.
Does Pornorgraphy Provide a Safe Outlet for Pedophiles?
Japan is to bow to international pressure and ban the possession of child pornography, although the new law is expected to anger child welfare groups by exempting manga comics and animated films. . . . Currently, Japan and Russia are the only G8 countries in which it is still legal to own pornographic images of children provided they do not intend to sell them or post them on the internet. . . . Sexually explicit comics account for a sizeable chunk of Japan's 500bn yen manga market. Many feature schoolgirls or childlike adults being raped or engaging in sadomasochism.
Manga belonging to the popular "lolicon" - Japanese slang for Lolita complex - genre are likely to escape the ban, as MPs are concerned that outlawing them could infringe on freedom of expression and drive men who use them as an outlet for their sexual urges to commit more serious offences.
Manga belonging to the popular "lolicon" - Japanese slang for Lolita complex - genre are likely to escape the ban, as MPs are concerned that outlawing them could infringe on freedom of expression and drive men who use them as an outlet for their sexual urges to commit more serious offences.
STDs and Abstinence Only Education
A disturbing national study released this week has found that one in four girls and young women is infected with at least one of four common sexually transmitted diseases. The statistics are even more staggering for African American teenagers ages 14 to 19 - nearly half had a sexually transmitted disease, compared with 20 percent for white teenagers. The numbers are another indication that the White House's insistence on reserving millions of sex-education dollars for abstinence-only programs isn't working.
Certainly, abstinence is the best way to avoid STDs, but many teenagers are making the decision to have sex, and they need to know there are other ways to reduce the danger of disease or pregnancy. One researcher called the new study, presented at a Centers for Disease Control and Prevention conference in Chicago, "alarming" and evidence that the infections are a major public health threat. The diseases monitored in the study were human papillomavirus (HPV), chlamydia, genital herpes and trichomoniasis, a common parasite. The first national study of these diseases found that 15 percent of the infected girls had more than one STD. The findings clearly show that America can no longer afford the Bush administration's $1 billion abstinence program. Too much is at stake.
Certainly, abstinence is the best way to avoid STDs, but many teenagers are making the decision to have sex, and they need to know there are other ways to reduce the danger of disease or pregnancy. One researcher called the new study, presented at a Centers for Disease Control and Prevention conference in Chicago, "alarming" and evidence that the infections are a major public health threat. The diseases monitored in the study were human papillomavirus (HPV), chlamydia, genital herpes and trichomoniasis, a common parasite. The first national study of these diseases found that 15 percent of the infected girls had more than one STD. The findings clearly show that America can no longer afford the Bush administration's $1 billion abstinence program. Too much is at stake.
As Population Grows Older, Geriatricians Grow Scarce
While the U.S. population age 55 and older is growing rapidly, according to a 2005 census report, the number of medical school grads going into geriatrics has been slow to keep up. According to one estimate, the nation's teaching hospitals are producing one or two geriatricians for every nine cardiologists or orthopedic surgeons.
Low reimbursements and the allure of higher-paying specialties have been largely responsible. Then, too, the prospect of working long hours treating severely ill patients in their homes or at a hospital or nursing facility can be a turnoff, some physicians say. "These are hard patients to treat because they're usually burdened with multiple complex disorders like Alzheimer's, dementia and congestive heart failure, and are often at the end of life," says Pittsburgh geriatrician Judith Black. Geriatrics isn't sexy, Black says, "but it can be extremely rewarding."
Low reimbursements and the allure of higher-paying specialties have been largely responsible. Then, too, the prospect of working long hours treating severely ill patients in their homes or at a hospital or nursing facility can be a turnoff, some physicians say. "These are hard patients to treat because they're usually burdened with multiple complex disorders like Alzheimer's, dementia and congestive heart failure, and are often at the end of life," says Pittsburgh geriatrician Judith Black. Geriatrics isn't sexy, Black says, "but it can be extremely rewarding."
March 15, 2008
Psychotherapy for All: An Experiment
The clinic is at the forefront of a program that has the potential to transform mental health treatment in the developing world. Instead of doctors, the program trains laypeople to identify and treat depression and anxiety and sends them to six community health clinics in Goa, in western India.
Researchers say that even in places with very poor people, the ailments require urgent attention. Severe depression can be as disabling as physical diseases like malaria, the researchers say, and can have serious economic effects. If a subsistence farmer is so depressed that he cannot get out of bed, neither he nor his children are likely to eat.
March 7, 2008
Will mandating the purchase of health insurance lead to universal coverage?
The biggest domestic-policy difference between Hillary Clinton and Barack Obama almost certainly concerns health care. Mrs Clinton proposes individual mandates, which would require people to buy health insurance. To help the poor afford it , she promises subsidies from the government.
Boosters of the individual-mandate approach, with which Massachusetts is now experimenting, hope that it would lower average costs by forcing the many young and healthy people now currently without coverage to buy a health plan. As Mrs Clinton pointed out this week, such people do get health care, but in the most expensive way—by turning up at emergency rooms uninsured.
Maybe not, if a report issued by the official Centres for Medicare and Medicaid on February 25th is to be believed. The government's actuaries calculate that even without any new universal-care scheme, spending on health care in America will reach nearly 20% of GDP by 2017, up from about 16% last year, with Medicare spending nearly doubling over that period.
Boosters of the individual-mandate approach, with which Massachusetts is now experimenting, hope that it would lower average costs by forcing the many young and healthy people now currently without coverage to buy a health plan. As Mrs Clinton pointed out this week, such people do get health care, but in the most expensive way—by turning up at emergency rooms uninsured.
Maybe not, if a report issued by the official Centres for Medicare and Medicaid on February 25th is to be believed. The government's actuaries calculate that even without any new universal-care scheme, spending on health care in America will reach nearly 20% of GDP by 2017, up from about 16% last year, with Medicare spending nearly doubling over that period.
About Those Health Care Plans by the Democrats
While Senators Hillary Rodham Clinton and Barack Obama fight over who has the better health plan for the uninsured, they say little about a more immediate challenge that will confront the next administration, whether Democratic or Republican: how to tame the soaring costs of Medicare and Medicaid. The two programs, for older Americans and low-income people, cost $627 billion last year and accounted for 23 percent of all federal spending. With no change in existing law, the Congressional Budget Office says, that cost will double in 10 years and the programs will account for more than 30 percent of the budget.
Into the Fray Over the Cause of Autism
“It’s indisputable that autism is on the rise among children,” Senator John McCain said while campaigning recently in Texas. “The question is, What’s causing it? And we go back and forth, and there’s strong evidence that indicates that it’s got to do with a preservative in vaccines.”
With that comment, Mr. McCain marked his entry into one of the most politicized scientific issues in a generation.
With that comment, Mr. McCain marked his entry into one of the most politicized scientific issues in a generation.
March 6, 2008
House Approves Bill on Mental Health Parity
| After more than a decade of struggle, the House on Wednesday passed a bill requiring most group health plans to provide more generous coverage for treatment of mental illnesses, comparable to what they provide for physical illnesses. The vote was 268 to 148, with 47 Republicans joining 221 Democrats in support of the measure. The Senate has passed a similar bill requiring equivalence, or parity, in coverage of mental and physical ailments. Federal law now allows insurers to discriminate, and most do so, by setting higher co-payments or stricter limits on mental health benefits. |
March 3, 2008
Issues for DSM-V: Internet Addiction
| Am J Psychiatry 165:306-307, March 2008 Editorial Issues for DSM-V: Internet AddictionJerald J. Block, M.D. Internet addiction appears to be a common disorder that merits inclusion in DSM-V. Conceptually, the diagnosis is a compulsive-impulsive spectrum disorder that involves online and/or offline computer usage (1, 2) and consists of at least three subtypes: excessive gaming, sexual preoccupations, and e-mail/text messaging (3). All of the variants share the following four components: 1) excessive use, often associated with a loss of sense of time or a neglect of basic drives, 2) withdrawal, including feelings of anger, tension, and/or depression when the computer is inaccessible, 3) tolerance, including the need for better computer equipment, more software, or more hours of use, and 4) negative repercussions, including arguments, lying, poor achievement, social isolation, and fatigue (3, 4). Some of the most interesting research on Internet addiction has been published in South Korea. After a series of 10 cardiopulmonary-related deaths in Internet cafés (5) and a game-related murder (6), South Korea considers Internet addiction one of its most serious public health issues (7). Using data from 2006, the South Korean government estimates that approximately 210,000 South Korean children (2.1%; ages 6–19) are afflicted and require treatment (5). About 80% of those needing treatment may need psychotropic medications, and perhaps 20% to 24% require hospitalization (7). . . . |
U.S. Imprisons One in 100 Adults, Report Finds
| For the first time in the nation’s history, more than one in 100 American adults are behind bars, according to a new report. Nationwide, the prison population grew by 25,000 last year, bringing it to almost 1.6 million, after three decades of growth that has seen the prison population nearly triple. Another 723,000 people are in local jails. The number of American adults is about 230 million, meaning that one in every 99.1 adults is behind bars. Incarceration rates are even higher for some groups. One in 36 adult Hispanic men is behind bars, based on Justice Department figures for 2006. One in 15 adult black men is, too, as is one in nine black men ages 20 to 34. |
February 28, 2008
Only Severely Depressed Benefit From Antidepressants
While popular antidepressants such as Prozac are widely prescribed for people with varying degrees of depression, the drugs are only effective for those with the most severe depression, a new study suggests. "Although patients get better when they take antidepressants, they also get better when they take a placebo, and the difference in improvement is not very great," lead researcher Irving Kirsch, a professor of psychology at the University of Hull in Great Britain, said in a prepared statement. "This means that depressed people can improve without chemical treatments," he added. . . . Based on these results, there appears to be little reason to prescribe these antidepressants to anyone but the most severely depressed patients, the study authors concluded.
(To read the actual article, go here.)
(To read the actual article, go here.)
What Addicts Need (Newsweek Article)
While the roots of addiction remain a dark tangle of factors—most experts agree that addicts trying to quit will always need psychological support—the old white-knuckle wisdom that addicts simply lack resolve passed out of fashion decades ago. The American Medical Association recognized addiction as a disease back in 1956. But only now are we beginning to see treatments that target the underlying biochemistry of that disease.
February 25, 2008
What is the cost of the war in Iraq? (The Times of London Editorial)
The Bush Administration was wrong about the benefits of the war and it was wrong about the costs of the war. The president and his advisers expected a quick, inexpensive conflict. Instead, we have a war that is costing more than anyone could have imagined.
The cost of direct US military operations -- not even including long-term costs such as taking care of wounded veterans -- already exceeds the cost of the 12-year war in Vietnam and is more than double the cost of the Korean War.
And, even in the best case scenario, these costs are projected to be almost ten times the cost of the first Gulf War, almost a third more than the cost of the Vietnam War, and twice that of the First World War. The only war in our history which cost more was the Second World War, when 16.3 million U.S. troops fought in a campaign lasting four years, at a total cost (in 2007 dollars, after adjusting for inflation) of about $5 trillion. With virtually the entire armed forces committed to fighting the Germans and Japanese, the cost per troop (in today's dollars) was less than $100,000 in 2007 dollars. By contrast, the Iraq war is costing upward of $400,000 per troop.
The cost of direct US military operations -- not even including long-term costs such as taking care of wounded veterans -- already exceeds the cost of the 12-year war in Vietnam and is more than double the cost of the Korean War.
And, even in the best case scenario, these costs are projected to be almost ten times the cost of the first Gulf War, almost a third more than the cost of the Vietnam War, and twice that of the First World War. The only war in our history which cost more was the Second World War, when 16.3 million U.S. troops fought in a campaign lasting four years, at a total cost (in 2007 dollars, after adjusting for inflation) of about $5 trillion. With virtually the entire armed forces committed to fighting the Germans and Japanese, the cost per troop (in today's dollars) was less than $100,000 in 2007 dollars. By contrast, the Iraq war is costing upward of $400,000 per troop.
Mentally ill unfairly portrayed as violent
[In] recent weeks, the news has been full of horrendous stories involving killers with known or suspected mental illness. As I write this, the nation is still reeling from the shootings at Northern Illinois University. Press reports now indicate that the shooter had a long history of mental illness and had recently stopped taking antidepressant medication.
To make matters worse, three psychotherapists have been assaulted or murdered in the past month. The most brutal attack involved a Manhattan psychologist murdered by a man who also gravely injured a psychiatrist. The New York Times reported that the accused man blamed the psychiatrist for having him institutionalized 17 years ago; apparently, the psychologist was not the intended victim. And only a few weeks ago, a social worker in Andover was killed, allegedly by her 19- year-old patient, during a visit to the man's home.
What do these attacks say about mental illness? Surely they create the impression that individuals with mental illness are a dangerous and violent lot. And as professor John Monahan and colleagues at the University of Virginia School of Law wrote recently, "the more a member of the general public believes that mental disorder and violence are associated, the less he or she wants to have an individual with a mental disorder as a neighbor, friend, colleague, or family member."
Yet the impression that we are awash in a sea of psychotic violence is clearly unfounded. Writing in the Nov. 16, 2006, New England Journal of Medicine, Dr. Richard A. Friedman of the Weill Cornell Medical College notes that only about 3 to 5 percent of violence in the general population is attributable to those with "serious mental illness," conventionally defined as schizophrenia, major depression, or bipolar disorder. The combined lifetime prevalence of these conditions in the US general population is estimated at 19 percent - far larger than their contribution to violence.
To make matters worse, three psychotherapists have been assaulted or murdered in the past month. The most brutal attack involved a Manhattan psychologist murdered by a man who also gravely injured a psychiatrist. The New York Times reported that the accused man blamed the psychiatrist for having him institutionalized 17 years ago; apparently, the psychologist was not the intended victim. And only a few weeks ago, a social worker in Andover was killed, allegedly by her 19- year-old patient, during a visit to the man's home.
What do these attacks say about mental illness? Surely they create the impression that individuals with mental illness are a dangerous and violent lot. And as professor John Monahan and colleagues at the University of Virginia School of Law wrote recently, "the more a member of the general public believes that mental disorder and violence are associated, the less he or she wants to have an individual with a mental disorder as a neighbor, friend, colleague, or family member."
Yet the impression that we are awash in a sea of psychotic violence is clearly unfounded. Writing in the Nov. 16, 2006, New England Journal of Medicine, Dr. Richard A. Friedman of the Weill Cornell Medical College notes that only about 3 to 5 percent of violence in the general population is attributable to those with "serious mental illness," conventionally defined as schizophrenia, major depression, or bipolar disorder. The combined lifetime prevalence of these conditions in the US general population is estimated at 19 percent - far larger than their contribution to violence.
Glutamate and Schizophrenia
The trial results were a major breakthrough in neuroscience, says Dr. Thomas R. Insel, director of the National Institute of Mental Health. For 50 years, all medicines for the disease had worked the same way — until Dr. Schoepp and other scientists . . . . focused their attention on the way that glutamate, a powerful neurotransmitter, tied together the brain’s most complex circuits. Every other schizophrenia drug now on the market aims at a different neurotransmitter, dopamine.
The Lilly results have fueled a wave of pharmaceutical industry research into glutamate. Companies are searching for new treatments, not just for schizophrenia, but also for depression and Alzheimer’s disease and other unseen demons of the brain that torment tens of millions of people worldwide.
The Lilly results have fueled a wave of pharmaceutical industry research into glutamate. Companies are searching for new treatments, not just for schizophrenia, but also for depression and Alzheimer’s disease and other unseen demons of the brain that torment tens of millions of people worldwide.
Antidepressant Discontinuation Syndrome
Steven Kazmierczak's bolt-from-the-blue shooting spree on Feb. 14 reignited a long-running debate over the benefits and risks of antidepressants -- taking them and discontinuing them."It's sad to watch this," says Ann Blake Tracy, executive director of the International Coalition for Drug Awareness and co-founder of a website, SSRI stories.com, that catalogs violent crimes like Kazmierczak's and links them to psychiatric drug use. "You find suicide, murder, rape, arson" -- all caused by drugs such as Prozac, she says. "How did they convince us that this is therapeutic?" Most in the psychiatric profession would counter that antidepressants overwhelmingly save lives, and salvage those hobbled by sadness and anxiety. They doubt that coming off these drugs -- especially Prozac, which Kazmierczak was reported to have taken -- led the Illinois gunman to kill. And they fret that depressed patients who believe the charges of critics like Tracy will turn their backs on medicine that can work wonders if taken -- and stopped -- correctly." When a story like this is brewing, people think, 'If this medication can possibly be related to a bad outcome, I'd better get off it now,' " says UCLA psychiatrist Andrew Leuchter. "We're talking about millions and millions of people who've been treated successfully with these drugs and stopped treatment without any kind of dramatic changes of behavior." At the center of the latest tempest over psychotropic drugs is a long-recognized phenomenon called Antidepressant Discontinuation Syndrome. First identified in psychiatric journals in the late 1990s, the condition is an assortment of symptoms that can plague patients for several weeks and, in a few cases on medical record, months after coming off a wide range of antidepressants. They include dizziness, headache, fatigue, changes in sleep patterns and appetite, vivid or disturbing dreams, agitation and anxiety. Some patients experience tingling or "electric zap" sensations passing through their extremities or head and, in rare cases, spasmodic jerking in the extremities, especially while sleeping.
February 24, 2008
A shortage of primary care doctors is predicted
The supply of primary care physicians is not keeping up with demand, which could be the start of a serious shortage, doctors and health advocates say. The gap is caused by retirements, better working hours and increased interest in specialty fields such as radiology and dermatology that offer higher salaries, health officials say. The Council on Graduate Medical Education projects an 85,000 physician shortfall in the United States by 2020.
February 15, 2008
Blue Cross halts letters amid furor
Facing a torrent of criticism Tuesday, Blue Cross of California abruptly halted its practice of asking physicians in a letter to look for medical conditions that could be used to cancel patients' insurance coverage.In a statement issued about 6 p.m., the state's largest for-profit insurer said, "Today we reached out to our provider partners and California regulators and determined this letter is no longer necessary and, in fact, was creating a misimpression and causing some members and providers undue concern.
February 12, 2008
Doctors balk at request for data
The state's largest for-profit health insurer is asking California physicians to look for conditions it can use to cancel their new patients' medical coverage. Blue Cross of California is sending physicians copies of health insurance applications filled out by new patients, along with a letter advising them that the company has a right to drop members who fail to disclose "material medical history," including "pre-existing pregnancies."
"Any condition not listed on the application that is discovered to be pre-existing should be reported to Blue Cross immediately," the letters say. The Times obtained a copy of a letter that was aimed at physicians in large medical groups.The letter wasn't going down well with physicians."We're outraged that they are asking doctors to violate the sacred trust of patients to rat them out for medical information that patients would expect their doctors to handle with the utmost secrecy and confidentiality," said Dr. Richard Frankenstein, president of the California Medical Assn. Patients "will stop telling their doctors anything they think might be a problem for their insurance and they don't think matters for their current health situation," he said.
"Any condition not listed on the application that is discovered to be pre-existing should be reported to Blue Cross immediately," the letters say. The Times obtained a copy of a letter that was aimed at physicians in large medical groups.The letter wasn't going down well with physicians."We're outraged that they are asking doctors to violate the sacred trust of patients to rat them out for medical information that patients would expect their doctors to handle with the utmost secrecy and confidentiality," said Dr. Richard Frankenstein, president of the California Medical Assn. Patients "will stop telling their doctors anything they think might be a problem for their insurance and they don't think matters for their current health situation," he said.
February 11, 2008
Is Tobacco Money Tainted?
Here's a recipe for academic controversy: First, find dozens of hard-core teenage smokers as young as 14 and study their brains with high-tech scans. Second, feed vervet monkeys liquid nicotine and then kill at least six of them to examine their brains. Third, accept $6 million from tobacco giant Philip Morris to pay for it all. Fourth, cloak the project in unusual secrecy. At UCLA, a team of researchers is following this formula to produce what it hopes will be a groundbreaking study of addiction. So far, the scientists have proved that the issues of animal testing and tobacco-funded research are among the most contentious on university campuses.
ERs fail as the nation's safety net
The long waits that government inspectors say endanger emergency room patients at Harbor-UCLA Medical Center can also be found in backlogged hospitals across the country, according to emergency care experts who have been trying for years to draw attention to the nation's overloaded safety net."Overcrowding in our emergency departments is a national crisis," said Dr. Linda Lawrence, president of the American College of Emergency Physicians, an advocacy group based in Washington D.C. "We no longer have the capacity to serve as the safety net for society."The group surveyed 1,000 emergency care physicians in September and found that one in five knew of a patient who had died because of having to wait too long for care, Lawrence said.
Do Free Pens and Lunches Influence Doctors' Prescribing Behavior?
A new UPMC conflicts-of-interest policy will take effect that day aimed at making doctors' decisions free from influence created by gifts or improper relationships with the drug or medical device industries. Among other provisions, the policy bans gifts such as pens, note pads and food provided by industry representatives as they work to present information about their products at doctors' offices. . . . The policy directly applies to about 50,000 faculty, staff and students of the university's Schools of the Health Sciences and other professionals and staff employed or contracted by UPMC's U.S. operations.
From Bush, Foe of Earmarks, Similar Items
President Bush often denounces the propensity of Congress to earmark money for pet projects. But in his new budget, Mr. Bush has requested money for thousands of similar projects. He asked for money to build fish hatcheries, eradicate agricultural pests, conduct research, pave highways, dredge harbors and perform many other specific local tasks. The details are buried deep in the president’s budget, just as most Congressional earmarks are buried in obscure committee reports that accompany spending bills. . . . The White House defines “earmarks” in a way that applies only to projects designated by Congress, not to those requested by the administration.
February 7, 2008
Planned Parenthood Blog
Missouri voters, like you, understand that votes matter and have already told us that you strongly support state funds for family planning (69%), that you believe pharmacies should dispense birth control without discrimination or delay (65%), that you believe sex education should be comprehensive (76%), and that the government should not step between a patient and her doctor (63%). Not what Governor Blunt wants to hear. But, together, we say "enough is enough to failed policies and failed politicians."
Very Premature Babies Don't Get Follow-Up Care
A groundbreaking study reports that most very low birth-weight babies born to low-income women failed to get critical follow-up care within their first two years of life. The study illustrates how these premature infants, who are vulnerable to vision, hearing and speech impairments, are falling through the cracks of the U.S. health-care system, the researchers said.
Only 20 percent of the babies with hearing problems returned for specialized care within their first six months of life, while fewer than one in four underwent recommended vision tests between 1 and 2 years of age.
Only 20 percent of the babies with hearing problems returned for specialized care within their first six months of life, while fewer than one in four underwent recommended vision tests between 1 and 2 years of age.
In Health Debate, Clinton Remains Vague on Penalties
Senator Hillary Rodham Clinton inched closer Sunday to explaining how she would enforce her proposal that everyone have health insurance, but declined to specify — as she has throughout the campaign — how she would penalize those who refuse. Mrs. Clinton, who did not answer Senator Barack Obama’s question on the topic in a debate last Thursday, was pressed repeatedly to do so Sunday by George Stephanopoulos on the ABC program “This Week.” When Mr. Stephanopoulos asked a third time whether she would garnish people’s wages, Mrs. Clinton responded, “George, we will have an enforcement mechanism, whether it’s that or it’s some other mechanism through the tax system or automatic enrollments.” She then added that the focus on enforcement clouded a more important point, that her proposal to cover the uninsured was superior to Mr. Obama’s because she would mandate coverage for all, while he would require it only for children.
What might seem a mundane debate over health policy has taken on outsized importance in the approach to Tuesday’s voting because it is one of the few substantive differences between the two leading Democratic presidential candidates. . . . Polling has found that health care is a top concern of Democratic voters, and that they rank covering the uninsured as more important than reducing health costs or improving quality.
What might seem a mundane debate over health policy has taken on outsized importance in the approach to Tuesday’s voting because it is one of the few substantive differences between the two leading Democratic presidential candidates. . . . Polling has found that health care is a top concern of Democratic voters, and that they rank covering the uninsured as more important than reducing health costs or improving quality.
Online house calls click with doctors
Consulting your family physician is finally moving into the 21st century and out of the doctor's office. Since the dawn of e-mail, patients have been pleading for more doctors to offer medical advice online. No traffic jams, no long waits, no germ-infested offices with outdated magazines and bad elevator music. There was always one major roadblock: Most health insurers wouldn't pay for it. Until now.
Keeping Your Brain Fit
Just within the past few months, several groups of researchers have added support for the growing consensus that plenty can be done to slow the age-related declines in memory, mental speed, and decision making that affect most people. In November, a team from the Mayo Clinic and the University of Southern California announced that one computer-based mental training program appeared to improve older people's cognitive performance by as much as 10 years. That same month, a Harvard researcher found that long-term use of beta carotene supplements delayed cognitive decline by up to a year and a half.
Wal-Mart Expands In-Store Health Clinics
Wal-Mart Stores Inc. will open its first in-store medical clinics under its own brand name after leasing space in dozens of stores to outside companies that operate the quick-service health stops.
Bentonville, Ark.-based Wal-Mart is among several U.S. supermarket and drug store chains that in the past couple of years have begun opening store-based health clinics, which are staffed mostly by nurse practitioners or physician assistants and offer quick service for routine conditions from colds and bladder infections to sunburn.
About 7 percent of Americans have tried a clinic at least once, according to an estimate by the Convenient Care Association, an industry trade group formed in 2006.
That number is expected to increase dramatically, as chains like Wal-Mart, CVS Corp., Target Corp. and Walgreen Co. partner with mini-clinic providers like RediClinic and MinuteClinic to expand operations. The trade group estimates there will be more than 1,500 by year-end, up from about 800 in November.
Bentonville, Ark.-based Wal-Mart is among several U.S. supermarket and drug store chains that in the past couple of years have begun opening store-based health clinics, which are staffed mostly by nurse practitioners or physician assistants and offer quick service for routine conditions from colds and bladder infections to sunburn.
About 7 percent of Americans have tried a clinic at least once, according to an estimate by the Convenient Care Association, an industry trade group formed in 2006.
That number is expected to increase dramatically, as chains like Wal-Mart, CVS Corp., Target Corp. and Walgreen Co. partner with mini-clinic providers like RediClinic and MinuteClinic to expand operations. The trade group estimates there will be more than 1,500 by year-end, up from about 800 in November.
February 4, 2008
Major Problem Often Overlooked When Linking Violence, Illness
Public and professional attention in recent years has tended to focus on whether people with mental illness are more likely than others to commit acts of violence, but a new study suggests that violent victimization of these individuals may be the greater public health problem.
A literature review of studies published since 1990 on the perpetration of violence by, and violent victimization of, mentally ill individuals indicates that victimization is considerably more common than perpetration. The study was published in the February Psychiatric Services as part of a special issue on violence and mental illness.
Among outpatients, 2 percent to 13 percent had perpetrated violence in the prior six months to three years, compared with 20 percent to 34 percent who had been violently victimized. Studies combining outpatients and inpatients reported that 12 percent to 22 percent had perpetrated violence in the prior six to 18 months, compared with 35 percent who had been a victim in the preceding year. "Although society may regard persons with mental illness as dangerous criminals, our review of the literature shows that violent victimization of persons with severe mental illness is a greater public health concern than perpetration of violence," wrote lead author Linda Teplin, Ph.D., and colleagues in their report.
A literature review of studies published since 1990 on the perpetration of violence by, and violent victimization of, mentally ill individuals indicates that victimization is considerably more common than perpetration. The study was published in the February Psychiatric Services as part of a special issue on violence and mental illness.
Among outpatients, 2 percent to 13 percent had perpetrated violence in the prior six months to three years, compared with 20 percent to 34 percent who had been violently victimized. Studies combining outpatients and inpatients reported that 12 percent to 22 percent had perpetrated violence in the prior six to 18 months, compared with 35 percent who had been a victim in the preceding year. "Although society may regard persons with mental illness as dangerous criminals, our review of the literature shows that violent victimization of persons with severe mental illness is a greater public health concern than perpetration of violence," wrote lead author Linda Teplin, Ph.D., and colleagues in their report.
People With Mental Illness Target of New Gun Law
Supporters of a new gun-control law claim it might have prevented the deaths of 32 people last year in a massacre at Virginia Tech carried out by a student who was mentally ill. Some psychiatrists, however, say the law falls short as a meaningful way to reduce gun violence.
The debate stems from President George W. Bush's signing of a measure in January intended to prevent people with serious mental illness from buying guns.
The legislation (HR 2640), sponsored by Rep. Carolyn McCarthy (D-N.Y.), authorizes up to $1.3 billion in state grants to improve the tracking and reporting of individuals who are legally barred from gun purchases, including those involuntarily confined to a psychiatric hospital. (McCarthy's husband was killed by a mentally ill gunman who went on a rampage on a suburban commuter train 14 years ago.)
Paul Appelbaum, M.D., a professor of psychiatry at Columbia University and chair of APA's Council on Psychiatry and Law, said that a fully funded Virginia background check that looked for involuntary psychiatric care before the gun sales to the Tech shooter and the reporting of his outpatient care by state officials might have kept him from buying his weapons. "But he could have easily gotten them through other means," such as private sales and gun-show sales, which are unregulated by the background-check system, said Appelbaum, a former APA president.
The debate stems from President George W. Bush's signing of a measure in January intended to prevent people with serious mental illness from buying guns.
The legislation (HR 2640), sponsored by Rep. Carolyn McCarthy (D-N.Y.), authorizes up to $1.3 billion in state grants to improve the tracking and reporting of individuals who are legally barred from gun purchases, including those involuntarily confined to a psychiatric hospital. (McCarthy's husband was killed by a mentally ill gunman who went on a rampage on a suburban commuter train 14 years ago.)
Paul Appelbaum, M.D., a professor of psychiatry at Columbia University and chair of APA's Council on Psychiatry and Law, said that a fully funded Virginia background check that looked for involuntary psychiatric care before the gun sales to the Tech shooter and the reporting of his outpatient care by state officials might have kept him from buying his weapons. "But he could have easily gotten them through other means," such as private sales and gun-show sales, which are unregulated by the background-check system, said Appelbaum, a former APA president.
Study backs value of U.S. state anti-smoking plans
U.S. state tobacco control programs are effective at cutting the number of smokers, and states that spend more get the best results, federal health officials said on Tuesday.
Declines in adult smoking rates in individual states are directly related to increases in state per-capita investments in tobacco control and smoking cessation programs, according to a study published in the American Journal of Public Health.
Declines in adult smoking rates in individual states are directly related to increases in state per-capita investments in tobacco control and smoking cessation programs, according to a study published in the American Journal of Public Health.
January 31, 2008
Flawed embryos seen as source for stem cells
From what is now considered medical waste might be fashioned bio-treasure: stem cells able to form into any of the body's 220 cell types, including blood, nerves, bone, and skin tissue, new research suggests. The poor quality embryos are "an ethically acceptable source" for the creation of stem cell lines. Scientists at Children's Hospital Boston have forged stem cells from the "flawed" and "poor quality" early-stage embryos that in vitro fertilization clinics discard by the hundreds of thousands every year, according to research published yesterday in the journal Nature Biotechnology.
Lilly Considers $1 Billion Fine to Settle Case
Eli Lilly and federal prosecutors are discussing a settlement of a civil and criminal investigation into the company’s marketing of the antipsychotic drug Zyprexa that could result in Lilly’s paying more than $1 billion to federal and state governments. If a deal is reached, the fine would be the largest ever paid by a drug company for breaking the federal laws that govern how drug makers can promote their medicines. . . . Zyprexa has serious side effects and is approved only to treat people with schizophrenia and severe bipolar disorder. But documents from Eli Lilly show that from 2000 to 2003 the company encouraged doctors to prescribe Zyprexa to people with age-related dementia, as well as people with mild bipolar disorder who had previously had a diagnosis of depression. Although doctors can prescribe drugs for any use once they are on the market, it is illegal for drug makers to promote their medicines for any uses not formally approved by the Food and Drug Administration.
State Response to Virginia Tech Shootings
A bill passed by the [Virginia] House Courts of Justice Committee would ensure that those who have been ordered to seek treatment are monitored by mental health workers. Seung Hui Cho, the gunman who shot and killed 32 students and teachers at Virginia Tech in April before killing himself, was ordered into treatment in 2005, but the local mental health agency never followed up. . . . Currently, people must be deemed an "imminent danger" to be hospitalized against their will. Under Howell's bill and a similar one advanced by a House committee last week, there must be a "substantial likelihood" that a person would cause "serious physical harm to himself" in the near future or could "suffer serious harm due to substantial deterioration."
Happiness is being young or old, but middle age is misery
People are most likely to become depressed in middle age, according to a worldwide study of happiness. The team of economists leading the work found that we are happiest towards the beginning and end of our lives, leaving us most miserable in middle years between 40 and 50.
The results, published in the journal Social Science & Medicine, showed that people's levels of happiness followed a U-shaped curve, a pattern that was remarkably consistent in the vast majority of countries the researchers looked at, from Azerbaijan to Zimbabwe. For both men and women in the UK, the probability of depression peaked at around the age of 44. In the US, men were most likely to be unhappiest at 50, while for women the age was 40.
The results, published in the journal Social Science & Medicine, showed that people's levels of happiness followed a U-shaped curve, a pattern that was remarkably consistent in the vast majority of countries the researchers looked at, from Azerbaijan to Zimbabwe. For both men and women in the UK, the probability of depression peaked at around the age of 44. In the US, men were most likely to be unhappiest at 50, while for women the age was 40.
Soldier Suicides at Record Level
Suicides among active-duty soldiers in 2007 reached their highest level since the Army began keeping such records in 1980, according to a draft internal study obtained by The Washington Post. Last year, 121 soldiers took their own lives, nearly 20 percent more than in 2006.
At the same time, the number of attempted suicides or self-inflicted injuries in the Army has jumped sixfold since the Iraq war began. Last year, about 2,100 soldiers injured themselves or attempted suicide, compared with about 350 in 2002, according to the U.S. Army Medical Command Suicide Prevention Action Plan.
The Army was unprepared for the high number of suicides and cases of post-traumatic stress disorder among its troops, as the wars in Iraq and Afghanistan have continued far longer than anticipated. Many Army posts still do not offer enough individual counseling and some soldiers suffering psychological problems complain that they are stigmatized by commanders. Over the past year, four high-level commissions have recommended reforms and Congress has given the military hundreds of millions of dollars to improve its mental health care, but critics charge that significant progress has not been made.
At the same time, the number of attempted suicides or self-inflicted injuries in the Army has jumped sixfold since the Iraq war began. Last year, about 2,100 soldiers injured themselves or attempted suicide, compared with about 350 in 2002, according to the U.S. Army Medical Command Suicide Prevention Action Plan.
The Army was unprepared for the high number of suicides and cases of post-traumatic stress disorder among its troops, as the wars in Iraq and Afghanistan have continued far longer than anticipated. Many Army posts still do not offer enough individual counseling and some soldiers suffering psychological problems complain that they are stigmatized by commanders. Over the past year, four high-level commissions have recommended reforms and Congress has given the military hundreds of millions of dollars to improve its mental health care, but critics charge that significant progress has not been made.
A wave of change in medical schools puts emphasis on care of seniors
At Brown University medical school in Providence, students discuss why the organs of their cadavers look different from their own. They spend hours studying how the brain ages. They practice physical examinations on residents of an assisted living complex. And even in obstetrics and gynecology, they learn about problems affecting seniors.
The new emphasis on aging is part of a wave of change sweeping medical schools nationwide as they focus - many for the first time - on preparing all newly minted doctors to treat the growing population of older Americans. Although students have traditionally trained in hospitals filled with older patients, many graduated with little knowledge of how elderly patients' bodies and minds differ from younger ones.
The new emphasis on aging is part of a wave of change sweeping medical schools nationwide as they focus - many for the first time - on preparing all newly minted doctors to treat the growing population of older Americans. Although students have traditionally trained in hospitals filled with older patients, many graduated with little knowledge of how elderly patients' bodies and minds differ from younger ones.
California Health Plan Defeated
In handing Gov. Arnold Schwarzenegger his biggest legislative setback, members of a Senate panel expressed concerns Monday that his plan to cover most Californians without health insurance was inadequately funded and would worsen the state budget crisis.
But the legislation negotiated by the Republican governor and Assembly Speaker Fabian Núñez, D-Los Angeles, was unable to surmount several political hurdles beyond the annual tab, now estimated at $14.9 billion. A proposed tobacco tax drew high-powered opposition. The fact that raising taxes takes a two-thirds vote in the Legislature made finding financing a complicated exercise. Republicans never supported the measure. Democrats weren't on the same page.
But the legislation negotiated by the Republican governor and Assembly Speaker Fabian Núñez, D-Los Angeles, was unable to surmount several political hurdles beyond the annual tab, now estimated at $14.9 billion. A proposed tobacco tax drew high-powered opposition. The fact that raising taxes takes a two-thirds vote in the Legislature made finding financing a complicated exercise. Republicans never supported the measure. Democrats weren't on the same page.
Lax oversight favors doctors over patients
PART 1: [Wisconsin's] lax system of oversight favors doctors over patients. A Journal Sentinel review of five years' worth of disciplinary action found that the board is slow to look into complaints, keeps many of its investigations secret and rarely imposes serious discipline, even when patients die.
PART 2: The patient, a man who had been injured on the job, was feeling out of it and dizzy and his vision was blurred. Huffman checked the patient's IV, according to court records. The next thing the man knew, he said, he felt Huffman performing oral sex on him. Three months after the February 1991 incident, a second patient at St. Mary's Hospital in Milwaukee said he awoke to Huffman indecently touching him. In June 1991 Huffman was charged with two felonies. He pleaded guilty to reduced charges of misdemeanor sexual assault in January 1992. The doctor went to jail. But he didn't lose his medical license. State officials say they took progressively harsher action against Huffman over the next decade - action they thought would protect patients. They were wrong.
Despite his record, Huffman managed to get hired at three other facilities. Patients at two of them accused him of sexual misconduct. His license was revoked effective Feb. 28, 2002 - 11 years after his first documented sexual assault of a patient.
PART 2: The patient, a man who had been injured on the job, was feeling out of it and dizzy and his vision was blurred. Huffman checked the patient's IV, according to court records. The next thing the man knew, he said, he felt Huffman performing oral sex on him. Three months after the February 1991 incident, a second patient at St. Mary's Hospital in Milwaukee said he awoke to Huffman indecently touching him. In June 1991 Huffman was charged with two felonies. He pleaded guilty to reduced charges of misdemeanor sexual assault in January 1992. The doctor went to jail. But he didn't lose his medical license. State officials say they took progressively harsher action against Huffman over the next decade - action they thought would protect patients. They were wrong.
Despite his record, Huffman managed to get hired at three other facilities. Patients at two of them accused him of sexual misconduct. His license was revoked effective Feb. 28, 2002 - 11 years after his first documented sexual assault of a patient.
Medicaid Managed Care Plans Place More Burden On Patients And Families With Severe Mental Illness, AJP Study Shows
Managed care health plans for Medicaid patients with schizophrenia and other severe mental illnesses may result in lower costs to the Medicaid system, but lead to greater personal expenditures and higher caregiver burden for patients and their families, new research indicates. . . . The managed care strategies employed by plans led to savings within the Medicaid budget, but these savings were offset by personal expenditures and the contributions of family and friends of the enrollees in the managed care plans. Managed care was not associated with increased overall costs to non-Medicaid government programs. Despite the Medicaid-specific savings, society's total costs were not reduced by managed care. This wider public health perspective is especially important when considering patients with long-term disabling illnesses, who have multiple needs that cross different types of services and payers. Although an earlier report by the same authors indicated similar clinical outcomes for the patients in the three plans studied, the outcomes may have depended in part on substantial contributions from families and friends. Cost substitution may further impoverish already destitute individuals and result in inefficient treatment.
States lead in rush to reform health care
An estimated 47 million Americans gamble daily that they won't suffer a major illness or injury and often go without needed medicine. With rapidly-rising health care costs, the number of uninsured has grown from 43 million in 2006. U.S. lawmakers have argued over reform plans for years, and the spiraling problem is a hot topic in the 2008 presidential campaign with leading Democrats and Republicans alike acknowledging changes are needed. But state leaders say they are tired of waiting for answers from Washington and at least a dozen states are trying to pass far-ranging health reforms this year.
Lackluster Legacy On Health Care
President Bush didn't dally on the matter of health care during last night's State of the Union address, but he did flick at some tired themes: tax breaks for individual health insurance buyers (as opposed to employers); pooled insurance policies that help small businesses save money by spreading risk; and the expansion of Health Savings Accounts, which allow consumers to sock away pretax dollars to cover medical expenses. Yet the one issue that didn't merit mention--the State Children's Health Insurance Program (SCHIP)--may likely be the linchpin of Bush's legacy on health care, both for small businesses and the Republican party. Twice last fall, Bush vetoed bills to double funding for SCHIP, a 10-year-old program that offers free or low-cost health insurance to children of low-income families. Last week, the House again failed to override the president's veto.
Job Stress and Heart Disease
Work really can kill you, according to a study on Wednesday providing the strongest evidence yet of how on-the-job stress raises the risk of heart disease by disrupting the body's internal systems. The findings from a long-running study involving more than 10,000 British civil servants also suggest stress-induced biological changes may play a more direct role than previously thought, said Tarani Chandola, an epidemiologist at University College London.
"This is the first large-scale population study looking at the effects of stress measured from everyday working life on heart disease," said Chandola, who led the study. "One of the problems is people have been skeptical whether work stress really affects a person biologically."
"This is the first large-scale population study looking at the effects of stress measured from everyday working life on heart disease," said Chandola, who led the study. "One of the problems is people have been skeptical whether work stress really affects a person biologically."
January 30, 2008
The Age of Ambition
With the American presidential campaign in full swing, the obvious way to change the world might seem to be through politics. But growing numbers of young people are leaping into the fray and doing the job themselves. These are the social entrepreneurs, the 21st-century answer to the student protesters of the 1960s, and they are some of the most interesting people here at the World Economic Forum (not only because they’re half the age of everyone else).
January 25, 2008
Employers put health coverage in workers' hands
Nick Trikolas plans to drop health insurance for his employees and give them money to buy their own coverage. He says doing so will put him in the vanguard of a movement by employers searching for answers to rising health costs. "This may be the future of health insurance," says Trikolas, CEO of Ilios Partners in Chicago, which plans to switch its 100 employees from group to individual coverage this year. As health insurance costs continue to rise, some employers are adopting a controversial new approach: ending group coverage and giving employees $50 to $200 or so a month to help them buy their own.
Puberty is arriving ever younger in American females
At 8 or 9 years old, the typical American schoolgirl is perfecting her cursive handwriting style. She's picking out nouns, verbs, adjectives and adverbs in sentences, memorizing multiplication tables and learning to read a thermometer.She's a little girl with a lot to learn. And yet, in increasing numbers, when girls this age run across the playground in T-shirts, there is undeniable evidence that their bodies are blossoming. The first visible sign of puberty, breast budding, is arriving ever earlier in American girls.Some parents and activists suspect environmental chemicals. Most pediatricians and endocrinologists say that, though they have suspicions about the environment, the only scientific evidence points to the obesity epidemic. What's clear, however, is that the elements of female maturity increasingly are spacing themselves out over months, even years -- and no one quite knows why.
Health Effects of Marriage
Decades of data collection have shown that marriage--for all its challenges--is like a health-insurance policy. A 2006 paper that tracked mortality over an eight-year period found that people who never married were 58% likelier to die during that time than married folks were.
Crying Out For Help
Latinas ages 12 to 17 are the largest minority group of girls in the country, and growing. They are more likely to try to take their lives than any other racial or ethnic group their age. Twenty-five percent say they've thought about suicide, according to the Centers for Disease Control and Prevention, and about 15 percent attempt it, compared with approximately 10 percent of white and black teen girls. Other studies put the proportion of attempters at 20 percent -- slightly less than the fraction who smoke cigarettes.
In most cases, a girl swallows pills at home, according to Luis Zayas, a psychologist and professor of social work at Washington University in St. Louis. Zayas is in the middle of a five-year study of more than 150 young Latina girls who have attempted suicide. He says cutting is also finding a following among Latinas.
In most cases, a girl swallows pills at home, according to Luis Zayas, a psychologist and professor of social work at Washington University in St. Louis. Zayas is in the middle of a five-year study of more than 150 young Latina girls who have attempted suicide. He says cutting is also finding a following among Latinas.
List of problem prescription drugs is growing
An increasing number of prescription drugs - some that have been widely promoted through seductive advertising - are turning out to have problems long after they've reached the market. With more than 40 percent of the U.S. population taking at least one prescription medication, the ever-growing list of medication concerns is drawing public attention and a sharp eye from consumer watchdogs. Research within the past week has raised questions about Vytorin, a popular cholesterol-lowering drug, and an analysis published in the New England Journal of Medicine suggested doctors and patients may have been misled about the effectiveness of many antidepressants.
psychiatric side effects of experimental medicines
After decades of inattention to the possible psychiatric side effects of experimental medicines, the Food and Drug Administration is now requiring drug makers to study closely whether patients become suicidal during clinical trials. The new rules represent one of the most profound changes of the past 16 years to regulations governing drug development.
Texans find gaps in candidates' health coverage plans
While health coverage is shaping up as one of the major issues of this presidential campaign, no candidate, Democrat or Republican, has proposed a plan that would address all of Texas' concerns. Democrats' stump speeches talk of covering all Americans but so far have avoided the politically explosive issue of whether to treat the 12 million illegal immigrants living in the U.S.
Along with such immigrants, Texas also has the second-highest number of uninsured residents – and some of the nation's highest rates of pre-existing chronic illnesses. Those illnesses could create problems if Republican candidates' plans to encourage more reliance on individual insurance policies are enacted because those people couldn't find insurance.
Along with such immigrants, Texas also has the second-highest number of uninsured residents – and some of the nation's highest rates of pre-existing chronic illnesses. Those illnesses could create problems if Republican candidates' plans to encourage more reliance on individual insurance policies are enacted because those people couldn't find insurance.
Veto Stands on Measure to Expand Health Plan
Democrats cited the nation’s economic problems as a reason to expand a popular health insurance program for children on Wednesday, but their effort failed as the House sustained President Bush’s veto of a bill to provide coverage to nearly four million uninsured children.
The vote for the bill was 260 to 152. Supporters were 15 votes short of the two-thirds majority needed to pass the measure over the president’s objections.
The vote for the bill was 260 to 152. Supporters were 15 votes short of the two-thirds majority needed to pass the measure over the president’s objections.
January 22, 2008
Blunt won’t seek re-election
JEFFERSON CITY Gov. Matt Blunt, facing a tough re-election fight and a slowing economy, bowed out of the race Tuesday, declaring that he had accomplished all he set out to do.
In a video posted on the YouTube Internet site, Blunt said he decided not to seek re-election because he had little left to achieve. . . . “You could have knocked me over with a feather,” said Rep. Margaret Donnelly, a St. Louis County Democrat who is running for attorney general.
The announcement came just a week after Blunt’s campaign filed a quarterly fundraising report showing he had raised $9.88 million for his re-election bid.
In a video posted on the YouTube Internet site, Blunt said he decided not to seek re-election because he had little left to achieve. . . . “You could have knocked me over with a feather,” said Rep. Margaret Donnelly, a St. Louis County Democrat who is running for attorney general.
The announcement came just a week after Blunt’s campaign filed a quarterly fundraising report showing he had raised $9.88 million for his re-election bid.
Please Review the Candidates Positions on Mental Health Policy
The National Alliance on Mental Illness (NAMI) has sent a questionnaire to all presidential candidates in each party. We also encouraged candidates to provide us with other relevant materials or explanations of their positions if they did not have time to respond to our questionnaire.
NAMI does not endorse specific candidates and any materials posted are intended for educational purposes only. They should not be used by any affiliate to endorse a candidate. Non-profit charitable organizations, including NAMI affiliates, are prohibited by law from endorsing specific candidates.
NAMI does not endorse specific candidates and any materials posted are intended for educational purposes only. They should not be used by any affiliate to endorse a candidate. Non-profit charitable organizations, including NAMI affiliates, are prohibited by law from endorsing specific candidates.
35 years after Roe: A legacy of law and morality
The January 22, 1973, Supreme Court decision legalizing abortion remains the law of the land, and passions remain high on both sides of the issue, with annual protests on the anniversary. Access to abortion, then and now, is more than just about simple legalities. Social, religious and family values, as well as finances and politics, still play a role in shaping the abortion issue, but many legal and medical experts say the debate has become predictable.
January 17, 2008
Could comparative-effectiveness studies rein in health-care costs?
MOST industries have grasped the idea that new products should be measured against rival offerings. From laptops to double-glazed windows, consumers have ready access to comparative studies from consumer magazines, independent testing bodies and the like.
When it comes to health care, however, comparative-effectiveness studies for new drugs, devices and procedures are rare. Drugs trials often compare new treatments with placebos, not rival pills. Device makers rush to get new gizmos into action before cost-benefit analyses can be done. In America the federal government's health programmes eschew comparative-effectiveness tests as a matter of policy. Now moves are afoot in America's Congress to promote the use of such techniques to rein in rampant cost inflation.
When it comes to health care, however, comparative-effectiveness studies for new drugs, devices and procedures are rare. Drugs trials often compare new treatments with placebos, not rival pills. Device makers rush to get new gizmos into action before cost-benefit analyses can be done. In America the federal government's health programmes eschew comparative-effectiveness tests as a matter of policy. Now moves are afoot in America's Congress to promote the use of such techniques to rein in rampant cost inflation.
What are your views on ECT?
Electroconvulsive therapy, discredited in a previous incarnation as "shock therapy," has gained acceptance from patients and doctors alike in recent years. As the means of administering the electric current have grown more sophisticated and less harmful, the benefits of the treatment have become more apparent, especially for people suffering depression.
The Mayo Clinic estimates that 100,000 people a year undergo the treatment in the United States -- a number that has roughly tripled in the last 25 years.
The Mayo Clinic estimates that 100,000 people a year undergo the treatment in the United States -- a number that has roughly tripled in the last 25 years.
Out from the shadow of teen suicide
It was fall 2005. Three Needham students had already committed suicide, and there would soon be a fourth. And as Haas, just 16, flirted with suicidal thoughts of his own, his parents, Chris and Ronnie Haas, were busy planning Michael's college education, not seeing signs of his deepening depression. It is the classic parent-child disconnect, mental health specialists said yesterday at a State House forum about teenage depression. Specialists say that depression often goes unnoticed by parents, which can lead to more serious problems, like the suicides in Needham or more recently Nantucket, where three teenagers - ages 15, 16, and 17 - have killed themselves in the last 11 months. The problem with teenage depression, specialists said yesterday, is that many people do not want to or do not know how to talk about it and often retreat into silence for fear of what others might think or say.
Change the environment to treat obesity
Several recent studies, papers and a popular weight-loss book argue that eating is an automatic behavior triggered by environmental cues that most people are unaware of -- or simply can't ignore. Think of the buttery smell of movie theater popcorn, the sight of glazed doughnuts glistening in the office conference room or the simple habit of picking up a whipped-cream-laden latte on the way to work.Accepting this "don't blame me" notion may not only ease the guilt and self-loathing that often accompanies obesity, say the researchers behind the theory, but also help people achieve a healthier weight.
Antidepressant Studies Unpublished
The makers of antidepressants like Prozac and Paxil never published the results of about a third of the drug trials that they conducted to win government approval, misleading doctors and consumers about the drugs’ true effectiveness, a new analysis has found.
In published trials, about 60 percent of people taking the drugs report significant relief from depression, compared with roughly 40 percent of those on placebo pills. But when the less positive, unpublished trials are included, the advantage shrinks: the drugs outperform placebos, but by a modest margin, concludes the new report, which appears Thursday in The New England Journal of Medicine.
In published trials, about 60 percent of people taking the drugs report significant relief from depression, compared with roughly 40 percent of those on placebo pills. But when the less positive, unpublished trials are included, the advantage shrinks: the drugs outperform placebos, but by a modest margin, concludes the new report, which appears Thursday in The New England Journal of Medicine.
Shelters can't help all fleeing abuse
Domestic violence shelters across the state are becoming overwhelmed and are increasingly turning victims away, driving some of those seeking help back to abusive partners or to the streets, according to advocates and shelter program directors. The number of victims turned away from shelters more than quadrupled, from 1,374 in fiscal 2003 to 5,520 in fiscal 2005, according to Jane Doe Inc., a statewide coalition against sexual assault and domestic violence that also tracks trends. On many days, only one bed will be available in the state for 100 people who call domestic violence hotlines seeking shelter. Sometimes, none can be found.
Do you support mandatory random drug-testing for student-athletes?
The Illinois High School Association on Monday joined a small but growing number of states to implement mandatory random drug-testing for student-athletes. Its Board of Directors voted 10-0 to begin testing with the 2008-09 school year. The timing was coincidental with two highly publicized incidents regarding drugs and sports. Last month the Mitchell report on the use of performance-enhancing substances in baseball included allegations Clemens, the seven-time Cy Young Award-winning pitcher, had taken steroids and human growth hormone.Last week a U.S. District Court judge sentenced former Olympic track champion Jones to six months in prison in part for lying about her use of performance-enhancing drugs.
January 13, 2008
Psychologists in state ask for authority to prescribe
Missouri psychologists and their patients are asking lawmakers for the authority to write certain prescriptions for mental health disorders, saying it will improve access to badly needed care.
It's a question of service and need, say advocates with Missouri Families for Access to Comprehensive Treatment.
The state has fewer than 400 licensed psychiatrists, the only mental-health professionals in Missouri allowed to prescribe drugs, advocates say. And, they add, waiting times to see a psychiatrist ranges from two weeks to eight months, especially in underserved rural and inner-city communities.
It's a question of service and need, say advocates with Missouri Families for Access to Comprehensive Treatment.
The state has fewer than 400 licensed psychiatrists, the only mental-health professionals in Missouri allowed to prescribe drugs, advocates say. And, they add, waiting times to see a psychiatrist ranges from two weeks to eight months, especially in underserved rural and inner-city communities.
Bush signs new gun bill
President Bush signed legislation on Tuesday aimed at preventing the severely mentally ill from buying guns, in a rare bipartisan agreement with the Democratic-led Congress after the bloody Virginia Tech shooting.
The bill authorizes up to $1.3 billion in grant money for states to improve their ability to track and report individuals who shouldn't qualify to buy a gun legally, including those involuntarily confined by a mental institution. Much of the money, to be spent over five years, would be used to increase state feeds to a national system used to run background checks on gun purchases.
The bill authorizes up to $1.3 billion in grant money for states to improve their ability to track and report individuals who shouldn't qualify to buy a gun legally, including those involuntarily confined by a mental institution. Much of the money, to be spent over five years, would be used to increase state feeds to a national system used to run background checks on gun purchases.
The Anti-Drug Drugs
Researchers are developing a range of vaccines—which are normally used to combat infectious diseases—against such highly addictive substances as cocaine, nicotine, heroin and methamphetamine. If these new drugs come to market, experts hope they can overcome one big hurdle that previous anti-addiction medications have failed to clear. "The idea of vaccines is not anywhere near as stigmatized as giving medication to the addicted," says Thomas Kosten, the Baylor Medical School psychiatrist who is leading research on the cocaine vaccine. "Vaccine sounds more wholesome than drug." Addiction is often seen as a personal weakness, not a medical condition to be treated or cured. Some experts say that stigmatization has stymied research into potential treatments for the estimated 20 million Americans who struggle with drug addiction.
Help your heart with exercise - and booze
Moderate drinkers are at 30% lower risk of heart disease than teetotallers, according to a study of nearly 12,000 people. And those who combine a mild tipple with regular exercise are even less likely to die of the disease. Their risk is between 44% and 50% lower than couch potatoes who abstain from alcohol.
The team behind the 20-year study said that previous research has shown that moderate drinking and exercise both lower the risk of heart disease. But this is the first time scientists have quantified the benefits of both together.
The team behind the 20-year study said that previous research has shown that moderate drinking and exercise both lower the risk of heart disease. But this is the first time scientists have quantified the benefits of both together.
New smoking restriction ignites debate
Never before has California banned smoking on private property used exclusively by members of the owner's family – until now.
Beginning this month, motorists can be fined $100 for lighting up a cigarette, cigar or pipe in their own car, even in their driveway, if one passenger is a child.
The law marks a new frontier in more than two decades of state smoking restrictions that focused on workplaces, public buildings, restaurants, airplanes, tot lots and gathering spots.
It also comes as cigar-smoking Republican Gov. Arnold Schwarzenegger is teaming with Democrats to push a proposed ballot measure that would increase cigarette taxes by $1.75 per pack to expand health insurance.
Beginning this month, motorists can be fined $100 for lighting up a cigarette, cigar or pipe in their own car, even in their driveway, if one passenger is a child.
The law marks a new frontier in more than two decades of state smoking restrictions that focused on workplaces, public buildings, restaurants, airplanes, tot lots and gathering spots.
It also comes as cigar-smoking Republican Gov. Arnold Schwarzenegger is teaming with Democrats to push a proposed ballot measure that would increase cigarette taxes by $1.75 per pack to expand health insurance.
December 17, 2007
Nation's Hospital Bill
A handful of high-cost and high-volume conditions helped drive the national hospital bill up 7% in 2005, to $873 billion, a record high and nearly double 1997 spending adjusted for inflation, a federal agency reported. The report, from the federal Agency for Health Care Research and Quality, analyzed figures from the most recent year available and found in part that triple-digit percentage growth in the amount charged for blood infections, nonspecific chest pain, respiratory failure, back pain and arthritis over the past decade contributed to the increase.
The 20 costliest conditions accounted for 52% of hospital charges, and the five costliest accounted for a fifth of all charges. Medicare and Medicaid, the government health plans for the elderly, disabled and poor, accounted for nearly two-thirds of total charges. The five costliest categories were coronary-artery disease, pregnancy and delivery, newborn-infant care, heart attack and congestive heart failure, followed by pneumonia and arthritis.
The 20 costliest conditions accounted for 52% of hospital charges, and the five costliest accounted for a fifth of all charges. Medicare and Medicaid, the government health plans for the elderly, disabled and poor, accounted for nearly two-thirds of total charges. The five costliest categories were coronary-artery disease, pregnancy and delivery, newborn-infant care, heart attack and congestive heart failure, followed by pneumonia and arthritis.
December 14, 2007
Point Counterpoint Essays on HR 2640 (Gun Control Law)
About 3%-5% of all violence in the United States is perpetrated by individuals with mental illness. But the risk of violence is much higher with “rampage killers,” those who go into schools, malls, and other public places and shoot. About 50% have a history of mental illness and 8% have been committed. Legislation recently passed in the House of Representatives is a good idea if even one life is saved. The bill, H.R. 2640 (the National Instant Criminal Background Check System Improvement Amendments Act of 2007), would require the states to update the NICS with the names and other identifying information of people committed to mental institutions so that they could not buy firearms.
BUT
We still have no data to show that this approach would be effective. Guns are widely available from legal and illegal sources in the United States. Federal purchase restrictions only apply to purchases from a dealer. They do not affect those who already own guns, obtain a gun from another person, or buy one at a gun show. If even a single life could be saved by stopping gun purchase by mentally ill patients, why not do it? Because the costs would vastly outweigh a small likelihood of benefit. The financial impact will be enormous. The federal bill offers states $1 billion to participate in a national database. Think of what else we could do with that money to combat gun violence.
BUT
We still have no data to show that this approach would be effective. Guns are widely available from legal and illegal sources in the United States. Federal purchase restrictions only apply to purchases from a dealer. They do not affect those who already own guns, obtain a gun from another person, or buy one at a gun show. If even a single life could be saved by stopping gun purchase by mentally ill patients, why not do it? Because the costs would vastly outweigh a small likelihood of benefit. The financial impact will be enormous. The federal bill offers states $1 billion to participate in a national database. Think of what else we could do with that money to combat gun violence.
December 13, 2007
Health care challenges fire up U.S. students
One measure of the troubled state of U.S. health care is the hordes of idealistic young people lining up to fix it. . . . students are pouring into health policy classes in economics, political science, history, and public health departments. Many plan on making health policy their career.
"I tell some of my friends that are a few years younger then me, if they are interested in politics and what is going on -- take policy courses. Health policy is something that affects us and it's going to affect us in the long run," said Chang, who hopes to attend law school.
"I tell some of my friends that are a few years younger then me, if they are interested in politics and what is going on -- take policy courses. Health policy is something that affects us and it's going to affect us in the long run," said Chang, who hopes to attend law school.
World 'must do more' for children
More must be done more quickly to make the world fit for children by 2015, the UN children's agency, UNICEF, has said. In a report it noted considerable strides had been made to meet pledges in education and areas of health care. But it stressed that "much more must be done" in order to meet the 2015 Millennium Development Goals deadline.
Marketing hype or a miracle cure?
A costly drug cocktail touted as the first pharmacological treatment for cocaine and methamphetamine addiction is at the center of a raging national debate.The treatment, called Prometa, is not approved by the Food and Drug Administration as an addiction therapy, nor has it undergone extensive scientific testing. But officials at Los Angeles-based Hythiam Inc., the company that sells the treatment protocol, say it can work miracles for people struggling to break their addiction.
December 11, 2007
Ranking America's Mental Health: An Analysis of Depression Across the States (Missouri Ranks #45)
Depression is a chronic illness that exacts a significant toll on America's health and productivity. It affects more than 21 million American children and adults annually and is the leading cause of disability in the United States for individuals ages 15 to 44.
Lost productive time among U.S. workers due to depression is estimated to be in excess of $31 billion per year. Depression frequently co-occurs with a variety of medical illnesses such as heart disease, cancer, and chronic pain and is associated with poorer health status and prognosis. It is also the principal cause of the 30,000 suicides in the U.S. each year. In 2004, suicide was the 11th leading cause of death in the United States, third among individuals 15-24.
Despite significant gains in the availability of effective depression treatment over the past decade, the level of unmet need for treatment remains high. On average, people living with depression go for nearly a decade before receiving treatment, and less than one-third of people who seek help receive minimally adequate care.
"Ranking the States: An Analysis of Depression Across the States" was researched and written by Mental Health America and Thomson Healthcare. It looks at data from 2002-2006 and was conducted from July to November 2007. The report compares depression levels and suicide rates in all 50 states and the District of Columbia and uses the information to highlight solutions to improve states' mental health status.
Lost productive time among U.S. workers due to depression is estimated to be in excess of $31 billion per year. Depression frequently co-occurs with a variety of medical illnesses such as heart disease, cancer, and chronic pain and is associated with poorer health status and prognosis. It is also the principal cause of the 30,000 suicides in the U.S. each year. In 2004, suicide was the 11th leading cause of death in the United States, third among individuals 15-24.
Despite significant gains in the availability of effective depression treatment over the past decade, the level of unmet need for treatment remains high. On average, people living with depression go for nearly a decade before receiving treatment, and less than one-third of people who seek help receive minimally adequate care.
"Ranking the States: An Analysis of Depression Across the States" was researched and written by Mental Health America and Thomson Healthcare. It looks at data from 2002-2006 and was conducted from July to November 2007. The report compares depression levels and suicide rates in all 50 states and the District of Columbia and uses the information to highlight solutions to improve states' mental health status.
December 6, 2007
Doctors don't report colleagues, errors
Nearly half of doctors surveyed say they have failed to report an impaired or incompetent colleague or a serious medical error, and more than one-third say they would order an unneeded MRI scan for an insistent patient - though these actions conflict with what the physicians consider the heart of their professional obligations.
The survey is the first broad attempt to measure the success of a new movement called "medical professionalism." Arguing that government regulation, financial incentives, and public reporting alone will not improve the quality and efficiency of medical care, physicians groups in the past several years have been promoting a new code of professional values, meant to modernize the ancient Hippocratic Oath.
The survey is the first broad attempt to measure the success of a new movement called "medical professionalism." Arguing that government regulation, financial incentives, and public reporting alone will not improve the quality and efficiency of medical care, physicians groups in the past several years have been promoting a new code of professional values, meant to modernize the ancient Hippocratic Oath.
Exercise pill hope for depression?
Yale University experts say that experiments on mice could show why regular exercise can help people suffering from depression. Writing in the journal Nature Medicine, they say it could lead to more effective drugs. Mental Health charities in the UK already back exercise programmes as a way of lifting depression. While the link between exercise and improved mood is well known, the reasons behind it are not fully understood. The latest research focuses on an area of the brain called the hippocampus, which is already established as a target for antidepressant drugs.
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