National Briefing | Health: F.D.A. Lists Sources of Tainted Drug

The beliefs of a Catholic media network have put it at odds with the Obama administration.

Room for Debate asks: What is missing from this sprawling legislation, and what should be cut?

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Female Cancer Survivors Report Worse Health Habits: Survey

MONDAY, Feb. 20 (HealthDay News) -- Female cancer survivors are more likely to smoke and have other unhealthy behaviors than women who have never had cancer, a new study finds.

Researchers compared nearly 20,000 women ageD 35 and older with no history of cancer to more than 2,700 female cancer survivors. Both groups were undergoing mammography screening for breast cancer.

Cancer survivors aged 30 to 49 had higher rates of smoking than women with no cancer history. Cancer survivors were also less likely to engage in strenuous exercise, and were more likely to rate their health as "poor."

Cancer survivors were less likely, however, to drink alcohol at least once a month.

Body-mass index (a measure of body fat based on a person's height and weight) did not differ between the two groups, but cancer survivors reported less weight gain than the noncancer group over the previous five years, according to study author Sarah Rausch, a clinical psychologist and director of integrative medicine at the Moffitt Cancer Center in Tampa, Fla., and her colleagues.

The study was published in a recent issue of the American Journal of Clinical Oncology.

It's possible that women who have survived cancer could benefit from programs to encourage them to adopt healthier habits, the researchers said.

"The differences in health behaviors between cancer survivors and those with no cancer history afford a 'teachable moment' in which a cancer survivor may be motivated to change behaviors to promote a healthier lifestyle and prevent cancer recurrence," Rausch said in a Moffitt news release.

"As the population of cancer survivors increases, the importance of health status and quality of life of cancer survivors is even more critical," Rausch said. "Approximately 10.5 million people in the United States have been diagnosed with cancer. Because of the progress in cancer diagnosis and treatment, there is a growing population of cancer survivors."

More information

The U.S. National Cancer Institute has more about cancer survivorship.

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After 37 years, Washington D.C. gets mental health system

A microchip inserted under the skin has been shown for the first time to successfully deliver a bone-loss drug to a small sample of women, according to US-led research published Thursday.

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FDA Warns Health Officials About Counterfeit Cancer Drug

The FDA announced on Tuesday that a counterfeit version of the drug Avastin has made its way into the U.S. market. Doctors, hospitals, and pharmacists are being urged to check their supply of the drug to make sure it was manufactured by Roche Group partner Genentech, the maker of the real Avastin.

What is Avastin?

Avastin is a "designer drug" created to treat cancer by isolating a protein known as vascular endothelial growth factor, or VEGF, according to Genentech. VEGF helps the body create new blood vessels, which in a person with cancer, can help feed the cancerous cells. By blocking VEGF, Avastin theoretically can "starve" cancer cells and kill them off, according to NPR.

Avastin has only been approved to help treat certain kinds of cancers, including colorectal, brain, kidney, and lung cancer. It was initially approved late last year for treating breast cancer as well, but the FDA withdrew the approval while it is re-evaluating the drug's effectiveness in treating advanced cases of the disease.

How did the FDA find out about the counterfeit?

CNN reports that the FDA tracked purchases made from Quality Specialty Products, which in the U.S. appears to also go under the moniker Montana Health Care Solutions. The company is alleged to have been sourcing counterfeit drugs from overseas distributors and then selling them to U.S. practitioners.

Genentech themselves tested the suspected counterfeit version of the drug and found it to be not merely repackaged but fraudulent. Some 19 different potential buyers have been identified. The FDA warned all of them individually about the counterfeit drug before releasing a more general press statement on Tuesday.

Is the counterfeit version dangerous?

Yes, in that it is missing the active ingredient bevacizumab, the key component in the real Avastin medication. Therefore, anyone who has been treated with the counterfeit would not have been getting needed cancer therapy. Roche and Genentech released a statement on Tuesday giving details on how to identify fake medications, as well as warning practitioners that the counterfeit should not be considered either safe or effective.

Does the FDA know if anyone has actually been given the counterfeit?

Not at this time. The path of the counterfeit drug once it hit American shores is still being investigated, according to MSNBC. Because the agency is still unsure just how much of the counterfeit was purchased and distributed, the FDA hasn't been able to determine whether anyone was actually administered the faux treatment.

Vanessa Evans is a musician and freelance writer based in Michigan, with a lifelong interest in health and nutrition issues.

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Health Care Mandate Was First Backed by Conservatives

The concept that people should be required to buy health coverage was fleshed out more than two decades ago by a number of conservative economists, embraced by scholars at conservative research groups, including the Heritage Foundation and the American Enterprise Institute, and championed, for a time, by Republicans in the Senate.

The individual mandate, as it is known, was seen then as a conservative alternative to some of the health care approaches favored by liberals — like creating a national health service or requiring employers to provide health coverage.

“In 1993, in fighting ‘Hillarycare,’ virtually every conservative saw the mandate as a less dangerous future than what Hillary was trying to do,” Newt Gingrich, the former speaker of the House, said at a debate in December, casting his past support of a mandate as an antidote to the health care overhaul proposed by Hillary Rodham Clinton during her husband’s administration.

Since then the politics of health care have grown more twisted and tangled than the two snakes entwined around the staff in a caduceus, which is sometimes used as a symbol of medicine. It is now Republicans and conservatives who oppose the individual mandate, arguing that it is unconstitutional, while Democrats, who were long resistant to it, are its biggest defenders.

Democratic health care analysts have been taken aback by the speed with which Republicans have made the individual mandate a symbol of socialist totalitarianism to much of their base.

“I noted the irony of a Republican idea being the source of Republican opposition,” said Neera Tanden, president of the Center for American Progress, a liberal research group, who served in the Obama administration and as the policy director for Mrs. Clinton’s presidential campaign in 2008. And longtime supporters of the mandate, who for years had believed the biggest obstacle to enacting it was attracting Democratic support, saw Democrats become its last supporters. “It totally flipped,” said Peter Harbage, a health care analyst who has advised Democratic and Republican supporters of individual mandates.

These shifting political winds have become a major factor in the presidential campaign. Mitt Romney is often challenged by Republican rivals about the health care law he signed as the governor of Massachusetts, which also contains an individual mandate. Mr. Gingrich is often asked about his years of support for the idea. And Mr. Obama — who opposed the individual mandate four years ago as a candidate, but came to accept it as president — is now waiting to see whether the Supreme Court upholds the idea or strikes it down.

Some conservatives originally saw the individual mandate as a way to make certain that uninsured people who became ill or were injured — but were still entitled by law to medical treatment — did not push the cost of their care onto others.

“If a young man wrecks his Porsche and has not had the foresight to obtain insurance, we may commiserate, but society feels no obligation to repair his car,” Stuart Butler, a distinguished fellow at the Heritage Foundation, said in a 1989 lecture on how to ensure affordable health care for all Americans. “But health care is different. If a man is struck down by a heart attack in the street, Americans will care for him whether or not he has insurance.”

Part of Mr. Butler’s solution back then? “Mandate all households to obtain adequate insurance.”

But Democrats were leery of the idea. In 1993, when President Bill Clinton put forward the broad outlines of his health care proposal in a speech to the National Governors Association in Tulsa, Okla., he called for requiring employers to buy coverage for their workers. The idea of an individual mandate, he noted in the speech, “has found some favor in the United States Congress, primarily among Republicans, but not exclusively, because it has the appeal of not imposing a business mandate, which has a bad sound to it.”

To combat President Clinton’s proposal, a large group of Republican senators, including the minority leader at the time, Bob Dole, and several who are still in office, proposed a bill that would have required individuals, and not employers, to buy insurance.

After Mr. Clinton’s health care proposal died, Democrats began searching for more politically palatable solutions.

But there was still little Democratic support for an individual mandate, as Senator John Breaux of Louisiana found when he proposed one several years later. But officials, centrist policy groups and even liberal research organizations slowly warmed to the idea.

When Senator John Edwards sought the Democratic presidential nomination in 2004, he proposed an insurance mandate for children, but not adults. The politics of the mandate really began to change when Massachusetts enacted its health care law. That effort united Mr. Romney, a Republican, with Senator Edward M. Kennedy, a liberal stalwart who got involved in part to protect the state’s share of federal Medicaid money, and Democratic lawmakers on Beacon Hill. All wound up supporting a plan with an individual mandate.

“Democrats, based on the Massachusetts experience, became much more comfortable with the idea of an individual mandate,” said John McDonough, a professor at the Harvard School of Public Health who was a health care advocate in the state at the time.

When Mr. Edwards ran for president again in 2008, his health plan called for an individual mandate for all. Mrs. Clinton followed suit. But Mr. Obama resisted the idea as a candidate, calling for a mandate for children only.

But as president, Mr. Obama changed his mind.

Many conservatives changed their minds too, however. Some of the Republican senators who once supported versions of the individual mandate railed against Mr. Obama’s plan. Mr. Romney, despite signing a similar plan into law in Massachusetts, has made a pledge to try to “repeal Obamacare” central to his presidential campaign.

Mr. Butler, of the Heritage Foundation, said in an interview that his views had evolved over the years. He said that he now believed that near-universal coverage could be achieved without a mandate, and added that the mandate he once supported was for basic catastrophic coverage, not comprehensive insurance.

The Heritage Foundation has taken pains to distance itself from its past support of an individual mandate: it wrote a court amicus brief noting its change of heart, and Mr. Butler wrote an op-ed article in USA Today this month headlined “Don’t blame Heritage for ‘ObamaCare’ mandate.”

But not all of the early conservative proponents have changed their minds. Mark V. Pauly, a professor of health care management at the University of Pennsylvania’s Wharton School who was a co-author of an influential 1991 paper that called for an individual mandate, said that he was discouraged to see so many Republicans shunning an idea they had once supported.

“My view was, I still agree with myself,” he said in an interview. “And I was pleased that this thought was getting bipartisan appeal where the whole thing was declared dead on arrival by Democrats 18 years before.”

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New mental health manual is "dangerous" say experts

LONDON (Reuters) - Millions of healthy people - including shy or defiant children, grieving relatives and people with fetishes - may be wrongly labeled mentally ill by a new international diagnostic manual, specialists said on Thursday.

In a damning analysis of an upcoming revision of the influential Diagnostic and Statistical Manual of Mental Disorders (DSM), psychologists, psychiatrists and other experts said new categories of mental illness identified in the book were at best "silly" and at worst "worrying and dangerous."

"Many people who are shy, bereaved, eccentric, or have unconventional romantic lives will suddenly find themselves labeled as mentally ill," said Peter Kinderman, head of Liverpool University's Institute of Psychology at a briefing in London about widespread concerns over the manual.

"It's not humane, it's not scientific, and it won't help decide what help a person needs."

The DSM is published by the American Psychiatric Association (APA) and has symptoms and other criteria for diagnosing mental disorders. It is used internationally and seen as the diagnostic "bible" for mental health medicine.

No one from the APA was immediately available for comment.

More than 11,000 health professionals have already signed a petition (at http://dsm5-reform.com) calling for the development of the fifth edition of the manual to be halted and re-thought.

Some diagnoses - for conditions like "oppositional defiant disorder" and "apathy syndrome" - risk devaluing the seriousness of mental illness and medical zing behaviors most people would consider normal or just mildly eccentric, the experts said.

At the other end of the spectrum, the new DSM, due out next year, could give medical diagnoses for serial rapists and sex abusers - under labels like "paraphilic coercive disorder" - and may allow offenders to escape prison by providing what could be seen as an excuse for their behavior, they added.

RADICAL, RECKLESS, AND INHUMANE

Simon Wessely of the Institute of Psychiatry at King's College London said a look back at history should make health experts ask themselves: "Do we need all these labels?"

He said the 1840 Census of the United States included just one category for mental disorder, but by 1917 the APA was already recognizing 59. That rose to 128 in 1959, to 227 in 1980, and again to around 350 disorders in the fastest revisions of DSM in 1994 and 2000.

Allen Frances of Duke University and chair of the committee that oversaw the previous DSM revision, said DSM-5 would "radically and recklessly expand the boundaries of psychiatry" and result in the "lexicalization of normality, individual difference, and criminality."

David Pilgrim of Britain's University of Central Lancashire said it was "hard to avoid the conclusion that DSM-5 will help the interests of the drug companies."

"Madness and misery exist but they come in many shapes and sizes," he said. "We risk treating the experience and conduct of people as if they are botanical specimens waiting to be identified and categorized in rigid boxes.

"That would itself be a form of collective madness for all those complicit in the continuing pseudo-scientific exercise."

Nick Craddock of Cardiff University's department of psychological medicine and neurology, who also spoke at the London briefing, cited depression as a key example of where DSM's broad categories were going wrong.

Whereas in previous editions, a person who had recently lost a loved one and was suffering low moods would be seen as experiencing a normal human reaction to bereavement, the new DSM criteria would ignore the death, look only at the symptoms, and class the person as having a depressive illness.

Other examples of diagnoses cited by experts as problematic included "gambling disorder," "internet addiction disorder" and "oppositional defiant disorder" - a condition in which a child "actively refuses to comply with majority's requests" and "performs deliberate actions to annoy others."

"That basically means children who say 'no' to their parents more than a certain number of times," Kinderman said. "On that criteria, many of us would have to say our children are mentally ill."

(Editing by Andrew Heavens)

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Most Teens Who Self-Harm Are Not Evaluated for Mental Health in ER

FRIDAY, Feb. 10 (HealthDay News) -- Most children and teens who deliberately injure themselves are discharged from emergency rooms without an evaluation of their mental health, a new study shows.

The findings are worrisome since risk for suicide is greatest right after an episode of deliberate self-harm, according to researchers at Nationwide Children's Hospital in Columbus, Ohio.

The researchers also found the majority of these kids do not receive any follow-up care with a mental health professional up to one month after their ER visit.

"Emergency department personnel can play a unique role in suicide prevention by assessing the mental health of patients after deliberate self-harm and providing potentially lifesaving referrals for outpatient mental health care," said lead study author Jeff Bridge, principal investigator at the hospital's Center for Innovation in Pediatric Practice, in a news release. "However, the coordination between emergency services for patients who deliberately harm themselves and linkage with outpatient mental health treatment is often inadequate."

For the study in the Journal of the American Academy of Child & Adolescent Psychiatry, researchers examined Medicaid data for adolescents aged 10 to 19 years. Only 39 percent of the patients discharged after trying to harm themselves received a mental health assessment in the emergency department.

Only about half of the children who had visited the ER for a mental health-related reason within the previous 60 days received a mental health evaluation during their visit to the ER for self-harm.

Up to 90 percent of young people who deliberately harm themselves meet criteria for at least one psychiatric disorder, particularly mood disorders, the researchers said.

The U.K.'s National Institute for Health and Clinical Excellence recommends that people who show up in an emergency room for self-harm should receive a mental health evaluation before being released from the hospital.

"This study highlights the need for strategies to promote emergency department mental health assessments, strengthening the training of physicians in pediatric mental health and adolescent suicide prevention and timely transitions to outpatient mental health care," Bridge said.

More information

The American Academy of Child & Adolescent Psychiatry has more about self-injury among teens.

View the original article here

Most Teens Who Self-Harm Are Not Evaluated for Mental Health in ER

FRIDAY, Feb. 10 (HealthDay News) -- Most children and teens who deliberately injure themselves are discharged from emergency rooms without an evaluation of their mental health, a new study shows.

The findings are worrisome since risk for suicide is greatest right after an episode of deliberate self-harm, according to researchers at Nationwide Children's Hospital in Columbus, Ohio.

The researchers also found the majority of these kids do not receive any follow-up care with a mental health professional up to one month after their ER visit.

"Emergency department personnel can play a unique role in suicide prevention by assessing the mental health of patients after deliberate self-harm and providing potentially lifesaving referrals for outpatient mental health care," said lead study author Jeff Bridge, principal investigator at the hospital's Center for Innovation in Pediatric Practice, in a news release. "However, the coordination between emergency services for patients who deliberately harm themselves and linkage with outpatient mental health treatment is often inadequate."

For the study in the Journal of the American Academy of Child & Adolescent Psychiatry, researchers examined Medicaid data for adolescents aged 10 to 19 years. Only 39 percent of the patients discharged after trying to harm themselves received a mental health assessment in the emergency department.

Only about half of the children who had visited the ER for a mental health-related reason within the previous 60 days received a mental health evaluation during their visit to the ER for self-harm.

Up to 90 percent of young people who deliberately harm themselves meet criteria for at least one psychiatric disorder, particularly mood disorders, the researchers said.

The U.K.'s National Institute for Health and Clinical Excellence recommends that people who show up in an emergency room for self-harm should receive a mental health evaluation before being released from the hospital.

"This study highlights the need for strategies to promote emergency department mental health assessments, strengthening the training of physicians in pediatric mental health and adolescent suicide prevention and timely transitions to outpatient mental health care," Bridge said.

More information

The American Academy of Child & Adolescent Psychiatry has more about self-injury among teens.

View the original article here

New mental health manual is "dangerous" say experts

LONDON (Reuters) - Millions of healthy people - including shy or defiant children, grieving relatives and people with fetishes - may be wrongly labeled mentally ill by a new international diagnostic manual, specialists said on Thursday.

In a damning analysis of an upcoming revision of the influential Diagnostic and Statistical Manual of Mental Disorders (DSM), psychologists, psychiatrists and other experts said new categories of mental illness identified in the book were at best "silly" and at worst "worrying and dangerous."

"Many people who are shy, bereaved, eccentric, or have unconventional romantic lives will suddenly find themselves labeled as mentally ill," said Peter Kinderman, head of Liverpool University's Institute of Psychology at a briefing in London about widespread concerns over the manual.

"It's not humane, it's not scientific, and it won't help decide what help a person needs."

The DSM is published by the American Psychiatric Association (APA) and has symptoms and other criteria for diagnosing mental disorders. It is used internationally and seen as the diagnostic "bible" for mental health medicine.

No one from the APA was immediately available for comment.

More than 11,000 health professionals have already signed a petition (at http://dsm5-reform.com) calling for the development of the fifth edition of the manual to be halted and re-thought.

Some diagnoses - for conditions like "oppositional defiant disorder" and "apathy syndrome" - risk devaluing the seriousness of mental illness and medical zing behaviors most people would consider normal or just mildly eccentric, the experts said.

At the other end of the spectrum, the new DSM, due out next year, could give medical diagnoses for serial rapists and sex abusers - under labels like "paraphilic coercive disorder" - and may allow offenders to escape prison by providing what could be seen as an excuse for their behavior, they added.

RADICAL, RECKLESS, AND INHUMANE

Simon Wessely of the Institute of Psychiatry at King's College London said a look back at history should make health experts ask themselves: "Do we need all these labels?"

He said the 1840 Census of the United States included just one category for mental disorder, but by 1917 the APA was already recognizing 59. That rose to 128 in 1959, to 227 in 1980, and again to around 350 disorders in the fastest revisions of DSM in 1994 and 2000.

Allen Frances of Duke University and chair of the committee that oversaw the previous DSM revision, said DSM-5 would "radically and recklessly expand the boundaries of psychiatry" and result in the "lexicalization of normality, individual difference, and criminality."

David Pilgrim of Britain's University of Central Lancashire said it was "hard to avoid the conclusion that DSM-5 will help the interests of the drug companies."

"Madness and misery exist but they come in many shapes and sizes," he said. "We risk treating the experience and conduct of people as if they are botanical specimens waiting to be identified and categorized in rigid boxes.

"That would itself be a form of collective madness for all those complicit in the continuing pseudo-scientific exercise."

Nick Craddock of Cardiff University's department of psychological medicine and neurology, who also spoke at the London briefing, cited depression as a key example of where DSM's broad categories were going wrong.

Whereas in previous editions, a person who had recently lost a loved one and was suffering low moods would be seen as experiencing a normal human reaction to bereavement, the new DSM criteria would ignore the death, look only at the symptoms, and class the person as having a depressive illness.

Other examples of diagnoses cited by experts as problematic included "gambling disorder," "internet addiction disorder" and "oppositional defiant disorder" - a condition in which a child "actively refuses to comply with majority's requests" and "performs deliberate actions to annoy others."

"That basically means children who say 'no' to their parents more than a certain number of times," Kinderman said. "On that criteria, many of us would have to say our children are mentally ill."

(Editing by Andrew Heavens)

View the original article here