Archive for the ‘Medical’ Category
Tom Jacobs reports at Pacific Standard:
Plenty of research has suggested immersing yourself in nature has significant mental and physical health benefits. But can it also make you a better person? New research from France suggests it just might.
In two experiments, pedestrians who had just strolled through a beautiful park were more likely to come to the aid or a stranger who had just dropped a glove. Writing in the journal Environment and Behavior, Nicolas Guéguen and Jordy Stefan of the University of Bretagne-Sud refer to this as “green altruism.”
Their first experiment featured
Another reason for traditional wet-shaving’s appeal: By requiring more effort it provides a sense of control
And a sense of control is exactly what people crave when the general situation, globally, nationally, and locally, feels out of control (cf. the three earlier posts on law enforcement, which was once a source of a sense of control). Tom Jacobs writes at Pacific Standard:
As a proposed advertising slogan, “Requires Effort” wouldn’t pass muster with Don Draper. But surprising new research finds that, under certain circumstances, people are in fact drawn to products that demand some work.
Such items become more desirable when people feel a lack of control over their lives, according to Keisha Cutright of the University of Pennsylvania and Adriana Samper of Arizona State University. These “high-effort products,” they write, enable frustrated individuals to recapture a sense of personal power.
“Beyond seeking products that merely symbolize a given trait,” Cutright and Samper write in the Journal of Consumer Research, “consumers sometimes prefer products that give them an opportunity to actually demonstrate that they possess a trait.”
The researchers describe five studies that provide evidence for their thesis. In the first, . . .
Feeling that one lacks control in his or her life puts one at serious risk for depression—or, as Martin Seligman termed it in his studies, “learned helplessness.” (His book Learned Optimism is quite interesting—inexpensive secondhand copies at the link.)
I feel better and better about my LCHF diet. Read this article in Pacific Standard by John Upton:
Colorectal cancer is a scourge of modern times, killing 50,000 Americans every year. It’s responsible for a heavier death toll than any other cancer besides lung cancer and, when it comes to women, breast cancer.
And new research, which was published last week in Cell, has provided insights into the dangerous link between colorectal cancers and modern diets heavy in wheat, rice, and other complex carbohydrates—diets that became possible with the advent of agriculture.
University of Toronto scientists led research that suggests a common type of gut-dwelling bacteria breaks down carbs into certain metabolites that can lead to cancer. These metabolites appear to cause cells that line the colon to divide and proliferate rapidly, forming polyps. These polyps, which can grow into a cancer, are the abnormal growths that your doctor is probing for when they subject you to a colonoscopy.
The scientists found that they could protect specially bred mice from the cancers in two ways. In some mice, they used targeted antibiotics to kill off the clostridia bacteria that convert carbs into the metabolite butyrate. In other mice, they reduced the amount of carbs in their diets.
“We know it depends on bacteria, and we know it depends on carbs,” says Alberto Martin, an associate immunology professor at the University of Toronto and one of the authors of the study. “This is the part of the study that’s still not solid, but we think that butyrate is somehow fueling the hyperproliferation of colon epithelial cells.” Other metabolites of carbohydrates might also be involved, he says. “It would be naïve to think it’s only butyrate.”
The phyla of bacteria . . .
The simple answer is that Medicare was not reviewing its billing data and seemed to have little interest in stopping fraud. Charles Ornstein reports in ProPublica:
A few years ago, Illinois’ Medicaid program for the poor noticed some odd trends in its billings for group psychotherapy sessions.
Nursing home residents were being taken several times a week to off-site locations, and Medicaid was picking up the tab for both the services and the transportation.
And then there was this: The sessions were often being performed by obstetrician/gynecologists, oncologists and urologists — “people who didn’t have any training really in psychiatry,” Medicaid director Theresa Eagleson recalled.
So Medicaid began cracking down, and spending plummeted after new rules were implemented. In July 2012 the program stopped paying for group psychotherapy altogether for residents of nursing homes.
Yet Illinois doctors are still billing the federal Medicare program for large numbers of the same services, a ProPublica analysis of federal data shows.
Medicare paid Illinois providers for more than 290,000 group psychotherapy sessions in 2012 — more than twice as many sessions as were reimbursed to providers in New York, the state with the second-highest total.
Among the highest billers for group psychotherapy in Illinois were three ob/gyns and a thoracic surgeon. The four combined for 37,864 sessions that year, more than the total for all providers in the state of California. They were reimbursed more than $730,000 by Medicare in 2012 just for psychotherapy sessions, according to an analysis of a separate Medicare data set released in April.
“That’s not good,” Eagleson said when told of the Medicare numbers.
Medicare’s recent data release has led to a string of analyses showing how waste and fraud is inflating the nation’s bill for health care. This work has echoed the findings of ProPublica’s investigation last year into Medicare’s prescription drug program known as Part D, which had fewer barriers to waste and fraud than other government health care programs – and was making less effective use of its own data.
Of the Illinois ob/gyns billing for group psychotherapy, . . .
Some of these physicians should face criminal charges for fraud and also lose their license to practice medicine.
Arthur C. Brooks writes in the NY Times:
ABD AL-RAHMAN III was an emir and caliph of Córdoba in 10th-century Spain. He was an absolute ruler who lived in complete luxury. Here’s how he assessed his life:
“I have now reigned above 50 years in victory or peace; beloved by my subjects, dreaded by my enemies, and respected by my allies. Riches and honors, power and pleasure, have waited on my call, nor does any earthly blessing appear to have been wanting to my felicity.”
Fame, riches and pleasure beyond imagination. Sound great? He went on to write:
“I have diligently numbered the days of pure and genuine happiness which have fallen to my lot: They amount to 14.”
Abd al-Rahman’s problem wasn’t happiness, as he believed — it was unhappiness. If that sounds like a distinction without a difference, you probably have the same problem as the great emir. But with a little knowledge, you can avoid the misery that befell him.
What is unhappiness? Your intuition might be that it is simply the opposite of happiness, just as darkness is the absence of light. That is not correct. Happiness and unhappiness are certainly related, but they are not actually opposites. Images of the brain show that parts of the left cerebral cortex are more active than the right when we are experiencing happiness, while the right side becomes more active when we are unhappy.
As strange as it seems, being happier than average does not mean that one can’t also be unhappier than average. One test for both happiness and unhappiness is the Positive Affectivity and Negative Affectivity Schedule test. I took the test myself. I found that, for happiness, I am at the top for people my age, sex, occupation and education group. But I get a pretty high score for unhappiness as well. I am a cheerful melancholic.
So when people say, “I am an unhappy person,” they are really doing sums, whether they realize it or not. They are saying, “My unhappiness is x, my happiness is y, and x > y.” The real questions are why, and what you can do to make y > x. . . .
Continue reading. It’s good.
Very intriguing article by Wen Chen in Pacific Standard:
My profession is filled with exceptional individuals who do amazing, lifesaving work. Many of us are jerks.
This is the trouble with surgeons. We are a sub-tribe of doctors who have long been celebrated for our abilities yet reviled for our personalities. In movies and TV shows, we are egomaniacal, hostile, and even mentally unstable. A low point came in 1993 with the film Malice, which featured a scenery-chewing turn by Alec Baldwin as a gifted but evil cardiac surgeon who denied having a God complex. “I am God,” he clarified.
Behind the caricatures lies some truth. Many surgeons are abrasive, abusive, and wildly self-centered—so much so that observers have speculated that they suffer from psychiatric disorders. In 2012, British psychologist Kevin Dutton published The Wisdom of Psychopaths: What Saints, Spies, and Serial Killers Can Teach Us About Success, a controversial book arguing there are certain benefits to being ruthless, cunning, and indifferent to the feelings of others. Dutton included a list (based on an Internet survey) of professions with the highest proportion of psychopaths. Surgeons landed at number five, barely trailing CEOs and lawyers.
Within the past two decades, though, the surgical profession has attempted a wholesale revamping of its image and ideals. Compassion, communication, and collaboration are now strongly emphasized during training. It’s been a rapid and turbulent metamorphosis that has undoubtedly led to improvements for patients, hospital co-workers, and even surgeons themselves. Nonetheless, in the process, surgery may have created its own identity crisis. We want to believe we’re better off with nicer surgeons. But what do we lose?
SURGERY HAS ALWAYS BEEN, at its core, a brutal undertaking. Prior to the introduction of anesthesia in the mid-19th century, surgeons often worked to a sound track of screams. Writing in 1812, British novelist and playwright Frances “Fanny” Burney provided a rare patient-centered account of the horrors of a mastectomy without anesthesia. “When the dreadful steel was plunged into the breast,” she wrote, “I began a scream that lasted unintermittingly during the whole time of the incision—& I almost marvel that it rings not in my Ears still! so excruciating was the agony.”
No surgeon could inflict such anguish for long without developing a tough shell. Thirteenth-century French surgeon Henri de Mondeville wrote that two of the most important requirements for a surgeon were a strong stomach and the ability to “cut like an executioner.” Samuel Cooper, a British surgeon of the early 19th century, identified the surgeon’s most valuable quality as “undisturbed coolness, which is still more rare than skill.”
Because of their grisly work and perceived lack of refinement, surgeons lagged far behind their medical counterparts in social status, on a par with blacksmiths or barbers. Then, with the invention of anesthesia in the 1840s, followed a few decades later by the introduction of antiseptic techniques, surgeons began to achieve success upon success in invading the body and curing disease. Their profession skyrocketed in prestige. In 1904, New York surgeon Frederic Dennis delivered an exuberant keynote address at the Universal Exposition in St. Louis and lauded the “conspicuous grandeur” of surgery’s ascendance and the “self-reliance, principle, independence, and determination” of those who could perform it.
While surgery grew somewhat less gruesome, surgeons of the 20th century retained many of the personality traits of their pre-anesthetic forebears: detachment, resolve, and a thirst for action.
They continue walking the earth even after they have been completely exposed as counterfactual. As Maher says:
What they do is they pass a zombie lie down to dumber and dumber people, who believe it more and more.
Hank Paulson may be over the one about climate change being a hoax, but it’s still good enough for Sean Hannity. Who then gets quoted by Michele Bachmann. Who forms the intellectual core of the thinking of Victoria Jackson. And when you think the zombie lie has finally gone to die at the idea hospice of the absolutely stupidest people on Earth, there it is being retweeted by Donald Trump.
But that’s just the summation of a very good rant about all the zombie lies about Obamacare. Maher goes through the list—lies that have been solidly refuted but never acknowledged by the GOP, which simply moves on to the next round of lies, leaving their litter of lies to blow around and soil our daily lives.
At least they are being open about it and taking emphatic steps to stop the damage. Here’s the story.
The eruption of the VA scandals showed clearly that the government does a poor job of investigating its programs. And now Medicare has been found to simply accept large-scale fraud, seemingly making no effort whatsoever to detect and punish fraud—until newspapers write stories about it. Charles Ornstein has an infuriating article in ProPublica:
The fraud scheme began to unravel last fall, with the discovery of a misdirected stack of bogus prescriptions — and a suspicious spike in Medicare drug spending tied to a doctor in Key Biscayne, Fla.
Now it’s led to two guilty pleas, as well as an ongoing criminal case against a pharmacy owner.
Last year, ProPublica chronicled how lax oversight had led to rampant waste and fraud in Medicare’s prescription drug program, known as Part D. As part of that series, we wrote about Dr. Carmen Ortiz-Butcher, a kidney specialist whose Part D prescriptions soared from $282,000 in 2010 to $4 million the following year. The value of her prescriptions rose to nearly $5 million in 2012, the most recent year available.
But no one in Medicare bothered to ask her about the seemingly huge change in her practice, Ortiz-Butcher’s attorney said. She stumbled across a sign of trouble last September, after asking a staffer to mail a fanny pack to her brother. But instead of receiving the pack, he received a package of prescriptions purportedly signed by the doctor, lawyer Robert Mayer said last year. Ortiz-Butcher immediately alerted authorities.
Since then, investigators have uncovered a web of interrelated scams that, together, cost the federal government up to $7 million, documents show.
In February, the U.S. Attorney’s office for the Southern District of Florida charged Maria De Armas Suero, who had been a secretary at Ortiz-Butcher’s Island Clinic from March 2011 to September 2013, with 11 counts of conspiracy, fraud and aggravated identity theft.
Suero subsequently agreed to plead guilty to two counts of conspiracy and identity theft. In a recounting of her wrongdoing, called a factual proffer, she acknowledged using Ortiz-Butcher’s paper prescriptions to “create fraudulent scripts for numerous Medicare beneficiaries…The prescriptions falsely represented that the Medicare beneficiary was seen by [Ortiz-Butcher] and that the listed prescriptions were medically necessary.”
Suero acknowledged that she was paid $100 for each prescription she generated. . .
Paul Krugman has a good blog post with links to graphs and stats about Obamacare. From one of his links:
In Brazil: the payoff from the experiment will, I bet, greatly exceed its cost. I hope they’re tracking things like sick days, public health expense, average hospital duration, etc. The outcomes will be interesting.
Tom Jacobs has an interesting article in Pacific Standard:
If you’re approaching retirement, you’ll be facing some difficult issues, even if your finances are in order. Fundamental concerns inevitably arise, including “What shall I do with my time?” and “How can I continue to feel strong and capable?”
New research from Germany suggests an advantageous answer to both of those questions could be to start making art.
A research team led by neurologist Anne Bolwerk reports “the production of visual art improves effective interaction” between certain regions of the brain.
What’s more, this improvement in brain function—found in a small group of new retirees who took a class in which they created paintings and drawings—was matched by self-reports of strengthened psychological resilience. . .
“Our results have important implications for preventative and therapeutic interventions,” the researchers write in the online journal PLoS One. . .
It sounds as though the benefits would be valuable even before retirement.
In the NY Times Adam Liptak points out the Catholic old boys on the Supreme Court have now expanded significantly the restricted Hobby Lobby ruling. That didn’t take long, did it?
In a decision that drew an unusually fierce dissent from the three female justices, the Supreme Court sided Thursday with religiously affiliated nonprofit groups in a clash between religious freedom and women’s rights.
The decision temporarily bars the government from enforcing against a Christian college part of the regulations that provide contraception coverage under the Affordable Care Act.
The court’s order was brief, provisional and unsigned, but it drew a furious reaction from the three female justices — Justices Sonia Sotomayor, Ruth Bader Ginsburg and Elena Kagan — who said the court had betrayed a promise it made on Monday in Burwell v. Hobby Lobby Stores, which involved for-profit corporations.
“Those who are bound by our decisions usually believe they can take us at our word,” the dissent, written by Justice Sotomayor, said. “Not so today.”
At issue in the order, involving Wheaton College in Illinois, are federal forms that groups must fill out and send to their insurers and plan administrators as an alternate way to deliver free contraception to be offered to female workers under the Affordable Care Act.
Monday’s majority opinion in the Hobby Lobby case, written by Justice Samuel A. Alito Jr., seemed to suggest that the accommodation in which the forms played a role was an acceptable alternative to having employers pay for the coverage. He referred to it when he said the government already “has at its disposal an approach that is less restrictive than requiring employers to fund contraception methods that violate their religious beliefs.”
The difference between a form sent to insurance companies and plan administrators on the one hand and a letter sent to the government on the other mattered, the college told the justices, “because it believes, as a religious matter, that signing the form would be impermissibly facilitating abortions and therefore forbidden,” the brief said.
Monday’s “Hobby Lobby” decision was just the latest challenge to the Affordable Care Act. Details on the 5-4 decision and other challenges that could — if successful — have even deeper implications.
Video Credit By Carrie Halperin on Publish Date June 30, 2014. Image CreditDoug Mills/The New York Times
“To be sure, free citizens in a diverse nation will have different views about whether signing the form makes someone complicit,” the college’s brief said. “But that is a question of ‘religious and moral philosophy’ for Wheaton,” not the government. The quoted phrase came from the Hobby Lobby decision.
The court’s majority said Wheaton College need not fill out the forms. Instead, the order said, the college could just notify the government in writing. The government, it said, remains free “to facilitate the provision of full contraceptive coverage.” . . .
I am a big advocate of shaving in a silent bathroom: no fan, no running water, no music, and no radio news. One reason is purely functional: the quiet sound of the cutting blade helps me optimize head angle. But another reason is the meditative aspect of shaving: a time in the day when you closely focus on one task only (with the focus probably even closer for men who shave with a straight razor) with full awareness of what you’re directly experiencing at the moment. Adding a distraction seems purely gratuitous.
And yet some seem curiously attached to distraction. I think some of that is because focusing on a task without distractions is a skill and thus has to be acquired through practice. A person who has little experience of distraction-free close focus on what he is experiencing in the moment suffers the usual negative feelings of any beginner: feeling awkward, not knowing how to do it, not liking how it feels so unfamiliar, feeling very conscious of mistakes, and so on. I understand how that would make one practically leap onto any distraction. But with practice it becomes easier and even, once you’ve learned how to achieve it, something worth seeking.
I just saw an article by Tom Jacobs in Pacific Standard on another factor that may be in play.
Which pastime would you prefer: Sitting alone quietly with your thoughts, or experiencing an electric shock?
The answer may seem obvious. But consider for a moment what it’s like to have no distractions from your ongoing mental chatter, which Buddhists refer to as “monkey mind.”
Thoughts pop up rapidly and randomly, like a sour, surrealistic movie we can’t turn off. Fears and regrets we’ve pushed aside reappear front and center, resulting in increased agitation and the desire for some form of escape—even, perhaps, a jolt of current.
That scenario may or may not sound familiar, but it clearly applies to a lot of people. A research team led by University of Virginia psychologist Timothy Wilson reports that, in a series of studies, “participants typically did not enjoy spending 6 to 15 minutes in a room by themselves with nothing to do but think.”
What’s more, in the researchers’ most remarkable result, “many preferred to administer electronic shocks to themselves instead of being left alone with their thoughts.”
“The untutored mind does not like to be alone with itself,” Wilson and his colleagues conclude in the journal Science.
The researchers demonstrated our aversion to rumination in 11 similarly structured studies.
Timothy Wilson wrote Strangers to Ourselves: Discovering the Adaptive Unconscious, a book I highly recommend.
I included this post in the “mental health” category, but really it’s more “mental fittness”: being able to have your mind easily switch from one mode to another. Perhaps “mental agility,” but with regard to state instead of ideas: the mind as environment rather than machine.
UPDATE: A Washington Post report on the study with more details.
David Heath reports at The Center for Public Integrity:
Living in the lush, wooded countryside with fresh New England air, Wendy Brennan never imagined her family might be consuming poison every day.
But when she signed up for a research study offering a free T-shirt and a water-quality test, she was stunned to discover that her private well contained arsenic.
“My eldest daughter said … ‘You’re feeding us rat poison.’ I said, ‘Not really,’ but I guess essentially … that is what you’re doing. You’re poisoning your kids,” Brennan lamented in her thick Maine accent. “I felt bad for not knowing it.”
Brennan is not alone. Urine samples collected by the Centers for Disease Control and Prevention from volunteers reveal that most Americans regularly consume small amounts of arsenic. It’s not just in water; it’s also in some of the foods we eat and beverages we drink, such as rice, fruit juice, beer and wine.
Under orders from a Republican-controlled Congress, the Environmental Protection Agency in 2001 established a new drinking-water standard to try to limit people’s exposure to arsenic. But a growing body of research since then has raised questions about whether the standard is adequate.
The EPA has been prepared to say since 2008, based on its review of independent science, that arsenic is 17 times more potent as a carcinogen than the agency now reports. Women are especially vulnerable. Agency scientists calculated that if 100,000 women consumed the legal limit of arsenic every day, 730 of them would eventually get bladder or lung cancer from it.
After years of research and delays, the EPA was on the verge of making its findings official by 2012. Once the science was complete, the agency could review the drinking water standard.
But an investigation by the Center for Public Integrity found that one member of Congress effectively blocked the release of the EPA findings and any new regulations for years. . .
Continue reading. There’s a lot more. For example:
Researchers from Columbia University gave IQ tests to about 270 grade-school children in Maine. They also checked to see if there was arsenic in their tap water at home. Maine is known as a hot spot for arsenic in groundwater.
The researchers found that children who drank water with arsenic — even at levels below the current EPA drinking water standard — had an average IQ deficit of six points compared to children who drank water with virtually no arsenic.
The findings are eerily similar to studies of lead, a toxin considered so dangerous to children that it was removed from paint and gasoline decades ago. Other studies have linked arsenic to a wide variety of other ailments, including cancer, heart disease, strokes and diabetes.
“I jokingly say that arsenic makes lead look like a vitamin,” said Joseph Graziano, a Columbia professor who headed the Maine research. “Because the lead effects are limited to just a couple of organ systems — brain, blood, kidney. The arsenic effects just sweep across the body and impact everything that’s going on, every organ system.”
And the Congressman who fought to keep arsenic in US drinking water?
. . . So, who did it? All the evidence from the Center’s investigation pointed to one congressman: Mike Simpson of Idaho.
Simpson was one of the Republicans who signed the letter to the EPA administrator complaining about the missing 300 studies. He was the chairman of the subcommittee that controlled funding for the EPA, where the language first appeared. He was also a member of another committee where the language surfaced again in a different report. He even asked the EPA administrator about arsenic at a subcommittee hearing.
Simpson, who worked as a dentist and state legislator before entering Congress, is a frequent critic of the EPA. But in the 2012 and 2014 election campaigns, he has been portrayed as too liberal by Tea Party candidates funded by the right-wing Club for Growth.
In a brief interview outside his Capitol Hill office, Simpson accepted credit for instructing the EPA to stop work on its arsenic assessment.
“I’m worried about drinking water and small communities trying to meet standards that they can’t meet,” he said. “So we want the Academy of Science to look at how they come up with their science.”
Simpson said he didn’t know that his actions kept a weed killer containing arsenic on the market. He denied that the pesticide companies lobbied him for the delay.
But lobbyist Grizzle offered a different account.
“I was part of a group that met with the congressman and his staff a number of years ago on our concerns,” Grizzle said, adding that there were four or five other lobbyists in that meeting but he couldn’t remember who they were.
Other organizations that disclosed lobbying the EPA and Congress on the agency’s arsenic evaluation were the U.S. Rice Federation; the Mulch and Soil Council; the Association of California Water Agencies; and the National Mining Association, including the mining companies Arch Coal and Rio Tinto.
Grizzle began making donations to Simpson’s re-election campaign in January 2011, a few months before Simpson took action to delay the arsenic assessment. Since then, Grizzle has given a total of $7,500. That’s more than he’s given in that time to any other candidate.
Asked if the contributions were made in exchange for the delay, Grizzle said, “I don’t see a connection. I’ve been a friend and supporter of Congressman Simpson for a long time.”
When Simpson was asked if he was aware of the donations, he terminated the interview, saying, “I have no idea. But I’ve got a hearing.” . . .
It’s not only the vets: Hospitals for active military constantly making errors that result in death or injury
Sharon LaFraniere and Andrew Lehren report in the NY Times:
Jessica Zeppa, five months pregnant, the wife of a soldier, showed up four times at Reynolds Army Community Hospital here in pain, weak, barely able to swallow and fighting a fever. The last time, she declared that she was not leaving until she could get warm.
Without reviewing her file, nurses sent her home anyway, with an appointment to see an oral surgeon to extract her wisdom teeth.
Mrs. Zeppa returned the next day, in an ambulance. She was airlifted to a civilian hospital, where despite relentless efforts to save her and her baby, she suffered a miscarriage and died on Oct. 22, 2010, of complications from severe sepsis, a bodywide infection. Medical experts hired by her family said later that because she was young and otherwise healthy, she most likely would have survived had the medical staff at Reynolds properly diagnosed and treated her.
“She was 21 years old,” her mother, Shelley Amonett, said. “They let this happen. This is what I want to know: Why did they let it slip? Why?”
The hospital doesn’t know, either.
Since 2001, the Defense Department has required military hospitals to conduct safety investigations when patients unexpectedly die or suffer severe injury. The object is to expose and fix systemic errors, often in the most routine procedures, that can have disastrous consequences for the quality of care. Yet there is no evidence of such an inquiry into Mrs. Zeppa’s death.
The Zeppa case is emblematic of persistent lapses in protecting patients that emerged from an examination by The New York Times of the nation’s military hospitals, the hub of a sprawling medical network — entirely separate from the scandal-plagued veterans system — that cares for the 1.6 million active-duty service members and their families.
Internal documents obtained by The Times depict a system in which scrutiny is sporadic and avoidable errors are chronic.
As in the Zeppa case, records indicate that the mandated safety investigations often go undone: From 2011 to 2013, medical workers reported 239 unexpected deaths, but only 100 inquiries were forwarded to the Pentagon’s patient-safety center, where analysts recommend how to improve care. Cases involving permanent harm often remained unexamined as well.
At the same time, by several measures considered crucial barometers of patient safety, the military system has consistently had higher than expected rates of harm and complications in two central parts of its business — maternity care and surgery.
More than 50,000 babies are born at military hospitals each year, and they are twice as likely to be injured during delivery as newborns nationwide, the most recent statistics show. And their mothers were . . .
Where’s the oversight? Why isn’t Darrell Issa having hearings on this instead of the IRS and Benghazi? Because this is real?
As pointed out in the article of the previous post, stress is particularly damaging to young children, whose neurological systems are still developing.In Pacific Standard Lois Beckett has an annotated reading list of articles on this scourge:
When people think of post-traumatic stress disorder, they often focus on military veterans. But there’s growing evidence that PTSD is also a serious problem for American civilians, especially those exposed to violence in their own neighborhoods. Researchers in Atlanta found that one out of three inner-city residents they interviewed had experienced symptoms consistent with PTSD at some point in their lives.
We’ve put together a collection of some of the best reporting on PTSD in children and teenagers exposed to community violence. The stories here take a nuanced look at the intersection of trauma, poverty, and racism. Not all stories about PTSD in high-violence neighborhoods meet that standard. This May, a local CBS affiliate released a segment on trauma in Oakland youth that referred to PTSD as “hood disease.” The anchor who used that term on air later apologized.
Among our recommendations here are magazine stories, radio segments, a book based on a doctor’s interviews with shooting victims, and a documentary film. You can also see our selection of the best reporting on PTSD and the U.S. military.
Brain Development Altered by Violence, Washington Post, May 1999
After the Columbine shootings, this article looked broadly at post-traumatic stress among American children. “The Columbine students are the lucky ones,” the story concluded. “Most child witnesses to violence in America live in inner cities, where shootings occur repeatedly, and where parents often are as traumatized by them as children. And counselors rarely come calling on them in the aftermath of horrors, as they have in Littleton.”
Children Who Survive Urban Warfare Suffer From PTSD, Too, San Francisco Chronicle, August 2007
Eleven-year-old Tierra’s brother was murdered two weeks before she began sixth grade. She wrote her brother’s name on the cover of her notebooks. Her grades dropped. She started getting into fights. And she wasn’t the only one: At her San Francisco middle school, a third of students said they had seen or knew someone killed with a gun. A look at how post-traumatic stress affects children’s school performance—and at the difficulties of getting treatment.
The Poverty Clinic, the New Yorker, March 2011
Experiencing traumatic events at a young age doesn’t simply affect a child’s emotional health. There’s increasing evidence that childhood trauma is linked to serious medical problems in adulthood. A look at how a clinic
The US is making progress. Our child poverty rate (23%) is not so good as that of the UK (10%) or the Nordic countries (7%-8%), but is better than Romania. Those figures are from Jeff Madrick’s article “Inequality Begins at Birth” in the NY Review of Books:
Over the past year, the lack of universal pre-kindergarten for American four-year-olds has become a national issue. In 2013, President Obama proposed to fund an ambitious new nationwide pre-kindergarten program through a new cigarette tax. That plan failed to gain support, but Bill de Blasio gave new urgency to the issue when he swept into the New York mayor’s office promising universal pre-K for all city children—which will begin in the fall. Even as these efforts are being made, however, new research is making it increasingly clear that educational disparities start much earlier.
The value of universal access to early education has long been recognized: it improves the life chances of disadvantaged children and is crucial to keeping a level playing field for all. The United States has fallen well short of this goal. In most of Europe there is universal, good-quality preschool for three- and four-year-olds. In America, recent data show that fewer than half of all three- and four-year olds are enrolled in some form of preschool. Head Start, the main federal program, provides preschool funding for only about two fifths of poor children in this group.
Moreover, America has the second highest child poverty rate out of the thirty-five nations measured by the United Nation Children’s Fund (only Romania is worse). Twenty-three percent of American kids are poor by international standards, compared to 10 percent in the UK and 7 or 8 percent in the Nordic countries. According to studies on the US population, the poorest children are those five and under—indeed, they are the poorest demographic group in the nation. Many of these kids live in deep poverty, with family income less than half of the poverty line. Poverty rates for black and Latino children are especially high.
Scholars have long documented that children who grow up poor face greater obstacles to social development and good health, obstacles that often remain with them the rest of their lives. They are more likely to have chronic diseases like asthma or attention deficit disorder, few of them graduate from high school, their wages are lower, and they often end up on welfare. Poor teenage women have more unwanted births.
But neurological evidence from recent years strongly suggests that the causes of these poor outcomes are neither solely cultural nor a function of a weak gene pool, as commentators like Charles Murray, author of The Bell Curve, once claimed. As Dr. David Keller made clear at a recent conference on child poverty in Washington, D.C. called “Inequality Begins at Birth” (primarily sponsored by the think tank I direct, The Bernard L. Schwartz Rediscovering Government Initiative at the Century Foundation), there is new biological evidence that a high-stress environment for very young children does not simply affect cultural and psychological conditions that predispose the poor to failure; it can also affect the architecture of the brain, changing the actual neurological functioning and quantity of brain matter.
In other words, pre-K is not enough. What is concerning, moreover, is that these findings have been known for some time but are not getting adequate attention. In fact, the original documentation was published back in 2000 in a vanguard article by Harvard’s Center on the Development of the Child, and corroborating studies have multiplied since then.
Indeed, two studies completed in 2013 relate neural deterioration directly to poverty. . .
Once more we see expectations contradicted by experience. Paul Krugman notes in his blog:
For reference: I count at least six distinct predictions of Obamacare doom made by the usual suspects, not one of which has come true. Here they are:
1. Enrollment will be very low, and
2. Even if people sign up, they won’t pay their premiums.
Reality: Signups exceeded expectations, and the vast majority paid.
3. More people will lose coverage cancelled by Obamacare than gain it.
Reality: Sharp drop in the number of uninsured.
4. Rate shock.
Reality: Like it says, affordable care.
5. Young people not signing up, and death spiral.
Reality: Pretty good demographics.
Reality: Health costs are below anyone’s expectations.
It’s quite an impressive track record, actually. And what’s even more impressive is that none of the usual suspects will even consider admitting having been wrong.
Stanton Peele has a very interesting article in Pacific Standard:
In 1975, I published Love and Addiction with Archie Brodsky. Now available as an ebook, a format unimagined back then, L&A anticipated every major development in the field since. To pass the time as I await delivery of my Nobel Prize, I’ll turn my attention to making a set of predictions for the next 40 years.
But first, let’s recap what I wrote in Love and Addiction and consider how that context frames our expectations.
The primary development since 1975 is the realization that addiction is not a byproduct of drugs, but applies equally to every powerful involvement. No drug is inherently addictive; nothing in which people become enmeshed is guaranteed not to be addictive. When Love and Addiction was written, one thing—one drug—was considered to cause addiction. Everybody, including pharmacologists, imagined that some peculiarity in heroin’s chemical structure made people become addicted to it, and it alone. How quaint! Alcohol was arbitrarily placed in a different category, as being addictive for only a special population of alcoholics.
Love and Addiction instead addressed addiction as a life issue. That a love relationship could be exactly as addictive as heroin meant that addiction didn’t spring from a drug’s chemistry. Rather, an addiction is an overwhelming destructive involvement with a powerful experience that provides essential emotional rewards for the addicted person.
We know—at least we did—that destructive love can’t be a disease. Now, however, one wing of the recovery movement has decided that addictive love and sex are real—and that they’re diseases. Recognition of love and sex addiction should have transformed the way we think about addiction. But it was used instead to reinforce existing misconceptions.
For example, Love and Addiction should have forced the recognition of natural recovery: Most people outgrow immature, addictive love relationships, and don’t need to join a 12-step or other program to do so. As for harm reduction, it seems self-evident that if people become addicted to sex and love, most aren’t going to have to quit these activities altogether to get better. Instead, they need to achieve more mature relationships by focusing on their own development.
Love and Addiction changed the addiction landscape, but not the way I intended—Codependent No More was but one example of how the revolutionary thinking in L&A was funneled back through the disease/12-step meat grinder, so that the product was unrecognizable. It is thus still necessary to return to the book to describe where future developments about addiction need to go.
Love and Addiction was also a cultural commentary about how we had lost our sense of efficacy in a world grown increasingly beyond our control. No label both represented and contributed to this sense of powerlessness more than “addictive disease”—the idea that we are incapable of controlling our basic appetites and needs. Unfortunately, both this loss of personal efficacy and the power of the disease meme have grown exponentially since 1975.
KEY QUESTION: Will we successfully challenge the disease meme—while reversing the constant increase in addiction?
Although it is true we are looking in more places for addiction, it is nonetheless also true that addiction is genuinely increasing. Aside from the ever-roiling heroin, painkiller, pick-your-new-drug scares, just look at people staring at their iPhones who are gaming, texting, and otherwise compulsively absorbing their attention all around you.
The American Psychiatric Association publishes its bible, the Diagnostic and Statistical Manual of Mental Disorders (DSM), every decade or two to tell us what’s wrong with us. The fifth edition was released in 2013. For the first time it recognized non-substance addictions—a mere 40 years after Archie and I detailed this phenomenon in Love and Addiction.
First (are you ready?)—DSM-5 doesn’t label substances as addictive or dependence-producing. There are simply mild, moderate, and severe Substance Use Disorders (SUDs). Only activities are “addictive” in DSM-5. Actually, only a single activity, gambling, is called addictive—sex and love were notably denied this status. Still, who would have guessed in 1975 that in 2013 psychiatry would eliminate addiction regarding drug effects, but decide that there were “behavioral addictions”?
Meditate on our confusion: . . .