Later On

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Archive for the ‘Mental Health’ Category

Doctors who sexually abuse patients go to therapy and then return to practice

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No protection, no oversight, no accountability. Ariel Hart reports in the Atlanta Journal-Constitution:

After medical regulators said he fondled patients, exposed himself and traded drugs for sex, Dr. David Pavlakovic easily could have lost his license. Law enforcement thought his acts were criminal.

Instead of losing his job, Pavlakovic was placed in therapy. He was allowed to return to practice. And he didn’t even have to tell his patients.

The way Alabama handled Pavlakovic’s case reflects a growing trend across the nation: Medical regulators are viewing sexual misconduct by doctors as the symptom of an impairment rather than cause for punishment. Doctors who abuse, regulators and therapists say, can be evaluated and managed — sometimes with as little as a three-day course on appropriate doctor-patient “boundaries,” other times with inpatient mental health treatment that may include yoga and massage.

Society has become intolerant of most sex offenders, placing some on lifelong public registries and banishing others from their professions or volunteer activities. But medical regulators have embraced the idea of rehabilitation for physicians accused of sexual misconduct, a national investigation by The Atlanta Journal-Constitution found.

Increasingly, it is left to private therapists, rather than police investigators, to unearth the extent of a doctor’s transgressions. There is little pretense of the check and balance of public scrutiny. Instead, some in the medical profession have discouraged public input, concerned it could trigger outrage that disrupts important work.

Even doctors with egregious violations are allowed to redeem themselves through education and treatment centers, which have quietly proliferated over the past two decades.

After boundary training and treatment, California reinstated a doctor who’d had a string of young women take off their underwear as he watched and then had them move their legs or butt cheeks so he could see or touch their anus and genitals. His victims included a high-school-aged girl in for a head cold.

Montana restored the license of a physician who served time in federal prison on a child pornography charge. The doctor exemplified the transformation that can result from treatment, the president of Montana’s medical board said this spring at a convention of medical regulators in San Diego.

“This was a very negative thing for the public,” Nathan Thomas said, acknowledging public criticism of the board’s decision.

However, he said the board worked with a program that pushed for the doctor’s rehabilitation., “I feel that this is a great example of the advocacy of our program,” Thomas said. . .

Continue reading. And read the whole thing: it’s very troubling.

Written by LeisureGuy

27 August 2016 at 12:26 pm

Scanning ultrasound removes amyloid-β and restores memory in an Alzheimer’s disease mouse model

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Very interesting article in Science Translational Medicine from the AAAS. The abstract:

Amyloid-β (Aβ) peptide has been implicated in the pathogenesis of Alzheimer’s disease (AD). We present a nonpharmacological approach for removing Aβ and restoring memory function in a mouse model of AD in which Aβ is deposited in the brain. We used repeated scanning ultrasound (SUS) treatments of the mouse brain to remove Aβ, without the need for any additional therapeutic agent such as anti-Aβ antibody. Spinning disk confocal microscopy and high-resolution three-dimensional reconstruction revealed extensive internalization of Aβ into the lysosomes of activated microglia in mouse brains subjected to SUS, with no concomitant increase observed in the number of microglia. Plaque burden was reduced in SUS-treated AD mice compared to sham-treated animals, and cleared plaques were observed in 75% of SUS-treated mice. Treated AD mice also displayed improved performance on three memory tasks: the Y-maze, the novel object recognition test, and the active place avoidance task. Our findings suggest that repeated SUS is useful for removing Aβ in the mouse brain without causing overt damage, and should be explored further as a noninvasive method with therapeutic potential in AD.

Written by LeisureGuy

24 August 2016 at 9:54 am

Wow! Amazing story.

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Just start reading it. See what you think.

Written by LeisureGuy

18 August 2016 at 8:26 pm

The Alabama approach to mental health clinics: Jail

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To be honest, the Alabama “solution” of simply putting the mentally ill in jail (as though mental illness were a crime, though didn’t Samuel Butler make illness in general a crime in Erewhon?) is not all that different across the US. John Sharp reports at Al.com:

Ferma Jackson oversees dozens of inmates with mental health concerns.

His work space is a large semi-circular area called a “pod.” Within the pod are smaller “wedges” including one wedge that consists of eight cells housing inmates with schizophrenia and bipolar disorder. Each of these inmates has specific medical requirements that take up a large portion of the day for correctional officers.

“After a while, you see the same people come in,” said Jackson, who has been employed as a county corrections officer for four years. “You get to know them and they get to know you.”

He added, “If they had a place to actually go and get some help, that would be the best way to go.”

But finding alternative housing is a problem for sheriffs throughout Alabama.

A months-long AL.com probe has found frustrated local law enforcement and corrections officials across the state reeling from cuts in mental health funding. The results: more corrections officers being attacked; more psychotropic drugs being issued;and fewer  hospital beds for the severely mentally ill.

Faced with a growing problem, the Sheriff’s Department in Mobile County is now looking to expand its jail to handle inmates with mental illness.

The proposed jail expansion would be the first at the 32-year-old facility since the mid-1990s.  It also comes four years after the state shuttered most of its psychiatric wards.

And while Mobile County’s overall jail population is trending downward since 2010, the number of inmates prescribed “psychotropic” medication remains steady, if not rising – about 14 percent of the jail’s inmates.

‘Necessary modifications’

To Sheriff Sam Cochran and Trey Oliver, the jail’s warden, mental health issues are not only creating extra expenses. They are also creating safety concerns.

Oliver said the number of corrections officers assaulted last year was nearly “double the norms.”

Mobile County is better equipped than most in Alabama to tackle the complex needs for inmates with mental illness. According to an AL.com analysis, 70 percent of 40 sheriff departments responding to a survey indicated they were holding someone in need of mental health services. Of those 40 counties, 65 percent said they had trouble finding services for at least one inmate with mental health problems. . .

Continue reading.

Written by LeisureGuy

16 August 2016 at 1:29 pm

Another one who misunderstands the Dunning-Kruger effect

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The Dunning-Kruger effect occurs when a person’s ignorance of a field is so great that they lack even enough knowledge to realize how ignorant they are. Victims of the Dunning-Kruger effect will often make pronouncements that reveal the depth of their ignorance: blunders that anyone with some knowledge of the subject will realize are howlers. Moreover, the pronouncements are made with great confidence, since the speaker has no clue to how ignorant s/he is, and confidence can be very convincing (cf. Donald Trump).

What is curious is that you will often see people, particularly intelligent people,  attribute the effect to stupidity rather than ignorance: instead of the DK effect being caused by a deficit of knowledge, they claim it is caused by a deficit of intelligence. (This misstatement in fact seems to be an example of the DK effect.) The speaker is implicitly saying, “The DK effect happens only to stupid people, but I am intelligent, so I am immune from the DK effect.”

For example, in this article in Raw Story, Bobby Azarian explores the cognitive problem that enables people to accept whatever Donald Trump is currently claiming. He explains the DK effect fairly well, but then summarizes: “Essentially, they’re not smart enough to realize they’re dumb.” So he views the DK effect purely as the result of low intelligence, so that “smart” people are protected by their intelligence and thus will never fall prey to the effect.

This statement is completely wrong: the Dunning-Kruger effect is caused by a lack of knowledge, not intelligence. It’s unfortunately not uncommon for brilliant people to opine about things outside their area of knowledge and make statements and claims that are completely wrong, and (to anyone who has some knowledge in that area) obviously wrong. But the error is not obvious to the speaker, however intelligent he or she is, because the speaker’s ignorance prevents him (or her) from recognizing the error. Not only that, their ignorance is so great in that area that they don’t even recognize that they are ignorant: they believe in fact that they know that are quite well and that there’s not that much to it.

We all are born totally ignorant, and life consists of gradually reducing that ignorance. In some areas we make great inroads against our ignorance—those areas that we study and practice—but however much progress we make in one or several fields, we remain ignorant in many more, and thus subject to the DK effect, regardless of our intelligence, in those areas.

It’s unpleasant to realize that, even though we are intelligent, we can fall into the trap of saying things that make us look foolish if we’re offering opinions on topics in which our ignorance is so great we don’t know that we’re ignorant. Blind to our ignorance, we can stumble into obvious errors, and if we think we’re automatically protected by our intelligence, we fail to on our guard. The DK effect can hit anyone.

Written by LeisureGuy

5 August 2016 at 9:07 am

Not snark: David Brooks wrote an interesting column.

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See what you think.

The previous post was written before I read Brooks’s column, but they seem to be on the same wave length.

BTW, it seems perfectly clear that David Brooks, like so many, has been following the James Fallows series on American Futures in his travels across America.

About time: Former Football Players Sue Stanford University, NCAA, PAC-12 Over Mishandled Concussions

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CBS reports:

A complaint filed on behalf of thousands of former Stanford University football players alleges the university, the National Collegiate Athletic Association and the Pac-12 Conference knew that football players were in danger of permanent brain injuries but did not protect the players so as to “protect the very profitable business of ‘amateur’ college football.”

Chris Dore, a partner at the law firm Edelson PC said the lawsuit filed Thursday against Stanford, the NCAA and Pac-12 is only one of 15 lawsuits that have been filed in recent weeks by his firm against colleges and athletic conferences on behalf of college football players.

The wave of lawsuits comes on the heels of two other related lawsuits: One is a a lawsuit against the NCAA, which did not include monetary compensation for players but made strides in medical monitoring and tests for concussions. The second is a $1 billion concussion settlement against the National Football League alleging that the league failed to warn players and hid the damages of brain injury.

Dore told CBS San Francisco Friday that the defendants didn’t want to discourage play or participation in the sport out of concern that there would be “loss of significant profits.”

He said that this punitive class action lawsuit is led by plaintiff David Burns, who played at Stanford University in the 1970s, but is filed on behalf of thousands of football players who played for the university’s team between 1959 and 2010.

Dore said the defendants knew about scientific studies, some even conducted at the very same universities, that described the dangers of concussions, but did nothing to protect players.

The complaint states that “… Defendants Stanford, Pac-12, and the NCAA have kept their players and the public in the dark about an epidemic that was slowly killing their athletes.”

The plaintiff is demanding a jury trial and monetary relief for players. Dore said dozens more lawsuits are expected in coming weeks. . .

Continue reading.

When money is involved, damage is ignored: cf. the cigarette industry, the oil and coal industry, and now the enormous amounts of money made in college sports (not by the players, of course, who get none of the revenue).

Later in the article:

“Unfortunately, for decades, Defendants Stanford, Pac-12, and the NCAA knew about the debilitating long-term dangers of concussions, concussion-related injuries, and sub-concussive injuries (referred to as “traumatic brain injuries” or “TBIs”) that resulted from playing college football, but actively concealed this information to protect the very profitable business of ‘amateur’ college football,” the complaint alleges.

Stanford, of course, denies everything. They had no idea that playing football caused any brain injury at all. Big surprise for them. (So will they continue to field teams?)

Written by LeisureGuy

11 July 2016 at 3:31 pm

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