Health and Medical News and Resources

General interest items edited by Janice Flahiff

Marijuana Use in Adolescence May Cause Permanent Brain Abnormalities, Mouse Study Suggests

English: Close up shot of some high quality ma...

English: Close up shot of some high quality marijuana. (Photo credit: Wikipedia)

 

While I believe the so called War on Drugs has largely been a failure, I am concerned about young folks indulging in substances that can have permanent health effects.

 

 

 

From the 24 July 2013 article at Science News Daily

 

Regular marijuana use in adolescence, but not adulthood, may permanently impair brain function and cognition, and may increase the risk of developing serious psychiatric disorders such as schizophrenia, according to a recent study from the University of Maryland School of Medicine. Researchers hope that the study, published in Neuropsychopharmacology — a publication of the journal Nature — will help to shed light on the potential long-term effects of marijuana use, particularly as lawmakers in Maryland and elsewhere contemplate legalizing the drug.

“Over the past 20 years, there has been a major controversy about the long-term effects of marijuana, with some evidence that use in adolescence could be damaging,” says the study’s senior author Asaf Keller, Ph.D., Professor of Anatomy and Neurobiology at the University of Maryland School of Medicine. “Previous research has shown that children who started using marijuana before the age of 16 are at greater risk of permanent cognitive deficits, and have a significantly higher incidence of psychiatric disorders such as schizophrenia. There likely is a genetic susceptibility, and then you add marijuana during adolescence and it becomes the trigger.”

“Adolescence is the critical period during which marijuana use can be damaging,” says the study’s lead author, Sylvina Mullins Raver, a Ph.D. candidate in the Program in Neuroscience in the Department of Anatomy and Neurobiology at the University of Maryland School of Medicine. “We wanted to identify the biological underpinnings and determine whether there is a real, permanent health risk to marijuana use.”

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July 25, 2013 Posted by | Consumer Health, Psychiatry | , , , , , , , | Leave a comment

Brain Research Shows Psychopathic Criminals Do Not Lack Empathy, but Fail to Use It Automatically

From the 24 July 2013 article at Science Daily

Criminal psychopathy can be both repulsive and fascinating, as illustrated by the vast number of books and movies inspired by this topic. Offenders diagnosed with psychopathy pose a significant threat to society, because they are more likely to harm other individuals and to do so again after being released. A brain imaging study in the Netherlands shows individuals with psychopathy have reduced empathy while witnessing the pains of others. When asked to empathize, however, they can activate their empathy. This could explain why psychopathic individuals can be callous and socially cunning at the same time.

Why are psychopathic individuals more likely to hurt others? Individuals with psychopathy characteristically demonstrate reduced empathy with the feelings of others, which may explain why it is easier for them to hurt other people. However, what causes this lack of empathy is poorly understood. Scientific studies on psychopathic subjects are notoriously hard to conduct. “Convicted criminals with a diagnosis of psychopathy are confined to high-security forensic institutions in which state-of-the-art technology to study their brain, like magnetic resonance imaging, is usually unavailable,” explains Professor Christian Keysers, Head of the Social Brain Lab in Amsterdam, and senior author of a study on psychopathy appearing in the journal Brain this week. “Bringing them to scientific research centres, on the other hand, requires the kind of high-security transportation that most judicial systems are unwilling to finance.”

The Dutch judicial system, however, seems to be an exception. They joined forces with academia to promote a better understanding of psychopathy. As a result, criminals with psychopathy were transported to the Social Brain Lab of the University Medical Center in Groningen (The Netherlands). There, the team could use state of the art high-field functional magnetic resonance imaging to peak into the brain of criminals with psychopathy while they view the emotions of others.

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Related Video

  • The Unrepentent (Canadian Broadcasting Company-The Fifth Estate)
     “They are marked by their ability to kill without passion and without remorse. Some are called psychopaths – a term that evokes nightmare images of murderers and monsters. But the label can also apply to men and women who are successful, intelligent, charismatic, charming and amusing – and so all the more dangerous. This week on the fifth estate, Linden MacIntyre looks at what makes a psychopath through the fifth estate’s close encounters with of four of Canada’s most frightening criminals. [From the CBC site…video at this site is only accessible in Canada]

July 25, 2013 Posted by | Psychiatry, Psychology | , , , , , , , , , | Leave a comment

[Reblog]Reform creates new incentives in health care

An aside…
Twice a week I volunteer at a soup kitchen/clothing distribution center. And three times a week I make phone calls screening folks for the Social Security Extra Help program which helps very low income people with their prescription drug costs.

English: U.S. Health Insurance Status (Under 65)

English: U.S. Health Insurance Status (Under 65) (Photo credit: Wikipedia)

Many folks are hard pressed to come up with $4.00 copays.
Reblog From the 24 July 2013 article at Kevin MD

 | POLICY | JULY 24, 2013

I advocated for the Affordable Care Act, and celebrated when it was passed.

It’s good to have everyone covered, I thought.

Insurance for everyone is the first step to health care for all.

Alas, access to health insurance isn’t the same as access to health care.

First there is the niggling detail of providers. We already have a primary care provider shortage.  Internists, pediatricians, family physicians are already working at full capacity in caring for the general health needs of a community. The poorest neighborhoods with the worse reimbursements already have a severe shortage of providers. More people with health care coverage, means more people will be seeking routine care, and we don’t have more providers ready to see them all.

For patients, this will mean longer waits to see a provider.  Or for providers, it will mean longer hours at work to see more patients.

Second, the ability to buy subsidized health insurance doesn’t automatically mean the ability to pay for health care.

I just learned that patients who are unable to pay their co-pays within 90 days may then need to face the entire medical bill on their own. How bad can a co-pay be, you may ask?

“When I say I have zero income, that means I have no money. None,” said one of my patients from the community health center where I work as a family physician on the South Side of Chicago, when I was encouraging him to buy generic medications at Walmart or Target. “$4 is too much for me,” he said.  “I’d need to steal to buy it. “

Zero income means an enormous challenge to pay anything, borrowing from a network of friends and relatives and searching out social programs for medical assistance. In some states, Medicaid will be expanded to cover everyone who is near the federal poverty line.  Other states are choosing not to expand coverage to young men.  Private insurance plans may effectively leave them unable to afford health care, even if they are able to afford subsidized health insurance on the state exchanges.

When patients who live on the financial edge, who currently don’t have health insurance miss their co-payments, they will become liable to pay the entire cost of the doctor’s visit.  After 90 days with no co-pay, then insurance companies would owe nothing.  The people who are poorest , who have the toughest time scraping together the money to cover their co-pays, may ultimately be responsible for paying not only their co-pay, but the entire medical bill, while also paying insurance premiums.

This would be unfortunate.

I wish we could turn back the clock and create a simpler system where everyone had access to care without needing to worry about who pays what.  Instead we have recreated pricing mechanisms that in effect result in tiered payments where the poorest patients continue to pay the most.

People are poised to buy into a broken system at the stroke of midnight announcing January 1, 2014.

The health insurance exchanges are coming—faciliating the buying and selling of imperfect products that promise access they can’t fully deliver, while potentially leaving vulnerable patients without full access to health care.

And still this is better than the alternative, where patients had no coverage at all, and the system wasn’t incentivized to find ways to become more efficient and more effective.

There will be new incentives in healthcare.  We’ll see what happens. The American healthcare system will need to continue to adjust to the needs of patients, to be responsive to the most vulnerable, in order to ensure a healthier America.

Kohar Jones is a family physician who blogs at Progress Notes.

  • The Math of State Medicaid Expansion (jflahiff.wordpress.com)
  • When considering health care costs, US physicians prioritize patients’ best interests (Medical News Today)
  • Viewpoints: Finding the benefits in reforming health care (sacbee.com)
  • Physician Skepticism About the Basic Doctrines of Health Care Reform: We’re In This Together and, by the way, More Believe In Care Management Than the EHR (diseasemanagementcareblog.blogspot.com)
  • Oregon medical community gears up for expansion (kansascity.com)
  • Cash-only doctors abandon the insurance system (money.cnn.com)
  • Railroading the health care law (kansascity.com)
  • My Family’s Obamacare (zocalopublicsquare.org)
  • Highmark forms alliance in bid to cut health costs (triblive.com)
  • Major Health Insurer Pulls Out of South Carolina, Two Other States, Because of ObamaCare (pjmedia.com)
  • Poll: only 11 percent of doctors think the ObamaCare exchanges will be ready (humanevents.com)
  • Views of US Physicians About Controlling Health Care Costs (Full Text Reports)
    July 24, 2013

    Views of US Physicians About Controlling Health Care Costs
    Source: Journal of the American Medical Association

    Importance
    Physicians’ views about health care costs are germane to pending policy reforms.

    Objective
    To assess physicians’ attitudes toward and perceived role in addressing health care costs.

    Design, Setting, and Participants
    A cross-sectional survey mailed in 2012 to 3897 US physicians randomly selected from the AMA Masterfile.

    Main Outcomes and Measures
    Enthusiasm for 17 cost-containment strategies and agreement with an 11-measure cost-consciousness scale.

    Results
    A total of 2556 physicians responded (response rate = 65%). Most believed that trial lawyers (60%), health insurance companies (59%), hospitals and health systems (56%), pharmaceutical and device manufacturers (56%), and patients (52%) have a “major responsibility” for reducing health care costs, whereas only 36% reported that practicing physicians have “major responsibility.” Most were “very enthusiastic” for “promoting continuity of care” (75%), “expanding access to quality and safety data” (51%), and “limiting access to expensive treatments with little net benefit” (51%) as a means of reducing health care costs. Few expressed enthusiasm for “eliminating fee-for-service payment models” (7%). Most physicians reported being “aware of the costs of the tests/treatments [they] recommend” (76%), agreed they should adhere to clinical guidelines that discourage the use of marginally beneficial care (79%), and agreed that they “should be solely devoted to individual patients’ best interests, even if that is expensive” (78%) and that “doctors need to take a more prominent role in limiting use of unnecessary tests” (89%). Most (85%) disagreed that they “should sometimes deny beneficial but costly services to certain patients because resources should go to other patients that need them more.” In multivariable logistic regression models testing associations with enthusiasm for key cost-containment strategies, having a salary plus bonus or salary-only compensation type was independently associated with enthusiasm for “eliminating fee for service” (salary plus bonus: odds ratio [OR], 3.3, 99% CI, 1.8-6.1; salary only: OR, 4.3, 99% CI, 2.2-8.5). In multivariable linear regression models, group or government practice setting (β = 0.87, 95% CI, 0.29 to 1.45, P = .004; and β = 0.99, 95% CI, 0.20 to 1.79, P = .01, respectively) and having a salary plus bonus compensation type (β = 0.82; 95% CI, 0.32 to 1.33; P = .002) were positively associated with cost-consciousness. Finding the “uncertainty involved in patient care disconcerting” was negatively associated with cost-consciousness (β = −1.95; 95% CI, −2.71 to −1.18; P < .001).

    Conclusion and Relevance
    In this survey about health care cost containment, US physicians reported having some responsibility to address health care costs in their practice and expressed general agreement about several quality initiatives to reduce cost but reported less enthusiasm for cost containment involving changes in payment models.

    The increasing cost of US health care strains the economy. Because physicians’ decisions play a key role in overall health care spending and quality, several recent initiatives have called on physicians to reduce waste and exercise wise stewardship of resources.1- 4 Given their roles, physicians’ perspectives on policies and strategies related to cost containment and their perceived responsibilities as stewards of health care resources in general are increasingly germane to recent pending and proposed policy reforms.5 We surveyed US physicians about their views on several potential proposed policies and strategies to contain health care spending, assessed physicians’ perceived roles and responsibilities in addressing health care costs, and ascertained physician characteristics associated with those views.

July 25, 2013 Posted by | health care | , , | Leave a comment

The stigma experienced by patients with psychiatric disorders

From the 24 July 2013 post at KevinMD.com

“It don’t matter how many men you shot in Memphis,” the saying goes, “if your name is Sierra or Sequoia, you can’t sing the blues”. In a sense, this adage reworks an older, more bitter joke from the civil rights era, the one that begins “some of my best friends are …” and ends with “but you wouldn’t want your sister to marry one.” Both statements embody stigma, the social effects of being someone who violates others’ expectations or fails to fit into an assigned social niche.

Stigma attached to illness has a long, ignoble history. The most classic example, the devalued social role of lepers, illustrates its classic elements: fear and avoidance. Deformities elicit basic revulsion in many, while infections also trigger fear of contagion. Historically, some of the positive stigma that doctors enjoy reflects our ability to transcend our fears and provide care to those whom society would consign to the desert beyond the pale of a socially integrated life.

In modern times, patients with psychiatric disorders (including addictions) experience stigma in painful and damaging ways. The American Journal of Public Health devoted its entire May edition to the consequences of the stigma that plagues those with mental illness and the disordered behaviors that it often causes. The bottom line of the Journal’s complex assessment across many articles: stigma kilIs. According to Hautzenbuehler et al, increased health care costs, poorer health outcomes and, most tellingly, premature death are all consequences of having a psychiatric disorder of any kind. While we all intuitively “get” why people with schizophrenia or addictions might face stigma based on their disruptive, non conforming behavior and the frustration caused by the intractability of their conditions, the negative consequences of having a psychiatric disorder also extend to otherwise normal appearing people with depression and anxiety, and, most tragically, to children.

Read the entire post here

 

July 25, 2013 Posted by | health care | , , , , | 3 Comments

[reblog] 3D printing at home could have health risks, says study

Reblog from the 24 July 2013 article at The Verge

While industrial 3D printers often use ventilation shafts and filters to evacuate airborne particles, commercially available printers are often set up in environments with little or no thought about the emissions they might be kicking out. In a new study looking into the particle emissions of home printers, researchers at the Illinois Institute of Technology identified that the operation of such devices in unventilated areas could potentially lead to health issues.

POPULAR HOME PRINTERS WERE CLASSIFIED AS HIGH EMITTERS

To conduct the test, Brent Stephens and his team used five models of popular 3D printers at Chicago-based 3D Printer Experience. The study doesn’t note the models used, the company advertises use of the UP Mini and MakerBot Replicator. According to the report, models using both ABS and PLA polymers as a plastic feedstock were classed as “high emitters” of ultrafine particles (UFPs), reporting similar emission rates (output, not toxicity) to the operation of a laser printer or the burning of a cigarette.

Because of their size, UFPs can be deposited in the lungs and absorbed directly into the bloodstream. High concentrations of UFPs have been linked to lung cancer, strokes, and the development of asthma symptoms. The study doesn’t detail the chemical constituents of ABS and PLA emissions, but ABS has previously been shown to have toxic effects, while PLA is a biocompatible polymer that has been widely used in drug delivery.

For now, researchers believe users should be cautious when operating 3D printers in “unvented or inadequately filtered indoor environments.” They also call for more experiments be conducted on a wider range of commercial printers, allowing experts to better understand the toxicity of particle emissions from devices and feedstocks currently in use.

 

 

July 25, 2013 Posted by | environmental health | , , | Leave a comment

   

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