Thursday, March 17, 2011

Despite Budget Cuts, Layoff Fears, Milwaukee Teachers Fight for Taxpayer-Funded Viagra







With the district in a financial crisis and hundreds of its members facing layoffs, the Milwaukee teachers union is taking a peculiar stand: fighting to get their taxpayer-funded Viagra back.



The union has asked a judge to order the school board to again include Pfizer Inc.'s erectile dysfunction drug and similar pills in its health insurance plans.



The filing is the latest in a two-year legal campaign in which the union has argued, so far unsuccessfully, that the board's policy of excluding erectile dysfunction drugs discriminates against male employees. The union says Viagra, Cialis, Levitra and others are necessary treatment for "an exclusively gender-related condition."



But lawyers for the school board say the drugs were excluded in 2005 to save money, and there is no discrimination because they are used primarily for recreational sex and not out of medical necessity.



The filing last month comes as the union, the Milwaukee Teachers' Education Association, is also protesting hundreds of layoff notices issued to teachers for the coming school year. Citing a "financial crisis" caused by exploding benefit costs and revenue shortfalls, the district's outgoing superintendent proposed laying off 682 employees in April.



The district gave layoff notices to 482 teachers in June, but recalled 89 of them last month. Additional teachers may be called back, but these are still the first layoffs of Milwaukee teachers in decades.



At least one lawmaker questioned why the union is fighting for Viagra while teachers are losing their jobs. A consultant for the school board has estimated that reinstating the drug benefit would cost $786,000 per year — the cost to keep perhaps a dozen first-year teachers employed.



State Rep. Jason Fields argues that the money could be better spent any number of ways — including saving jobs.



"You've got to be kidding me," said Fields, a Milwaukee Democrat. "The fact that is the point of contention is kind of frightening. What are our priorities? I'm all for love and peace. But almost 1 million dollars? And you go to court over this issue?"



Union spokeswoman Kris Collett declined comment. But its lawyer Barbara Quindel said the case was worth fighting despite the district's grim finances. Quindel said erectile dysfunction is associated with heart disease, prostate cancer and other conditions, and the drugs are approved by the Food and Drug Administration and recommended by the American Urological Association.



"MTEA believes that men should not be discriminated against in receiving treatment for their medical conditions," she said.



The union has argued the costs are tiny compared to the $1.3 billion annual budget. But the school board says they are "particularly burdensome" when it is under pressure to reduce benefit costs.



That the pills — which can cost $20 apiece without insurance — were included in the first place is somewhat unusual. Health insurer Aetna Inc., which provides one of the district's two plans, says its standard pharmacy plans exclude Viagra and other "drugs for lifestyle enhancement or performance."



Basic state employee health plans also generally don't cover those drugs, but more expensive premium plans might, said Dick Cauchi, who tracks health benefits at the National Conference of State Legislatures. Lisa Soronen, National School Boards Association senior staff attorney, also said she had never heard of a similar case or an example of a union negotiating coverage for erectile dysfunction drugs.



"If you are getting down to what drugs are covered, you are really getting in the weeds," she said, explaining most negotiations are over premiums and co-payments.



Board and union negotiators reached a deal in 2002 to cover six tablets per month for erectile dysfunction drugs in health plans that insure 10,000 employees, dependents and retirees. They quickly became popular.



By 2004, the number of claimants receiving prescriptions skyrocketed to more than 1,000 per year, costing the district $207,000. During negotiations in 2005, the board proposed eliminating the benefit and an arbitrator adopted the plan.



The union in 2008 filed a sex discrimination complaint with the state. In June, the Labor and Industry Review Commission ruled the union couldn't pursue the case without identifying employees who have been injured by the policy and the complaint was filed after the statute of limitations expired.



The union is asking a Milwaukee County Circuit Court judge to overturn that decision and declare the policy violates the Wisconsin Fair Employment Act. A ruling isn't expected for months.



Viagra is usually on the other side in discrimination cases. In recent years, several lawsuits have claimed that employer health plans discriminate against women when they cover Viagra but not contraceptives or infertility treatment.



But the Milwaukee union says males are treated unfairly here. In one brief, its lawyers argued that vaginal cream, anti-bacterial medicine and estrogen replacement medication for female sexual dysfunction are covered. Other options such as penile pumps and implants included in the plans "are far less desirable than oral medication," the filing said.



District spokesman Philip Harris said school officials won't comment because "we just want to leave it alone." But Miriam Horwitz, an attorney representing the board, argued in court filings the drugs weren't necessary to treat life-threatening disease or have children.

Boehringer Pulls the Plug on 'Pink Viagra'


FRANKFURTGermandrugmakerBoehringerIngelheimhasstoppeddevelopingadrugdubbedthe"pinkViagra"afterfailingtoconvinceU.S.regulatorstheexperimentalpillcouldboostwomen'ssexdrive.



"Thedecisionwasnotmadelightly,consideringtheadvancedstageofdevelopment,"chiefexecutiveAndreasBarnersaidonFridayofthehoped-formoneyspinneraimedatpremenopausalwomenwithapersistentandunexplainedlackofsexdrive.



Boehringer'smovemarkedthefailureofthelatestattempttofindafemalecounterparttoPfizer'sViagra,theblockbusterbluepillformen.Drugmakershavetestedvariouswaystoboostfemalelibido,butwomen'ssexliveshaveproveddifficulttotargetwithmedication.



U.S.governmentadviserssaidinJunethatBoehringer'spinkpill,basedontheactiveingredientflibanserin,offeredlittlehelptowomenandhadunacceptablerisks;nearly15percentofwomenstoppedtakingapillbeforeastudyendedduetosideeffectsincludingdepression,faintingandfatigue.



ThatledtheU.S.FoodandDrugAdministrationtoaskunlistedBoehringerinAugustformoreinformationonflibanserin,whichwouldhavebeenmarketedasGirosa.



"Theresponseoftheauthoritiesandthecomplexityandextentoffurtherquestionsthatwouldneedtobeaddressedtopotentiallyobtainregistrationforflibanserinhaveimpactedthecompany'sdecisiontofocusonotherpipelineprojects,"Boehringersaid.



Drugmakershavebeensearchingforamedicinetoimprovewomen'ssexlivessinceViagra'sdebut12yearsago.Themarketfora"pinkViagra"couldstretchintothebillionsofdollars.



NOMEDICINEFORLIBIDO



Originallydevelopedasanantidepressant,flibanserinwasbelievedtoactonbrainchemicalsthatplayaroleinsexualresponse.But,intrials,womenontheonce-a-daypill,takenatbedtimereportedunwantedsideeffects.



AnFDAadvisorycommitteevoted11-0inJunethatthedrug'srisksandbenefitswereunacceptableand10-1thateffectivenessdatawaslacking.



Boehringer,a125-year-oldcompanycontrolledbygreat-grandchildrenofthecompany'sfounder,saiditwouldnowmerelycompletethetwomostadvanceddrugtrials.



MaleimpotencepillsincludingViagraworkbywideningbloodvesselstoincreasethebloodflowneededforanerection.PfizerdroppedtestsofViagrainfemalesin2004afterstudiesfailedtoshowithelpedwomen.



TheflibanserinsetbackwasincontrasttoBoehringer'ssuccessinpioneeringanewbloodthinningpillforamarketthatrivalBayersaidcouldbeworth$15billion.



AU.S.advisorypanellastmonthrecommendclearanceofBoehringer'sPradaxapillforpreventingstrokesinpatientswithatypeofirregularheartbeat.

GOP Senator: Health Care Law Will Permit Sex Offenders to Get Viagra



The Congressional Research Service has confirmed Sen. Tom Coburn's assertions that sex offenders not in prison could get Viagra and other drugs treating erectile dysfunction under health plans subsidized by taxpayer dollars. (AP)


AP


The Congressional Research Service has confirmed Sen. Tom Coburn's assertions that sex offenders not in prison could get Viagra and other drugs treating erectile dysfunction under health plans subsidized by taxpayer dollars. (AP)



Sen. Tom Coburn drew ridicule last month for trying in vain to prohibit sex offenders from getting Viagra prescriptions under the new health care law.



But Coburn is now having the last laugh after the Congressional Research Service confirmed his assertions that sex offenders not in prison could get Viagra and other drugs treating erectile dysfunction under health plans subsidized by taxpayer dollars.



In a memo to the Oklahoma Republican, who is one of two doctors in the chamber, and provided to FoxNews.com, the CRS said there are no provisions in the new health care law "which would require health plans to limit the type of benefits that can be offered based on the plan beneficiary's prior criminal convictions."



"Additionally, there do not appear to be any provisions that would specifically restrict qualified health plans' coverage of drugs prescribed to treat ED," the memo read.



"Therefore, a convicted rapist, child molester, or other sex offender who is not incarcerated would not appear to be excluded from enrolling in a qualified health plan through an American Health Benefit Exchange in their state solely because of that conviction," the memo added.



Coburn offered an amendment blocking this to the companion bill that reshaped parts of the health care law. Sen. Dick Durbin, D-Ill., dismissed it as a "gotcha amendment" designed to be difficult for Democrats to oppose. But the amendment failed 57-42.



The CRS is also seeking information from the Department of Health and Human Servicers congressional liaison office per Coburn's request on whether there have been known cases in which federal health programs such as Medicaid provided sex offenders coverage for drugs to treat erectile dysfunction.



But the CRS sent Coburn news articles that describe cases in which sex offenders did receive those drugs through state Medicaid programs.

Wednesday, March 16, 2011

Despite facing budget cuts and layoffs, Milwaukee teachers fight for taxpayer-funded Viagra


MADISON, Wis. With the district in a financial crisis and hundreds of its members facing layoffs, the Milwaukee teachers union is taking a peculiar stand: fighting to get its taxpayer-funded Viagra back.


The union has asked a judge to order the school board to again include Pfizer Inc.'s erectile dysfunction drug and similar pills in its health insurance plans.


The filing is the latest in a two-year legal campaign in which the union has argued, so far unsuccessfully, that the board's policy of excluding erectile dysfunction drugs discriminates against male employees. The union says Viagra, Cialis, Levitra and others are necessary treatment for "an exclusively gender-related condition."


But lawyers for the school board say the drugs were excluded in 2005 to save money, and there is no discrimination because they are used primarily for recreational sex and not out of medical necessity.


The filing last month comes as the union, the Milwaukee Teachers' Education Association, is also protesting hundreds of layoff notices issued to teachers for the coming school year. Citing a "financial crisis" caused by exploding benefit costs and revenue shortfalls, the district's outgoing superintendent proposed laying off 682 employees in April.


The district gave layoff notices to 482 teachers in June, but recalled 89 of them last month. Additional teachers may be called back, but these are still the first layoffs of Milwaukee teachers in decades.


At least one lawmaker questioned why the union is fighting for Viagra while teachers are losing their jobs. A consultant for the school board has estimated that reinstating the drug benefit would cost $786,000 per year the cost to keep perhaps a dozen first-year teachers employed.


State Rep. Jason Fields argues that the money could be better spent any number of ways including saving jobs.


"You've got to be kidding me," said Fields, a Milwaukee Democrat. "The fact that is the point of contention is kind of frightening. What are our priorities? I'm all for love and peace. But almost 1 million dollars? And you go to court over this issue?"


Union spokeswoman Kris Collett declined comment. But its lawyer Barbara Quindel said the case was worth fighting despite the district's grim finances. Quindel said erectile dysfunction is associated with heart disease, prostate cancer and other conditions, and the drugs are approved by the Food and Drug Administration and recommended by the American Urological Association.


"MTEA believes that men should not be discriminated against in receiving treatment for their medical conditions," she said.


The union has argued the costs are tiny compared to the $1.3 billion annual budget. But the school board says they are "particularly burdensome" when it is under pressure to reduce benefit costs.


That the pills which can cost $20 apiece without insurance were included in the first place is somewhat unusual. Health insurer Aetna Inc., which provides one of the district's two plans, says its standard pharmacy plans exclude Viagra and other "drugs for lifestyle enhancement or performance."


Basic state employee health plans also generally don't cover those drugs, but more expensive premium plans might, said Dick Cauchi, who tracks health benefits at the National Conference of State Legislatures. Lisa Soronen, National School Boards Association senior staff attorney, also said she had never heard of a similar case or an example of a union negotiating coverage for erectile dysfunction drugs.


"If you are getting down to what drugs are covered, you are really getting in the weeds," she said, explaining most negotiations are over premiums and co-payments.


Board and union negotiators reached a deal in 2002 to cover six tablets per month for erectile dysfunction drugs in health plans that insure 10,000 employees, dependents and retirees. They quickly became popular.


By 2004, the number of claimants receiving prescriptions skyrocketed to more than 1,000 per year, costing the district $207,000. During negotiations in 2005, the board proposed eliminating the benefit and an arbitrator adopted the plan.


The union in 2008 filed a sex discrimination complaint with the state. In June, the Labor and Industry Review Commission ruled the union couldn't pursue the case without identifying employees who have been injured by the policy and the complaint was filed after the statute of limitations expired.


The union is asking a Milwaukee County Circuit Court judge to overturn that decision and declare the policy violates the Wisconsin Fair Employment Act. A ruling isn't expected for months.


Viagra is usually on the other side in discrimination cases. In recent years, several lawsuits have claimed that employer health plans discriminate against women when they cover Viagra but not contraceptives or infertility treatment.


But the Milwaukee union says males are treated unfairly here. In one brief, its lawyers argued that vaginal cream, anti-bacterial medicine and estrogen replacement medication for female sexual dysfunction are covered. Other options such as penile pumps and implants included in the plans "are far less desirable than oral medication," the filing said.


District spokesman Philip Harris said school officials won't comment because "we just want to leave it alone." But Miriam Horwitz, an attorney representing the board, argued in court filings the drugs weren't necessary to treat life-threatening disease or have children.

Tuesday, March 15, 2011

What Dems Must Do If They Want to Hold the Senate


Withjustamonthleftbeforethemidtermelections,andwiththeRepublicansleadingbysixpointsinRasmussenReports’GenericCongressionalBallot,ithasbecomeincreasinglyclearthatdissatisfactionwiththeDemocratsisgoingtoresultinaswingtotheRepublicansthisfall.



WhileitseemsalmostcertainthattheRepublicanswilltakecontroloftheHouse,theDemocratscanstillholdtheSenate.



TheGOPneedstenseatstotakecontroloftheSenate,andtheyarelikelytopickupsevenoreightseatsatthispoint.Thus,itappearsthatcontroloftheSenatewillcomedowntothreeorfourracesinthebluestatesofCalifornia,Washington,Connecticutandtoalesserextent,NewYork.TomaintaincontroloftheSenate,thePartymustputallofitsresourcesintheseraces.



InWashingtonState,DemocratPattyMurray’sadvantageoverRepublicanDinoRossiisthatshe’srunninginastatethathasconsistentlygoneDemocraticinstatewideelectionsthankstoSeattle’sliberal-leaningKingCounty.



However,whileMurrayhasaboutafive-pointleadoverRossiaccordingtotheRealClearPoliticsAverage,RasmussenReports’mostrecentpollhasMurraytrailingbyonepoint,47%to48%.



Towin,Murraymuststeerawayfromherliberalvotingrecordandemphasizetheneedforfiscalrestraint,balancingthebudgetandreducingspending.MurrayhascriticizedRossiforsayingheopposedthenewWallStreetregulations;sheshouldcontinuetodoso,andemphasizehisstrongtiestocorporatelobbyistsandspecialinterests,andhisveryconservativepositionsongayrights,theenvironmentandwomen’srights.



CaliforniahasalsobeenatraditionallyDemocraticstate,withevenmoreDemocratsthanusualwinningin2006and2008asthesubprimemortgagecrisisbatteredthestate.SenatorBarbaraBoxer’sstrongwinin2004andObama’s61%to37%wininCaliforniain2008ledmosttoassumeshewouldberelativelysafein2010.



However,thebadeconomyhascausedthestate’svoterstoturnontheDemocrats.Boxer’sweakestsupportisintheInlandEmpireandCentralValley,theareashithardestbythesubprimemeltdown.Further,Boxer’sliberalvotingrecordputsheratoddswiththecurrentsentimentsofthevoters.AsofJuly,herfavorabilityhaddroppedto42%,with48%unfavorable.



Justrecentlyasmid-September,theRealClearPoliticsAveragehadBoxerinadeadheatwithformerHewlett-PackardCEOCarlyFiorina.However,Boxer’sleadhasgrowninthepastfewweekstoaboutsevenpointsaheadofFiorina.



WhileBoxermaybemoreliberalthanvotersinCalifornia,Fiorinaismuchfarthertotherightthanthestate’spoliticalmainstream.BoxerneedstoemphasizeFiorina’sextremelyconservativepositionsonabortion,oildrilling,immigrationandguns,andarguethatsheistooextremeforCalifornia,particularlyforwomen.



BoxerparticularlyneedstocontinuetocalloutFiorina’soppositiontoabortionrights–notonlyhasBoxermadethisissuecentraltohercareer,butnoanti-abortioncandidatehaswonhighstatewideofficeinCaliforniainover20years.



Further,BoxermusttellFiorina’sstoryasthefailedCEOofHewlett-Packard:shefiredover30,000workersasCEOandshippedjobsoverseas,whilemaking$100millionandtakinga$21millionseverancepackagewhensheleft.Fiorina’sfailedbusinessexperiencegivesvotersnoreasontothinkshewouldbeagoodSenator.



ChrisDodd’sretirementinConnecticuthaslefthisseatopenforthefirsttimesince1974.TheDemocraticnominee,AttorneyGeneralRichardBlumenthal,hashadrelativelysolidpollingnumbers,buthisopponent,formerWWECEOLindaMcMahon,wonawell-runprimarycampaignthatemphasizedherexperienceasawomanturningasmallenterpriseintoamulti-billiondollarbusiness.



AsamoderateRepublicanrunningduringatimeofanti-Democraticsentiments,McMahonturnedthisintoacloserace.RasmussenReportshasBlumenthalleadingbyfivepoints,50%to45%,andtheQuinnipiacpollhasBlumenthal’sleadatthreepoints,49%to46%.



BlumenthalneedstomakethecasethatMcMahon’sbusinessisbuiltonhumansufferingandfailings.McMahondidnotprovidehealthcareforthewrestlers.Hundredsdiedofsteroidabuseandtherehasbeenwidespreaddrugaddiction.HerstoryisnottheAmericandream,butoneofhorrorandfailure..



Finally,inNewYork,DemocratKirstenGillibrandhasheldontoaleadoverRepublicanJoeDioGuardi,althoughasmallerleadthanwhatistypicalfromaDemocratinaNewYorkSenaterace.TheRealClearPoliticsAveragehasherleadingbyalmost11points,butthelatestpollfromSurveyUSAshowsheraheadbyjustonepoint,45%to44%.



Gillibrandwasabletoavoidanyseriousprimarychallengers,thankstoherbackingbytheDemocraticestablishment,buthercandidacyisnotparticularlystrongandshehasvulnerabilities.Tomakesureshewins,shewillneedthecontinuedsupportoftheParty.



Mostly,however,whatthePartyneedstowinisanationalmessageoffiscalprudenceanddisciplinetohelpgivethesefourkeyDemocratsthecovernecessarytowintheirraces.ThePartymustadvocateabold,centristagendathatfocusesonfiscaldisciplineandfiscalstimulusinitiativesthattargettheprivatesectorandencourageentrepreneurshipandjobcreation.Theymustberesponsivetovoters’desirestocurbspendingandtaxation,andreducethedeficitandthedebt.Ifnot,theSenatecouldfalltotheRepublicanstoo.



DouglasE.Schoenisapoliticalstrategist,FoxNewscontributorandauthorofthenewbook"MadasHell:HowtheTeaPartyMovementisFundamentallyRemakingOurTwo-PartySystem"publishedbyHarper,animprintofHarperCollins.



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EXCLUSIVE: Anne Hathaway "Mortified" Being Nude in Front Of Jake Gyllenhaal





In her latest drama “Love Other Drugs,” Anne Hathaway portrays free-spirited Maggie Murdock, who suddenly finds herself under the “drug” of love when she is charmed by Viagra salesman Jamie Randall, played by Jake Gyllenhaal.



But getting hot and heavy wasn’t exactly an enjoyable experience for the 27-year-old starlet.



“It’s racy – very racy. I keep asking people if it is too sexy for them. However it is just part of the job,” Hathaway told Pop Tarts at the film’s Hollywood premiere last week. “That being said, it is intensely mortifying taking your clothes off in front of other people, but it is also intensely mortifying doing a lot of things in front of people and I’ve learned how to deal with that. Who knows if I will ever do it again, it depends on the material.”



And according to Gyllenhaal, it is as real as reel can be.



“The sex is portrayed in a real way, in an intimate way, and nobody is hiding behind anybody,” he said. “I think that that is hopefully what love is about and that is what these two characters do in this movie. I hope people would want to see that, and if not then we’re both naked – so..."



But luckily for Hathaway and Gyllenhaal, the “awkward” situation was softened a little by the fact they’ve gotten intimate on-screen together before.



“We had already had fake onscreen sex before in ‘Brokeback Mountain’ so it came naturally, we just had to do it again. But in all seriousness, it was very brave of Anne. I think women tend to be objectified more than men and she really does bare a lot, not only literally but figuratively. Her performance was incredible,” Gyllenhaal said. “But we’re friends and we understand the process of acting, and as a result of that we felt comfortable, even when it was awkward, and we try to joke about it. I try to be as respectful as possible, and if you are respectful on the set it makes it as dirty as it can be onscreen.”



And despite of Gyllenhaal’s A-list status, the folks in the Viagra world weren’t too warm when it came to giving characterization tips.



“It was an amazing world to learn about, primarily the sales in pharmaceuticals. I was fascinated to find out how hard it is to get into that world – to learn information from active people, particularly people selling from Viagra,” he added. “So often when you’re making a movie about something, (the real professionals) are like ‘come on in.’ That wasn’t the case for this movie, but it was fascinating. It took a while for people to open up – I didn’t know why there was so much secrecy."

Study on Acne Suicide Risk Fuels Debate Over Drugs







Peoplewithsevereacneareatincreasedriskofattemptingsuicide,scientistssaidonFridayinastudy,whichfuelsadebateaboutwhetheracnedrugssuchasRoche'sAccutanepromptsuicidalthoughts.



Swedishscientistsfoundpatientshadanadditionalsuicideriskforuptoayearaftertreatmentwithisotretinoin,thegenericversionofAccutane,whichiscommonlyprescribedforpeoplewithsevereacne.



"Amoreprobableinterpretationisthattheunderlyingsevereacnemaybestexplaintheraisedrisk,"theysaid,althoughtheycouldnotruleoutthatitmaybe"asaconsequenceofexposuretothedrug."



Accutane,whichSwissdrugmakerRochesaidlastyearitwouldstopsellingbecauseofgenericcompetition,hashadacontroversialhistorysinceits1982launch.



Whilepowerfulatclearingacne,thedrughasbeenlinkedtobirthdefectsiftakenduringpregnancyandhasalsobeensuspectedofcausingmentalsideeffects,althoughRochehasvigorouslydefendedpersonalinjuryclaimsinthisarea.



ItisnowavailableasgenericisotretinoinandsoldbydrugmakersincludingMylan,RanbaxyandTevaPharmaceuticalIndustries.



Acneisawidespreadskincomplaintfoundinupto80percentofadolescents.Whilemostcasesaremild,moreseverecasescanbequitedisfiguring,asensitiveprobleminsocialgroupsoftenalreadyselfconsciousabouttheirbodies.



Doctorssayisotretinoiniseffectiveinpatientswithsevereacne,butalsonotereportslinkingisotretinointodepressionandsuicidalbehavior.Scientificstudieshavehadconflictingresults.



AstudybyCanadianscientistspublishedintheJournalofClinicalPsychiatryin2008suggestedisotretinoinmightdoubletheriskofdevelopingdepression.



ANorwegianstudyearlierthisyearfoundthatlevelsofdepressionandsuicidalthoughtsweretwoorthreetimeshigherinyoungpeoplewhohadthemostsevereacnethaninthosewithoutit,suggestingthedrugtreatmentmaynotbetoblame.



NaturalCourse?

Againstthisbackground,AndersSundstromandateamfromtheKarolinskaInstituteinSwedeninvestigatedsuicideattemptsbefore,duringandafterisotretinointreatmentforsevereacne.



Theyassesseddatafrom5,756peoplewhohadbeenprescribedisotretinoinfrom1980-89andlinkedthesetohospitaldischargeandcauseofdeathregistersfrom1980-2001.



Theresults,publishedintheBritishMedicalJournal,found128patientsadmittedtohospitalafterasuicideattempt.Thestudyalsofoundthenumberofsuicideattemptsrosebetweenoneandthreeyearsbeforestartingtotakeisotretinoin.



Theriskswerehighestwithinsixmonthsoftreatmentending.



Sundstrom'steamsaiditwasimpossibletosayforcertainwhetherthecontinuedriseinsuicideriskwas"duetothenaturalcourseofsevereacne,ortonegativeeffectsofthetreatment."



Commentingonthestudy,SarahBaileyofthepharmacyandpharmacologydepartmentatBritain'sBathUniversitysaiditwasimportantresearchwhichstrengthenstheviewthatacneitselfcanhavesignificantpsychologicaleffects.



"Thecontroversialissueofincreasedsuicideriskwithisotretinoinuseisnotresolvedbythispaper,"shesaid,addingthatthemostinterestingfindingwasthattheriskofsuicideisincreasedaftertreatment,showingthatitis"essentialtocontinuetomonitorpatientscarefully."

Saturday, February 26, 2011

Bob Lorsch seeks to lead health IT through his blog


I last wrote about Bob Lorsch of MMR Information Systems (right) at SmartPlanet last year. He was helping China automate its medical records.

Well, he has a big new idea.

A blog.

Launched in March at multiple MMR sites, the Lorsch blog is part pep talk, part travelogue and part business adventure story, with its author always at the center as the hero, pulling the strings and bringing people together.

The blog has no graphics, no pictures, and the hyperlinks are all written-out, so you have to copy-and-paste them to use them, you can’t click them. All this makes the project seem more genuine, more personal, like the entrepreneur who comes to the big business meeting in a flowered shirt but is certain he’s going to charm you anyway. He usually does.

Lorsch is a special southern California type — informal, gregarious, self-confident, always selling, trophy wife by his side, hey look at me life is wonderful. He’s the kind of guy my dad always wanted to be, but my dad could never pull it off. Some can. Lorsch can.

I found Mr. Lorsch’s blog because he ordered a press release on it. It’s not a meeting I would like to have been in on.

But, Mr. Lorsch. You have no hyperlinks, no pictures.

That makes it genuine! That’s what people are looking for today, honesty. Heart!

But sir, we’ve barely started putting it on the servers.

And I want our other executives to blog too. That’s what the kids like. Blog, blog, blog.

Sir, can’t you just send it in to us and we’ll publish it for you?

What? You don’t trust me to do my own blogging? How long have you been working for me? Want to still be doing it tomorrow?

<cringe>Yes, sir. I’ll put out the press release today. </cringe>

From all this snark you may think I am making fun of Mr. Lorsch, that I find something repellent about him. I don’t. I like him a lot. He puts a smile on my face. He’s supremely self-confident, he doesn’t take himself too seriously, he’s a real go-getter.

We need more like him in health IT.

Yemen faces 'complicated' juggling act on security

Hisham Mohammed Assem, 19

Hisham Mohammed Assem says he was tortured into confessing
Continue reading the main story








Cargo Bomb Plot





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The young man behind the wall of wire mesh was smiling - a little surprisingly, as he was in Yemen's State Security Court on trial for his life.

Hisham Mohammed Assem, 19, is accused of killing a French businessman here in Sanaa on 6 October and wounding one of his British colleagues.

The prosecution alleges that he confessed to killing a foreigner after being incited by Anwar al-Awlaki, a leader of al-Qaeda in the Arabian Peninsula (AQAP) and so notorious that even though he is an American citizen, President Barack Obama has ordered his assassination.

Mr Awlaki and a relative were also on trial, in absentia. They are believed to be in hiding somewhere in the remote regions of Yemen.

I followed Hisham Mohammed Assem out of the court after the hearing and managed to talk to him after he was locked up in another wire cage.

He denied the charges, called al-Qaeda "destroyers" and said his confession had been extracted under torture.

He claimed he had a personal issue with the Frenchman, with whom he worked as a security guard. Mr Assem said he had intended to frighten him, but not to kill him.

Sitting with his wrists handcuffed, he told me he was smiling because his trial was a sham.

"It's a farce, not a court. The verdict is ready - it's a play. The hero is the prosecutor. And the director is the judge. They want to appease the West."

He bit his sleeve and hitched it up to show a mark he said was made while he was being tortured.

I have no idea whether the prosecutors are right about Mr Assem, or whether he is telling the truth.

Multiple threats
Veil-clad women walk past a car with a sticker portraying Yemeni President Ali Abdullah Saleh and his eldest son Ahmed, in Sanaa

President Saleh faces security challenges on several fronts

But it seems clear that the trial is serving a wider political purpose for the Yemeni authorities. It was announced only after the two bombs that had been sent from Yemen as air freight were found.

The regime of President Ali Abdallah Saleh, embarrassed by what happened, is doing all it can to show that it is making moves against AQAP, which claims to have dispatched the two latest bombs.

Yemen has been concentrating minds in Western governments since Umar Farouk Abdulmutallab, another young man said to have been groomed by Anwar al-Awlaki, was caught apparently trying to blow up an airliner over Detroit last Christmas Day.

All this year, military and development aid to Yemen has been increased.

American pilotless drone aircraft have been firing missiles at ground targets, sometimes killing al-Qaeda operatives, sometimes killing innocent civilians.

The court case is something that President Saleh can offer in response to pressure from his allies to move against the organisation, which is showing signs of ambition and self-confidence.

Continue reading the main story

Start Quote

You can't just kill your way out of the problem”

End Quote
Western diplomat in Sanaa


President Saleh has kept power since he seized it in 1978 because he recognises that governing Yemen is a juggling act, needing the consent of as many of Yemen's powerful tribes as possible.

The new factor in 2010 has been that rich foreign countries, very concerned about al-Qaeda attacks coming out of Yemen, have been throwing their own balls into the game. They add big new complications to what was already complicated.

The West wants President Saleh to make al-Qaeda his number one security priority.

Counter-terrorism teams from Britain and the United States have been in Sanaa looking for information and delivering advice.

But President Saleh has other security preoccupations. He is also fighting an insurgency in the north, and a separatist movement in the south.

In the past, the president's behaviour has shown that he believes the internal opposition to be more of a threat to his regime than al-Qaeda.

Western diplomats believe they are slowly winning the argument that al-Qaeda is a threat to him as well.

It is also possible that he is sending out the signals they want to hear, in the hope of getting more deliveries of money and weapons.

Development solution

Al-Qaeda is the reason why Yemen gets so much Western attention. But its problems go much deeper than that.

Schoolchildren at Abu Bakr school just outside Sanaa

Yemen's teachers and students make the most of limited resources

Many people in Yemen have hard lives, without much hope of anything better.

Yemen is the poorest Arab country. Yemen's small deposits of oil and gas are running out. A big chunk of officialdom is corrupt. The country has one of the highest rates of illiteracy in the world.

It is short of jobs and water, the population is growing fast and more and more people cannot afford enough food.

Resources are swallowed up by the production of khat, a mildly narcotic leaf. Chewing it is a national pastime but growing it uses up water and land that used to produce food.

The tourist trade used to be a good earner - Yemen is a stunningly beautiful country - but most foreigners have been scared off.

A diplomatic process called the Friends of Yemen, in which Britain and Saudi Arabia have been prominent, has been promising development aid in return for reform.

They want, at the very least, to stop Yemen's problems getting any worse. The idea is that development will continue in parallel with shorter-term action against AQAP.

At the Abu Bakr school just outside Sanaa, teachers and students do their best with limited resources.

Classes at the school have more than 100 pupils, but thanks to foreign aid administered by dedicated Yemenis in the Social Fund for Development, there is a computer room, a library and an exhibition of the children's arts and crafts.

The US, Britain and the others believe that development has to be part of the solution.

They recognise that a heavy-handed fight against Al-Qaeda in the Arabian Peninsula - whose numbers are thought to be in the hundreds, not thousands - will make matters here much worse.

"Eighty percent of the fight against terror is non-kinetic," said one Western diplomat in Sanaa who did not want to be named. "You can't just kill your way out of the problem."

But if the next attacks launched from Yemen succeed, remembering that principle might become more difficult.

Development takes time, and Western leaders who want to show that they are protecting their own people will always be impatient.



Will these Irish migrants be different from the past?

Irish ferry

Over the years, thousands have crossed the Irish Sea
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The Celtic Tiger is in intensive care and young people are rushing for the exits. But how will a new exodus of Irish to Britain compare with previous waves of Irish immigration, asks Tom de Castella?

A couple of days before Ireland's politicians meekly agreed to the EU's financial bailout, a gleaming new terminal opened at Dublin airport.

T2 cost 600m euros but with the economy in deep recession and passenger numbers falling, it is being seen as a monument to Ireland's economic collapse.

Ryanair boss Michael O'Leary arrived at the opening in a hearse dressed in an undertaker's outfit and bearing a coffin, while a taxi driver told the Financial Times: "I suppose they're getting it ready for all the young people trying to emigrate."

Black humour is rife but beneath the joking lies a serious point. Ireland may be on the verge of sending another wave of migrants to foreign shores.

Passport

Many young Irish are now reaching for one of these

In the year up to April 2010, Irish emigration grew by 40% to 65,000 but almost half of those were Eastern Europeans returning home. The difference now is that the numbers are accelerating and it is the Irish who are leaving, according to the country's Economic and Social Research Institute. In July the research body predicted that 200,000 people would emigrate between 2010 and 2015.

"We've always had a culture of emigration," says Jamie Smyth, social affairs correspondent at the Irish Times, referring to the potato famine of the 1840s in which the Irish population shrank by more than 20% after a million people died and another million emigrated.

With a third of under-25s out of work it is the young who are most likely to leave, with Australia, New Zealand and Canada ahead of the UK as destinations according to last year's figures, says Smyth.

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Claire Weir

If you can get out you do”

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Claire Weir, 25


Indeed in the first nine months of 2009, there was only a 7% rise in the number of Irish people registered to work in the UK, hardly a major increase. But he cautions that these figures are a year out of date, and since then the UK economy has begun to recover while Ireland's economic malaise has worsened.

Claire Weir, a 25-year-old graduate, is one of the new arrivals to Britain. At the weekend she packed up her stuff, got a lift to Dublin and took the ferry to Holyhead, en route to a new life in London.

The trained photographer is sleeping on a friend's sofa, looking for part-time work in a supermarket or pub to pay the bills while she finds regular photography work.

"I just want a job, I need a bit of money coming in and can't live on thin air. I don't think I can get that consistency in Ireland."

Emigration of Irish nationals

Part of her photography studies involved taking pictures of the many unfinished property developments that now litter Ireland. She and her friends feel betrayed by a political and business class that has indebted the country for her generation. Now they are voting with their feet.

"If you can get out you do. I come from a rural area in County Meath and there are very few graduates left. Four of my closest friends have gone, the others are either in a relationship or at college so can't leave."

Mary Corcoran, professor of sociology at the National University of Ireland, Maynooth, says that the boom years were an exception - for nearly every other decade since the Irish state was founded in 1919, emigration has been part of its economic survival.

Emigration reached its apogee in the 1950s when 50,000 people left a year. The outward trend stopped briefly during the 1970s but returned with a vengeance the following decade when unemployment soared. On average, 35,000 people were leaving the country a year during the 80s.

"That is the decade many are comparing today's situation with. People remember airports at Christmas time packed with emigrants coming home and the farewells in January when they all went back again."

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A 1950s Irish childhood in Britain




Poet and academic Eavan Boland moved to Britain in the early 50s when her father took up the post of Irish ambassador to London. Despite her family's exalted position in society, she recalls a British establishment that saw the Irish as "a sub race". It led her to write the poem An Irish Childhood in England: 1951, which reflected on an incident when she first went to school in England aged six. "The Irish frequently say 'I amn't' instead of 'I'm not'. But when I stood there in school and uttered the phrase the teacher turned to me scathingly and said: 'You're not in Ireland now'. It was a very small incident but has always stayed with me. We went onto the shores of England as a defeated people."



Britain, along with America, was the traditional choice for Irish people seeking a new life. In the 19th Century it was the Irish navvies who built Britain's railways, in the 20th Century they manned the nation's building sites or worked as domestic help, creating Irish ghettos in the big cities.

"When we think of emigration we think of the famine ships or the people who went to Kilburn in the early 70s and drank themselves into an early grave," she says. But the character of emigration has changed. The Irish population today is far better educated with nearly half of 25-34 year-olds having gone on to higher education, the second highest rate in the EU.

Today's immigrants are more likely to be in IT or business than construction. And whereas in the past the US was easy to settle in without papers, today the Patriot Act and tighter checks makes America off limits to most Irish.

So how will the new arrivals to Britain fare? Highly-skilled graduates in areas such as IT will find it relatively easy to get jobs, she believes. But the construction workers who once had easy pickings on British building sites will now be competing against well established East Europeans. On the plus side, whereas it was hard for previous generations to keep in touch with home, the advent of e-mail, Skype and Ryanair has made it much easier for the new wave of immigrants.

Hurling player

The loss of young hurlers has affected village teams

And neither will they face the same hostility as their forebears. Britain was once a byword for prejudice against Irish workers with the notorious "No Blacks, No Dogs, No Irish" signs posted on B&B doors. Later, IRA bombings intensified anti-Irish feelings.

But things have changed beyond recognition for the new wave of Irish arrivals in the UK. Not only has the peace process reset the political context and the boom years given the Irish self-confidence, but the activities of radical Islamist groups have created a new scapegoat, she says.

Poet Eavan Boland, who moved to the UK in the 1950s, believes that despite possible tensions over historical baggage, the new wave of immigrants will not face the prejudices expressed in the past.

"The UK is no longer anti-Irish. In those days Ireland was a country that had been disloyal in World War II by staying neutral. It was Catholic. It was only when it became a republic in 1948 - previously it was a Free State - that Irish people could travel in Britain without papers.

"Now we're all European, we have the same passport and are entitled to free movement. Britain was a great partner in the peace process, people went through a lot together.

"And David Cameron made a beautiful speech about Bloody Sunday that was an extremely healing moment. It's come too far, there's too much understanding. I don't think you can reverse that now."

But with some resentment evident on both sides of the Irish Sea about the UK role in the rescue package agreed this week - British taxpayers unhappy and Irish pride rather injured - it remains to be seen where the relationship goes from here.

A selection of your comments appears below.


I have many friends who are immigrants, quite a few from Ireland. They greatly enrich the UK and today everyone has a chance to contribute to our open and free society. What isn't needed though is the baggage of victimhood. Everyone, whoever they are, can relate instances of being subject to unthinking or even bigoted behaviour. Everyone has a story. Start your new story without rancour.

Keith, Hertfordshire

Some of the friendliest, and most patient people in all of Europe, and one of the most beautiful places you can visit if you get the chance. Unfortunately, the socio-economic and political entity that is Ireland is a different matter. A country that was supposed to be built around the purest forms of socialism, we undoubtedly have one of the most hypocritical systems in the world. No NHS, a deeply flawed (even by UK standards) welfare system, and countless estates that have seen no benefit of the imaginary Celtic Tiger have left it a slave to global capitalism. And, those very people who got nothing from the so-called economic boom, are the very ones who are being forced to pay for the mistakes of the government and financial sector. I'm glad I got out.

Meath Mad, Liverpool, ex-Meath

I think the phrase "We're all European" has great relevance. 150 years ago, my forebears decided that Walsall was more attractive than Erin but their "Irishness" seems to have disappeared very quickly. I only found out my family's origins when I did some research so national identity doesn't appear to have had any great import. My wife is Polish-German, our son's wife is part Somali, so what does ethnic origin matter? Why don't we all simply consider ourselves as belonging to the human race!

Tony Cooley, Wallsall

"Britain was once a byword for prejudice against Irish workers with the notorious "No Blacks, No Dogs, No Irish" signs posted on B&B doors." Actually that was the case in the US too.

J McDowall, New York

Years ago, I lost my pay packet - containing cash - while delivering some stuff to a building site. When I went back to look for it - without much hope of finding it - an Irish labourer handed it to me, saying "Don't forget now, a man from Southern Ireland did this for youse." I have never forgotten this. More recently, I take a balanced view of the Irish. Part of me resents the fact that they were neutral during World War 2, which, rightly or wrongly, I interpret as being pro-German, ie. pro-Nazi. Even now, some republican Irish express pro-Nazi views. Another part of me looks at the vital role that the Irish - including the republican Irish - played in the peace process. On the whole, I welcome the Irish, they are overwhelmingly honest and hard-working, assimilate easily and don't pose a threat to us.

Paul Gooch, Nottingham




Half of Welsh women report mental health problems

Depressed girl (picture posed by model)

Within Wales 22% of women experiencing low level mental health problems have self-harmed
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A women's charity has called for a review of the treatment women with poor mental health in Wales receive.

Research by Platform 51 revealed 53% of Welsh women are suffering from "low level" mental health problems.

The charity urged policy makers to act now to stop the "dependency culture" surrounding anti-depressants.

In response, the assembly government said it recognised "the importance of preventing mental health problems".

Platform 51, formerly Young Women's Christian Association (YWCA), said more than half the women and girls in Wales believe problems like low self-esteem, self-confidence and stress negatively affect their lives.

The report "Women like me; supporting wellbeing in girls and women" was based on evidence found in a poll of more than 2,000 women and girls in England and Wales, surveys of more than 450 service users and focus groups involving more than 170 women.

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"We are not saying drugs don't have a role to play but they should be part of a solution, not the cure-all solution”

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Rebecca Gill
Platform 51

Within Wales 35% of women experiencing problems have taken at least a week off work, 22% have self-harmed and 33% have lost friends as a result of their issues.

The research also found two thirds did not leave their homes for long periods, 20% regularly drank enough to get drunk and one in six have built up debt.

Platform 51's director of policy, research and campaigns Rebecca Gill said it was time those responsible for dictating health policy found effective methods of intervention.

She said: "We were staggered by the results and shocked at how many women are experiencing these problems and feelings of loneliness and isolation when dealing with them.

"We want the Welsh Assembly Government to review prescription drugs as we are concerned some of our service users have been on anti-depressants for more than four years while waiting a very long time for counselling.

'Crisis point'

"We are not saying drugs don't have a role to play but they should be part of a solution, not the cure-all solution.

"We want more focus on these low-level mental health problems that so many women and girls suffer from, but which stop them from fulfilling their potential.

"We should be addressing these problems as they arise otherwise they accumulate and women reach a crisis point, which is far more expensive for the NHS to deal with.

Ms Gill said women were often not identifying the issues as mental health problems and said more needed to be done to encourage self-referral.

Platform 51's chief executive Penny Newman echoed this view: "Women are often the lynch pins of their families and their communities, and if over half of Welsh women aren't meeting their potential, they lose out, their family and friends lose out and so does the wider society.

An assembly government spokesman said: "While we cannot comment on a report that we haven't had an opportunity to study in detail, as outlined in Our Healthy Future, the public health strategic framework for Wales, we recognise the importance of preventing mental health problems and promoting positive mental health."

He added that the bilingual CALL (Community Advice and Listening Line) has become a round the clock support service for people experiencing mental health problems and their friends or relatives.