Pa. proceeds with creating state-run health insurance exchange

By Don Sapatkin and Marie McCullough

Philadelphia Inquirer Staff Writers

After months of study, the Corbett administration said Tuesday that it was moving forward with a key - and widely supported - option offered by the federal health-care overhaul: a state-run insurance exchange.

Exchanges have gained neither the high-profile status nor the derision aimed at other parts of President Obama's program. But they are expected to transform the arduous process of buying health insurance for millions of people who get coverage individually or are covered by small businesses.

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"While the governor believes that the law requiring the purchase of health insurance is unconstitutional, we must be prepared if the Supreme Court does not strike down the law," said Rosanne Placey, state Insurance Department spokeswoman. Plus, she said, "the governor recognizes that doing nothing would result in a federally run exchange, which is not the best option for Pennsylvania."

Read the entire story here.

Statement of the American Psychological Association on the DSM-5 Development Process

There are a variety of posts on this blog highlighting concerns about DSM-5.  APA published this press release on December 2, 2011.

Press Release

WASHINGTON—Diagnostic classification systems of disorders and diseases are an integral part of health care delivery. Any such system, including the upcoming 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) of the American Psychiatric Association and the pending revision of the International Classification of Diseases (ICD-11) of the World Health Organization, must be based on the best available science and serve the public interest. 

The American Psychological Association has members with significant expertise in the scientific areas relevant to the DSM, and we have urged them to take part in the DSM revision efforts. We are encouraged that many psychologists are making meaningful contributions to the process as individuals, as members of the DSM-5 Task Force and work groups, and through the divisions of the American Psychological Association. This involvement includes offering comments on draft provisions and participating in field trials. 

We applaud the Society for Humanistic Psychology (Division 32 of our association) for its leadership role in generating dialogue and information-sharing within the broader mental health community concerning the revisions process. The Society also has prepared, disseminated, and garnered wide support for an "open letter" to the DSM-5 Task Force and the American Psychiatric Association, which expresses specific concerns related to the DSM-5 development process. 

We share their belief that the purpose of any diagnostic classification system should be to improve treatment outcomes. Thus it is essential to consider the impact of any new diagnostic system or category on vulnerable individuals, groups and populations, particularly children, older adults, and ethnic minorities. By appropriately identifying individuals in need of treatment, it is possible to both safeguard the welfare of individuals and to direct treatment resources where they are most needed. Concerns also have been raised that over-identification or misidentification of individuals as being in need of treatment could lead to the use of unnecessary and potentially harmful interventions.

The American Psychological Association recognizes that there is a diversity of opinion concerning the ongoing DSM-5 development process. Our association has not adopted an official position on the proposed revision; rather, we have called upon the DSM-5 Task Force to adhere to an open, transparent process based on the best available science and in the best interest of the public. In this regard, we appreciate the Task Force's expressed commitment to seriously consider the issues and concerns raised by experts in the mental health field in their deliberations.

We call upon our members (either as individuals or groups) to continue to add their perspectives to enhance the validity and clinical utility of the DSM-5. The American Psychological Association will continue to monitor the revision process and be a strong voice for its transparency. 

The American Psychological Association, in Washington, D.C., is the largest scientific and professional organization representing psychology in the United States and is the world's largest association of psychologists. APA's membership includes more than 154,000 researchers, educators, clinicians, consultants and students. Through its divisions in 54 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance psychology as a science, as a profession and as a means of promoting health, education and human welfare.

$1B suit filed against Sutter Health over data breach

By Bernie Monegain, Editor

HealthcareITNews

The theft of a computer during a break-in in October has spurred a $1B class action lawsuit against Sutter Health, according to a report published today by the Sacramento Bee. The computer contained data on more than 4 million patients.

The suit was filed Nov. 21 in Sacramento Superior Court.

In a news release posted online by the Sacramento-based health system on Nov. 16, Sutter officials detailed the findings of its investigation into the theft and offered an apology.

“Sutter Health holds the confidentiality and trust of our patients in the highest regard, and we deeply regret that this incident has occurred,” said Sutter Health President and CEO Pat Fry. “The Sutter Health Data Security Office was in the process of encrypting computers throughout our system when the theft occurred, and we have accelerated these efforts.”

Sutter Physicians Services (SPS) and Sutter Medical Foundation (SMF) – two affiliates within the Sutter Health network of care – announced the theft of a company-issued password-protected unencrypted desktop computer from SMF’s administrative offices in Sacramento the weekend of Oct. 15, 2011.

The story is here.

Antipsychotic drugs tied to diabetes risk in kids

By Amy Norton
Reuters/Yahoo! News

The antipsychotic drugs that are increasingly being used to treat bipolar disorder, autism and other mental disorders in children may come with an increased risk of diabetes, a new study suggests.

Previous research has linked the so-called second-generation antipsychotics to an increased risk of diabetes in adults. And there's been some evidence that the drugs can cause weight gain in children.

The new findings, published in the journal Pediatrics, add to concerns that the medications may ultimately lead to diabetes in some kids.

Using records from three U.S. health plans, researchers found that children and teens who started on an antipsychotic had four times the risk of being diagnosed with diabetes, versus kids not using any psychiatric medication.

They developed diabetes at a rate of just over three cases per 1,000 children per year. That compared with just under 0.8 cases per 1,000 among medication-free kids.

Second-generation antipsychotics include drugs such as Risperdal, known generically as risperidone, Zyprexa (olanzapine), Seroquel (quetiapine) and Abilify (aripiprazole).

The drugs are used to treat conditions like bipolar disorder, schizophrenia and irritability and aggression in children with autism. They are also sometimes given to children with attention-deficit hyperactivity disorder (ADHD), even though there's no research evidence to support that.

The entire story is here.

Merck to Pay $950 Million Over Vioxx

By Duff Wilson
The New York Times

Merck has agreed to pay $950 million and has pleaded guilty to a criminal charge over the marketing and sales of the painkiller Vioxx, the company and the Justice Department said Tuesday.

The negotiated settlement, which includes resolution of civil cases, was the latest of a series of fraud cases brought by federal and state prosecutors against major pharmaceutical companies.

By the time Vioxx, which was approved by the Food and Drug Administration in 1999, was pulled off the market in 2004 because evidence showed that it posed a substantial heart risk, about 25 million Americans had taken the drug.

In a statement on Tuesday, Merck said that it had previously disclosed the seven-year investigation by the United States attorney in Massachusetts and had charged $950 million against its earnings in October 2010.

Merck agreed to pay a $321 million criminal fine and plead guilty to one misdemeanor count of illegally introducing a drug into interstate commerce, the Justice Department said in a news release. The charge arose from Merck’s promotion of Vioxx to treat rheumatoid arthritis before the Food and Drug Administration approved it for that purpose in 2002.

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No person was held liable for Merck’s conduct. “It’s just a cost of doing business until a pharmaceutical executive does a perp walk,” said Erik Gordon, a pharmaceutical analyst and clinical assistant professor at the Ross School of Business at the University of Michigan.

The whole story is here.

CFS Researcher Jailed, Notebooks Still Missing

Janis C. Kelly

Medscape Medical News

Judy A. Mikovits, PhD

The world of chronic fatigue syndrome (CFS) research took a dramatic turn this month when a prominent researcher was put (briefly) behind bars, accused of stealing data and suborning theft of research materials, and the fate of nearly $1 million in research funding was put in doubt.

The XMRV Papers

The researcher is Judy A. Mikovits, PhD, who until September 29 was research director at the Whittemore Peterson Institute (WPI) for Neuro-Immune Disease in Reno, Nevada. Dr. Mikovits led the WPI research team that has been mired in controversy since reporting an apparent association between xenotropic murine leukemia virus–related virus (XMRV) and CFS. As previously reported by Medscape Medical News, attempts by others to replicate the findings were unsuccessful, and the emerging consensus is that the association was an artifact of laboratory contamination. Parts of the paper were subsequently withdrawn, and 2 of the original authors asked to have their names removed from the paper.

Dr. Mikovits' departure from WPI apparently was due not to problems with the XMRV study but to her refusal to turn over cell samples to fellow WPI researcher Vincent C. Lombardi, PhD. Dr. Lombardi, who was first author on the original XMRV paper, is now interim research director at WPI.

After Dr. Mikovits' departure, WPI discovered that 12 to 20 laboratory notebooks and flash drives containing years of research data were also missing.

Who Has the Notebooks?

Dr. Mikovits was arrested at her California home on November 18 and held without bail in the Todd Road Jail in Santa Paula, California. On November 22 she appeared in Superior Court in Ventura, California, for an extradition hearing on felony charges that she was a fugitive from justice and in possession of stolen property from WPI.

The entire story is here.

N.Y. Malpractice Program May Offer Model For Medical Liability Cases

Kaiser Health News

Medical malpractice lawsuits can be complicated, expensive and emotionally wrenching for patients, doctors and hospital officials alike. Now a program pioneered by a Bronx judge that speeds up the resolution of these cases is expanding into other parts of New York.

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The Designated Jurist

At its core, the New York program, called judge-directed negotiation, is simple: When a medical malpractice lawsuit is filed, a judge with expertise in medical matters becomes the point person for that case. He or she supervises the entire process and brings the parties together as often as necessary to discuss the case and help broker a settlement.

This is very different from what typically happens now: The pre-trial discovery phase, in which depositions are taken and other evidence is gathered, sometimes drags on for months or even years. A number of judges may be involved over that period, and with no one person pushing the parties toward resolution, serious settlement discussions generally don't happen until late in the process, often after a court date has been set.

A judge overseeing the entire case can make sure the parties don't dawdle over such things as procedural meetings to set up discovery dates. From the beginning, that designated jurist can delve into the case with an eye toward settlement, says Judge Douglas E. McKeon, an administrative judge in the Supreme Court of Bronx County, who pioneered this approach in 2002. He discovered that "if you created a process that people knew had the potential to get a case settled sooner rather than later for significant sums of money, they came in and they were ready to talk," he says.

The story can be found here.

Discussion Paper on Developing Guidelines for Online Psychology Services

New Zealand Model of Internet Guidelines

Survey: 1 in 4 Teens Bullied at School

By Salynn Bolyes

WebMD Health News

One in four high school students in a recent survey said they were victims of school bullying, and nearly 16% said they were victims of cyberbullying.

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Among the major findings from the survey:

• 33% of gay, lesbian, and other non-heterosexually identified teens reported being victims of cyberbullying, compared to just under 15% of teens who identified themselves as heterosexual.
• 47% of teens who reported being victims of both forms of bullying also reported having symptoms of depression, compared to 34% of those who reported being victims of cyberbullying only and 27% of those reporting being bullied only at school.
• Victims of both forms of bullying were also most likely to report having attempted suicide, with 15% saying that they had tried to kill themselves, compared to 9%, 4%, and 2%, respectively, of teens who reported being cyberbully victims, school bully victims, or those who were not victims of bullying.

Cyberbullying victims also reported poorer school performance than students who were not victims, and less attachment to the school they attended.

The story can be found here.

The entire research article can be found here.

Here is a portion of the conclusion:

Another important reason for schools to address cyberbullying is the link between victimization and school attachment and self-reported school performance. This is true even for the 6% of students who were victimized only through cyberbullying. Although this cross-sectional survey cannot make attributions of causality, cyberbullying may be a contributing factor to negative school  experiences, suggesting the need for schools to incorporate cyberbullying into their antibullying programs and policies. Efforts to increase student engagement in school, connectedness to peers and teachers, and academic success may also promote a climate in which school and cyberbullying are less likely to occur.