Health Care Spending in Last Five Years of Life Exceeds Total Assets for One Quarter of U.S. Medicare Population

ScienceDaily

Originally published September 8, 2012

As many as a quarter of U.S. Medicare recipients spend more than the total value of their assets on out-of-pocket health care expenses during the last five years of their lives, according to researchers at Mount Sinai School of Medicine. They found that 43 percent of Medicare recipients spend more than their total assets minus the value of their primary residences.

The findings appear online in the current issue of the Journal of General Internal Medicine.

The amount of spending varied with the patient's illness. Those with dementia or Alzheimer's disease spent the most for health care, averaging $66,155, or more than twice that of patients with gastrointestinal disease or cancer, who spent an average of $31,069. Dementia patients often require special living arrangements, which accounts for the sizeable difference in cost.

Theentire story is here.

Dishonorable Conduct?

By Allie Grasgreen
Inside Higher Ed
Originally published September 6, 2012

Officials at Harvard University were quick to condemn the behavior of the 125 students suspected of collaborating inappropriately on a take-home exam.

“These allegations, if proven, represent totally unacceptable behavior that betrays the trust upon which intellectual inquiry at Harvard depends,” Harvard President Drew Faust said in a statement.

Harvard officials, who declined to comment for this story, say they plan to revisit their academic integrity policies and possibly create an honor code. It’s not the first time they’ve raised the idea – for at least two years now, administrators have recognized the potential need for a makeover. In 2010, undergraduate dean Jay Harris told The Harvard Crimson that academic dishonesty there was “a real problem.”

Harvard's official handbook says students should “assume that collaboration in the completion of assignments is prohibited unless explicitly permitted by the instructor.” And the university apparently created a voluntary academic integrity pledge students could sign last year, the Globe reported, but scrapped it this year.

The entire story is here.

The Relationship Between Level of Training and Accuracy of Violence Risk Assessment

by A. R. Teo, S. R. Holley, M. Leary, and D. E. McNeile
Psychiatric Services
Psychiatric Services 2012; doi: 10.1176/appi.ps.201200019

Objective  Although clinical training programs aspire to develop competency in violence risk assessment, little research has examined whether level of training is associated with the accuracy of clinicians’ evaluations of violence potential. This is the first study to compare the accuracy of risk assessments by experienced psychiatrists with those performed by psychiatric residents. It also examined the potential of a structured decision support tool to improve residents’ risk assessments.

Methods  The study used a retrospective case-control design. Medical records were reviewed for 151 patients who assaulted staff at a county hospital and 150 comparison patients. At admission, violence risk assessments had been completed by psychiatric residents (N=38) for 52 patients and by attending psychiatrists (N=41) for 249 patients. Trained research clinicians, who were blind to whether patients later became violent, coded information available at hospital admission by using a structured risk assessment tool—the Historical, Clinical, Risk Management–20 clinical subscale (HCR-20-C).

Results  Receiver operating characteristic analyses showed that clinical estimates of violence risk by attending psychiatrists had significantly higher predictive validity than those of psychiatric residents. Risk assessments by attending psychiatrists were moderately accurate (area under the curve [AUC]=.70), whereas assessments by residents were no better than chance (AUC=.52). Incremental validity analyses showed that addition of information from the HCR-20-C had the potential to improve the accuracy of risk assessments by residents to a level (AUC=.67) close to that of attending psychiatrists.

Conclusions  Having less training and experience was associated with inaccurate violence risk assessment. Structured methods hold promise for improving training in risk assessment for violence.

The full article is here.

President Obama orders VA to expand suicide prevention services

By Rebecca Ruiz
MSNBC.com
Originally published September 1, 2012

President Obama issued an executive order Friday tasking the Department of Veterans Affairs to expand its suicide prevention and mental health services.

Under the order, VA is expected to increase its veteran crisis line by 50 percent by the end of the year; ensure that a veteran in distress is given access to a trained mental health worker in 24 hours or less; and launch a national 12-month suicide prevention campaign to educate veterans about available mental health services.

The order reinforces some initiatives that VA has already undertaken.


In April, VA announced that it would hire 1,600 mental health clinicians to meet surging demand, and the order instructs the agency to use loan repayment programs and scholarships, among other strategies, to recruit those professionals by June 2013.

The entire story is here.

U.S. officials launch new strategy to prevent suicide

Reuters
Originally published September 10, 2012

A new nationwide strategy to prevent suicides, especially among U.S. military veterans and younger Americans, is tapping into Facebook, mobile apps and other technologies as part of a community-driven push to report concerns before someone takes his own life.

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The initiative includes $55.6 million in grant funding for suicide prevention programs.

Suicide is a growing concern and results in the deaths of more than twice as many people on average as homicide, officials said.

On average, about 100 Americans die each day from suicide, officials said. More than 8 million U.S. adults seriously thought about suicide in the last year, according to the Substance Abuse and Mental Health Services Administration.

The entire story is here.

Anti-Gay Bias or Academic Freedom?

By Scott Jaschik
Inside Higher Ed
Originally published September 4, 2012

The gay alumni group at Franciscan University of Steubenville last week tried to draw attention to a course it views as anti-gay, and ended up embroiled in disputes not only over that course but over the group's right to link itself to the university in a public way.

Franciscan is a university that prides itself on strict adherence to Roman Catholic teachings, and the alumni group has no official connection to the university. But it has called itself, based on its members and their affiliations, Franciscan University Gay Alumni and Allies. Under that name, the group last week issued a news release questioning why the university offers a course that links homosexuality with forms of deviant behavior.

The course description, pulled from the university's catalog, states: "DEVIANT BEHAVIOR focuses on the sociological theories of deviant behavior such as strain theory, differential association theory, labeling theory, and phenomenological theory. The behaviors that are primarily examined are murder, rape, robbery, prostitution, homosexuality, mental illness, and drug use. The course focuses on structural conditions in society that potentially play a role in influencing deviant behavior."

The entire story is here.

Former Harvard professor Marc Hauser fabricated, manipulated data, US says

By Carolyn Y. Johnson
Boston Globe
Originally published September 5, 2012

Marc Hauser, a prolific scientist and popular psychology professor who last summer resigned from Harvard University, had fabricated data, manipulated results in multiple experiments, and described how studies were conducted in factually incorrect ways, according to the findings of a federal research oversight agency posted online Wednesday.

The report provides the greatest insight yet into the problems that triggered a three-year internal university investigation that concluded in 2010 that Hauser, a star professor and public intellectual, had committed eight instances of scientific misconduct. The document, which will be published in the Federal Register Thursday, found six cases in which Hauser engaged in research misconduct in work supported by the National Institutes of Health. One paper was retracted and two were corrected, and other problems were found in unpublished work.

Although Hauser “neither admits nor denies committing research misconduct,” he does, the report states, accept that federal authorities “found evidence of research misconduct.”

The entire story is here.

There are other stories related to Marc Hauser on this blog.

Ohio Doctor Can Be Sued in Inmate’s Suicide: Update

Insurance Journal
Originally published August 29, 2012

A psychiatrist is not immune from being sued for damages by the family of a teenage inmate who killed himself in prison, a federal appeals court has ruled.

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The lawsuit stems from the March 2007 suicide of 19-year-old Timothy Hughes, who hanged himself from his bunk with a sheet in Butler County Prison after a social worker at the facility denied him access to Tepe to talk about his depression, history of suicide attempts and medication needs, according to the lawsuit.

The entire story is here.

Indiana board issues complaint against psychologist Pamela Christy

Psychiatric Crime Database
Originally published August 30, 2012

Here are some excerpts:

On May 23, 2012, the Indiana Professional Licensing Agency State Psychology Board issued a complaint against psychologist Pamela Christy, Ph.D., citing conduct which indicates that she has become unfit to practice due to her failure to keep abreast of current professional theory or practice.

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Christy informed Patient A of this and also cited in a letter to the Board that she would only release the records with the daughters’ permission and that “Patient A believes that he can make that decision for his children merely because they are under the age of 18…. I see no such distinction in the law” and even if there were a such a provision, “Patient A is still not entitled to the information.
 

Christy however was wrong. Indiana Code § 16-39-2-9(b)(1) states that a noncustodial parent has equal access to the minor child’s mental health records as the custodial parent.

 

There entire story is here.