Category - Health Issues

Depressed? Try Therapy Without the Therapist

New York Times, By Tina Rosenberg, June 19

Elle is a mess. She’s actually talented, attractive and good at her job, but she feels like a fraud — convinced that today’s the day she’ll flunk a test, lose a job, mess up a relationship. Her colleague Moody also sabotages himself. He’s a hardworking, nice person, but loses friends because he’s grumpy, oversensitive and gets angry for no reason.

If you suffer from depression or anxiety as Elle and Moody do, spending time with them could help. They are characters in a free online program of cognitive behavioral therapy called MoodGYM, which leads users through quizzes and exercises — therapy without the therapist.

Cognitive behavioral therapy is a commonly used treatment for depression, anxiety and other conditions. With it, the therapist doesn’t ask you about your mother — or look at the past at all.

Instead, a cognitive behavioral therapist aims to give patients the skills to manage their moods by helping them identify unhelpful thoughts like “I’m worthless,” “I’ll always fail” or “people will always let me down.” Patients learn to analyze them and replace them with constructive thoughts that are more accurate or precise. For example, a patient could replace “I fail at everything” with “I succeed at things when I’m motivated and I try hard.” That new thought in turn changes feelings and behaviors.

The success of cognitive behavioral therapy is well known; many people consider it the most effective therapy for depression. What is not widely known, at least in the United States, is that you don’t need a therapist to do it. Scores of studies have found that online C.B.T. works as well as conventional face-to-face cognitive behavioral therapy – as long a there is occasional human support or coaching. “For common mental disorders like anxiety and depression, there is no evidence Internet-based treatment is less effective than face-to-face therapy,” said Pim Cuijpers, professor of clinical psychology at the Vrije Universiteit Amsterdam and a leading researcher on computer C.B.T.

[…]

Online therapy is effective against an astonishing variety of disorders. A Swedish survey of studies found that online C.B.T. has been tested for 25 different ones. It was most effective for depression, anxiety disorders, severe health anxiety, irritable bowel syndrome, female sexual dysfunction, eating disorders, cannabis use and pathological gambling. “Comparison to conventional C.B.T. showed that [online] C.B.T. produces equivalent effects,” the researchers concluded.

The Supreme Court Just Killed One of the Country’s Most Extreme Anti-Abortion Laws

Mother Jones, By Pema Levy, June 15

The Supreme Court killed one of the nation’s most extreme anti-abortion laws on Monday.

The justices declined to hear a case concerning the constitutionality of a North Carolina law that required women seeking an abortion to submit to a mandatory ultrasound. The law also compelled physicians to show women the images and describe the fetus in detail. Unlike similar laws in Texas, Wisconsin, and Louisiana that include some exceptions for victims of rape or incest, the North Carolina measure made no exceptions for rape, incest, health risks to the mother, or severe abnormalities in the fetus.

Most abortion cases center on the rights of pregnant women, but this one hinged on doctors’ First Amendment right to free speech—or in this case, their lack of freedom to choose what to tell their patients. The North Carolina law, passed in 2011 over the veto of then-Democratic Gov. Bev Perdue, was struck down by a federal district court in North Carolina. The Fourth Circuit agreed that the “compelled speech provision” was unconstitutional. By refusing to take the case, the Supreme Court has assured that the law remains dead.

Fracking Associated With Smaller Babies

New York Times, By Nicholas Bakalar, June 8

A new study has found an association between hydraulic fracturing, or fracking, and smaller babies.

The scientists used data on 15,451 live births in southwest Pennsylvania from 2007 to 2010. They categorized the mothers by how close they lived to gas wells and the concentration of wells in the area.

Babies born in the highest exposure areas were not at higher risk of being born prematurely, but they were 34 percent more likely to be small for gestational age than those born in areas of least exposure.

The analysis, published in PLOS One, was observational and did not prove causality. The researchers controlled for mother’s age, race, prenatal care, smoking during pregnancy and other health and behavioral factors.

Nigeria Becomes Latest African Nation to Outlaw Female Genital Mutilation

VICE News, By Hilary Beaumont, June 3

In one of his last moves as president of Nigeria, outgoing leader Goodluck Jonathan outlawed female genital mutilation last week, continuing a trend of criminalizing the practice in nations across Africa.

The new law criminalizes the cultural tradition of FGM, also known as female circumcision, which is performed on an estimated 125 million women and girls worldwide, according to a 2013 UNICEF report. The procedure can range from partial to total removal of the clitoris and labia. About a quarter of Nigerian women and girls are affected by the procedure, the report says.

According to a 2013 version of Nigeria’s bill, which criminalizes “harmful traditional practices,” anyone in Nigeria who performs female genital mutilation or engages someone to carry it out can be jailed for four years or fined the equivalent of $1,000. Attempting or aiding the procedure can also land Nigerians in jail for two years, with a fine up to $500.

According to Equality Now, an international group that’s working to end the practice, 23 African nations including Nigeria have enacted laws against FGM.

Kenya-based Mary Wandia, FGM Program Manager for Equality Now, called Nigeria’s criminalization of the practice “a vital first step.”

Portugal decriminalizes all drugs and watches overdoses fall

Washington Post, June 6

Washington – Portugal decriminalized the use of all drugs in 2001. Weed, cocaine, heroin, you name it — Portugal decided to treat possession and use of small quantities of these drugs as a public health issue, not a criminal one. The drugs were still illegal, of course. But now getting caught with them meant a small fine and maybe a referral to a treatment program — not jail time and a criminal record.

Whenever we debate similar measures in the U.S. — marijuana decriminalization, for instance — many drug-policy makers predict dire consequences. “If you make any attractive commodity available at lower cost, you will have more users,” former Office of National Drug Control Policy deputy director Thomas McLellan once said of Portugal’s policies. Joseph Califano, founder of the Center for Addiction and Substance Abuse at Columbia University, once warned that decriminalization would “increase illegal drug availability and use among our children.”

But in Portugal, the numbers paint a different story. The prevalence of past-year and past-month drug use among young adults has fallen since 2001, according to statistics compiled by the Transform Drug Policy Foundation, which advocates on behalf of ending the war on drugs. Overall adult use is down slightly too. And new HIV cases among drug users are way down.

Now, numbers just released from the European Monitoring Centre for Drugs and Drug Addiction paint an even more vivid picture of life under decriminalization: drug overdose deaths in Portugal are the second-lowest in the European Union.

‘Historic’ Ruling States That Abstinence-Only Sex Ed Isn’t Sex Ed

Think Progress, By Tara Culp-Ressler, May 13

In a decision that’s being hailed as “historic,” a judge in California has ruled that health classes focusing exclusively on telling students to remain abstinent until marriage fall short of the state’s comprehensive sex ed requirements.

In his opinion, Fresno County Superior Court Judge Donald Black concludes that, given the high rates of sexually transmitted infections and unintended pregnancy in the U.S., medically accurate sexual health information is “an important public right.”

Black’s decision narrowly applies to about 40,000 students who attend the Clovis Unified School District. However, since his opinion represents the first-ever ruling on California’s decade-old sex education standards, the American Civil Liberties Union (ACLU) — whose legal counsel represented the plaintiffs in the suit — believes it sets an important precedent for the rest of the state.

“This is the first time that abstinence-only-until-marriage curricula have been found to be medically inaccurate,” Phyllida Burlingame, the director of reproductive justice policy at the ACLU, told the San Francisco Chronicle. She added that the ruling should send a strong message to other schools that “young people need complete, accurate health information required by law.”

Liberia Is Free of Ebola, World Health Organization Declares

New York Times, By Sheri Fink, May 9

The World Health Organization declared Liberia free of Ebola on Saturday, making it the first of the three hardest-hit West African countries to bring a formal end to the epidemic.

“The outbreak of Ebola virus disease in Liberia is over,” the W.H.O. said in a statement read by Dr. Alex Gasasira, the group’s representative to Liberia, in a packed conference room at the emergency command center in Monrovia, the capital.

Just before Dr. Gasasira’s statement, Luke Bawo, an epidemiologist, showed a map depicting all of Liberia in green with the number 42 superimposed on it. This represented that two maximum incubation periods of the virus, a total of 42 days, had passed since the safe burial of the last person confirmed to have had Ebola in the country, fulfilling the official criteria for concluding that human-to-human transmission of the virus has ended.

[…]

In the past week, Guinea and Sierra Leone each reported nine cases of the disease, the lowest weekly total this year. Dr. Bruce Aylward, head of the W.H.O.’s Ebola response efforts, cautioned that hidden chains of transmission were probably occurring in those two countries. “We don’t know where that virus is,” he said.

Dr. Aylward said it had taken Liberia several months to get to zero cases after reaching single digits.

New York Times: After Ebola Outbreak, Liberian Churches Confront Crisis of Faith

Battling America’s other PTSD crisis

Research shows that inner-city violence can be as traumatizing as war. A program in Philadelphia is pioneering new ways to treat the urban wounded/

Yahoo News, By Tina Rosenberg, March 6

The fight that started Keith Davis on a path to a new life began when he was buying marijuana. It was early afternoon on Aug. 8. As he tells it, he was in at his usual hangout in North Central Philadelphia, in front of an abandoned church at 18th and Ridge. He was taking too long mulling over his purchase, and another man got impatient and told him to go buy his stuff somewhere else.

“I go wherever I want to go,” said Davis. The man said some things back. A fight broke out, which ended when the man pulled out a knife and stabbed Davis in the abdomen and left arm.

Davis, who was 21, was still punching at the man even as he watched the knife go in. He saw the blood, but he felt no pain. He thought about calling an ambulance. “But I don’t want to pay $2,000 for an ambulance,” he said. And an ambulance would probably mean police — nobody wanted that. “I ain’t no snitch,” Davis said in December, recalling his thinking. Hahnemann University Hospital’s emergency department, a place well known to Davis and his friends, was a little over a mile away. He started to walk.

This was Davis’ corner. He grew up a few blocks away in the Francisville neighborhood, and these were his people. But no one volunteered to come with him. “I didn’t ask nobody, and they know what kind of person I am,” he said — one who can take care of himself. As Davis walked, holding his stomach wound, the bloodstain bloomed across his shirt and began to drip onto the sidewalk. Strangers offered help, but Davis shrugged them off and kept walking. He got to the emergency room. He remembers one gentle doctor calming him down. “Let’s call your mom,” the doctor said, “and then we’re going to put you to sleep.” Nurses took off his sneakers, cut off his clothes and stuck a needle in his arm. He woke up a day later with 72 stiches in his left arm and more than 30 staples in his stomach.

It was the type of crime that kills more young men in America than any other: The ingredients are an argument over nothing, an audience (ensuring that neither man can back down) and a weapon. The weapon was a knife, so Davis woke up. It’s usually a gun, and often they don’t wake up.

That knife, though, did not just wound his stomach and arm. It also altered his brain. When he woke up in the hospital, he was surrounded by his family, but his first thoughts were new worries: Who can I trust? It now seemed too dangerous even to walk to the store. “I can’t let my guard down when I go around the neighborhood.” And then, “I need to retaliate.”

Five billion people ‘have no access to safe surgery’

BBC, By Tulip Mazumdar, April 27

Two-thirds of the world’s population have no access to safe and affordable surgery, according to a new study in The Lancet – more than double the number in previous estimates.

It means millions of people are dying from treatable conditions such as appendicitis and obstructed labour.

Most live in low and middle-income countries.

The study suggests that 93% of people in sub-Saharan Africa cannot obtain basic surgical care.

Previous estimates have only looked at whether surgery was available.

But this research has also considered whether people can travel to facilities within two hours, whether the procedure will be safe, and whether patients can actually afford the treatment.

One of the study’s authors, Andy Leather, director of the King’s Centre for Global Health, said the situation was outrageous.

Brazilians Spraying and Praying for Dengue Vaccine Breakthrough

Bloomberg, By Mac Margolis, April 24

A cup of cloves, a half-liter of alcohol and a dollop of body oil: You won’t find this homemade mosquito repellent in Brazilian drugstores, but the recipe went viral after a worried sanitarian posted a cell phone video on Facebook last week.

Amid one of their worst outbreaks of dengue fever — 460,000 people infected and 132 dead this year — Brazilians are understandably jumpy. That humming sound is aedes aegypti, a familiar pest storied for spreading yellow fever throughout tropical America and now enjoying a comeback as the vector for what has become a 21st-century pandemic.

Once a mostly Asian affliction, the dengue virus has gone global because of breakneck urbanization, bad management of water, haphazard public health care and travel on jets that can take passengers anywhere overnight. A 2013 study in Nature reckoned that dengue had infected 390 million people that year, with 94 million falling ill.

The outbreak is especially severe in the Americas, which have seen a 30-fold increase in the disease over the past 50 years. Counting hospitalization and sick leave, the disease costs the region at least $2.1 billion a year, says the Pan American Health Organization.

Brazil, alone, accounts for six of every 10 reported cases of illness from dengue worldwide.

After Record Drought, Dengue Fever Is Now Sweeping Across Sao Paulo

3bb1012ca7881a903f6bb688401857a5453d3be4