California wildfires take mental health toll.   In the aftermath of devastating wildfires, mental health professionals in southern California prepare to deal with the short- and long-term mental health issues faced by residents as they return home. While some people have lost property and pets, others whose homes are still intact may also find themselves psychologically traumatized.

      The NBC Nightly News (10/28, story 2, 2:30, Holt) covered the financial and emotional trauma now experienced by California residents as they return after the wildfires, and face the reality of destroyed homes. "The reality [is] that starting over may be much harder than they imagined."

      The AFP (10/28, Sheridan) reported that according to mental health professionals, "psychological scars will remain" long after the last fire is put out. For those newly homeless who are dealing with "depression and loss," transition also means the growing realization that "their welcome with family or friends is limited, or that their paychecks cannot withstand long-term hotel bills." To help in the psychological recovery effort, a "team of 75 Red Cross mental health counselors" is on its way to help "fire victims deal with stress and feelings of anger, frustration, and sadness." Psychiatrist Jeff Rowe, M.D., who works for children's mental health services for San Diego County, explained, "Once you find out you have lost your home, devastating sadness, helplessness, and hopelessness come into play." Dr. Rowe said that mental health professionals "focus on getting victims in contact with people in similar situations so that their sense of identity can be reaffirmed, and they can be involved in their own rebuilding."

      California's North County Times (10/28, James) quoted James Lepanto, vice president of the Family Services Division at Mental Health Systems Inc. in San Diego, as saying, "Losing a home is apocalyptic. It challenges everything we know about security and safety." The Times noted, "Besides the threat of physical destruction, the threat of losing other possessions is traumatic." Residents of fire-ravaged neighborhoods, regardless of whether they lost their homes or not, "may feel stressed, anxious, disoriented, angry, and powerless long after the fires have been extinguished," and they may even feel survivor's guilt. To help residents to deal with fire-related psychological trauma, Lepanto's group has posted recommendations "for reducing stress and anxiety" on San Diego County's emergency website under "Press Releases."

      The San Diego Union-Tribune (10/27) pointed out that the San Diego Wildfire Mental Health Relief Fund will assist "uninsured residents directly or indirectly affected by the wildfires obtain access to mental health services." Based on need, the Mental Health Association in San Diego "will provide assistance in connecting families and individuals to mental health services."

      Survey indicates nearly one in three Americans reports extreme stress.   Not only those who live in fire-ravaged California are dealing with extreme stress. According to WebMD (10/26, Hitti), "Nearly a third of U.S. adults [32 percent] report 'extreme stress' in a new survey from the American Psychological Association." The survey also indicates that "participants are suffering physically, emotionally, professionally, and personally as a result of stress," much of it related to work, workload, or financial problems. The survey was carried out through an "online poll" which was "conducted by Harris Interactive in late August and early September." It "included 1,848 adults," and "has a two percent margin of error."

Pediatrician urges autism research, not demonization of childhood vaccine program.   In an op-ed appearing in the Wall Street Journal (10/27, A8), Texas pediatrician Ari Brown, M.D., a fellow of the American Academy of Pediatrics, discussed the controversy and public health implications surrounding vaccines and autism. In response to actress Jenny McCarthy's bestselling book, Louder Than Words: A Mother's Journey in Healing Autism, in which McCarthy claims that "vaccines caused her son's autism," Dr. Brown wrote, "Vaccines are one of mankind's greatest scientific achievements," saving children from suffering and death due to former killers such as diphtheria and measles. "When a well-meaning parent like Ms. McCarthy blames vaccines for her child's autism, it's dangerous," because the "media hysteria" surrounding the book may influence some parents not to have their children vaccinated. Dr. Brown continued, "I also desperately want to know why autism happens and how to treat it. But let's put our energy into funding autism research and treatment, not demonizing our vaccination program." Dr. Brown concluded, "I am on the front lines everyday, trying to keep our kids healthy and protected. And, after all I have seen, one thing is certain -- I've vaccinated my own kids and would do it again in a heartbeat."

Falls are a leading cause of traumatic brain injuries among elderly and children.   HealthDay (10/28, Preidt) reported, "In 2006, an estimated 1.1 million people were treated at U.S. hospital emergency departments for head injuries related to common household products and settings such as ladders, steps, and showers, the federal Consumer Product Safety Commission (CPSC) reports." According to the American Association of Neurological Surgeons (AANS), the "actual number of head injuries suffered by people in their homes is likely greater, since many injuries are treated at doctor's offices and immediate-care centers, or people don't seek any medical treatment." Falls are a serious matter, particularly among the elderly, where they can result in head injuries. Among those 65 and older, "falls are the most common cause of traumatic brain injury, which account for 46 percent of fatal falls among older adults." Traumatic brain injury is also the "leading cause of death and severe injury in children who suffer falls."

      Former quarterback designs new shock-absorbing helmet.   In its Health Highlights section, HealthDay (10/28) reprised coverage of an article appearing on the front page of the New York Times (10/27, A1, Schwarz) that described an "innovative [football] helmet containing 18 thermoplastic shock absorbers instead of the more conventional foam and urethane." Recently "developed by former Harvard quarterback Vin Ferrara," who has himself sustained several concussions, the new helmet can absorb "hundreds of impacts without any degradation," unlike, for instance, a bicycle helmet that must be replaced after a rider takes a serious spill. The medical significance of Ferrara's "design breakthrough" could mean safer football for the nation's youth. Studies "have found that as many as 50 percent of high-school players suffer from concussions during the football season."

Deep brain stimulation may cause compulsive behaviors in Parkinson's patients.   Psych Central (10/26, Grohol) reported that "although deep brain stimulation (DBS) offers a means to relieve the tremors and rigidity that afflict individuals with Parkinson's disease, compulsive behaviors may arise," according to research appearing in the journal Science. Michael Frank, Ph.D., of the University of Arizona, and colleagues, discovered that DBS may interfere "with the brain's innate ability to deliberate on complicated decisions," because of the effect DBS implants have on the "subthalamic nucleus (STN)." The researchers found that DBS "actually sped up the decision-making process, a signature," Frank said, indicative of "impulsive decision making." The AP (10/26) and the UPI (10/26) also reported the story, as did ABC News (10/26, Williams) on its website.

Democrats are "wasting time" on SCHIP, Bush says.   In continuing coverage from previous briefings, the Washington Times (10/27, A1, Curl) reported on its front page on Saturday that President Bush said Friday that congressional Democrats "are 'wasting time'" in attempting to expand the State Children's Health Insurance Program (SCHIP) bill which he plans to veto again. Bush stated, "This is not what congressional leaders promised when they took control of Congress earlier this year. In January, one congressional leader declared, and I quote: 'No longer can we waste time here in the Capitol, while families in America struggle to get ahead.' He was right."

      Similarly, the Wall Street Journal (10/27, Pulizzi) noted that according to President Bush, "With only a few weeks left on the legislative calendar, Congress needs to keep their promise to stop wasting time and get essential work done on behalf of the American people." The president expressed incredulity that the Senate plans to vote again on the SCHIP bill this week. Modern Healthcare (10/27, Lubell) also covered the story, as did the AP (10/27, Babington).

      Senate to vote on SCHIP bill next.   Congressional Quarterly (10/29, Wayne) reiterates recent coverage of the SCHIP expansion bill, noting, "The Senate will vote on a cloture motion on whether to proceed to the bill on October 30. The measure Bush vetoed had passed the Senate by 67-29 on September 27, and the new version is expected to receive strong Senate support as well."

      Wall Street Journal says Democrats driven by politics, not children, in SCHIP debate.   The Wall Street Journal (10/27, A8) editorialized, "Democrats say [that] they are urgently concerned for children's health, but their main priority seems to be politics." Last "Thursday, they forced a House vote on a new version of their major expansion" of SCHIP. The "good news is that the bill once again failed to achieve a veto-proof majority. ... The Democrats say [that] they 'modified' the bill to placate conservative objections, but the policy changes are ornamental." The "Bush Administration is the one bending here. Health and Human Services Secretary Mike Leavitt recently said [that] the administration will countenance as much as a $20 billion expansion over five years, which quadruples their previous offers. ... Democrats have spurned all administration genuflections, even ones this broad. After President Bush vetoes SCHIP 2.0, and assuming the override fails, the Democrats are likely to pass a continuing resolution funding SCHIP at current levels for another a year, positioning a new political blow-up just before the election. So much for the priority of covering children."

      Dean criticizes Republicans for opposing SCHIP bill.   The AP (10/27, Sanner) reported that Democratic National Committee Chairman Howard Dean "on Saturday criticized Republicans in Congress for not supporting legislation to expand" SCHIP. In the weekly Democratic radio address, Dean said, "The Republican leaders have made their choice. They want to stay in Iraq and deny our kids healthcare." Furthermore, Dean noted that "Republicans support significant borrowing to continue wars in Iraq and Afghanistan, but won't support the legislation to increase spending for" SCHIP.

Maryland governor's healthcare plan would expand Medicaid, subsidize small business.   Modern Healthcare (10/26, DoBias) reported that on Thursday, Maryland Gov. Martin O'Malley (D) "unveiled a $739 million blueprint for healthcare reform that would expand Medicaid enrollment criteria, create a statewide health insurance option, and subsidize small businesses in an effort to provide coverage to 100,000 Marylanders over the next five years." Gov. O'Malley "also issued an executive order creating the Maryland Health Quality and Cost Council, a quality- and performance-improvement organization charged with developing state-based best practices to improve healthcare access and quality."

      The Washington Post (10/26, B6, Rein) pointed out that the plan will first cover "parents with incomes of less than $20,000 for a family of three -- about 30,000 people. Then adults without children -- who now are eligible only if their income is 40 percent of the federal poverty level, or about $5,000 -- would be covered." Gov. O'Malley's plan would "give insurance subsidies to employees earning less than $50,000 at firms with up to nine workers, about 5,500 companies that don't offer benefits. Another 4,000 small businesses that provide coverage also would get help from the state to prevent them from dropping it."

      The AP (10/26, Witte) noted that according to Maryland Health Secretary John Colmers, M.P.H., the proposal "would include a subsidy to employers with low-income employees to help offer health insurance. About $20 million would be available to help pay for premiums, and the money would be targeted at thousands of small businesses." The AP added, "Up to $10 million would be available for firms that already offer health insurance to encourage them to continue, Colmers said."

      According to the Baltimore Sun (10/27, Smitherman), "The plan would cost about $500 million, including $250 million in new state revenue plus federal matching dollars and funds redirected from other areas." But, O'Malley "stressed the plan's 'pay-as-you-go' feature," suggesting that "residents who have private insurance would save money because the cost of treating the uninsured in Maryland is added to their premiums." Still, Republican lawmakers are concerned "about the cost of the proposal" and "would prefer private-sector solutions." Maryland's General Assembly plans to "consider the legislation during the special legislative session that begins Monday."

      Meanwhile, the Baltimore Examiner (10/27, Lazarick) noted, "The program includes raising the eligibility for Medicaid to 116 percent of the federal poverty level -- $20,000 for a family of three." The proposal, which "hinges on passing new taxes and slot machine gambling," comes "two days after he disclosed $1.7 billion in budget cuts he would have to make if the legislature does not raise taxes, including doubling the cigarette tax." The Washington Times /AP (10/27, Witte) also covered the story.

Rhode Island Health Department to investigate psychiatric emergency care.   The Providence Journal (10/27, Freyer) reported that the Rhode Island "Health Department plans to investigate whether hospitals that hold psychiatric patients in emergency rooms are violating the state's charity-care regulations, which require them to provide treatment to patients who cannot pay," according to health director David R. Gifford, M.D., M.P.H. Dr. Gifford said that the action "comes in response to a lawsuit filed Thursday by the state mental health advocate, H. Reed Cosper," in which Cosper faults Rhode Island's Department of Mental Health, Retardation and Hospitals (MHRH) "for not providing enough inpatient beds for uninsured people with mental illness who need to be hospitalized on an emergency basis." The suit alleges that psychiatric patients "go to the hospital emergency rooms where...they are often held for days -- against their will and without treatment -- while waiting for a state-funded bed." However, MHRH director Ellen R. Nelson, Ph.D., "questioned why the hospitals are holding the patients rather than admitting and treating them. Even if a state-funded bed is not available, hospitals with psychiatric units should provide the patients free care, she said." Connecticut's The Day (10/27) also reported the story.

Programs ease transition into higher education for autistic and disabled.   The Washington Post (10/29, B2, Minaya) reports that the college experience may be difficult or impossible for many students with autism spectrum disorders and learning disabilities. However, College Living Experience, "a program that helps students with learning disabilities make the transition to college," helps "students who might not otherwise consider leaving home to attend college. Students receive tutoring, mentoring and instruction in living skills to help them survive in the often disorderly world of a college campus." College Living Experience, "originally based in Fort Lauderdale, Fla., was bought two years ago by Educational Services of America, a for-profit company that operates alternative- and special-education programs." Demand for transitional programs like College Living Experience "has grown as students with disabilities, who gained access in large numbers to regular classes in the 1980s," now matriculate into institutes of higher education.

Medical school enrollment increases, underscoring need for more residency positions.   The Houston Chronicle (10/28, Grant) reported, "Enrollment is increasing sharply at medical schools across the country, a trend that's expected to help the nation combat a worsening shortage of physicians." However, "it's also focusing attention on the need to expand the other half of the physician pipeline: residency programs." The Chronicle continued, "Though medical school enrollment is on the rise, increasing the number of residency positions is arguably more difficult." This is due mainly to the fact that "programs in most states depend largely on funding from the federal government through Medicare, and that funding has remained static for the past few years."

Psychiatrist discusses "brain enrichment" DVD/videos for infants.   In a column appearing in the San Francisco Chronicle (10/28), psychiatrist Keith Humphreys, M.D., a professor of psychiatry at Stanford University School of Medicine, discussed "brain enrichment" DVD/videos for infants. Dr. Humphreys noted that according to "a recent study of 1,008 parents and children published in the Journal of Pediatrics," the more hours infants ages eight to 16 months "spent watching allegedly educational baby DVDs/videos, the fewer words" they knew. This "pattern held whether infants watched the videos alone, or with their parents." Reminding new parents that they are indeed the best teachers, Dr. Humphreys added, "In any case, research shows that if you want your infant to learn words, DVDs can't hold a candle to putting baby on your lap and reading a book together at least once a day."

Study indicates divalproex, lithium may significantly improve childhood bipolar symptoms.   In its Health Highlights section, HealthDay (10/26) reported that the "mood stabilizer drugs divalproex and lithium significantly improved symptoms in children and adolescents with bipolar I disorder," according to a study presented at the annual meeting of the American Academy of Child and Adolescent Psychiatry in Boston. Robert A. Kowatch, M.D., of Ohio's Cincinnati Children's Hospital Medical Center, and colleagues, studied "153 patients, ages 7 to 17," for six months in this "largest pediatric study of its kind to date."

      Psych Central (10/27) noted that the study group "randomly assigned" the participants "to receive a placebo, lithium or divalproex sodium." After "an eight-week" double-blind "treatment phase, patients receiving divalproex significantly decreased their average scores on the study's primary outcome measure for manic symptom severity, the Young Mania Rating Scale (YMRS)." Psych Central continued, "Fifty-six percent of patients in the divalproex group, 41 percent of those in the lithium group, and 30 percent of the placebo group experienced a more than 50 percent decrease in their YMRS scores." But that was not all. The "response rates on the study's other primary outcome measure, the Clinical Global Impressions Ratings (CGI) improvement score, indicated that 54 percent of the divalproex group, 42 percent of the lithium group, and 29 percent of the placebo group improved their CGI scores by one or two points." In addition, patients "who responded to treatment" were allowed to "continue in the double-blind testing for another 16 weeks."

FDA issues approvable letter for new delayed-release valproic acid capsule.   Psych Central (10/26, Grohol) reported, "A new type of delayed-release valproic acid capsule is one step closer to receiving final approval for sale in the U.S. by the Food and Drug Administration (FDA). The new drug will be marketed under the brand name Stavzor (valproic acid) by Noven Pharmaceuticals." In a letter, the FDA stated that it had "completed its review" of Noven's application for Stavzor, and said that the drug "is approvable." Once approved, the "delayed-release valproic acid capsules" will be "available in 125mg, 250mg and 500mg strengths." The FDA is expected to approve Stavzor for use "in the treatment of manic episodes associated with bipolar disorder, adjunctive therapy in multiple seizure types (including epilepsy), and prophylaxis of migraine headaches." Approval is expected by "the end of July 2008."