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Disease Prevention Not Necessarily A Money Saver
The Associated Press reports on the costs of disease prevention: "When it comes to health care spending, an ounce of prevention is seldom worth a pound of cure. ...The truth is, shockingly few prevention efforts actually save the health care system money overall, despite claims by the president and some in Congress."
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Alastair Campbell Gets Majority Vote! Mind Champion Of The Year 2009
Alastair Campbell has won Mind"s Champion of the Year Award for his significant contribution to raising awareness of mental health. He beat fellow nominee and chat show host Paul O"Grady, among other mental health campaigners, to the prestigious award announced yesterday evening.
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Advocates Weigh Impact Of Tiller Murder On Future Of Abortion Debate
Opponents and supporters of abortion rights on Monday said they expect the murder of Kansas abortion provider George Tiller on Sunday to further intensify the debate over reproductive rights in the U.S., with some abortion-rights advocates expressing concern that the killing could spur a new wave of protests or violence from opponents, the Washington Post reports. Tiller, one of the few U.S. doctors who performed abortions later in pregnancy, was shot to death on Sunday at his church in Kansas. According to the Post, Tiller"s death has brought the issue of violence back into the spotlight in the abortion debate at a time when President Obama is urging both sides to find "common ground." Nancy Keenan, president of NARAL Pro-Choice America, said the "ongoing pattern of hateful rhetoric" used by some in the antiabortion-rights movement contributes to violence like Tiller"s shooting (Slevin, Washington Post, 6/2). Keenan singled out groups that she said have used "hateful rhetoric" in recent months. "If they truly abhor the violence their rhetoric is encouraging, then they need to stop using the inflammatory phrases to describe the people they don"t agree with," she said, adding that "until then, I think their claims of the shock of Dr. Tiller"s murder ring very hollow." The antiabortion-rights group Operation Rescue is at the center of debate over whether certain rhetoric stokes violence in the movement, NPR"s "Morning Edition" reports. The group"s founder, Randall Terry, said after the shooting, "What that man did by shooting George Tiller is wrong. Period" (Rovner, "Morning Edition," NPR, 6/2). However, Terry also called Tiller a "mass murderer" who "reaped what he sowed" (Milligan, Boston Globe, 6/2). Tom McClusky, vice president of the Family Research Council"s legislative arm, said the group is concerned with "how an action like this might be exploited" by abortion-rights supporters, particularly the idea of condemning the entire antiabortion-rights movement for Tiller"s death. He said that FRC is "already seeing some indications of people trying to throw everybody into the same boat" ("Morning Edition," NPR, 6/2).The Rev. Rob Schenck, president of the National Clergy Council, said that Terry"s views do not represent the modern antiabortion-rights movement. Schenck added that he believes "that a lot of pro-life leaders from the past are not carefully, prayerfully thinking through the moral consequences of an act like" the shooting. Schenck and abortion-rights opponents also expressed concerns that the murder will harm the credibility of their attempt to block the Supreme Court nomination of Judge Sonia Sotomayor. "When an act like this happens, it becomes a greater threat to the pro-life movement than anything the pro-choice movement" could do, Schenck said (Boston Globe, 6/2). Andy Wollen of the centrist group Kansas Traditionalist Republican Majority said that Tiller"s shooting "brings home the impact of the kind of rhetoric that the hard right uses when they talk about abortion." He said that when antiabortion-rights advocates "called him "Tiller the Killer" and they call their political opponents "baby killers," as they do on a regular basis, they"re opening the doors" to acts of violence.Meanwhile, USA Today reports that U.S Attorney General Eric Holder has increased security measures for abortion providers and clinics across the country, including Tiller"s clinic (Bello/Stone, USA Today, 6/2). Dan Monnat, Tiller"s attorney, said that the clinic is currently closed for mourning but will reopen next week to serve women who "came to Dr. Tiller because they had nowhere else to turn" (Washington Post, 6/2). Scott Roeder, the man accused of shooting Tiller, remained in custody in Wichita, Kan., the day after the shooting. USA Today reports that the district attorney has until today to file charges (USA Today, 6/1).
Cardiovascular

Detection Of "Prolonged Grief Disorder" May Help Bereaved Individuals

Identification of criteria for the detection of prolonged grief disorder (PGD) appear able to identify bereaved persons at heightened risk for enduring distress and dysfunction, says a new study in this week"s open access journal PLoS Medicine. The results support the psychometric validity of the criteria for PGD and should be included in the Diagnostic Statistical Manual of Mental Disorders, 5th Edition (DSM-V) and the International Statistical Classification of Diseases and Related Health Problems (ICD-11), say the authors. Dr. Holly Prigerson from the Dana Farber Cancer Institute in Boston, Massachusetts and her colleagues conducted a field trial to develop and evaluate algorithms for diagnosing PGD based on a set of symptoms agreed upon by experts in bereavement, mood and anxiety disorders, and psychiatric nosology. They interviewed 291 bereaved individuals three times in the two years following the loss of a spouse about their experiences of these symptoms. Using item response theory and combinatoric analysis, the researchers identified the most sensitive and specific algorithm for the diagnosis of PGD. This algorithm included yearning (physical or emotional suffering because of an unfulfilled desire for reunion with the deceased) and at least five of nine additional symptoms including emotional numbness, feeling that life is meaningless, and avoidance of the reality of the loss, which had to have persisted for at least 6 months after the bereavement and to be associated with functional impairment. In addition, the researchers report that individuals in their study given a diagnosis of PGD 6-12 months after a death had a higher subsequent risk of mental health and functional impairment than people not diagnosed with PGD. Currently, grief is not recognized as a mental disorder in the DSM-IV or the ICD-10. The authors say that their work confirms the distinctiveness of the symptoms of PGD, and "that PGD meets DSM criteria for inclusion as a distinct mental disorder on the grounds that it is a clinically significant form of psychological distress associated with substantial disability." In an accompanying Perspective article, Dr. Stephen Workman (not involved in the research) from the Queen Elizabeth II Health Sciences Center in Halifax, Nova Scotia, Canada, says that by persuasively establishing PGD as a uniquely identifiable illness that may require specific treatments, Dr. Prigerson and colleagues have separated PGD from normal grief and from other forms of pathologic grief responses. He says from a clinician"s perspective that the work is "rigorous, compassionate, and humane." Article by Dr Prigerson and Colleagues: Funding: HGP was supported by National Institute of Mental Health grants MH56529 and MH63892, and National Cancer Institute grant CA106370. PKM was supported by NIH grant NS044316. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing Interests: Michael First received consultant fees over the past 5 years from Roche, Corcept, Wyeth, Cephalon, Astra-Zeneca, Shire, GSK, and Eli Lilly for preparing diagnostic interviews and/or conducting diagnostic trainings at investigator meetings. Citation: Prigerson HG, Horowitz MJ, Jacobs SC, Parkes CM, Aslan M, et al. (2009) "Prolonged Grief Disorder: Psychometric Validation of Criteria Proposed for DSMV and ICD-11." PLoS Med 6(8): e1000121. doi:10.1371/journal.pmed.1000121 PLoS


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