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Majority of children don’t get appropriate health care

Up to three-quarters of children and adolescents don’t get appropriate care Washington, D.C., April 15, 2004—Despite a number of noted successes, American children largely don’t get the quality of health care they should, with up to three-quarters of children and adolescents not receiving care scientifically proven or recommended, according to a new overview of children’s health care released today by The Commonwealth Fund. The review, Quality of Health Care for Children and Adolescents: A Chartbook, shows a number of clear advances in children’s health care and improved outcomes on a series of measures. But it also notes that one-third of children with asthma don’t get appropriate controller medications and three-fourths of children with severe mental health problems don’t get evaluation or treatment. In addition, it illustrates ongoing racial disparities in care and inadequate attention to widely effective preventive measures. Distilled from a review of 500 studies, the report illustrates through 40 charts and commentary the quality of care children receive in numerous categories, such as preventive care and treatment of chronic conditions. The chartbook was produced by Sheila Leatherman, research professor at the University of North Carolina School of Public Health, and Douglas McCarthy, president of Issues Research, Inc., based in Durango, CO, in consultation with national experts in child and adolescent care quality. “Given the fact that we spend far more on health care than other countries, we should be doing better for our children,” Leatherman said. “The report shows dangerous lapses in patient safety, substantial shortcomings in providing effective and recommended care, persistent racial and ethnic disparities in care, and widespread failure to provide needed preventive services...

Penn State Sex Abuse Scandal

Published Online Wed, 11 Nov 2011 22:46:00 Tonight Penn State Board of Trustees made a “rush to judgment“ according to some media sources regarding the ongoing sex abuse scandal at the university.  Coach Paterno was removed and dismissed as athletic director due to a reported moral lapse of judgment in not pursuing the suspected child abuse reporting himself despite his reports to his superiors of what he knew of the alleged sex abuse of a child by his former assistant coach Jerry Sandusky.  According to many students and faculty, the Board of Trustees appears to be using this opportunity to “scapegoat” Coach Paterno while apparently taking the focus off of those who legally failed to report the alleged child abuse perpetrated by Jerry Sandusky to the police. A report of a KDKA-TV News Poll Conducted By Survey USA of a survey of Penn State alumni is consistent with the recent Grand Jury findings in not condemning or invoking consequences for Coach Paterno.  Consequences are apparently due with the lack of action by Penn State University and administrators in not reporting the alleged abuse of children by Jerry Sandusky. The same survey placed the responsibility with President Spanier and his lack of action in not having reported the child sexual abuse to the police as mandated by Pennsylvania law for professionals such as teachers and faculty.  See Pennsylvania’s legal reporting laws:...

Overdose: A Review of 100 Consecutive Cases

1. Evaluate and treat patients with significant overdose. 2. Understand risk factors for significant overdose. Patients who overdose represent a significant challenge(1) for consultation-liaison psychiatrists. Methods: A retrospective chart review of 100 patients over 18 consecutively admitted from July through December, 1998 by the toxicology service following overdose warranting hospitalization was performed. Diagnoses were based on DSM-IV criteria. Results: Seventy-eight percent of the 100 toxicology cases reported suicidal intent. The age range was 18 to 79; the mean was 34.8. Fifty-five percent were female. The primary psychiatric diagnoses are as follows: 64% mood disorder, 16% substance related disorder, 8% adjustment disorder, 7% psychotic disorder, 2% anxiety disorder, 3% other. Sixty-eight percent had a prior Axis I diagnosis other than substance abuse. Forty-one percent were currently receiving psychiatric treatment. Sixty-four percent had co-existing substance abuse. Twenty-nine percent ingested at least one substance of abuse as part of the overdose. Forty-six percent had previously attempted suicide. Seventy-five percent identified a stressful life event. Conclusion: Adult overdose patients share risk factors(1,2) for suicidal behavior including the presence of an Axis I diagnosis, particularly a mood disorder; lack of current psychiatric treatment; history of prior suicide attempt; and significant life stressors. Substance abuse represents a significant independent and comorbid risk factor for overdose.   Klerman GL. Clinical epidemiology of suicide. Journal of Clinical Psychiatry, 1987;48:33-8. Beaumont G, Hertzel W. Patients at risk of suicide and overdose. Psychopharmacology,...

Orphanages are an ‘option’

Posted 12/18/2009 1:09 AMBy Wendy Koch, USA TODAY“Children who live in orphanages fare as well or better than those in family homes, reports a Duke University study that tracked more than 3,000 children in five Asian and African countries. The study is touted as one of the most comprehensive ever done on orphans. Orphaned and abandoned children ages 6-12 were evaluated over a three-year period in 83 institutions and 311 families in Cambodia, Ethiopia, India, Kenya and Tanzania. Those in institutions had significantly better health scores, lower prevalence of recent sickness and fewer emotional problems.“ The findings were reported in USA...

Obama Supports Early Education

Obama Supports Early Education as Ultimately Cost Saving CHICAGO, Dec 16 (New York Times) — “Mr. Obama’s platform, which Mr. Duncan helped write, emphasizes extending care to infants and toddlers as well, and it makes helping poor children a priority. It would also provide new federal financing for states rolling out programs to serve young children of all incomes.“ Mr. Obama’s platform accepts the broad logic of the Ypsilanti study. “For every one dollar invested in high-quality, comprehensive programs supporting children and families from birth,” the platform says, “there is a $7-$10 return to society in decreased need for special education services, higher graduation and employment rates, less crime, less use of the public welfare system and better health.” The report was published in the New York...
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