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11 Ways to Avoid Answering a Question: A Year in Review

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When my grandfather was alive, each of his children and grandchildren was responsible for reporting to him about the world in which they worked. He loved knowledge; he always had. As the only scientist in the family, I was in charge of “science.” This never quite seemed fair and yet I did what I could until the day he asked me to explain dark matter. I am a broadly trained scientist. I have worked on bacteria, birds, plants, insects and a great deal else. But, when pressed, late in the evening, dark matter was beyond my comfort zone. I faltered. Sometimes with my grandfather, faltering could be propped up with grandstanding, but on this particular day there was no such doing. He knew I was guessing. His shoulders slumped and he announced softly, “I don’t think I am ever going to learn everything.” My ignorance was the BS that broke the camel’s back.


In part because of my grandfather I have always felt a responsibility to answer questions people ask about science. This year, I decided I would make this responsibility more conscious. I would try to focus much of my writing on answering questions that came up in my daily life, questions that I am responsible for because I am a scientist. It was a sort of New Year’s resolution. My other resolution was to write shorter articles.1–Sitting around enjoying a glass of wine with my family and our friends Ari Lit and Michelle Trautwein, Ari asked, Hey dude, why do we drink alcohol? Do monkeys drink alcohol? This led me to think about the big story of alcohol and, in as much, to write a whole series about our complex relationship with the yeasts that, as waste, produce our favorite drinks. It ended up becoming a forty thousand word online series, about alcohol, civilization and yeast. So much for the resolution to write short articles. Also, I forgot to check on the monkeys.2–My favorite questions tend to come from kids and earnest parents. This year at my daughter’s school, every third student and then every other students and then, jeez, almost every student seemed to have lice. Parents asked me, “what should we do about lice?” This was a follow-up to an article I had written years prior in response to a similar query. I was able to tell the story of how the louse problem (or success, depending on your perspective) came to be, over the last million years. But I failed to really answer what a parent should do if their kid gets lice. It turns out parents whose kids have lice don’t want to hear about ancient hominids and their lice. Go figure.Image 1. Picture of the louse species, Pthirus pubis, descended from an interaction between a human ancestor and a gorilla ancestor and that is all I am saying. Photo courtesy of the CDC. 3-In the last chapter of my book The Wild Life of Our Bodies I argue for a more serious gardening of nature in the places we live. Reading this, someone wondered about the ways in which we garden evolution itself. She emailed asking, Could we favor the evolution of good species in our houses? I wasn’t sure and am still not, but the question prompted me to reconsider the ways in which we have gardened evolution historically. I wrote the Garden of Our Neglect about this history. I then started to consider how we might favor the presence (if not evolution) of beneficial species on our bodies and in our homes. This led me to propose the Ecological Theory of Disease and to write Letting Biodiversity Get Under Our Skin, and How Clean Living is Bad for You. I also wrote an article about what our body might be doing to favor beneficial species in Your Appendix Could Save Your Life. None of these articles really told anyone which species to plant much less engender in their invisible gardens of indoor life.4-Another night with friends, we sat around talking about paleo diets. Ari asked who we should count as our ancestors, which ancestors should we consider if we were to eat ancestral diets? This debate inspired the piece Were Our Ancient Ancestors Vegetarians and then How to Eat Like a Chimpanzee. Later when Ari tried an essentially all nut and fruit super-fiber diet I found myself writing about the Hidden Truth about Calories. With these articles, I learned about diet, but I also learned that people can get very angry when it comes to discussing food. I never really answered Ari’s question.5-At one evening talk associated with the Museum of Life and Science in Durham, NC, someone asked me why her armpits smell sweet when she lives in the desert. She asked me that question in Durham, not in a desert, so I felt compelled to take her word for it rather than sniff around the story, but I did begin to wonder about what we do and don’t know about the microbial smells produced on our bodies and those of, for example, dogs, so I wrote Why Sick People Smell Bad. The article was fun, but I still don’t know why the woman had sweet pits; perhaps it is just her nature.6-My daughter (who sometimes seems to channel the pure inquisitivness of my grandfather) asked me “Why are our bodies warm and not cold?” This is the kind of question she asks so as to avoid going to bed. It led me to write the article How Killer Fungus May Have Made us Hot Blooded. The article offers a partial, possible, speculative answer to her question, which is her favorite kind of answer because it means she can stay up later as she asks follow-up questions.7–My son has started asking, “papa, who took your hair?” I told him, as I told my daughter when she was smaller, that the squirrels took it for their nest. This just seemed to make him afraid of squirrels so I decided to figure out the real answer, the result was a story in New Scientist (unfortunately pay-walled) about the mystery of baldness and its evolution. Balding, it turns out, is fascinating, but why we bald is still largely unresolved. Back to the squirrels.8–I sometimes introduce talks about social insects by mentioning the similarities between insect and human societies and the idea that insect societies can allow us to learn about our own. In response (and during election season), someone recently asked “who would the ants vote for?” The closest I could get to an answer was to discuss how other animals (mostly honey bees) choose their leaders. I figured out that we know far less about leaders in other societies, including those of ants, than I had thought.9–Piotr Naskrecki visited my house and found, in my basement, a species of camel cricket apparently native to Japan. He also found, to my wife’s dismay, two species of “interesting roaches.” This spurred me to ask other people about their camel crickets, which caused me to have to answer how a Japanese camel cricket has come to take over our basements? I don’t really have an answer yet, though if you check out the website there are ways for you to help me find one.10–For a number of years now, people have been offering me story ideas. “Man, you should totally write about…” Its often difficult to follow up on such ideas, but this year I tried. When my family and I were living in Parma, Italy Donato Grosso asked me if I knew about the species of crab living under Rome. “That,” he said, “would be a good story.” It was. It became “new species of crab living in Rome.” A visit to Girona, Spain where a friend had built a niche in his house for animals to colonize got me wondering about the niches in our cities that we have built for wild species. Pera said, “you should write about it.” I did, in the form of a story about the most common bird in the world, the house sparrow. There were no questions here, but even without a question to answer I seem to have written something slightly different from what Donato or Pera might have imagined.11-Finally, I have started to try to answer the question I have heard most often throughout my career, including from my grandfather, “what do I do about the ants in my kitchen?” Answering this question has required figuring out what the heck is going on with ants in kitchens and backyards and so I wrote one article about a backyard discovery made by English majors, another about a discovery made by an eight year old and another still about how little we seem to know about the most common ant species in eastern North America. I also recruited Eleanor Spicer to write Dr. Eleanor’s Book of Common Ants. None of these answered the question about what to do about the ants in your kitchen, though maybe the distraction bought me some time.Image 2. Camponotus pennsylvannicus, a common backyard (and occasionally kitchen) ant. Photo by Alex (the great) Wild.In short, although I’ve written something like 200,000 words this year, very few seem to have directly answered the questions I was asked. So much for my New Year’s resolution, though maybe part of the problem is that we still know so little about so many fields that it is nearly impossible to make it to the end of a story without encountering the unknown. Perhaps I can try to write shorter answers, answers short enough that I don’t get to what we don’t know. History is not on my side. I seem incapable of writing short articles (one of my shortest articles this year was repeatedly described as “long form”). Also, I come from a long history of “long form” people. My grandfather’s stories went long and, well, his father was apparently worse. When asked to comment on the history of the Episcopal church in his town, Greenville, Mississippi, my great grandfather wrote that he could not write about the history of the Episcopal church in Greenville without commenting on the history of the Episcopal church more generally. And he could not, he said, write about the Episcopal church in general without commenting upon the history of religion. And so he began. My people. It seems we start at the very beginning and answer a question similar too but not identical too the one we were asked. In this light, if my granddad were still around, I’d tell him now that, yes, I can explain dark matter now, but before I do I need to explain the big bang which, ironically, is what I do in my first article of 2013. So stay tuned and send me your questions. But don’t be surprised if, in commenting upon the history of your question, I need to comment on a broader church, the history of life or even the universe.Go ahead and post your science questions you think should be answered in 2013 here…   






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Mood drug no help for smoking cessation in prison study

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NEW YORK (Reuters Health) – The addition of the antidepressant nortriptyline to conventional smoking cessation therapy didn’t improve the chances of longterm success among male prisoners, Australian researchers have found.


Depression and other mental illnesses raise the likelihood of smoking, and quitting can depress a person’s mood – which in turn can make it harder to quit. Studies have shown that antidepressants, including nortriptyline, can improve the success of smoking cessation efforts.






And prison inmates are notoriously heavy smokers, with higher rates of depression and other mental illness than the general population.


But the new study found that nortriptyline (marketed as Aventyl) – which is not FDA-approved for smoking cessation but often is used for that purpose – did not seem to help inmate smokers stay tobacco-free over time.


Compliance with the therapy appeared to a significant issue, however, said Robyn Richmond, a public health researcher at the University of New South Wales, in Kensington, who led the study.


Prisoners who were faithful to the treatment as ordered at least three-quarters of the time were much more likely to break their smoking habit than those who could not stick to the regimen, Richmond told Reuters Health.


Another factor, Richmond added, was that the prison population in the study tended to migrate, making follow-up of the participants difficult.


“One thinks that you have a captive audience” in prison studies, she said. “However, half of the prisoners were either transferred to another prison within the study or released into the community.”


The study, which appears in the journal Addiction, included 425 male inmates from prisons across Australia. All were smokers, with a habit lasting on average 20 years and more than 23 cigarettes a day.


Nearly three-quarters of the inmates in the study had tried to quit in the previous year, according to the researchers.


All of the prisoners in the study received 10 weeks of smoking cessation therapy consisting of nicotine patches and two sessions of behavioral counseling. To that was added either a dummy pill or nortriptyline.


The researchers recorded the inmates’ tobacco use at three, six and 12 months after the end of treatment, relying on self-reporting and direct measurements of exhaled carbon monoxide, a byproduct of smoking.


At the three-month mark, about one-quarter of prisoners who had received the antidepressant had managed to stay off smoking continuously, compared with 16 percent of those who had not taken the drug. But by the one year mark, the abstinence rate had fallen to about 11 percent for both groups.


Psychologist Karen Cropsey, a smoking researcher at the University of Alabama at Birmingham, said most jails and prisons in the United States have significantly restricted tobacco use by inmates. Roughly half of prisons, and many jails, now ban smoking completely, she said, while facilities that permit it typically require inmates to go outside to smoke.


Cropsey, who has studied tobacco use by female inmates, said the latest work is the first to look at smoking by male inmates.


Source: http://bit.ly/U67ejn Addiction, online December 11, 2012.


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Palestinians say 9 dead from swine flu outbreak

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RAMALLAH, West Bank (AP) — A Palestinian health official says an outbreak swine flu has killed nine people.


Deputy Health Minister Asad Ramlawi also said Monday more than 225 people have been infected by the H1N1 influenza strain, known as swine flu. He said more than 25,000 vaccinations have been administered this year to prevent it. The West Bank has 2.5 million residents.






The West Bank has been struck by swine flu before. Dozens died in the Palestinian territories during the 2009 worldwide pandemic.


The first outbreak was discovered in Mexico in March 2009. Thousands died around the world, causing a global panic. The World Health Organization declared swine flu the first global flu pandemic in 40 years.


H1N1 is now considered a seasonal flu and included in the standard annual flu vaccine.


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Italian Nobel scientist Montalcini dies at 103

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ROME (Reuters) – Rita Levi Montalcini, joint winner of the Nobel Prize for Medicine and an Italian Senator for Life, died on Sunday at the age of 103, her family said.


The first Nobel laureate to reach 100 years of age, she won the prize in 1986 with American Stanley Cohen for their discovery of nerve growth factor (NGF), a protein that makes developing cells grow by stimulating surrounding nerve tissue.






Her research helped in the treatment of spinal cord injuries and has increased understanding of cardiovascular diseases, Alzheimer’s and conditions such as dementia and autism.


One of twins born to a Jewish family in Turin in 1909, Montalcini was the oldest living recipient of the prize.


During World War Two, the Allies’ bombing of Turin forced her to flee to the countryside where she established a mini-laboratory. She fled to Florence after the German invasion of Italy and lived in hiding there for a while, later working as a doctor in a refugee camp.


After the war she moved to St. Louis in the United States to work at Washington University, where she went on to make her groundbreaking NGF discoveries.


She also set up a research unit in Rome and in 1975 became the first woman to be made a full member of the Vatican’s Pontifical Academy of Sciences in 1975. She won several other awards for her contributions to medical and scientific research.


Her face was instantly recognizable in Italy and she was well known as a dignified and respected intellectual, a counterbalance to the image of women succeeding through their looks and sexuality, exacerbated during the scandal-plagued era of former prime minister Silvio Berlusconi.


Two days after her birthday in April this year she posted a note on Facebook saying it was important never to give up on life or fall into mediocrity and passive resignation.


“I’ve lost a bit of sight, and a lot of hearing. At conferences I don’t see the projections and I don’t feel good. But I think more now than I did when I was 20. The body does what it wants. I am not the body, I am the mind,” she said.


Italian Prime Minister Mario Monti said in a statement that Montalcini’s Nobel prize had been an honor for Italy, and praised her efforts to encourage young people, especially women, to play a central role in scientific research.


(Editing by Louise Ireland)


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Brazil president, cancer survivor, pronounced healthy

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BRASILIA (Reuters) – Brazilian President Dilma Rousseff, who survived lymphoma cancer in 2009, was pronounced healthy by doctors after a routine exam on Friday.


Rousseff’s health was “within normal levels,” according to a statement released by her office following the check-up at the Sirio-Libanes Hospital in Sao Paulo, one of South America‘s leading cancer treatment centers.






Rousseff underwent chemotherapy in 2009 and briefly wore a wig, but the cancer went into remission and she appeared to be in good health by the time she staged her winning campaign for the presidency in 2010.


Concerns over her health have faded since then, although a bout with pneumonia and a lengthy recovery in 2011 have kept the issue on some investors’ radar screens.


(Reporting by Ana Flor, Writing by Brian Winter; Editing by Doina Chiacu)


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No fewer side effects for prostate proton therapy

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NEW YORK (Reuters Health) – An expensive prostate cancer radiation treatment known as proton beam therapy has just as many side effects as a more common and cheaper radiation method, according to a new study.


In terms of side effects, “In the long term, there’s really no difference in outcomes between proton radiation and IMRT for men with prostate cancer,” said lead author Dr. James Yu, a radiation oncologist at Yale University School of Medicine in New Haven, Connecticut.






Proton therapy advocates argue that protons blast radiation directly to the tumor and therefore avoid side effects. The more common “intensity-modulated” radiotherapy (IMRT) exposes some healthy tissue to radiation that researchers hypothesized would increase side effects and even additional cancers.


After a year, however, the study found the same number of side effects among men who’d had both treatments.


Prostate cancer, the most common cancer in men, kills about 28,000 Americans each year. However, many men don’t die of the disease, because many tumors grow very slowly.


Treatments include chemotherapy, hormone therapy, surgery, and frequent surveillance – aka “watchful waiting.”


Although researchers are at odds over which treatment – proton therapy or IMRT – is the better option for men who choose radiation, that hasn’t stopped the growth of proton beam centers. There are ten such centers in the U.S., according to the National Association for Proton Therapy, with eight more under development or being built.


Each one can cost more than $ 125 million, and Medicare pays doctors about twice as much for proton therapy.


For the study in the Journal of the National Cancer Institute, researchers tracked Medicare claims in 2008 and 2009 for treatment-related complications in nearly 28,000 men with prostate cancer for up to a year. Only two percent of the prostate cancer patients underwent proton therapy and the remainder had IMRT.


After six months, nearly 10 percent of IMRT-treated patients, and six percent of proton therapy patients, had side effects including incontinence, a burning sensation while urinating or difficulty getting an erection. However, the difference disappeared a year after treatment, when nearly one in five patients suffered side effects regardless of which radiation treatment they had.


Yu and colleagues found that proton therapy costs nearly twice as much: $ 32,428 per course of treatment, versus $ 18,575 for IMRT. That difference was consistent with that found in other studies.


“The ball is in the court of the proton folks in terms of proving a benefit,” Yu told Reuters Health.


The study only looked at side effects, and did not compare the effectiveness of the treatments, which proton therapy advocates said was a significant weakness.


If Yu is “willing to make recommendation or clinical judgments based on this sort of data, I think he’s at risk to doing a disservice to his patients,” said Dr. Andrew Lee, director of the Proton Therapy Center at the University of Texas MD Anderson Cancer Center in Houston. “It’s like trying to read a license plate from 30 thousand feet up in the air.”


Lee, who was not involved in the new work, said that the study’s length – a year – wasn’t enough time to look at the full scope of side effects from either treatment. The study also failed to include side effects that didn’t require a hospital visit, and couldn’t say how long treatments lasted.


Proton therapy isn’t for everyone, both noted. Lee said the treatment was best for young healthy patients, while Yu said it is most useful for cancers in children or in sensitive areas where minimizing the radiation is critical.


Yu would not recommend it for prostate cancer.


“The cancer center next door or the radiation oncologist in the community will likely do just as good a job at treating prostate cancer with IMRT as a proton center three times out of the way,” Yu said.


SOURCE: http://bit.ly/V6PkLT Journal of the National Cancer Institute, online December 14, 2012.


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Condom Dispensers in Philly Schools

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Philadelphia is installing condom dispensers in 22 city high schools where students as young as 14 will be able to receive condoms for free in an effort to combat an “epidemic” of sexually transmitted disease among the city’s teenagers.


Students returning to school from Christmas break will find clear plastic dispensers filled with condoms in the offices of nurses whose schools have the highest rates of sexually transmitted diseases.






“We believe distributing condoms is part of our obligation to keep students healthy and to remain healthy,” said school district spokesman Fernando Gallard. “The health department has described this as a continued epidemic of STDs among teenagers in Philadelphia.”


Condoms have in the past been provided to students in Philadelphia as part of wider program in which the teenagers are provided “free, voluntary and confidential” testing for sexual diseases in their schools, Gallard said.


It was the results of those tests that led officials to launch the current program to distribute condoms regularly in schools instead of once a year when the tests are administered.


Of the 130,000 student who have received testing in the last five years, some 6,500 or 5 percent of them have tested positive for diseases including HIV, the virus that causes AIDS.


Parents were made aware of the distribution program in October and were given the chance to opt their children out of receiving the prophylactics.


Gallard said the school district has not received “specific calls” from parents objecting to the program. The total number of parents who chose to disallow their children from receiving condoms, however, is unknown.


According to Advocates for Youth, a nonprofit organization that advocates for sexual health among young people, there are at least 418 schools nationwide providing condoms.


In August, despite outrage from some parents, the school board in Springfield, Mass., approved a plan to distribute condoms in public high schools, as well as middle schools, providing free contraception to students as young as 11.


Philadelphia has plans to expand condom distribution to more schools, but has no plans to introduce prophylactics to middle schoolers, Gallard told ABCNews.com.


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Wife’s Garbled Text a Sign of Stroke

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Dec 25, 2012 12:57pm



8ae4a  gty texting ll 121225 main Wifes Garbled Text a Sign of Stroke

Sending garbled texts may be a sign of stroke. Image credit: Stone/Getty Images.







Smartphone autocorrect is famous for scrambling messages into unintelligible gibberish but when one man received this garbled text from his 11-week-pregnant wife, it alarmed him:


“every where thinging days nighing,” her text read. “Some is where!”


Though that may sound like every text you’ve ever received, the woman’s husband knew her autocorrect was turned off. Fearing some medical issue, he made sure his 25-year-old wife went immediately to the emergency room.


When she got there, doctors noted that she was disoriented, couldn’t use her right arm and leg properly and had some difficulty speaking. A magnetic resonance imaging scan — MRI — revealed that part of the woman’s brain wasn’t getting enough blood. The diagnosis was stroke.


Fortunately, the story has a happy ending. A short hospital stay and some low-dose blood thinners took care of the symptoms and the rest of her pregnancy was uneventful.


Click here to read about how texting pedestrians risk injuries


The three doctors from Boston’s Harvard Medical School, who reported the case study online in this week’s Archives of Neurology, claim this is the first instance they know of where an aberrant text message was used to help diagnose a stroke. In their report, they refer to the woman’s inability to text properly as “dystextia,” a word coined by medical experts in an earlier case.


Dystextia appears to be a new form of aphasia, a term that refers to any trouble processing language, be it spoken or written. The authors of the Archives paper said that at least theoretically, incoherent text messages will be used more often to flag strokes and other neurological abnormalities that lead to the condition.


“As the accessibility of electronic communication continues to advance, the growing digital record will likely become an increasingly important means of identifying neurologic disease, particularly in patient populations that rely more heavily on written rather than spoken communication,” they wrote.


Even though jumbled texts are so common, Dr. Larry Goldstein, a neurologist who is the director of the stroke center at Duke University, said he also believes it’s possible they can be used to sound the alarm on a person’s neurological state, especially in a case like this where the text consisted of complete words that amounted to nonsense rather than the usual autocorrected muddle.


“It would have been very easy to dismiss because of the normal problems with texting but this was a whole conversation that wasn’t making sense,” Goldstein said. “I might be concerned about a patient based on a text like this if they were telling me they hadn’t intended to send a disjointed jumble but they weren’t able to correct themselves.”


In diagnosing stroke, Goldstein said both patients and medical professionals tend to discount aphasic symptoms, even in speech, but they can often be the first clue something is up. In this woman’s case, other signs were there. Her obstetrician realized in retrospect that she’d had trouble filling out a form earlier in the day. She had difficulties speaking too which might also have been picked up sooner if a recent upper respiratory infection hadn’t reduced her voice to a whisper.


But unlike this woman, most people leave their autocorrect turned on. If we relied solely on maddeningly unintelligible text messages to determine neurological state, neurologists might have lines out the door.



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Lawmakers play waiting game with “fiscal cliff” deadline in sight

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WASHINGTON (Reuters) – With only a week left before a deadline for the United States to go over a “fiscal cliff,” lawmakers played a waiting game on Monday in the hope that someone will produce a plan to avoid harsh budget cuts and higher taxes for most Americans from New Year’s Day.


Though Republicans and Democrats have spent the better part of a year describing a plunge off the cliff as a looming catastrophe, the nation’s capital showed no outward signs of worry, let alone impending calamity.






The White House has set up shop in Hawaii, where President Barack Obama is vacationing.


The Capitol was deserted and the Treasury Department – which would have to do a lot of last-minute number-crunching with or without a deal – was closed.


So were all other federal government offices, with Obama having followed a tradition of declaring the Monday before a Tuesday Christmas a holiday for government employees, notwithstanding the approaching fiscal cliff.


Expectations for some 11th-hour rescue focused largely on Senate Minority Leader Mitch McConnell, a Republican, in part because he has performed the role of legislative wizard in previous stalemates.


But McConnell, who is up for re-election in 2014, was shunning the role this year, his spokesman saying that it was now up to the Democrats in the Senate to make the next move.


“We don’t yet know what Senator Reid will bring to the floor. He is not negotiating with us and the president is out of town,” said McConnell’s spokesman, referring to Senate Majority Leader Harry Reid, a Democrat. “So I just don’t know what they’re going to do over there,” he said.


Two-day-old tweets on leadership websites told the story insofar as it was visible to the public.


House Speaker John Boehner‘s referred everyone to McConnell. McConnell’s tweet passed the responsibility along to Obama, saying it was a “moment that calls for presidential leadership.”


Reid’s tweet said: “There will be very serious consequences for millions of families if Congress fails to act” on the cliff.


The next session of the Senate is set for Thursday, but the issues presented by across-the-board tax hikes and indiscriminate reductions in government spending, were not on the calendar.


The House has nothing on its schedule for the week, but members have been told they could be called back at 48 hours notice, making a Thursday return a theoretical possibility.


However, aides to the Republican leaders in Congress said there were no talks with Democrats on Monday and none scheduled after negotiations fell off track last week when Boehner failed to persuade House Republicans to accept tax increases on incomes of more than $ 1 million a year.


“Nothing new, Merry Christmas,” an aide to Boehner responded when asked if there was any movement on the fiscal cliff.


SCALED-BACK EXPECTATIONS


If there is some last-minute legislation, Republicans and Democrats agreed on Sunday news shows that it will not be any sort of “grand bargain” encompassing taxes and spending cuts, but most likely a short-term deal putting everything off for a few weeks or months, thereby risking a negative market reaction.


A limited agreement would still need bipartisan support, as Obama has said he would veto a bill that does not raise taxes on the wealthiest Americans.


On Monday, Texas Senator Kay Bailey Hutchison urged fellow Republicans to be flexible.


“We’re now at a point where we’re not going to get what we think is right for our economy and our country because we don’t control government. So we’ve got to work within the system we have,” she told MSNBC.


Two bills in Congress could conceivably form the basis for a last-minute stopgap measure.


Last spring, Republicans in the House passed a measure that would extend Bush-era tax cuts for everyone, reflecting the party’s deep reluctance to increase taxes.


The Democratic-controlled Senate passed a bill in August, extending lower tax rates for everyone except the wealthiest Americans – a group defined at that point as households with a net income of $ 250,000 or above. Obama has since increased that to $ 400,000 a year, in an effort to win Republican support.


Analysts say Democrats might be able to get the backing of enough Republicans in both the House and Senate, especially if they are willing to raise the number to $ 500,000.


Under that scenario, lawmakers might also put off spending cuts of $ 109 billion that would take effect from January and agree to Republican demands for cuts in entitlement programs such as Medicare and Medicaid, the government-run health insurance plans for seniors and the poor.


However, with only a few work days left in Congress after Christmas, there is a good chance that no deal can be worked out and tax rates would then go up, at least briefly, until an agreement is reached in Washington.


“We may go off the cliff on January 1, but we would correct that very quickly thereafter,” Democratic Representative John Yarmuth told MSNBC.


The prospects of the United States going over the fiscal cliff dampened enthusiasm on Wall Street for a “Santa rally” in the holiday season, when stocks traditionally rise.


The Dow Jones industrial average dropped 51.76 points, or 0.39 percent, in Monday’s shortened holiday session.


Failure to work out tax rates in the coming days would cause chaos at the Internal Revenue Service, said analyst Chris Krueger of Guggenheim Securities.


“Next weekend is going to be a total, total debacle,” he said. The IRS is unlikely to have enough time to revise its tables for withholding taxes.


“The withholding tables are sort of like an aircraft carrier, you can’t turn the thing on a dime.” he said.


(Additional reporting by Alina Selyukh, Patrick Temple-West and David Lawder; Editing by Alistair Bell, Fred Barbash and David Brunnstrom)


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Former President George H.W. Bush remains hospitalized

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(Reuters) – Former President George H.W. Bush, who has been hospitalized for a month undergoing treatment for bronchitis, may not be released from a Houston hospital in time to celebrate Christmas at home as doctors had hoped.


Bush, 88, remained in stable condition and doctors were optimistic he would make a full recovery, George Kovacik, a spokesman at Methodist Hospital, said in an emailed statement on Sunday.






But doctors were being “extra cautious” with his care and no discharge date had been set, the statement said. Earlier this month, Kovacik said doctors expected Bush would be able to spend Christmas at home with his family.


“His doctors feel he should build up his energy before going home,” the statement said.


Bush, the 41st president and a Republican, took office in 1989 and served one term in the White House. The father of former President George W. Bush, he also is a former congressman, U.N. ambassador, CIA director and vice president for two terms under Ronald Reagan.


(Reporting by Kevin Gray; Editing by Daniel Trotta and Vicki Allen)


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U.S. teen smoking declines to record low in 2012: study

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(Reuters) – Cigarette smoking among American teenagers dropped to a record low in 2012, a decline that may have been partly driven by a sharp hike in the federal tobacco tax, researchers said on Wednesday.


An annual survey of about 45,000 students in the eighth, 10th and 12th grades found that the overall proportion of those saying they had smoked in the prior 30 days fell by just over a percentage point to 10.6 percent.






“A one percentage point decline may not sound like a lot, but it represents about a 9 percent reduction in a single year in the number of teens currently smoking,” Lloyd Johnston, the principal investigator in the study, said in a statement.


He said reductions on that scale can translate into the prevention of thousands of premature deaths and tens of thousands of cases of cancer and other serious disease.


More than 400,000 Americans are estimated to die prematurely each year as a result of cigarette smoking – the No. 1 cause of preventable U.S. deaths – and most smokers begin their habit as adolescents, experts say.


Healthcare advocates hailed Wednesday’s findings as evidence that higher cigarette taxes were paying off, combined with federal curbs on youth-oriented tobacco marketing and sales and a sweeping anti-smoking media campaign.


The researchers also cited the increase in federal cigarette taxes, raised by 62 cents a pack in 2009, as a likely contributing factor. The findings were part of an annual survey by University of Michigan researchers released by the National Institute on Drug Abuse.


Smoking rates fell for each of the individual age groups surveyed, most notably among eighth graders – from 6.1 percent in 2011 to 4.9 percent in 2012, the survey found.


Longer-term trends showed teen smoking rates dropping by about three-fourths among eighth graders, two-thirds among 10th graders and by half among 12th graders since a peak in the mid-1990s, researchers said.


One reason cited by experts is that the proportion of students who have ever tried smoking has declined sharply. Whereas nearly half of all eighth graders had tried cigarettes in 1996, just 16 percent had done so this year.


Teen attitudes toward smoking also continued to become more negative. For example, 80 percent of teens said they preferred to date nonsmokers in 2012.


But anti-tobacco advocates said their battle to stamp out teen smoking was far from over, noting that 17 percent of high school seniors still graduate as smokers.


Researchers singled out concerns over new forms of smokeless tobacco, including dissolvable products like Camel-branded “Orbs” and “Strips,” and a fine, moist form of snuff called snus (rhymes with “loose”), which users place under their upper lip.


They said a significant portion of older teens have experimented with small cigars and water pipes called hookahs, which are becoming popular among young adults.


“We cannot let our guard down when the tobacco industry still spends $ 8.5 billion a year – nearly $ 1 million ever hour – to market its deadly and addictive products and is pushing new products … that entice youth,” said Susan Liss, executive director for the Campaign for Tobacco-Free Kids.


(Writing by Steve Gorman; Editing by Cynthia Johnston and Stacey Joyce)


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Halozyme inks drug development deal with Pfizer

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SAN DIEGO (AP) — Halozyme Therapeutics Inc. said Friday it has reached an agreement with Pfizer to develop injectable versions of the drugmaker’s biotech drugs.


Halozyme specializes in a recombinant hyaluronidase enzyme technology, which is designed to temporarily break down a substance in the body that forms a barrier between cells so drugs can be absorbed faster. That would allow some drugs to be delivered by an injection instead of an IV drip.






Under the terms of the agreement, Halozyme of San Diego has granted to Pfizer, based in New York, a license to develop and release up to six products using its enzyme technology. Halozyme will receive an initial payment of $ 8 million, which includes the upfront fee for exclusive licenses to two specified drugs in primary care and specialty care, and the right for Pfizer to choose up to four additional targets after additional payments.


Halozyme is entitled to additional payments of up to $ 507 million if Pfizer’s products reach certain regulatory and sales milestones. The company is also entitled to additional royalty payments on sales of the drugs.


Shares of Halozyme surged 26 percent, or $ 1.45, to $ 6.97 in midday trading Friday. Pfizer shares slipped 32 cents to $ 25.11 as the broader markets declined.


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The Benghazi Report and Parents of Children With Mental Illness: Today’s Qs for O’s WH, 12/20/12

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TAPPER: Has the president read the Accountability Review Board report?


CARNEY: I don’t know. I haven’t – I know he has been briefed on it. I don’t know if he’s read it word for word, but he’s a voracious reader, so he may have.






TAPPPER: The – I believe one person has resigned and three have been – stepped down from their current duties but are still State Department employees. There might – there might have been an update for that since I last read about that. Is that sufficient for the president? Is that – is that enough accountability from the Accountability Review Board?


CARNEY: I think by every measure, the report has been assessed to be – to have been sharply critical and very blunt and clear-eyed about both problems that exist, problems that need to be fixed and the need for accountability, and actions are – already have been taken, as you just – as you just noted.


TAPPER: I’m not questioning the report. I’m -


CARNEY: Well, again, I think -


TAPPER: I’m wondering: is that enough?


CARNEY: I think independent experts here, Admiral Mullen and Ambassador Pickering, oversaw a – Accountability Review Board which I think everyone is judging to have been quite – and the recommendations that they have made are being adopted in full, and there has already been, in this very short period of time, actions that demonstrate accountability is being upheld.


I don’t – I mean I haven’t had a discussion with the president, but I think he is both appreciative of Ambassador Pickering and Admiral Mullen for the service they provided to the nation here, for the depth that they delved into in this report and the seriousness of the recommendations, the speed with which they acted; and, you know, he intends to make sure that the administration, as the secretary of state has said, begins implementation of all of these recommendations before the next secretary of state takes office.


Some of this has to do – some of it will have to do with working with Congress to ensure that Congress provides the necessary funds to allow for enhanced security at our diplomatic missions around the world. So there is obviously more action that needs to be taken, but this is a very serious report and the president has indicated that he expects it to be implemented fully.


TAPPER: Again, I’m not disparaging the report. I’m just wondering if -


(Cross talk.)


CARNEY: Again, I think – I don’t have another answer for you. Four people have already, in one way or another, been held accountable, fairly senior people, so -


TAPPER: Is that sufficient for the president? That’s the only question.


CARNEY: I believe the president believes that the recommendations and the actions taken have been the right ones.


TAPPER: O.K., one other thing I wanted to ask about the mental health ramifications following Sandy Hook, and that is there have been some interesting personal stories in the media about parents – a lot of them single parents, but not exclusively – struggling with children who are mentally ill, some of them violently so, most of them not, who do not have enough help from society. They fall through some holes, some cracks in the system. I’m just wondering if the president has seen any of these, have read any of the – of the essays that have been written, and caught any of them on television, because it’s been – it’s actually been – it’s been remarkable to hear, because normally you don’t hear stories like this.


CARNEY: Well, I haven’t had that discussion with him. He is someone who reads widely, and it would surprise me if he hasn’t read or seen some of the reports that you’re talking about, probably more likely to have read rather than seen, with all due respect to the broadcast media.


But the fact is that he believes very strongly that mental health is one of the major areas that needs to be addressed as we take a kind of comprehensive approach to this problem. It’s why – setting aside the issue of gun violence – but the issue of mental health in general is extremely important to – in the president’s view, to our – what our overall approach to health care in this country ought to be, which is why, as you know, he made sure that the health care law that he passed with Congress will ensure 30 million more Americans have access to mental health services, and that will also – makes recommended mental health services available without a co-pay or a deductible – again, part of the effort here to make it clear that issues of mental health are as important, both for the individual and for the society, as issues of physical health.


So – but as it relates to the gun violence there is no question that this is something that needs more exploration and likely more action, which is why the president has taken the action that he has.


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Amgen pagará 762 millones por vender un medicamento para usos no autorizados

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Nueva York, 19 dic (EFE).- El gigante estadounidense de la biotecnología Amgen pagará una sanción de 762 millones de dólares tras declararse culpable de introducir en el mercado un medicamento para usos no permitidos por las autoridades federales.


La compañía aceptó hoy en un tribunal federal de Brooklyn (Nueva York) un acuerdo para declararse culpable, clausurar el caso y pagar 150 millones en sanciones criminales y 612 millones para cubrir las solicitudes de compensación a programas públicos de seguro médico, como Medicare o Medicaid.






El caso se refiere al “Aranesp”, un medicamento aprobado por la Administración de Fármacos y Alimentos (FDA, por sus siglas en inglés) para favorecer la formación de glóbulos rojos en los tratamientos de anemias.


“A fin de incrementar las ventas de Aranesp y lograr más beneficios, Amgen ilegalmente vendió el medicamento con la intención de que se usara con dosis que la FDA había estudiado y rechazado, y para tratamientos que la FDA nunca aprobó”, señaló el tribunal federal en un comunicado.


El acuerdo supone la mayor sanción por fraude a una compañía de biotecnología en la historia de Estados Unidos.


El fiscal federal Marshall Miller señaló que “en lugar de trabajar para alargar y mejorar la vida humana, Amgen buscó ilegalmente los beneficios empresariales mientras ponía en peligro la seguridad de consumidores vulnerables que sufrían enfermedades”. EFE


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Amgen to pay $762 million, pleads guilty in marketing case

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NEW YORK (Reuters) – Amgen Inc pleaded guilty in a New York federal court on Tuesday for improper marketing practices involving its once top-selling Aranesp anemia drug, and prosecutors said the company has agreed to pay $ 762 million in a civil settlement and criminal fines.


The world’s largest biotechnology company had set aside funds it expected to have to pay as a result of federal and state investigations, as well as nearly a dozen civil whistleblower lawsuits.






Federal prosecutors said in court that the company had agreed to pay $ 612 million in a civil settlement, a $ 14 million criminal forfeiture payment, and a $ 136 million criminal fine.


Amgen entered the guilty plea to one misdemeanor count. Acting U.S. attorney Marshall Miller confirmed that under the agreement Amgen will not lose any federal business or contracts. Exclusion from federal programs, such as Medicare, could have crippled its business.


As part of the deal, Amgen will enter into a five-year corporate integrity agreement with the Office of Inspector General of the U.S. Department of Health and Human Services, prosecutors said. The agreement will require Amgen’s executives and members of its board of directors to certify compliance with applicable regulations, institute new transparency measures and put corporate officers “on the hook” for compliance failures within that five-year period, prosecutors said.


The plea agreement must be approved by U.S. District Judge Sterling Johnson. He has scheduled a hearing for Wednesday morning.


Aranesp, primarily used to treat anemia in cancer patients undergoing chemotherapy, remains one of Amgen’s largest drugs with sales of $ 2.3 billion in 2011. Its sales, and that of a related older red blood cell booster Epogen, have declined significantly over the past few years amid safety concerns, stricter usage guidelines and reimbursement restrictions.


Amgen was accused of promoting Aranesp for anemia caused by cancer, for which it was not approved, rather than to combat anemia as a side effect of chemotherapy treatments. The company was also accused of pushing higher doses and more convenient treatment schedules than what was approved in the drug’s label for both cancer and chronic kidney disease patients.


The government said the illegal practices were undertaken in part to help Amgen take market share from Johnson & Johnson’s similar anemia drug Procrit.


Amgen was “pursuing profits at the risk of patients’ safety,” Miller told reporters Tuesday after the plea hearing. He added that while the company “circumvented the FDA approval process,” the investigation had not uncovered any evidence of fraudulent intent on Amgen’s part.


Federal prosecutors declined to comment further on the civil portion of the settlement, which they said is still under seal.


A spokeswoman for the company, based in Thousand Oaks, California, said that if the judge accepts the criminal plea tomorrow, “Amgen expects immediately thereafter to complete the comprehensive resolution of related civil and criminal matters,” for which it had previously recorded a $ 780 million charge in the third quarter of 2011.


In a recent regulatory filing with the U.S. Securities and Exchange Commission, Amgen said it had accrued $ 806 million related to the proposed settlement of charges arising out of the federal civil and criminal investigations.


Amgen shares were down 14 cents at $ 89.36 in late morning trading on the New York Stock Exchange.


(Additional reporting and writing by Bill Berkrot and Caroline Humer; Editing by Lisa Von Ahn, Andrew Hay and David Gregorio)


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Global malaria battle stalls as financing gets tight

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LONDON (Reuters) – Global funding for the fight against malaria has stalled in the past two years, threatening to reverse what the World Health Organisation (WHO) says are “remarkable recent gains” in the battle to control one of the world’s leading infectious killers.


After rapid expansion between 2004 and 2009, funding for malaria prevention and control leveled off between 2010 and 2012 – meaning there were fewer life-saving steps taken in hard- hit malarial regions such as sub-Saharan Africa.






“If we don’t scale up vector control activities in 2013 we can expect major resurgences of malaria,” said Richard Cibulskis, lead author of the WHO’s World Malaria Report, which was published on Monday.


“Vector control” means stopping transmission of the disease with tools such as treated mosquito nets. The report found that deliveries of such nets to endemic countries in sub-Saharan Africa dropped from 145 million in 2010 to an estimated 66 million in 2012.


“This means that many households will be unable to replace existing bed nets when required, exposing more people to the potentially deadly disease,” the report said.


Malaria is caused by a parasite carried in the saliva of mosquitoes and kills hundreds of thousands of people a year, mainly babies and children under the age of five in Africa.


According to WHO data, the disease infected around 219 million people in 2010, killing around 660,000 of them. Robust figures are, however, hard to establish and other health experts say the annual malaria death toll could be double that.


GLOBAL TARGETS


An estimated $ 5.1 billion a year is needed between 2011 and 2020 to get malaria medicines, prevention measures and tests to all those who need them in the 99 countries which have on-going transmission of the disease.


“Essentially, with the tools that we’ve got, we need to make sure that we continue the investments in the control measures that we have,” Cibulskis told a news conference in Geneva.


“If we don’t do that, malaria will bounce back. As soon as you take bed nets away, malaria will come back. If you stop indoor residual spraying, it will come back, and with a vengeance. So yes, we need to keep on investing in malaria ultimately until new tools are developed.”


The WHO says while many countries have increased financing for malaria, the total available global funding remained at $ 2.3 billion in 2011 – less than half of what is needed.


“Global targets for reducing the malaria burden will not be reached unless progress is accelerated in the highest burden countries,” Robert Newman, director of the WHO Global Malaria Programme, said in statement with the report.


“These countries are in a precarious situation and most of them need urgent financial assistance to procure and distribute life-saving commodities.”


The WHO report found that by far the greatest impact of malaria is concentrated in 14 endemic countries which account for an estimated 80 percent of malaria deaths.


Nigeria and the Democratic Republic of the Congo are the most affected countries in sub-Saharan Africa, while India is the hardest hit in South East Asia.


WHO director general Margaret Chan wrote in a forward to the report that there is now an urgent need to identify new sources of funding to boost and sustain malaria control.


“We also need to examine new ways to make existing funds stretch further by increasing the value for money of malaria commodities and the efficiency of service delivery,” she said.


The Roll Back Malaria Partnership, which includes the WHO, UNICEF and the World Bank, said it was already exploring several options, including financial transaction taxes, airline ticket taxes and a potential “malaria bond” to encourage more involvement from private sector investors.


Fatoumata Nafo-Traore, executive director of the Roll Back Malaria Partnership, said Mozambique and one other African country were preparing to pilot such a bond in 2013, with the hope that other countries would follow their example.


(Reporting by Kate Kelland; Additional reporting by Tom Miles in Geneva; Editing by Stephen Powell)


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Pope speaks of his pain over “senseless violence” in Connecticut

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VATICAN CITY (Reuters) – Pope Benedict expressed his pain over the killing in the United States of 26 people, including 20 schoolchildren, by a gunman and prayed for the consolation of the victims’ families at his weekly address on Sunday.


“I was deeply saddened by Friday’s senseless violence in Newtown, Connecticut,” the pontiff told crowds of pilgrims gathered in St Peter’s Square in Vatican City.







“I assure the families of the victims, especially those who lost a child, of my closeness in prayer. May the God of consolation touch their hearts and ease their pain.”


“Upon those affected by this tragedy, and upon each of you, I invoke God’s abundant blessings!”


On Friday a 20-year-old gunman identified as Adam Lanza forced his way into the Sandy Hook Elementary School in Newtown where he shot dead six adult women, and 12 girls and eight boys aged six and seven years old, before killing himself.


Services to mourn the victims have been held at St. Rose of Lima Catholic Church in Newtown.


(Reporting by Naomi O’Leary; Editing by Mark Heinrich)


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School murders silence “cliff” rhetoric as deadline nears

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WASHINGTON (Reuters) – Mass murder in Connecticut silenced “fiscal cliff” talk on Saturday as the White House and Congress quietly got ready for a final scramble to avert the tax hikes and spending cuts set for the New Year, with sessions of the U.S. House of Representatives now scheduled just days before Christmas.


President Barack Obama canceled a trip he had planned to make next Wednesday to Portland, Maine to press his case for tax hikes for the wealthy. His weekly radio and Internet address on Saturday focused on Newtown, the site of Friday’s school shootings, in which a gunman killed 20 children and six adults before taking his own life.






House Speaker John Boehner of Ohio canceled the standard Republican radio response to Obama “so that President Obama can speak for the entire nation at this time of mourning,” he said in a statement issued late Friday.


The moratorium on cliff pronouncements masked a growing recognition that the two sides could remain deadlocked at the end of the year on the key sticking point – whether to leave low tax rates in place except for high earners, as Obama wants, or extend them for all taxpayers, as Boehner wants.


With multiple polls showing that the public supports Obama’s position, Republicans in the U.S. Senate prodded their counterparts in the House to make a face-saving retreat, in a fashion that would allow Obama’s proposal to pass the Republican-controlled House while simultaneously letting Republicans cast a vote against it.


Republicans could then shift the debate onto territory they consider more favorable to them, cutting government spending to reduce the deficit.


“Just about everyone is throwing stuff on the wall to see if anything sticks,” one Republican aide said with reference to various proposals being discussed on how to proceed. Alluding to public opinion polls, the aide added: “We know if there is no deal, we will get blamed.”


“We could win the argument on spending cuts,” said a Republican senator who asked not to be identified. “We aren’t winning the argument on taxes.”


However, Republican leaders in both chambers are leery about seeming to cave on taxes. “There’s concern that if we did that, Obama would simply declare victory and walk away and not address spending,” said one aide. “We don’t trust these guys.”


Some of the prodding was coming from Senate Minority Leader Mitch McConnell of Kentucky.


Don Stewart, a McConnell spokesman, said the minority leader in the Democratic-controlled Senate hasn’t embraced any single plan, but has discussed and circulated measures offered by fellow Senate Republicans.


“Senator McConnell does not advocate raising taxes on anybody or anything,” Stewart said.


“We’re focused on getting a balanced plan from the White House that will begin to solve the problem of our debt and deficit to improve the economy and create American jobs,” said Boehner spokesman Michael Steel.


“Right now, all the president is offering is massive tax hikes with little or no spending cuts and reforms,” Steel said.


House Majority Leader Eric Cantor scheduled “possible legislation related to expiring provisions of law,” a reference to the expiring tax cuts, for the end of the week, portending a weekend session.


Cantor has said the House would meet through the Christmas holidays and beyond.


Hopes expressed after the November6 general election of some “grand bargain” on deficit reduction have all but disappeared, at least for this year. This is partly because time is running out and partly result of growing warnings from Democrats in Congress that they would not support big changes in the Medicare program, the government-run health insurance program for seniors that is a major contributor to the government’s debt.


House Democratic Minority Leader Nancy Pelosi of California ruled out one frequently mentioned proposal – raising the age of eligibility for Medicare, in a December 12 CBS television interview.


Asked if she was drawing a “red line,” around that idea, Pelosi said her comments were “something that says, ‘don’t go there,’ because it doesn’t produce money.


(Reporting by Thomas Ferraro and Kim Dixon; Editing by Fred Barbash and David Brunnstrom)


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Connecticut School Shooting: What to Tell Your Kids

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Dec 14, 2012 2:11pm



ced7b  ap ct shooting dm 121214 wblog Connecticut School Shooting: What to Tell Your Kids

(Image credit: Jessica Hill/AP Photo)







Your child doesn’t need to have been at the scene of today’s Connecticut school shooting to be traumatized.  Hearing about it and seeing images from it can be quite traumatic.


LIVE UPDATES: Newtown, Conn., School Shooting


It’s important to remember that children of different ages and levels of development will react differently to the tragedy. Here are some tips to help tailor your conversation to your child’s needs.


Children younger than 7


Shield them from this. They don’t need to know about it.


Children 7-12


They need to know that they are safe, and they’ll look to you for cues.


If you’re sobbing uncontrollably, overly angry or unable to express your feelings, it might affect how they process the tragedy. But if you’re expressing appropriate emotion — like sadness, concern and empathy — they’re going to see that it’s OK to be worried about this.


You want them to talk about it.  You want to ask, “How do you feel about this?” And then it’s important to support their feelings.  If your child says, “I’m really scared,” the worst thing you can do is say, “There’s no need to be scared.” Instead, tell them, “We’re going to keep you safe, and they got the bad guy.”


Children Older Than 12


With teenagers, you really want to engage them. Ask them why they think this happened?  And do they think anything could have prevented this?  You can have a real conversation out of that. You might also be able to channel them to a community project, some act of charity so that they believe they are taking positive action.



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Therapy without drugs may suffice to ward off psychosis

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NEW YORK (Reuters Health) – Young adults at very high risk of psychotic illness should receive talk therapy rather than antipsychotic drugs as an initial treatment, a new study suggests.


The results might ease fears about overtreating people who have warning signs of psychosis but not a full-blown disease, but the study findings were not conclusive because the number of participants was too small.






“This shows it’s quite safe and reasonably effective … to offer supportive psychosocial care to these patients,” Dr. Patrick McGorry, an author of the study, told Reuters Health. There is “no evidence to suggest that antipsychotic medications are needed in first-line” treatment, he said.


The clinical trial included 115 clients of a Melbourne, Australia, clinic for young people deemed to be at “ultra-high risk” for a psychotic disorder such as schizophrenia.


The study was open to individuals between the ages of 14 and 30 who met at least one of three criteria: having low-level psychotic symptoms, having had previous brief episodes of psychotic symptoms that went away on their own or having a close relative with a psychotic disorder along with low mental functioning during the past year.


The study compared three regimens: talk therapy focused on reducing depression symptoms and stress while building coping skills plus a low dose of the antipsychotic risperidone, or talk therapy plus a placebo pill or therapy emphasizing social and emotional support plus a placebo.


The goal was to see how many participants in each group progressed to full-blown psychosis.


After a year, there was no notable difference between the groups, however about 37 percent of the participants dropped out during the study. McGorry said if the trial had included more people, significant differences between the groups might have emerged.


The study appears online in the Journal of Clinical Psychiatry.


Researchers have been working to identify people at risk of developing psychotic disorders. “The importance of detecting early signs and symptoms of a serious mental illness is not controversial,” said Dr. Matcheri Keshavan, a professor of psychiatry at Harvard Medical School. “But the best way of treating or preventing it remains controversial.”


McGorry, a professor at the Centre for Youth Mental Health at The University of Melbourne, said that only about 36 percent of high-risk individuals will likely progress to psychosis within three years. So many health professionals worry about the prospect of treating everyone at risk with drugs, which come with side effects.


Another concern is that individuals will carry the label of mental illness unnecessarily.


McGorry said that the “vast majority” of the at-risk young adults in the study, most of them university-age, met the requirement for some kind of mental illness. That’s why all the participants received some level of care, even if it was just basic emotional and social support and coping skills.


The rates of progression to full-blown psychosis – which ranged from about 10 percent to about 22 percent – were lower in all three groups than in previous studies.


It’s not clear why, but McGorry said it’s possible that more participants will develop psychosis after the end of the 12-month study period. Many of the study participants were also taking antidepressants, which may have eased psychotic symptoms.


As with many trials, most participants showed poor adherence to the medications used, which may have influenced the results, the authors note.


McGorry was also an author of a 2010 study that found fish oil supplements might prevent psychosis in the same type of at-risk individuals. That research continues, he said.


Going forward, “what is needed is some way of finding predictive biomarkers that can tell who might be at the highest risk,” said Keshavan. “We need to understand their brains.”


McGorry and some of his co-authors have served as consultants or received research funding from pharmaceutical companies. One of them, Janssen-Cilag, which developed risperidone, partially funded the study.


SOURCE: Journal of Clinical Psychiatry, online November 27, 2012.


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