November 2009

Animals have a calming influence on people who are emotionally troubled. Some mental health professionals, particularly marriage and family therapists, use dogs in session to help diffuse conflict between partners, for example.

Ron Rice has a therapy practice in Farmington Hills, Michigan near Detroit. He bills his dog, Bella, as his “co-therapist” and says some patients insist on scheduling appointments only when the dog is available.

In an interview, Rice told me: “She’s part of the whole therapeutic environment.” If one party raises his or her voice, Bella will often come and put her head on the person’s knee.

Now, there’s a new push to use horses in therapy – not only to mend mental health problems but to accelerate physical therapy work as well.

At the 25-acre Maryland Therapeutic Riding (MTR) outside of Annapolis, horses are being used to treat kids with autism, attention deficit disorder and physical problems like muscular dystrophy and brain injuries.

The center has had autistic clients speak for the first time after getting on a horse, according to an in-depth article in last Friday’s Psychiatric News.

A student social worker told the magazine: “Three women with severe autism have started riding with us. One usually doesn’t speak, but when she rides a horse around the ring, she looks over at us and says, ‘Hi. Happy!’ ”

Practitioners are also using horse therapy to treat returning soldiers with post traumatic stress disorder.

An autism research project was conducted at MTR, examining emotional responses of children both in the program and outside the program. The researchers found that the children who had been on horseback showed that they were better able to focus on issues than those in the control group.

I spoke earlier this week with a marriage and family therapist in Prescott, Arizona who has used her horse in therapy for a variety of problems. The therapist, Wendy McCord recalled the case of a mother who complained that she had lost control over her daughter.

She asked the mother to lead her horse around the corral. “She weakly tried to tug on the rope but the horse wouldn’t budge,” McCord said. After she was told confidence and assertiveness were the key, the mother went back and led the horse around the track without a problem. “The horse instinctively knows,” said McCord.

The lesson can be applied to parental relationships.

“When a human and horse are true partners there is a spiritual bond that can be seen. This is the ultimate lesson in relationships – what we all want with our children.”


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Most Americans understand that conditions in Afghanistan are pretty bleak, and the long-term future is not rosy, despite the debate in Washington over how to rebuild the chaotic desert nation. “Rebuild” is probably not the best word to use – the country has long been victimized by war and tribal animosities.

That view is reinforced once again in a report released last week by the United Nations identifying Afghanistan as the world’s worst place for a child to be born. Especially girls, according to the United Nations Children’s Fund (UNICEF) annual report, The State of the World’s Children.

Rural health care is basically non-existent in Afghanistan. The report says the country suffers from a horrendous infant mortality rate of 257 deaths per 1,000 lives births. (The number for the U.S. is 8.)

The children who do survive face primitive and hostile conditions in which 70 percent have no access to clean water, and the Taliban – the religious extremists who played host to Al Qaeda – have increased attacks on new girls’ schools because it violates their principles.

The Taliban is running rampant through rural parts of the country even as U.S. troops and forces from other Western nations struggle to maintain order in the cities.

There were 317 schools in Afghanistan attacked over the last year, killing 124 and wounding 290, according to Daniel Toole, UNICEF regional director for South Asia.

“We have seen a drop in the number of children who are attending schools and particularly young girls,” he said at a press conference.

Basically, the country is backsliding away from the progress made after the U.S. invaded the country is 2001. School enrollment had risen to 5 million, include 2 million girls.

I recently interviewed Rory Stewart, a British diplomat and human rights advocate who walked across the back country of Afghanistan shortly after the 9-11 terrorist attacks in 2001. Stewart also runs The Turquoise Mountain Foundation in Kabul, which offers educational opportunities to Afghan men and women while promoting the country’s traditional arts and crafts.

But Stewart couldn’t be much gloomier about prospects for a turnaround. First, he says the government of President Hamid Karzai is “tremendously corrupt” and offers little hope to people outside the major cities.

The Taliban, on the other hand, “are unsophisticated people who couldn’t find the United States on a map.”

“Credible government does not exist,” Stewart says. Village chiefs are not loyal to Kabul and their biggest problem is protecting their families from marauding bands of criminals.

A U.S. troop surge won’t help, Stewart contends. He believes it would take 600,000 U.S. troops – roughly the level we had in Vietnam at the height of that war – in order to maintain control and improve conditions throughout Afghanistan.

“We’re not going to get to that level. I don’t think the American people would stand for it.”

My comment: Nation building has never worked for the United States, outside of Germany and Japan, and those were vastly different cultures and circumstances. There’s no reason to believe we can have a big military impact on Afghanistan, but we should be helping to improve the world’s worst health care conditions by supporting UN programs.

Unbelievably, the U.S. is one of the few nations that has not signed the Convention on the Rights of the Child, a global agreement aimed at protecting children, approved by the UN General Assembly 20 years ago. The Obama administration has taken no action on it.

US Army photo:

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Take some advice from mummy: A healthier lifestyle doesn’t necessarily guarantee you won’t end up with clogged arteries.

Ancient Egyptian mummies have proven to the medical world that people get atherosclerosis without touching a burger, spreading Cheez Whiz on Ritz crackers or lighting up a cigarette. Going to the gym may not save them either, according to researchers reporting at the recent American Heart Association meeting in Orlando, Fla.

The research appears in the November 18 issue of the Journal of the American Medical Association (JAMA).

“Heart disease is as old as Moses,” Randall Thompson, a researcher involved in the study, told Bloomberg News. “Even though their lifestyles were healthier – no processed foods, no smoking and they got more exercise – many still contracted the disease showing a certain genetic susceptibility.”

Calcification was found equally in both male and female mummies 45 years old or more at the time of death, according to a report released by Saint Luke’s Mid America Heart Institute in Kansas City, where Thompson is a cardiologist.

It happened despite the fact that their diets included unprocessed foods such as grain and fish, along with some domesticated animals and wild game.

Thompson and others are quick to point out that the study doesn’t mean you can’t reduce your risk factors for atherosclerosis and heart disease.

“We all may be at risk for atherosclerosis, but it should be emphasized there is much we can do to minimize its extent and severity,” he said.

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Ho-ho-hold on a minute: Should shopping center Santa Clauses get priority this season for the swine flu shot?

Naturally, kids and health care workers are at the front of the line for the H1N1 vaccine. But Santas say they need it too, with all the germy kids jumping on their laps from now through Christmas Eve.

Congress has been asked to put Santas higher up on the vaccination list.

And a group called the Amalgamated Order of Real Bearded Santas has advised members to use hand sanitizers and load up on vitamins to stay in the pink.

“We don’t want any child to go away without seeing Santa,” organization President Nicholas Trolli told The New York Daily News. “But it’s not worth bringing your child to the mall, infecting the Santa, and infecting other children.”


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The pattern is similar in offices across the country. Employees swarm the coffee room in the morning and head to the diner for lunch at noon. And they’re out of their desks and down the hall at 3 p.m. – not for more coffee, but to pay their daily visit to the junk food vending machines.

They want a mid-afternoon pick-me-up, and it’s usually a high fat snack bomb – a bag of corn chips, potato chips or some cheese puffs. Maybe a package of peanut butter cups if they’re really having a bad day. “I need my afternoon fix,” I’ve heard people say.

A very appropriate choice of words, according to a study out of Scripps Research Institute in Jupiter, Florida.

Scientists studying rat behavior on junk food concluded that they become addicted to it in the same way they can become addicted to heroin. One of the definitions of addiction is that you need more and more of the same substance in order to achieve the same effect – and that’s exactly what happens with high calorie, high fat foods, they said.

Which means as time goes on, you need to consume more and more of the unhealthy food in order to achieve the same level of satisfaction.

“This is the most complete evidence to date that suggests obesity and drug addiction have common neurobiological underpinnings,” study coauthor Paul Johnson told ScienceNews.

Johnson launched the study at the supermarket, loading up on sausages, Ho Hos and cheesecake. Then he and colleagues fed the stuff to lab rats who gobbled the food down like it was the last day on the Mayan calendar. Naturally, they became obese.

A control group was given a nutritious low-cal menu – the healthy rats were consuming half the calories of their junk food lab buddies.

Researchers concluded that the junk food rats were addicted using a couple of different methods. One way was to cut the rats off and give them an electrical shock in order to get the food. The non-addicted rats passed the food up under those circumstances, but the obese junk food rats went for the grub anyway, despite the shock.

There are political angles to this story. The idea has been floated in Washington, and addressed by President Obama, of taxing soda. Some might consider an additional tax on junk food. I’m not keen on this idea. You’d end up with people who are not only obese, but poorer, too.

Australia has been considering a ban on junk food TV advertising aimed at kids, and this makes some sense to me.

The media is a powerful influence on kids. It would take time, but eventually we’d see fewer kids in the supermarket checkout line throwing tantrums because they can’t get a package of Skittles.

If you want a box of toaster pastries, buy one. But why should we allow producers to exploit an ever-bigger market by pandering to children? They automatically assume, because the product is on TV, that this one of the most healthy, wholesome breakfast foods on the planet?

Why bother with a bowl of oatmeal?


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computer screenThe concept of Internet addiction is controversial in this country. Psychiatrists and psychologists debating what should go in to the next edition of the Diagnostic Statistical Manual (DSM-V) due out by 2012 have so far shied away from making excessive Internet use an actual mental illness.

This has not been the case in China and other parts of Asia, where Internet addiction is viewed as a very serious problem. Unlike the U.S., Internet use is not strictly home-based. Youth congregate at Internet cafes, often playing games all night at the expense of their schoolwork.

The government basically whipped parents up into a frenzy over the problem – so much so that about 200 “boot camps” sprang up throughout the country where these overzealous Internet users, mostly teenagers, were sent for some rather brutal reorientation.

The Los Angeles Times reported in August: “To a large extent, the camps follow the logic of Mao Tse-tung’s movement in the late 1960s and ’70s to send urban youths to the countryside; only this time, it is the parents themselves who are sending their children.”

The camps are run like military facilities, and in fact often employ former members of the People’s Army. At best, hours spent in front of the computer screen are replaced with a harsh physical regimen. If that’s where it stopped, we might conclude that the Chinese attitude toward Internet misuse is simply an overreaction.

But one psychiatrist administered electro-shock therapy to 3,000 Web- and game-addicted teens. A student was forced to stand in one spot from 2 p.m. to 5 a.m. without food or rest. As an advertising brochure for one camp said: “Suffering can help a person improve.”

But now it appears that the Chinese government is making some attempts to move out of the Dark Ages of mental health treatment. Last week, government officials announced a ban on physical punishment at the boot camps after a 15-year-old boy was beaten to death during “treatment.”

Electro-shock therapy has been banned. And the Chinese government has removed references to Internet Addiction on its Ministry of Health Web site. The government’s official position is that intervention should “urge the target people to use the Internet in a healthy way. It’s not to stop them from using the Internet.”

Sounds quite reasonable.

Americans can appreciate the wide gap between the way Asians have treated this problem and the more laissez-faire approach in this country. Even though Internet addiction is not a recognized disorder, many psychologists, clinical social workers and other mental health care providers offer services to get abusers back on track.

Regardless of how Internet use is officially classified, it might be wise for American parents to take a more serious look at the issue, since from my observation many teens and youth seem glued to their electronic devices 24/7.


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Flu vaccineWall Street mosaicWho should be first in line for vaccinations during a major influenza epidemic?

The indispensable, frontline workers, of course – physicians, paramedics and other health care providers, for sure, and police, firefighters and other safety officials.

And, it turns out, Wall Street banking firms.

Banks and other financial companies were given “a private allocation” of the vaccine, according to a post on the Washington political Web site, The Hill. This, notes The Hill’s Brent Budowsky, “while many kids, hospitals and pregnant women cannot get enough of the swine flu vaccine.”

The Guardian in the UK reports that Goldman Sachs, Citigroup, and Morgan Stanley employees were among the first New Yorkers to get the H1N1 vaccine. The newspaper says U.S. Sen. Christopher Dodd was “stunned” when he found out and penned a protest letter to Health and Human Services (HHS) Secretary Kathleen Sebelius.

“Vaccines should go to people who need them most, not people who happen to work on Wall Street,” Dodd said.

No kidding.

New York Health Department officials said the bankers were among the first to get the vaccine because they were among the first to apply. The Health Department is encouraging companies to distribute the vaccines at work sites.

The investment companies only received a percentage of the doses they requested. But I know first hand of hospitals that have been unable to offer their employees – people who are exposed to sick patients every day – H1N1 vaccines because there weren’t enough to go around.

At best, public officials are persuing grossly misguided policy by lumping hospitals and clinics in with private companies that have nothing whatsoever to do with alleviating public suffering during a health care crisis.

At worst, they are creating a public relations debacle at a time when investment banks are already scorned by Americans for playing fast and loose with the economy, then making the taxpayers pick up the tab for their bad bets.

As The Hill’s Budowsky says, the policy “does not do well on the smell test,” whatever the motivation.

Repair work is under way. Morgan Stanley gave its allotment of 1,000 doses to area hospitals, according to Bloomberg. And the White House reiterated that no matter where the vaccines were administered, only high risk people would get them.

Of course, at private companies that’s based on the “honor system,” according to public health officials. Interesting choice of words, isn’t it?

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math formulaAnd now for a look at one of the hottest issues raging in America today: The Baby Einstein controversy.

The Walt Disney Company began offering refunds in September to parents who didn’t think their kids got the best intellectual bang for their buck with their series of videos intended to stimulate young minds.

Baby Einstein, for the uninitiated, offers an array of products for several age groups. For example, you can buy a “Baby Bach” DVD for $6.99. “Introduce your little one to Bach in a creative way,” says the promotional copy for the item, which contains “Orchestral Suite No. 3 in D.”

You can take a detailed look at all of the company’s products online, and judge for yourself how beneficial they may or may not be.

Now along comes Susan Linn, co-founder and director of The Campaign for a Commercial-Free Childhood. She’s also a psychologist at Harvard Medical School. As she points out, the American Academy of Pediatrics recommends no videos for children younger than 2.

On Oct. 23, the CCFC issued a news release headlined: “CCFC Victory: Disney Offers Parents Refunds on Baby Einstein Videos.”

It went on to say: “In an important development in the Campaign for a Commercial-Free Childhood’s ongoing efforts to stop companies from marketing screen media as educational for babies, the Baby Einstein Company, a Walt Disney company, is offering a refund to anyone who purchased a Baby Einstein video in the past five years.”

This occurred after the organization filed a complaint with the Federal Trade Commission (FTC) against Baby Einstein “for making unsubstantiated claims that their videos were educational for babies.”

This is where the plot thickens, because Baby Einstein claims the FTC failed to act on the complaint. However, the company began offering refunds shortly after that.

“There is no credible evidence that any screen media is educational for children under two,” Linn maintains. “So we are pleased by this offer.”

But now Baby Einstein has bitten back, with its own explanation of the legal and marketing battle that has been taking place this fall. “Baby Einstein Sets the Record Straight on Refund,” says the notice on the top of the company’s home page.

“For the past several years, Baby Einstein has been under attack… unfortunately we can not be silent any longer.”

Baby Einstein does not mince words. Baby Einstein General Manager Susan McLain refers to Linn’s “latest stunt” and her “obvious dislike for Baby Einstein,” which has “now turned into a sensational, headline-grabbing publicity campaign that seeks to twist and spin a simple, customer satisfaction action into a false admission of guilt.”

The company insists it never claimed its products were educational, and that the FTC took no action on the CCFC complaint.

The message seems fairly clear: Don’t mess with Baby Einstein.

For those wondering about the true value of videos for babies, see this analysis by Lucia French, a developmental psychologist at the University of Rochester.

French says young children get most of their language skills by interacting with parents.

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new big shirtShould health insurance be treated like traditional insurance, where consumers who pose the greatest risk for making a claim pay the highest premiums? That, essentially, is one of the major questions before the country these days.

The National Women’s Law Center has weighed in with their take on it. Absolutely not, they said.

The organization exposed what is really the heart of the matter in its new campaign, which they have chosen to call: “Being a woman is not a pre-existing condition.” They’re even selling T-shirts with the slogan.

In truth, though, insurance companies charge increased premiums for more than just pre-existing conditions. It’s all about statistics, not a vendetta against any certain sex or age group. It’s the same reason that older people pay a higher premium for health insurance – they simply use more services.

“The most expensive purchase in auto (insurance) is the young, invincible male; they are the risk-takers,” Rebecca Weiss, director of government affairs for Anthem Blue Cross Blue Shield of Colorado, told The Denver Post. “For some reason, auto insurance doesn’t seem as inflammatory to people as health insurance.

“Shouldn’t health insurance premiums be based on some degree on how many medical services you receive so that everyone is paying according to what they are using?”

The issue is individual policy sales – not group policies. Women, particularly those under 40, pay up from 10 percent to 59 percent more than men the same age, according to a Post survey. Naturally, the biggest factor is child birth. A vaginal birth with no complications averages $7,500, while a Caesarian section costs $13,200.

Eleven states now bar discrimination based on gender, and more legislatures are considering that option. So, they’ve already decided that health insurance should be treated differently than other kinds of insurance. The question is whether this will be addressed in federal legislation working its way through Congress – assuming a bill ever emerges.

But nationally, the problem is getting worse, not better, according to the Women’s Law Center: 95 percent of plans in the individual insurance market practice gender rating this year compared to 93 percent a year ago.

The effect of it is to discourage women from having children, or expanding their family.

For those opposed to health insurance reform I would ask: Is this really what you want? I suspect a lot of them would say no.

But then they would be forced to admit that the model itself needs a fundamental overhaul. The devil really is in the details, isn’t it?

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