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February 2008
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April 2008

The Business of Being Born, the film

Childbirth My wife and I had 9 children. The last four were born at home between 1978 and 1987. We were way ahead of our time or way behind the time however you want to look at it, because during these years all babies were born in hospitals except for very, very, very, few. The people who gave birth at home either alone or with a midwife were considered to be very counter-cultural, or irresponsible, or crazy. Yet, 70 - 80% of babies in every first world country, except the United States, are born with a midwife, many at home.

Why is the United States with the second highest infant mortality rate of first world countries, so unusual in that it has professionalized and institutionalized one of the most natural functions in the world? As usual, follow the money. Birthing has become a big business even if it is bad for mothers and babies.

No woman in the United States should have a baby without seeing Ricki Lake's new documentary, released in 2008, The Business of Being Born. I highly recommend this film.

To watch the trailer, click here.

Link: The Business of Being Born (2008).

The Real Face of War - Bush's folly

The Real News Network dares to broadcast what the corporate media won't. Americans are being propagandized about the Iraq War. Here is a 3 minute segment on the Iraq Veterans Against The War hearings which failed to be covered by the news networks. The testimonies are called The Winter Soldier stories. These are the soldiers of conscience.

The images are graphic and the truth is hard to look at. This is what is being done in our name by George W. Bush and his administration of neo-cons.

U.S. economy, badly in debt, needs to shift to green technologies and rebuilding the public infrastructure

The Real News Network had a good 5 minute piece yesterday on the sagging U.S. economy. You'd think the 2008 Presidential candidates and pundits would be talking about the real issues and not arguing over what pastor said what and whether the candidate was in the church when he said it. The Republicans have again distracted the American citizens with bogus issues while they have run up huge deficits, expanded the income inequality, given tax cuts to the rich while saddling the middle and working classes with increasing prices and interest costs. I recommend this video.

Is GDP a good measure of well being in the United States?

The GDP, Gross Domestic Product, simply measures the amount of money changing hands. It does not measure other quality of life indicators which we might use to assess our common good. It would be nice to see the 2008 Presidential candidates discuss what they think the key indicators are which measure the well being of our society.

Here is a brief 3 minute video which describes this issue. It is worth watching.

Should the legal drinking age be lowered?

Since the drinking age was raised to 21 tens of thousands of lives have been saved not to mention injuries, rapes, property destruction. From a public health perspective, raising the legal drinking age from 18 to 21 has been a huge success. However, critics have been concerned about the amount of binge drinking that occurs especially in the first couple of years of college which has lead some opinion leaders to suggest that the drinking age should be lowered again to 18.

While this is a serious discussion, I think the arguments for lowering the drinking age are largely without merit. Here's a satirical piece from The Onion on Teenagers and Alcohol.

Only Severely Depressed Benefit From Antidepressants

And while I am writing about antidepressants today and the treatment of depression, let me mention here that antidepressants, while a great revenue enhancer for the pharmaceutical companies, don't seem to work beyond what one would expect from the placebo effect.

Reuters HealthDay reported on March 1, 2008 on a study which appears in the on-line journal, PLoS Medicine, on February 25, 2008 which found that antidepressants only helped in severe depression. They did not seem to have much of an effect beyond the placebo effect for mild and moderate depression.

Again, these are not new findings. Most of us in the mental health field have known this for years. Primary Care Physicians continue to prescribe antidepressants because it is an easy, quick way to respond to patient's complaints, and the pharmaceutical companies have plied Primary Care Phsysicians with plenty of free samples to give the physician and patient the illusion that there is a quick fix in popping a pill. Here's a snippet from the Reuters article:

While popular antidepressants such as Prozac are widely prescribed for people with varying degrees of depression, the drugs are only effective for those with the most severe depression, a new study suggests.

"Although patients get better when they take antidepressants, they also get better when they take a placebo, and the difference in improvement is not very great," lead researcher Irving Kirsch, a professor of psychology at the University of Hull in Great Britain, said in a prepared statement. "This means that depressed people can improve without chemical treatments," he added.

In the study, Kirsch and his colleagues collected data on 35 clinical trials of antidepressant drugs whose results had been submitted to the U.S. Food and Drug Administration. The antidepressants included in the trials were fluoxetine (Prozac), venlafaxine (Effexor), nefazodone (Serzone), and paroxetine (Seroxat/Paxil).

An analysis of the data showed that patients taking antidepressants fared no better than patients receiving a placebo. This appeared to be the case whether the patients were mildly or moderately depressed.

The drugs only seemed to benefit a small group of patients -- those with the severest depression when the study began.

Based on these results, there appears to be little reason to prescribe these antidepressants to anyone but the most severely depressed patients, the study authors concluded.

The findings were published online Feb. 25 in the journal PLoS Medicine.

Psychotherapy_2 Brief cognitive behaviorally oriented psychotherapy is treatment of choice for mild to moderate forms of depression, and has been shown to be very helpful with medications and other treatments with severely depressed patients as well.

Link: MedlinePlus: Only Severely Depressed Benefit From Antidepressants: Study.

Psychotherapy helps for Depressed Teens

Depressed_teen Reuters HealthDay reported on February 26, 2008 on a study published in the February 27, 2008 issue of JAMA, the Journal of the American Medical Association, that if adolescent depression doesn't lift after treatment with an antidepressant, guess what, psychotherapy helps and/or maybe another antidepressant.

While the Reuters article headline is "New Hope for depressed teens", this is old news and mental health professionals, I hope, have known this for years. Most careful research has found that psychotherapy is the treatment of choice especially for adolescent depression, and sometimes, medication can help. Of course, it is much easier for Primary Care Physicians to write out a prescription or give the teen pharmaceutical samples than it is to actually listen to the kid's troubles.

At any rate, it is validating to see some research which finds what I and most of my collegaues already know and that is, psychotherapy is helpful.

Link: MedlinePlus: New Hope for Depressed Teens.