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Annual Convention Of The American Psychological Association
American Psychological Association 117th Annual Convention in Toronto, Canada, Aug. 6-9, 2009
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Calculating Preventative Medicine's Return On Investment
There are many reasons why health care costs in the US are spiraling out of control: ineffective use of res, unmanaged chronic conditions and infrequent implementations of proven prevention strategies all contribute. While it stands to reason that preventative actions are one solution, no one has yet quantified the value of investing in non-traditional prevention programs.
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Health Care Reform Debate Renews Focus On Insurance Coverage Of Abortion Care
The issue of whether government-subsidized health care programs should include coverage for abortion procedures is gaining attention as Congress continues drafting health care reform legislation, Time reports. Currently, the Hyde Amendment -- a legislative provision attached annually to major spending bills since 1976 -- prohibits states from using federal Medicaid funds to pay for abortion. All but 17 states have similar restrictions on their own funds. Although current versions of health reform legislation do not yet address the issue of abortion, congressional s involved in the process say that an explicit ban on abortion coverage could have "much further-reaching implications" than the Hyde Amendment. According to Time, the restrictions could deny abortion coverage to women whose private insurance plans currently cover the procedure. A 2002 Guttmacher Institute survey found that nearly 90% of private insurers cover abortion procedures. Under the legislation being worked on in three House committees, U.S. residents with incomes up to 400% of the poverty level -- about $88,000 annually for a family of four, or $43,000 for an individual -- would be eligible for government subsidies to help purchase coverage. However, antiabortion-rights lawmakers are pushing to prohibit those subsidies from being used to purchase health insurance policies that include abortion coverage, Time reports. Such restrictions would mean that women who currently have abortion coverage in their private plans would have to give up the benefit. According to Time, such a provision also "would raise all sorts of other questions if insurers were allowed to discriminate among their customers based on whether or not they are using federal dollars to pay for their policies."Pelosi Negotiating With House Dems Over ConcernsLast week, 19 House Democrats sent a letter to House Speaker Nancy Pelosi (D-Calif.) stating that they "cannot support any health care reform proposal unless it explicitly excludes abortion from the scope of any government-defined or subsidized health insurance plan." They also said that abortion "must be addressed clearly in the bill text" of the legislation. The signers of the letter include Reps. Bart Stupak (Mich.) and Charlie Melancon (La.), both members of the House Energy and Commerce Committee, one of the three panels with jurisdiction over health care reform. According to Time, Pelosi"s office is attempting to address the concerns through negotiations.Poll Shows Support for Reproductive Health CoverageMeanwhile, abortion-rights advocates are "pushing back" against those seeking to specifically exclude abortion coverage in health care reform legislation, Time reports. The National Women"s Law Center on Monday released results of a nationwide poll of 1,000 likely voters showing that 71% of respondents favor including reproductive services like birth control and abortion in health care reform (Tumulty, Time, 7/8). The poll also found that 72% would oppose exclusion of abortion coverage from any national health care plan (Eaton, Plain Dealer, 7/7). In addition, 75% of respondents said that an independent commission, not Congress, should determine what medical services are included in the basic benefits offered under health reform. Congress also is weighing giving that power to HHS Secretary Kathleen Sebelius (Time, 7/8).Judy Waxman, NWLC vice president, said that 80% of employer-based insurance plans provide coverage for abortion services, adding that "people will be angry if they don"t get to keep what they already have" under any public insurance option (Cleveland Plain Dealer, 7/7). Waxman said Congress should "refrain from practicing medicine and instead let medical professionals determine what health care services will be included in a benefits package" (Time, 7/8).
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First Murder By Propofol Reported By Leading Anesthesia Journal

Recent questions about the death of Michael Jackson have focused media attention on the commonly used intravenous anesthetic propofol. In the April 2009 issue of Anesthesia & Analgesia, the leading clinical journal for anesthesiologists, Robert R. Kirby, James M. Colaw and Michael M. Douglas reported on a 24-year-old woman whose 2005 death was attributed to propofol toxicity. The article "Death from Propofol: Accident, Suicide, or Murder?" has enough intrigue to satisfy anyone who follows "Law and Order." The woman who died had no history of drug abuse and no evidence of such behavior at autopsy. The possibility of suicide was remote because the injection site for the propofol was in the woman"s elbow. The medical examiner and police investigators felt that she died from probable homicide. Attention turned to a male registered nurse acquaintance who had acquired propofol in the course of his regular duties in a surgical intensive care unit. A follow-up investigation of the propofol national drug code lot numbers on the bottles at the crime scene revealed the drug had been obtained from an automated Omnicell® dispenser by a male registered nurse who worked in the surgical intensive care of Shands Hospital at the University of Florida, Gainesville. The most recent propofol had been dispensed to him on November 3, 2005. On or about the day of the woman"s death (between November 8 and 9, 2005), he left the area and fled the U.S. to Ireland. He was later apprehended in the West African republic of Senegal and returned to the United States. He was tried and convicted of first-degree murder and was sentenced to life in prison without the possibility of parole in May 2008. "All intravenous sedatives have similar risks of depressing breathing, blood pressure, and protective reflexes. Propofol is not intrinsically more dangerous than other intravenous sedatives," stated Dr. Steven L. Shafer of Columbia University, Editor-in-Chief of Anesthesia & Analgesia. "We have known since the days of Paracelsus that it is the dose that renders a drug toxic. Propofol is dispensed in doses intended to produce general anesthesia. Administration of an anesthetic dose of any hypnotic by an untrained individual, or in a setting in which general anesthesia cannot be properly managed, is a recipe for disaster." Propofol has been used in anesthesiology since 1986. Although its clinical properties are well known to anesthesia providers, knowledge concerning its abuse potential and more complex issues, such as its use in suicide, are less commonly appreciated. Before 1992, clinicians and the manufacturer were convinced that such abuse was rare to nonexistent. Since 1992, however, reports have been published largely in forensic medical journals concerning abuse, accidental overdose, and suicide. In the October 2007 issue, for example, Anesthesia & Analgesia included several papers on drug diversion, including one on propofol. The journal has reported on the use of propofol since 1986. About the IARS The International Anesthesia Research Society is a nonpolitical, not-for-profit medical society founded in 1922 to encourage, stimulate, and fund ongoing anesthesia-related research and projects that will enhance and advance the anesthesiology specialty. The IARS has a worldwide membership of 15,000 physicians, physician residents, and others with doctoral degrees, as well as health professionals in anesthesia-related practice. In additional to publishing the monthly scientific journal Anesthesia & Analgesia, the IARS sponsors an annual clinical and scientific meeting, funds anesthesia-related research, and sponsors the SAFEKIDS research initiative in conjunction with the FDA. About Lippincott Williams & Wilkins Lippincott Williams & Wilkins (LWW) is a leading international publisher for healthcare professionals and students with nearly 300 periodicals and 1,500 books in more than 100 disciplines publishing under the LWW brand, as well as content-based sites and online corporate and customer services. LWW is part of Wolters Kluwer Health, a leading provider of information and business intelligence for students, professionals and institutions in medicine, nursing, allied health, pharmacy and the pharmaceutical industry. International Anesthesia Research Society


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