NFL says it will address the needs of ex-players with memory-related problems, mental health issues

From The AP:

WASHINGTON — When a recent study conducted for the NFL suggested that retired pro football players may have a higher rate than normal of Alzheimer's disease or other memory afflictions, the NFL was quick to point out that the study did not prove a link between concussions and memory disorders.

NFL Commissioner Roger Goodell was to tell Congress on Oct. 28 that while the research by the University of Michigan was "a telephone survey and not a true medical diagnosis," the number of players reporting memory-related problems is a concern. In written testimony to the House Judiciary Committee, he said the NFL will offer free follow-up medical work to 56 players who reported dementia, Alzheimer's disease or other memory-related problems in the survey.

Goodell said the league also will reach out to the players to see whether they are receiving money from the 88 Plan, which provides up to $88,000 a year to former players suffering from dementia, Alzheimer's or Parkinson's, regardless of the cause. A copy of Goodell's testimony was obtained late Tuesday by The Associated Press.

The study's lead author, David Weir, who is among the witnesses for Wednesday's hearing, has said the results show the topic is worth further study but they do not prove a link between playing football and later mental troubles.

"We have directed Dr. Weir to contact in a confidential manner those 56 former players and their families who reported memory problems to see if they are receiving 88 Plan funding and offer them the opportunity to have follow-up medical work done at our expense," Goodell said. "That process has already begun."

Goodell said the health and welfare of all members of the "NFL family, particularly our retired players," is important to him. "Since becoming commissioner, I can think of no single issue to which I have devoted as much time and attention."

As for head injuries specifically, he said medical considerations must always trump competitive ones, and that the league has established a toll-free hot line for players if they believe they're being pressured to return to the field before fully recovering from a concussion or other head injury.

"All return-to-play decisions are made by doctors and doctors only," the commissioner said. "The decision to return to the game is not made by coaches. Not by players. Not by teammates."

He also pointed to changes in rules aimed at reducing contact to the head and neck, the development of improved helmets, research and education.

The new head of the NFL Players Association, DeMaurice Smith (pictured), said in his prepared remarks, also obtained by the AP, that the union "has not done its best in this area. We will do better."

But he also criticized the NFL for diminishing studies that showed a connection between football injuries and post-career mental illness. Smith promised that the union's new concussion and traumatic brain injury committee will act as a "superconductor to commission, evaluate, follow and disseminate ongoing research."

On Tuesday, Smith told reporters that while his union has differences with the NFL over how to address head injuries suffered during football games, "This is not a battle between us and the league." He also credited the NFL for doing a "tremendous job" to improve player safety in the past five years.

Other witnesses expected to testify included Rep. Bill Pascrell, a New Jersey Democrat and co-chairman of the Congressional Brain Injury Task Force; medical experts and former players, including former New York Giants running back Tiki Barber.

Among the medical experts on the witness list are researchers from the Boston University School of Medicine's Center for the Study of Traumatic Encephalopathy, who announced last week that a football player who never competed beyond the college level suffered from a degenerative brain disease previously discovered in former NFL players.

It was the first time an advanced case of chronic traumatic encephalopathy was found in a player who did not advance past the college game, suggesting athletes could be at risk for CTE even if they don't play professionally. CTE, originally found in boxers, is caused by repetitive trauma to the brain, with similar symptoms to Alzheimer's disease.

Chris Nowinski, co-director of the Boston University center, planned to make a series of proposals at Wednesday's hearing, "to save football." Nowinski, a defensive tackle at Harvard University and former professional wrestler, suffered six concussions that he "can remember" between the ages of 19 and 23.

The proposals will be focused on youth, high school and college sports.

Maldives celebrates its first sign language dictionary

From the Minivan News in the Maldives. In the picture, the deaf community applauds the new dictionary in sign language.

In the stifling afternoon heat, a momentous occasion came to pass today. There was excited chattering all around but with a difference - it was soundless. Animated facial expressions and rapid-fire hand gestures created an atmosphere of exhilaration. This was the inauguration ceremony of the first Maldivian sign language dictionary. A book that will work as a bridge between the deaf community and the rest of society.

The event kicked off with a recitation of the Qur’an. A translation followed with Mohamed Awwam accompanying in sign language, setting the tone for the rest of the ceremony. Mariyam Fazni, the first-ever Maldivian teacher specialising in teaching deaf students presented each of the speeches through sign language. Even their applause, which came in the form of waving both hands in the air, was different.

Speaking at the ceremony, Hassan Mohamed, the principal of Jamaaludeen School said, “This will enable parents to help children with their school work and help people communicate with members of the deaf community.” He spoke about the start of special classes set aside in the school for children who were hearing-impaired.

The school first started offering classes for deaf children in 1985, after a class full of children with a variety of disabilities, proved too difficult to teach. “This year we started grade eight and we have five students,” said Mohamed. “We hope that these students will be able to finish secondary school here.”

Two years ago Jamaaludeen School introduced primary school classes for hearing-impaired children. “We still don’t have enough students,” said Mohamed. “There are still some parents who hide their children, despite the fact that it had been proven these kids perform better than average.” He called for a survey to be conducted to find out the number of deaf children and ensure they had access to education.

Amaresh Gopalakrishnan, a special educator and architect of the book, said language was of paramount importance to any community. “This will give an identity to the deaf community,” he said. Amaresh moved his mouth without uttering a sound, saying, “Even for two minutes you can’t stand this.” In response to the myth about sign language being universal, he said, “Each has its own methodical structure. The deaf community is a linguistic minority that does not depend on any language.”

When he first arrived in the Maldives in 2007, Amaresh was surprised to find he could not communicate with deaf people on the street with the signs he was learning at the school. He travelled with Ahmed Ashfag, the head of the Maldives Deaf Association, to four islands and found that each had their own set of signs. “From all this we have documented 650 signs and we have shown the book to many people to ensure that even a layman could understand it,” said Amaresh. His father, who is deaf, did the illustrations.

Mariyam Fazni said the book would enable teachers on the islands to teach deaf children, while Ashfag summed up the feelings of many of those present today by saying that it was the happiest day of his life in sign language. “This is my language. The doors have opened for this community now and we will not be silent anymore. We will scream,” he gesticulated. Ahmed Mohamed, one of the student’s parents, said those present had both the “brains and the will” to go on to higher education. “I hope they get the chance soon,” he said.

The project was funded by Handicap International and Lucy Roberts, the charity’s country manager, said the dictionary helped raise awareness about the deaf community and the problems they faced. Short theatrical productions followed, each highlighting the challenges experienced by deaf people in school, in society and even in matters of the heart.

Speaking at the occasion, President Mohamed Nasheed said he was pleased to be part of the day as he had two deaf relatives and had witnessed their problems. He also said an absence of communication hampered freedom of expression.

“I might not have stood in front of a podium and made promises about this, but I have given my word to a person from the deaf association who worked closely with me on the campaign trail that my government would do all it could to help this community,” he said. Nasheed said he hoped sign language would be taught in all schools so that everyone could communicate with deaf people. By the end of the year, he added, he hoped 1,000 people would learn sign language, equal to the 1,000 dictionaries that had been published.

The president said he envisaged a Maldives where selfishness was not a virtue and where people did not always seek out others who were like them. “What is lacking in one Maldivian should be compensated by another,” he said. At the end, students celebrated with a dance performance, throwing confetti into the air. Mariyam Rizwana, the first deaf teacher, ended the event by thanking those involved, adding that it was was “a new dawn for the deaf community.”

Vic Chesnutt rocks on in New York City

A review of Vic Chesnutt's concert that doesn't mention his wheelchair and included this powerful photo of him.

Jon Pareles' music review in The New York Times:

Vic Chesnutt’s music attracts musicians by offering them open spaces to transform. Structurally, his songs are nothing fancy: bleak, flinty lyrics set to slow, folky melodies and basic chords — the makings, if Mr. Chesnutt were more conventional, of folk-rock.

But he and his musicians see other possibilities. Since Mr. Chesnutt made his first album in 1990, he has collaborated with members of R.E.M. and Widespread Panic, with the jazz guitarist Bill Frisell, with the Nashville band Lambchop, with the Los Angeles songwriter and arranger Van Dyke Parks and now with his darkest, noisiest band yet. He has made two albums with them: “North Star Deserter” in 2007 and the new “At the Cut,” both on Constellation. At the Bowery Ballroom on Monday they played, as Mr. Chesnutt summed it up near the end of the set, “all these songs about death.”

The music moved slowly and even more slowly: a series of dirges methodically flooded with massed-guitar crescendos of tolling chords and distortion. Led by the guitarist Guy Picciotto, from the intricate and influential Washington post-punk band Fugazi, Mr. Chesnutt’s group also includes members of Thee Silver Mt. Zion, a Montreal band (with former members of Godspeed You Black Emperor) that favors extended, enveloping instrumental buildups.

The band at the Bowery Ballroom mustered as many as five guitars (including Mr. Chesnutt’s acoustic), along with violin and keyboard, and there were few individual leads or solos; the tone was of shared dread, gathering and eventually imploding, then subsiding in the aftermath.

Mr. Chesnutt’s grainy voice — weathered, unblinking and sometimes breaking into a desolate howl — gave the songs just enough focus, with verbal imagery to justify the apocalyptic interludes. The songs, mostly from the two recent albums, contemplated not just mortality but also the broader inevitability of collapse and decay.

Mr. Chesnutt opened the set with “Everything I Say,” which begins, “The barn fell down since I saw it last/It’s rubble now, well so much for the past.” With this band to orchestrate his unsparing observations, Mr. Chesnutt has music for both the structure and the rubble.

The opening acts sang quiet songs that only accentuated Mr. Chesnutt’s dire crescendos. Clare and the Reasons played sweetly intricate chamber-pop that somehow mingled folk-pop, Philip Glass, cabaret oompah and the Beach Boys — for starters — behind the songwriter Clare Muldaur Manchon’s poised high voice, with an endearing quaver as she sang choruses like “Ooh, you hurt me so.” Liz Durrett opened the show solo, picking stark guitar parts and singing with the breathy vulnerability of Beth Orton or Cat Power. Her folky ballads succinctly balanced sorrow and the determination to hope.

Actress Marlee Matlin becomes official NAD spokesperson for accessible broadband services, Internet media

The National Association of the Deaf (NAD) press release:

Academy Award winning actress and author Marlee Matlin (pictured), a member of the National Association of the Deaf (NAD), is taking on a new role as an NAD spokesperson for accessible broadband services and Internet media.

Matlin will take part in a Federal Communications Commission (FCC) hearing addressing the needs of people with disabilities in the development of the FCC’s National Broadband Plan, which will be submitted to Congress in February 2010.

The hearing, along with innovative technology exhibitions, will be presided over by Commissioner Michael Copps at Gallaudet University in Washington, D.C., from 9 a.m. - 1 p.m., on November 6, 2009. The public is encouraged to attend the event and to share their ideas and comments with the Commission. More information about the hearing is available at http://hraunfoss.fcc.gov/edocs_public/attachmatch/DOC-294267A1.pdf.

"Not only is Marlee a phenomenal actress, she understands our experience," said NAD President Bobbie Beth Scoggins. "The nationwide adoption of broadband and Internet services can only be achieved when those services are available, affordable, and accessible to every American, including Americans who are deaf and hard of hearing. The disability community must not be left behind as our nation’s communication, information, and entertainment services migrate to the Internet."

While in Washington, Matlin will also visit key legislators on Capitol Hill with NAD representatives and other members of the Coalition of Organizations for Accessible Technology (COAT). Matlin’s meetings will spotlight on the need to enact the “Twenty-first Century Communications and Video Accessibility Act of 2009” (H.R. 3101) introduced by Representative Edward J. Markey (MA).

An outspoken advocate for captioning Internet media, Matlin first testified before Congress in 1990, successfully paving the way for a law requiring most television sets to be capable of displaying closed captions. Presently, Matlin is leading social media advocacy efforts to urge online video content providers, such as Netflix and Blockbuster, to caption their media. Her efforts have captured both providers’ attention in making their online content accessible to 36 million deaf and hard of hearing Americans.

"Internet captioning is very important to me as a deaf person because captions provide access to content that affects my life and my livelihood," said Matlin. "Legislators need to know that captions are necessary to follow the latest news, information, and entertainment available on the Internet. I join millions of other deaf and hard of hearing Americans advocating for Internet access."

Matlin is an acclaimed actress who gained worldwide fame with her role in the film "Children of a Lesser God." Her performance was recognized by the film community with an Academy Award, making Matlin the youngest recipient of the Oscar for Best Actress at age 21. She has also starred in many popular television programs and series, such as “West Wing” and “Dancing with the Stars.” Her autobiography, "I'll Scream Later," published by Simon Spotlight, is available in bookstores nationwide.

The NAD thanks Purple Communications for sponsoring Matlin’s visit to Washington.

GAO: Only 27% of U.S. polling places accessible in 2008

From Disaboom:

Are we really living under the ADA? It's a national embarrassment: the latest U.S. Government Accountability Office (GAO) survey shows that a mere 27 percent of polling places in the 2008 election were accessible to people in wheelchairs.

We're not talking accessibility to the neighborhood ice cream store, or curb cuts so wheelchair users can reach the community pool (although there certainly should be access to both); we are talking about the very foundation of our democratic system being denied to a group of voters with disability.

People in wheelchairs are not a tiny number of the population. The National Health Interview Survey on Disability found that in 1994-95, 1.6 million Americans used wheelchairs outside of an institutional setting, the last year for which I could find statistics. If perhaps a million of those were eligible adult voters, that would imply that up to 600,000 people in wheelchairs found it impossible to fulfill their duty, their obligation and their basic right in a free society.

How ironic that someone might have fought in Iraq to ensure a democratic society, paid the price by losing their legs, then come back to the U.S. only to find that voting in a presidential election in their own country was impossible.

And it goes farther than that. Poll workers are so poorly trained in how to deal with people having disabilities (we're talking 54 million citizens), that in some polling places, the accessible voting device never got turned on. In many more, poll workers showed "poor etiquette" that discouraged people with disabilities from voting once they reached the polling place.

It's disgraceful.

To read the initial report in its entirety, visit http://www.gao.gov/products/GAO-09-685.

Alison Pill, Abigail Breslin to star in "The Miracle Worker" revival on Broadway

From Broadway.com:

As we recently reported, William Gibson’s The Miracle Worker is coming to Broadway. The 50th anniversary production of the Tony-winning play will star Oscar nominee Abigail Breslin and Tony nominee Alison Pill. Directed by Kate Whoriskey, the revival will begin previews on February 12, 2010, at Circle in the Square and open on March 3. (Both are pictured.)

Set in Alabama in the 1880s, The Miracle Worker tells the story of real-life Medal of Freedom winner Helen Keller (Breslin), born blind and deaf, and Annie Sullivan (Pill), the extraordinary teacher who taught her to communicate with the world.

Breslin will make her Broadway debut in the role of Helen Keller. She made her breakthrough feature film appearance at the age of five in M. Night Shyamalan’s 2002 film Signs, and received an Academy Award nomination for her performance in the comedy Little Miss Sunshine.

Pill returns to the stage following starring on Broadway in Mauritius and in off-Broadway’s Reasons to Be Pretty and Blackbird, for which she received Lucille Lortel, Outer Critics Circle and Drama League Award nominations. She was nominated for a Tony Award for her Broadway debut in The Lieutenant of Inishmore. She recently appeared in the film Milk opposite Sean Penn and the HBO series In Treatment.

Whoriskey most recently directed the acclaimed and much-extended world premiere of Lynn Nottage’s Ruined at the Goodman Theatre and Manhattan Theatre Club and Inked Baby at Playwrights Horizons. Additional credits include regional productions of Heartbreak House, The Rose Tattoo, Drowning Crow, Antigone and Intimate Apparel, as well as off-Broadway’s Fabulation. Whoriskey has just been named artistic director of Seattle’s Intiman Theatre.

Gibson first adapted the story of Keller and her teacher into a TV teleplay called The Miracle Worker in 1957. He made his Broadway debut as a playwright with the love story Two for the Seesaw, starring Henry Fonda and Anne Bancroft, receiving his first Tony nomination for the show, which played 750 performances at the Booth Theatre. The Miracle Worker followed in 1959, with Bancroft as Sullivan and Patty Duke as Keller. The piece won the Tony Award for Best Play in 1960. Gibson’s other works include Golden Boy, Raggedy Ann, A Cry of Players and Golda. The scribe passed away in November 2008 at the age of 95.

A previous revival, starring Academy Award winner Hilary Swank as teacher Annie Sullivan and Skye McCole Bartusiak as Helen Keller, had been prepped for the Rialto in April 2003. Directed by Marianne Elliott, the show tried out during a sold-out engagement at the Charlotte Repertory Theatre before its scheduled move to the Music Box Theatre, but producers canceled the Broadway transfer shortly before it finished its tryout.

People with mental illnesses in Massachusetts protest cuts to services

From The Boston Herald:

Disabled Bay State residents may now face even more cuts to the services they urgently need, advocates said.

As Gov. Deval Patrick prepares to narrow the $600 million budget shortfall, mentally ill residents and their advocates say they are bracing for slow processing of disability claims, as well as cuts that could eliminate services.

About 800 mental health advocates and mentally ill adults gathered in front of the State House Oct. 27, demanding the governor’s support to keep their clubhouses - facilities that provide job training, education and employment.

There are 32 Massachusetts clubhouse facilities across the state, which serve 15,000 adults.

The cuts come as the governor also looks at furloughs for employees at Massachusetts Disability Determination Services, a move that could stall processing for disability claims - worsening the services they provide - even as increasing numbers of people file for their Social Security disability payments.

David Beckwith, a member of Forum House in Westfield, has been receiving Social Security for disability for nearly 20 years.

“Usually when people apply for disability, they need that money right away. They have nothing else going for them,” said Beckwith about alternative income for the disabled, at yesterday’s rally.

Amos Pierre, a member of Boston’s 50-year-old Center Club, carried a sign that read “Save clubhouses” at the protest.

“These people need that money. We need help and support,” said the South Boston resident. Before going to the clubhouse, Pierre “was depressed and sick,” he said, “but I’ve made progress. My life’s been turned around.”

Patrick administration spokeswoman Cyndi Roy, said the governor’s office was hoping for “limited impact” on all social services.

The Herald reported Oct. 26 that the Massachusetts Clubhouse Coalition, which organized the rally, feared that budget cuts could close down the clubhouses as early as next month, cutting off the lifeline for many of the state’s mentally ill residents.

Obituary: Ed Eames, access activist and founder of organization for those who use assistance dogs, dies

From The Fresno Bee:

Ed Eames, who lost his sight at age 42, spent the rest of his life advocating for the needs of people with disabilities.

Mr. Eames (pictured), 79, who died Oct. 25, worked to improve bus service for the disabled, founded an organization for people who use assistance dogs and lobbied for more sidewalks.

"He was a fighter, but he also was a thinker," said Fresno City Council Member Henry T. Perea. "He knew the issues, but he did his homework."

Perea represents the city's District 7, in which Mr. Eames lived.

"I'll never forget the first time I met Ed," Perea said. "I was campaigning door-to-door and he was one of the few people who invited me in. We sat around his kitchen table and talked issues for a good hour."

Sidewalks were a big issue to Mr. Eames, Perea said. He wanted to see sidewalks throughout Fresno, even in county islands, because they're easier for people who use wheelchairs to negotiate.

Mr. Eames and his wife, Toni, who also is blind, met while living in New York when he was writing a book to guide dog schools.

He invited her to be a co-author on the book. "And one thing led to another," she said. "He was my favorite topic" of conversation.

The couple came to Fresno in 1987 shortly after they married to team-teach a class at California State University, Fresno, on the sociology of disabilities. Mr. Eames was on sabbatical from Bernard M. Baruch College in New York City, but they fell in love with Fresno and retired here.

Mr. Eames became involved in improving services to the disabled. "He wanted a barrier-free Fresno," his wife said.

Mr. Eames founded and was president of the International Association of Assistance Dog Partners. A memorial page on the organization's Web site called him "one of our great champions."

He served on the Americans With Disabilities Act Advisory Committee for Fresno Area Express.

"He was a mentor and a great guy," said Paul Kwiatkowski, manager of Handy Ride, which provides transportation for disabled people.

"He certainly helped improve the lives of people with disabilities in Fresno," Kwiatkowski said. "The city is unfortunately going to miss him."

Mr. Eames inspired those who provide services to the disabled "to realize we impact the people who need us the most," Kwiatkowski said, and influence improvements to the Handy Ride system.

Mr. Eames was a member and past president of the North Fresno Lions Club, said Steve Wakefield, who drove Mr. Eames and his service dog, Latrell, to weekly meetings.

"He was such a great guy," Wakefield said. "I learned a lot about the lives of the disabled from him."

Mr. Eames was an example of one person making a difference. Perea recalled a demonstration Mr. Eames helped organize in which civic leaders spent several hours as if they were disabled.

"It was my job to navigate City Hall and downtown in a wheelchair," Perea said. "For me, it was a real eye-opener. He's done a lot for the people of Fresno."

Superior Court rules California regulators have illegally allowed insurers to deny care to children with autism

From KPBS in California:

A Superior Court judge has ruled California regulators have illegally allowed insurers to deny care to children with autism. The case involved Kaiser Permanente's refusal to pay for a particular type of autism treatment.

Applied behavioral analysis is a therapy for autism that helps children develop social and motor skills.

In the case in question, Kaiser refused to pay for the therapy, saying the provider wasn't licensed by the state. State regulators upheld that decision.

The court says such denials are illegal. Attorney Fred Woocher represents a group that sued the state over the move.

"The court found that the department has been violating its obligation under the law, to protect the interest of the consumers, and instead has been siding illegally with the insurance companies in allowing these denials to go forward," Woocher says.

State officials say they won't change their position. Woocher says he'll drag the state back into court.

Hospitals flooded with children with swine flu

From USA Today:

BALTIMORE — To Mitchell Goldstein, the flood of sick children seemed endless. Day after day, nearly three times as many kids as usual streamed into the rainbow-colored pediatric emergency room at Johns Hopkins Hospital, sniffling and feverish, worried parents hovering.

The press of children with swine flu was so relentless that doctors opened an annex in a hospital dining room to handle the overflow. "Our worst day" was Sunday, Oct. 11, says Goldstein, one of the ER doctors. "We had 15 to 20 patients an hour. It was 24/7. There wasn't a lull."

Last week, the epidemic of ailing children let up somewhat. But doctors here are expecting a new run of flu patients — the children's parents. "What we see first in (children) we see two to three weeks later in adults," says Trish Perl, the hospital's director of infection control.

The scenes at Johns Hopkins are being repeated at hospitals in Denver and Duluth, Seattle and San Diego, as waves of flu patients arrive at their doors, doubling their emergency room volume. Just as significant is the effect on intensive care units: A relatively small number of flu patients are requiring intensive care, but some are so ill they will need round-the-clock care for weeks.

Doctors at Johns Hopkins and elsewhere expect the number of patients needing hospitalization and intensive care to rise. Such an influx of intensive care patients eventually could force some hospitals to cancel services such as elective surgery, they say.

"Why did President Obama declare a national emergency? Because what's going on at Hopkins is happening across the country," Perl says. "An infection that generally doesn't appear to be severe is pushing hospitals to their limit."

The White House declaration, announced Oct. 24, was designed to give hospitals the flexibility to move patients to satellite facilities if they are overwhelmed in dealing with an outbreak that is now widespread in 46 states and afflicting millions of people, says Reid Cherlin, an administration spokesman.

"H1N1 is moving rapidly, as expected," Cherlin says. "By the time regions or health care systems recognize they are becoming overburdened, they need to implement disaster plans quickly."

Thomas Frieden, director of the Centers for Disease Control and Prevention, reported Friday that the swine flu virus, also known as H1N1, has killed more than 1,000 people nationwide and prompted 20,000 to be hospitalized. For the second week in a row, deaths from flu and pneumonia increased last week, reaching a total of 2,416 from Aug. 30 to Oct. 17. Ninety-five children have died of swine flu since April, 11 more last week, he says.

Seasonal flu typically kills about 36,000 people and hospitalizes 200,000, the CDC says.

Flu's unpredictability makes planning a challenge.

One scenario by the President's Council of Advisors on Science and Technology forecasts that if 30% of the U.S. population contracts H1N1 flu, 90 million could get sick, 1.8 million would be hospitalized and 30,000 or more would die. The Trust for America's Health, a non-profit public-health advocacy group, reported in early October that if the infection rate hits 35%, many states may run out of hospital beds, forcing hospitals to begin canceling elective procedures.

So far, hospitals have been taxed — but not to that degree.

"We aren't seeing the surge in hospitalizations that might be predicted with a huge attack rate," says the trust's executive director, Jeffrey Levi. "We're seeing a small segment of people who are hospitalized, incredibly sick and in need of treatment."

To many analysts, swine flu appears to be two overlapping epidemics: one a cascade of mild to moderate cases that is stressing hospital emergency rooms, and the second a narrow stream of unusually young patients who need intensive care.

At most hospitals, swine flu has had "very little impact on patient care — except in ICUs," says Eric Toner of the University of Pittsburgh Center for Biosecurity.

'We've been inundated'

Even so, many hospitals are struggling to keep up with the growing number of swine flu patients. Since May 1, doctors at Hopkins have treated 581 patients, 298 of them children, records show. Eighty-six adults and 96 children were admitted to the hospital. Thirty-four patients needed intensive care, 14 of them children. Three flu patients have died.

Connie Price, chief of infectious diseases at Denver Health, the city's public hospital, says, "I've been living this" since Aug. 28, when the hospital's lab reported 12 positive tests for swine flu.

"Since then we've been inundated," she says. "In a typical flu season, we may hospitalize 15 patients. With H1N1, we've hospitalized 10 times that many. We're not even in flu season yet."

In Rio Grande County, a rural community in the Rockies about 200 miles south of Denver near the New Mexico border, clinics were so overwhelmed with patients that they began turning away those who didn't have flu. With absentee rates of 40%, schools closed. Many of those children turned up in local clinics and emergency rooms.

"In San Luis Valley, we have three small rural hospitals. Flu burned through all of them in a couple of days," county health department spokeswoman Paula Hendricks says, noting that it was difficult to respond rapidly because the community is so remote it takes FedEx two days to deliver supplies from Denver.

P.J. Brennan, chief medical officer for the Penn Health System at the University of Pennsylvania in Philadelphia, says: "We're seeing in our health system right now about 40 to 50 patients a day with influenza-like illness. This is a significant increase over what we've seen (in the past), but not so much that we've had to implement our surge plan," annexing extra space and pulling in additional staff to handle overflow.

The surge of infections led thousands of people in communities across the USA to line up this week for vaccinations, which remain in short supply. As of Friday, 16 million doses of H1N1 vaccine were available for shipping, far fewer than the 40 million federal officials predicted would be available by now. Health officials have blamed the vaccine shortages on production delays among some of the five manufacturers churning out the swine flu vaccine.

The vaccine shortage is a major concern for doctors and nurses working with flu patients, especially for those who perform procedures that put them at high risk of infection. At Johns Hopkins, Perl, Sara Cosgrove and other members of the infectious-disease team routinely are accosted in the hallways by doctors not on the list who want vaccinations.

Topping the list of those being vaccinated first are pregnant health care workers or those working in areas of the hospital where they are most likely to be exposed to the virus. Next come pregnant patients, young patients with serious chronic diseases and patients ages 6 months to 4 years.

Last Wednesday, a doctor stopped Perl and Cosgrove in a hallway near the cafeteria, where vaccine was being offered to "high-risk" hospital staffers. "I'm in hematology. I work with immune-compromised patients," the doctor said. "One clinic a week."

A look from Cosgrove gave the doctor his answer: no. "This is the pressure I get from some of my own people," Perl said moments later.

Perl says vaccine supplies are too limited to vaccinate any but the most critical, front-line health workers. Although she declined to say how many doses of vaccine the hospital received, Perl says Johns Hopkins got just one-fifth of the amount it had ordered. One-quarter of the doses were given to high-risk patients, including children with asthma and cystic fibrosis. The remainder were divided up among front-line health personnel and Hopkins' three sister hospitals, which hadn't received any vaccine at all.

The next shipment isn't due until November.

Valerie Rhymer, a nurse who has worked at Hopkins for 47 years, got her H1N1 vaccination Wednesday. She says she gets her seasonal flu shot every year because she routinely performs bronchoscopies and other procedures on flu patients that can release flu virus into the air.

Vaccine is in such demand, says Deborah Dooley, clinical manager of occupational health, that the hospital pharmacy treats it like a controlled substance. "I'm one of two people who can take it out," says Dooley, presiding over the triage desk where health workers learn whether they're cleared for vaccination.

Many of these workers are on the list because they care for the sickest flu patients, a fraction of the total but a group in critical need of care. That's because, in some cases, H1N1 flu wreaks havoc within the lungs, causing blood clots and bleeding.

"It's impressive even to me, the damage done to these lungs," says Jeffrey Jentzen, director of autopsy and forensic services at the University of Michigan, who has performed postmortems on several H1N1 patients.

In some cases, patients hardest hit by the virus are children with asthma, cerebral palsy, cystic fibrosis and other neurodevelopmental disorders. Others are pregnant women, who account for a disproportionate number of deaths. In some cases, the flu has claimed otherwise healthy people with no apparent risk of severe disease. Perl calls some cases 1918-esque, referring to the dreaded Spanish flu that killed an estimated 675,000 people in the USA.

In one recent H1N1 case, Perl says, a previously healthy 30-year-old man landed in Hopkins' ICU and stayed there.

"It took us 2½ months to get him out of the hospital," she says.

Roy Brower, who is in charge of the ICU at Johns Hopkins, says that "there was a period of time when he was desperate, in terms of our ability to get oxygen in and carbon dioxide out. We were very worried about him."

Some patients' lungs are in such bad shape that doctors bypass them using an advanced ventilation technique called ECMO, for extra-corporeal membrane oxygenation, which works something like the heart-lung machines that are used during heart surgery.

The University of Michigan, which pioneered the technique, has started a national registry of H1N1 patients. As of Oct. 9, the latest data available, at least 54 flu patients have been so sick that they've needed a temporary lung bypass; 62.8% of those whose outcomes are known survived, says Pauline Park, co-director of the hospital's critical care unit.

Brower, of Hopkins, says doctors are still divided on whether the technique provides an extra benefit to patients with adult respiratory distress syndrome. But, he says, it represents one illustration of how far medicine has come since the 1918 epidemic, which occurred long before researchers discovered that flu was caused by a virus.

"They had no intravenous therapy, no antibiotics for patients who got super-infections with bugs like staph, no influenza vaccinations," he says. As a result, the death rate in the 1918 epidemic topped 2.5%. The death rate from H1N1 flu is, so far, a fraction of 1%.

Gabor Kelen, director of Hopkins' emergency department and its office of critical event preparedness and response, says the university system — with its liberal arts college and network of four hospitals — has been able to keep up with the epidemic's rapid growth through careful planning that began as soon as the first cases emerged in the spring.

"If we hadn't planned for this surge, it could have produced a deadly increase in volume that we couldn't have handled," he says. "The trouble is, we don't quite know how deep into this we are."

Study: Psychiatric drugs can cause obesity in children

From The AP:

CHICAGO — Children on widely used psychiatric drugs can quickly gain an alarming amount of weight; many pack on nearly 20 pounds and become obese within just 11 weeks, a study found.

"Sometimes this stuff just happens like an explosion. You can actually see them grow between appointments," said Dr. Christopher Varley, a psychiatrist with Seattle Children's Hospital who called the study "sobering."

Weight gain is a known possible side effect of the anti-psychotic drugs which are prescribed for bipolar disorder and schizophrenia, but also increasingly for autism, attention deficit disorders and other behavior problems. The new study in mostly older children and teens suggests they may be more vulnerable to weight gain than adults.

The study also linked some of these drugs with worrisome increases in blood fats including cholesterol, also seen in adults. Researchers tie these changes to weight gain and worry that both may make children more prone to heart problems in adulthood.

The research is the largest in children who had just started taking these medicines, and provides strong evidence suggesting the drugs, not something else, caused the side effects, said lead author Dr. Christoph Correll of North Shore-Long Island Jewish Health System in Glen Oaks, N.Y.

But because these drugs can reduce severe psychiatric symptoms in troubled children, "We're a little bit between a rock and a hard place," he said.

The study authors said their results show that children on the drugs should be closely monitored for weight gain and other side effects, and that when possible, other medicines should be tried first.

The study appears in Wednesday's Journal of the American Medical Association. It involved 205 New York City-area children from 4 to 19 years old who had recently been prescribed one of the drugs; the average age was 14.

Depending on which of four study drugs children used, they gained between about 10 and 20 pounds on average in almost 11 weeks; from 10 percent to 36 percent became obese.

The drugs are Abilify, Risperdal, Seroquel and Zyprexa. Of the four, Seroquel and Zyprexa are not yet approved for children, and they had the worst effects on weight and cholesterol. However, a government advisory panel recently voted in favor of pediatric use for the two drugs, and the Food and Drug Administration often follows its advisers' recommendations.

The drugs' makers said these problems are known side effects but emphasized the drugs' benefits in helping patients cope with serious mental illness.

The four drugs have been considered safer than older anti-psychotic drugs, which can cause sometimes permanent involuntary muscle twitches and tics. That has contributed to widespread use of the newer drugs, including for less severe behavior problems, a JAMA editorial said.

The number of children using these drugs has soared to more than 2 million annually, according to one estimate.

Doctors "should not stretch the boundaries" by prescribing the drugs for conditions they haven't been proven to treat, said Varley, co-author of the editorial.

Why these drugs cause weight gain is uncertain but there's some evidence that they increase appetite and they may affect how the body metabolizes sugar, said Jeff Bishop, a psychiatric pharmacist at the University of Illinois at Chicago. The drugs also can have a sedation effect that can make users less active.

International pop star Ladyhawke talks about her Asperger's, debut album, ARIA awards

A Time Out Sydney interview by Dan Rookwood:

Having toured her debut album non-stop around the world for the last year, Ladyhawke (pictured) – aka Pip Brown – returns “home” to Sydney next month to play at The Enmore and at the ARIA Awards where she is expected to clean up. Brown spells out what it’s like to be Ladyhawke.

L is for London
That’s in the past now, thank God. I found London really hard. I never settled down and didn’t like it. I didn’t have any friends in the UK because I haven’t really been based in any one place so there was no time to make any. And when I did get a day off, the only thing I’d ever want to do is be alone playing video games and listening to music. I wouldn’t leave the house.

A is for Asperger’s
I have this thing called Asperger's syndrome. When I found out, it explained my whole childhood. I told my mum and she said: ‘That's why you used to sit on the floor doing puzzles for hours.’ It was the reason I was so solitary. I'd say completely inappropriate things. The other kids thought I was a weirdo.

D is for Dress sense
I have this thing where I refuse to wear anything made for a female because I don't like conforming to gender stereotypes. It's so predictable to get girly-cut jeans and blouses. I wear men's clothes: jackets, shirts and shoes. It doesn't take away from my femininity. I have Dr Martens in every colour and length. I've got really big feet so they fit into men's shoes.

Y is for Youth
I had a ‘modern’ upbringing, growing up in Wellington. My parents split up when I was 12 years old. My stepfather, who got together with my mum when I was 14, is a jazz musician; my Mum is also a singer and played the guitar and piano. Every one of my school reports said, 'Philippa is a lovely child but she stares out the window a bit much.'

H is for Health
I’m allergic to everything. I was lactose intolerant from the minute I was born; I couldn't be breast-fed. On planes, if I order a non-dairy meal, they always give you a vegan eggplant thing – and I'm allergic to aubergine. When I was 10, I got this weird random disease [erysipeloid] that no-one had seen in New Zealand for 20 years. It's common in seagulls, but is rarely transmitted to humans. Somewhere in New Zealand there's a photo of my face in a medical journal. It crept up to my brain. They caught it hours before I was about to slip into a coma. So they put me on penicillin and I had an allergic reaction to that! I nearly died.

A is for ARIA Awards
It really surprised me when I heard [about the five ARIA nominations]; I was just honoured to be nominated. I don’t know if I’ll get any awards. I was completely shocked when I won the New Zealand awards. [She won six New Zealand Music Awards last month.] I was speechless the entire time.

W is for Worry
I wish I didn't have such bad anxiety and wasn't so shy. I've always been a nervous person, very awkward. I can't walk without looking awkward – it's my middle name. I find live performances hard. I can't look anyone in the eye. I'm so conscious of everyone staring at me. I start to think I'm terrible or I'm singing out of tune. I sometimes get sickly-nervous before I play. I throw up and start shaking and sweating. The second I get on stage it disappears and the adrenaline kicks in. But I try not to look at anyone in the audience or it will freak me out.

K is for Kings Cross
I’ve got a flat in Sydney that I keep because Sydney is my favourite place. Kings Cross is where I feel most at home. I live on the cusp of Kings Cross in Elizabeth Bay. I’m having a short break in New Zealand with my family at the moment but then I’m going to work on my second album. I’m planning on it being a bit different. I want to get most of it done over the summer. That’s me being really optimistic though.

E is for eBay
I get lots of my old band t-shirts and stuff off eBay. I collect old cameras and I also collect video game consoles from the 80s up to now. I’ve got like a really large video game collection.Ever since I was a kid I loved the bright colours and the weird, kind of cartoon world that you’re in. As the years have gone on the graphics have become so realistic that it’s not so much a cartoon world anymore it’s just like another world. I like the escapism.

Ladyhawke’s debut album Ladyhawke (Modular Recordings) is out now.

Australian Paralympics swim champion dies in train accident

From the Geelong Advertiser:

Paralympian Alex Harris (pictured) was killed by a train at Lara Oct. 27, devastating friends and the sporting community.

Harris was struck by a Pacific National Freight train and died at the scene.

His death came a week before the Paralympic gold medallist was to undergo life-changing brain surgery in the hope of again swimming for his country. Police said his death was not suspicious.

He was due to have electrodes implanted in damaged areas of his brain Nov. 4 to calm his uncontrollable movements.

Harris suffered a brain injury in a car crash at Bellbrae in 1993.

The accident claimed the life of his friend and fellow school captain Sharon Kirchner, injured others and left him with severe head trauma.

Ian Hanson, former Australian swimming media manager and father of Olympian Brooke, yesterday recalled fond memories of his mate "Shakey".

"There's no doubt that Alex Harris was one of the great characters of Australian swimming," Mr Hanson said.

"I am sure that a lot of people would agree that as soon as Alex stepped on to the pool deck there was never a dull moment."

Harris won gold and silver for Australia at the Athens Paralympics in 2004. He won three gold medals and a silver medal at the Canadian Open in 2003 and swam for his country in Argentina and the Sydney 2000 Paralympics.

Tributes flowed yesterday for the loveable larrikin, who wrote on his Facebook page that he was "engaged to the love of my life", Nikki Smith.

Friend Liz Moore said she would always remember the fun times at swimming training with Harris.

"You'll go down in the history books fella as being a real fighter and never giving up on your dreams. You proved that anyone can achieve them," she wrote on Facebook.

Louise Angel said she would remember Harris as an inspiration.

"I was looking forward to hearing more about your upcoming surgery, the brightest flames burn quickest," she wrote in an online tribute.

V/Line spokesman Daniel Moloney said two trains were delayed 30 minutes as police sealed off the scene, and several other morning trains were delayed. Police will prepare a report for the coroner.

Wounded Iraq vet will accompany First Lady Michelle Obama to game one of the World Series

Michael Daly's column in the NY Daily News:

The White House could not have imagined it was a step behind generous Daily News readers when it invited a wounded Marine to join the First Lady at the Oct. 28 opening game of the World Series.

Lance Cpl. Michael Stilson had already gotten a pair of tickets as part of an outpouring by News readers offering to help wounded vets see the Yankees try for another world championship.

Of course, the 22-year-old recovering at Bethesda Naval Medical Center was still more than honored by the offer from the White House. He did not want just to say thanks, but no thanks.

Stilson called the company that gave a total of four World Series tickets to disabled vets in response to an article in The News. He explained that he planned to go with the White House group and was giving the company's tickets to another wounded warrior.

He made sure the company understood he was still totally appreciative of its generosity.

"In that Stadium, anywhere I'm sitting is wonderful," he later said.

In the meantime, word may have reached the Marine higher-ups that Stilson already had tickets. Or maybe the command simply decided on another wounded Marine to accompany Michelle Obama and the vice president's wife, Jill Biden.

"You think you got one thing planned out perfectly and the Marine Corps chooses instead," Stilson said. "They told me I was going, then I wasn't any more."

Stilson was not the least disappointed he would be sitting among the fans. And, he was thrilled when he learned that the Marine going with the First Lady was a buddy and equally devoted Yankee fan, 20-year-old Lance Cpl. Daniel Aristy of the Bronx (pictured).

Aristy grew up in Soundview and joined the Marines shortly after turning 18. He had been in Iraq two months when a roadside bomb found him. He was at the hospital in Bethesda on Oct. 26, when he was told he'd be part of a White House delegation to the World Series.

"I didn't believe it at first," he said. "Then I found out it was true."

He will attend the opening game with the First Lady.

"First time going to the World Series, first time going to the new Stadium," Aristy said.

Yesterday, Aristy and Stilson were both making ready their uniforms. They had been instructed to wear them to the game, or Stilson might have opted for other World Series attire.

"I'd be wearing my Derek Jeter jersey or my Mariano Rivera jersey," Stilson said.

Stilson's family is rooted in New York, where his grandfather, uncle and cousin either were or are with the FDNY. Stilson grew up in Washington State.

"I was the only Yankee fan," he said.

He was 18 and on the way to boot camp when his grandfather took him to his first and only game at the old Yankee Stadium.

"When I walked into that Stadium with my grandfather it felt like I was 4 years old going to my first ballgame," Stilson said.

The other hallowed place was his grandfather's firehouse, Ladder 9/Engine 33, which lost 10 firefighters on 9/11.

"That is my real reason for joining the Marine Corps," Stilson said.

Stilson arrived in Iraq in 2007 and had been there only six weeks when he was wounded.

He has decided to give his other ticket to a buddy and fellow Marine, Staff Sgt. Thomas Sweeney, whose brother was killed in Afghanistan six years ago this week. The brother, Army Special Force Staff Sgt. Paul Sweeney, was adopted as an honorary firefighter by a Staten Island firehouse. He was wearing an FDNY pin when he was shot in an ambush.

This morning, Thomas Sweeney and Stilson will drive up from Bethesda. Aristy will fly up with the First Lady. She is scheduled to visit the James J. Peters VA Medical Center in the Bronx before the game, which has been dedicated to veterans and their families.

Obama, Biden, Aristy, Stilson and Sweeney will all be in the new Stadium when everybody rises to sing "The Star-Spangled Banner," the anthem of the nation that the veterans built.

After stabbing, psychiatric patient fatally shot by cop at Boston clinic

From WHDH-TV in Boston:

BOSTON -- A man stabbed a female doctor while being treated at a psychiatric office and then was fatally shot by an off-duty security guard Oct. 27, police said.

The incident happened just after 2 p.m. on the fifth floor of the Massachusetts General Hospital Bipolar Clinic & Research Program at 50 Staniford Street.

According to Boston Police, psychiatric patient Jay Carciero, 37, of Reading, attacked his female physician, identified by hospital officials as Dr. Astrid Desrosiers, with a knife.

The off-duty security guard, Paul Langone, told the patient to drop the knife. When he did not comply, he shot him.

Police said Carciero died of the gunshot wounds. Officials said he was shot twice in the side and once in the head.

Desrosiers is listed in serious, but stable condition.

Police told 7News that Desrosiers was stabbed so many times, that there weren't many areas on the doctor's body that were untouched.

"During the course of the stabbing incident, an off-duty security officer, who was armed, interceded. He produced weapon and ordered the suspect to drop the knife, and when the suspect did not comply he shot the suspect," said Commissioner Ed Davis, of the Boston Police Police Department.

The security guard was not affiliated with the hospital and just happened to be on the fifth-floor of the building where the attack occurred, according to Bonnie Michelman, the hospital's security director.

Michelman referred to Langone's actions as "heroic" and said that they were happy he was there.

The victim also works as an instructor in psychiatry at Harvard Medical School and is affiliated with the Haitian Mental Health Program.

"A caring and dedicated professional, Dr. Desrosiers has spent her career providing extraordinary care and treatment to patients who are among the most vulnerable and those with the most severe psychiatric disorders. Her commitment, compassion and courage are an inspiration to all of us. The entire MGH family is pulling together for her speedy recovery," Mass. General said in a statement Tuesday night.

Security locked down the building, notifying employees and patients inside they could not immediately leave. Streets also were shut down nearby for almost an hour. All were allowed back in when authorities deemed the situation safe.

Carciero's family said they are not in a position to comment.

The incident remains under investigation.