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February 09, 2007
By Stephen Smith, Globe Staff
They're still doing the leadership limbo down at 250 Washington St., headquarters of the state Department of Public Health.
Back on Jan. 17, Dr. JudyAnn Bigby, the new health secretary in the administration of Governor Deval Patrick, sent out a memo announcing that she was replacing Paul Cote as commissioner of public health. That wasn't much of a surprise: Cote was appointed by then-Governor Mitt Romney, and there's a long tradition of new governors wanting to appoint their own public health commissioner.
JudyAnn Bigby
In that memo, Bigby promised that "in coming weeks" she would select a new commissioner.
Latest update, as of today, courtesy of Bigby spokeswoman Courtney Gorzkowicz: Bigby is "definitely, actively interviewing candidates."
No specific timetable for selecting someone to oversee the public health agency and its $500 million-plus annual budget.
Posted by Karen Weintraub at 05:24 PM
February 09, 2007
The Food and Drug Administration and Baxter International Inc. are warning health-care professionals about mix-ups of two heparin products that resulted in the deaths of three infants, the Wall Street Journal reports.
The FDA posted a Feb. 6 letter from Baxter discussing the medication errors to its Web site late Wednesday.
Posted by Elizabeth Cooney at 08:41 AM
February 09, 2007
Beth Israel Deaconess Medical Center and New England Baptist Hospital will work together on a suburban expansion. Tufts-New England Medical Center had planned to build a $300 million suburban hospital with New England Baptist but will now proceed alone.
Harry Spence, commissioner of the Department of Social Services, defended how his agency handled the case of 4-year-old poisoning victim Rebecca Riley but said his department needs more medical expertise to help social workers review the diagnoses and drugs prescribed by doctors treating children overseen by the agency. JudyAnn Bigby, secretary of Health and Human Services, said she would appoint an independent physician in the next few days to be on call to help DSS, until the agency develops a medical review system.
About 1 in 150 American children has autism, an urgent public health concern, said US health officials yesterday who reported on the largest study done so far on the disorder. The new numbers, based on 2002 data from 14 states, are higher than previously reported.
Babies conceived through fertility treatments have higher rates of birth defects, but the overall risk is so small that it should not keep couples from having children this way, doctors are reporting.
Posted by Elizabeth Cooney at 06:23 AM
February 08, 2007
By Carey Goldberg, Globe Staff
It almost always strikes girls, in infancy. It can leave them unable to walk, talk or use their hands, racked by seizures or gasping for irregular breaths, with little prospect of improvement. But now the devastating symptoms of Rett Syndrome, a rare genetic disease related to autism, have been dramatically reversed in mice, raising a great wave of hope for families that previously had little.
Researchers reported today that when they undid the genetic defect involved in Rett Syndrome, they brought on a stunning recovery even in mice just days from death: irregular breathing returned to normal, and mobility was restored. Brain activity, too, appeared to improve, and tremors abated.
Scientists caution that it is a long way from mice to humans, that the experiments must be replicated by others and that the genetic manipulation that restored the brains of the mice is not currently feasible in people.
But they also point out that the new findings raise hope not only for people with Rett but for some with autism and other "developmental" brain diseases that strike after birth, because the dramatic recovery of the mice suggests that the brain is far more fixable than many have thought.
"Everyone assumes that autism, schizophrenia, all these things are done deals once the symptoms are there," said Adrian Bird, senior author of the findings published on-line yesterday in the journal Science.
"But we have to ask ourselves, 'Why do we believe the brain is so fixed and non-plastic?'" said Bird, a professor of genetics at Edinburgh University and discoverer of the gene that, when mutated, causes Rett. "Maybe we should look more carefully at what else can be reversed."
Rett Syndrome affects an estimated 1 in every 10,000 girls, and occasional boys. Like autism, it often involves a regression early in life. For example, Lori McTernan of Needham had seemed a fairly normal baby at first, but at nine months she was still not crawling, and over the next few months, she made no progress with language and lost the ability to pick up food between two fingers, said her mother, Maria.
Lori is now almost 15, and Maria McTernan said the Science paper's findings restore hope that had long since waned.
"If Lori could even nod her head yes or no, that would be just unbelievable," she said.
For doctors as well as researchers, the Science paper provides a boost broader than Rett Syndrome, said Dr. Omar Khwaja, director of the new Rett Syndrome program at Children's Hospital Boston.
"There are very few if any childhood neurological diseases that are curable," he said. But the paper provides "proof of principle" that, in an animal model at least, the symptoms of such a disease can be reversed.
So what will Khwaja tell families now about potential help for humans? He does not think it can come within five years, he said, but "It's very unpredictable."
Bird's team worked on a mouse model that had been engineered to have Rett Syndrome that could effectively be turned on and off. The researchers put a "Stop cassette," a kind of chemical roadblock, on the key gene involved in Rett.
When the Stop cassette was in place, the gene did not work in brain cells and the mice had all the symptoms of the mouse version of Rett. For example, when a cage lid is lifted, normal mice scurry about but Rett mice just sit there.
When the mice were a few weeks old, the researchers gave them a drug that would remove the cassette, and the gene began to function. Nine of the 17 mice died, perhaps because the gene came back on too strongly, and the remaining eight showed an amazing recovery.
"The first thing we thought was, 'This can't be true! These mice are completely cured! So we'd better do it again," said Bird, the senior author, whose research was funded in part by the Rett Syndrome Research Foundation. "The next time we got the drug dose just right, and nearly all mice were cured."
The same key gene has been implicated recently in autism, learning disabilities and some forms of mental retardation.
There are three possible ways that the Science experiment may eventually be translated to humans, Bird said, all just beyond the realm of what is currently possible: Gene therapy aimed at somehow producing the same effect as what was done in the mice; a drug that would imitate the effect of turning the gene back on; and a method that would somehow activate the "good," non-mutated copy of the gene that is present along with the "bad" copy, in people with Rett.
Neuroscientists not involved in the Science paper welcomed it, though with the usual scientific caution.
Mark Bear, director of the Picower Institute for Learning and Memory at MIT, said that the paper provided "welcome good news," with its suggestion that "it is never too late to try a new treatment for a developmental brain disorder."
Of course, he added in an e-mail, "the less interesting aspect of the study is that the rescue was achieved by re-expressing the same gene. I do not think anyone expects that it will be possible, in the near future anyway, to replace a disease gene throughout the nervous system in humans like what they did here in mice."
Local parents of children with Rett said they are realistic, and know that a cure remains far away. Still, news that the symptoms could be reversed in animals "seems like a miracle," said Jennifer Endres, of South Yarmouth, whose 3-year-old daughter, Jillian, has Rett.
(Vincent DeWitt for the Boston Globe)
Jillian and her mother Jennifer play with toys adapted to handicapped children in their home.
Asked what improvement in Jillian they hope for most, Jennifer and her husband, Justin, said they would most love to hear Jillian speak some day.
"It would be nice to hear her say, 'Mommy,' 'Daddy,' 'I love you,'" Justin Endres said. "Or to reach up to give you a hug. She doesn't have the use of her arms to do even that, to make any sign of definite communication."
Posted by Karen Weintraub at 06:56 PM
February 08, 2007
Nearly three-quarters of patients with advanced cancer felt their spiritual needs were not met by the medical system, including chaplains, a survey by Harvard researchers shows. Nearly half of the patients thought their religious communities gave them little or no support.
People who had spiritual support tended to have better quality of life, according to the Coping With Cancer study, based at Dana-Farber Cancer Institute. And people who described themselves as religious were twice as likely to want more aggressive treatment to extend their lives, it said. The survey of 230 patients is reported in Saturday's Journal of Clinical Oncology.
"These findings provide further evidence that oncology practitioners really should include a spiritual history as part of a patient's history of social support and culture," Dr. Tracy A. Balboni said in an interview today. She is a senior resident in the Harvard Radiation Oncology Program and the paper's lead author. "It allows the practitioner to know whether something's important to the patient and also makes the statement, 'We understand this might be an important part of dealing with your illness.' "
Most of the people in the study (88 percent) said religion was at least somewhat important to them. More African Americans (89 percent) and Hispanics (79 percent) than whites (59 percent) said it was very important.
As people got sicker, they were less able to attend religious services. Just over half (52 percent) reported getting visits from chaplains or other clergy members.
Most patients (72 percent) said the medical system offered little spiritual support, and 47 percent said the same about their religious community.
Physicians may be leery of overstepping their bounds by asking their patients about religion, the authors wrote. In an accompanying editorial, Betty Ferrell, a research scientist in the City of Hope Cancer Center's department of nursing research and education, urges doctors to take a different approach.
"This report is a strong statement of a seriously unmet need in the vast majority of patients in our care," she wrote. "The oncologist who dares to ask about spirituality imparts a vital message to patients that they are being cared for by someone who has not forgotten that a broken patient remains a whole person, and that healing transcends survival."
Posted by Elizabeth Cooney at 06:00 PM
February 08, 2007
By Alice Dembner, Globe Staff
Bruce Butler, a member of the board overseeing the state's universal health insurance law, has threaded his way through a conflict of interest by giving up some paid work.
"I will stay on the board, fully engaged," he said in an interview after a meeting of the Commonwealth Health Insurance Connector board.
Former Governor Mitt Romney appointed Butler last year to fill the seat designated for an actuary on the 10-member volunteer board.
Butler had worked for many years as chief actuary at Blue Cross Blue Shield of Massachusetts. After retiring, Butler started a consulting business and recently helped a local firm develop web-based products for insurance companies.
As part of the consulting job he expected to be meeting directly with Massachusetts insurers to solicit business. Some of those same insurers are seeking approval from the Connector board to sell new insurance plans.
Last month, he told the board and Romney that he did not believe his consulting work posed a conflict of interest, but that he would abstain from discussions and votes involving specific insurers to avoid the appearance of any conflict.
But the Ethics Commission told Butler that abstaining from board business was not enough to prevent a conflict of interest. That left Butler with a choice: resign from the board or limit his paid consulting efforts.
Today, Butler told fellow board members that he would not market products to any insurers who are submitting bids to the connector. Therefore, he said, he had the Ethics Commission's blessing to participate in all board activities.
Butler said he still planned to help market the web-based products to insurers in other states who do not have business with the connector.
Posted by Karen Weintraub at 05:57 PM
February 08, 2007
By Alice Dembner, Globe Staff
A state board decided today to reconsider whether prescription drug coverage should be part of the basic health insurance everyone in the state must have by July 1.
Members of the board, which is overseeing the state's universal health insurance law, agree that medicines are an essential part of any comprehensive coverage, but they are seeking ways to keep insurance premiums affordable.
In addition, they are concerned that a drug requirement could force as many as 200,000 people who are already insured to buy more coverage.
Today, the Commonwealth Health Insurance Connector board asked insurance companies to price out two new plans -- one with drug coverage and one without.
The board is expected to review the new bids at its March 8 meeting and make a final decision on March 20 about what level of coverage will satisfy the new state mandate.
"Hopefully, what we're doing is insuring more and more people and not throwing people off," said Leslie Kirwan, chairman of the board. "If that means a phased approach, we should consider that."
(George Rizer/Globe Staff)
Leslie Kirwan with Gov. Deval Patrick
Under the new law, all adults must obtain at least the minimal coverage by July 1 or pay a penalty, unless they secure a waiver by proving they can't afford insurance.
Individuals earning less than 300 percent of the poverty level, of $29,400, are eligible for a separate, state-subsidized insurance plan.
Posted by Karen Weintraub at 02:58 PM
February 08, 2007
Michel Kazatchkine, France's AIDS ambassador and a Harvard-educated doctor specializing in infectious diseases, was selected today as the new head of the $7 billion Global Fund to Fight AIDS, Tuberculosis and Malaria.
Kazatchkine, 60, takes over an organization that in just over five years has provided grants to 450 programs in 136 countries, accounting for two-thirds of all international funding against TB and malaria, and 20 percent of global funding to fight AIDS.
From 1977 to 1981, Kazatchkine lived in Boston while doing post-doctoral work at Brigham and Women's Hospital as a member of Harvard's Immunology Department.
-- John Donnelly
Posted by Gideon Gil at 01:51 PM
February 08, 2007
Massachusetts General Hospital has no immediate plans to open a health-care facility in northern Palm Beach County, Florida, but the institution is still considering the idea, President Peter Slavin said yesterday, according to the Palm Beach Post.
Massachusetts General officials, in Palm Beach this week for their annual fund-raising trip, say several factors stand in their way of opening a satellite facility in Jupiter, including the large number of uninsured patients, the popularity of concierge practices and concern that it could not offer the same array and quality of services away from its Boston base.
"We're still interested in the opportunity," Slavin said Tuesday before a late afternoon health symposium and cocktails with donors at the Four Seasons Palm Beach. "But we have no specific plans yet."
Any plans would include Brigham and Women's Hospital, also owned by Partners HealthCare, the Post story said.
Posted by Elizabeth Cooney at 06:49 AM
February 08, 2007
The state Department of Social Services received a report raising concerns about whether 4-year-old Rebecca Riley was taking too many powerful prescription drugs last summer, but dropped the issue after receiving assurances from her mother and doctors that the treatment was appropriate. Her psychiatrist, Dr. Kayoko Kifuji, has agreed to halt her medical practice while the state invesigates her role in the child's death.
The Food and Drug Administration yesterday approved the first diet pill for sale without a prescription in a marketplace dominated by unregulated over-the-counter supplements that promise weight loss. GlaxoSmithKline Consumer Healthcare expects to begin selling the drug, known as Alli, as early as this summer for about 60 cents per dose.
Posted by Elizabeth Cooney at 06:17 AM
February 07, 2007
Dr. Desmond H. Birkett of Lahey Clinic has been named president-elect for 2007 of the Massachusetts chapter of the American College of Surgeons.
Birkett is the chair of general surgery at Lahey and a clinical professor of surgery at Tufts University School of Medicine.
Posted by Elizabeth Cooney at 06:05 PM
February 07, 2007
Most physicians believe it is ethically acceptable to tell patients if they find a legally available medical procedure morally objectionable, but most also feel obligated to present all treatment options and refer patients to other clinicians who don't share their opposition, according to a nationwide survey being published in tomorrow's New England Journal of Medicine.
The physicians were asked how they would respond to requests for treatments such as sedation for dying patients to make them unconscious; abortion after failed contraception; and prescribing birth control to adolescents without their parents' permission.
"Many physicians do not consider themselves obligated to disclose information about or refer patients for legal but morally controversial medical procedures," concluded the authors from the University of Chicago. "Patients who want information about and access to such procedures may need to inquire proactively to determine whether their physicians would accommodate such requests."
Male physicians and those who describe themselves as religious were most likely to say they would express personal objections and least likely to say they would disclose information about procedures they found objectionable or refer patients to providers who don't share their views, the study concluded.
The researchers randomly surveyed 2,000 doctors by mail. Of the 1,144 who responded, 63 percent said they thought it was permissible to state their moral objections, 86 percent felt physicians are obligated to present all options to their patients, and 71 percent believed they are bound to refer patients to another provider who does not object to the procedure on moral grounds.
That could mean 14 percent of patients, or more than 40 million Americans, may have doctors who do not feel ethically bound to disclose information about treatments they find objectionable, the authors wrote. And 29 percent of patients, or nearly 100 million Americans, may be cared for by doctors who do not feel they must refer patients to another doctor who would provide the service the patient requests.
The study found that 52 percent of physicians object to abortion for failed contraception and 42 percent object to contraception for adolescents without parental approval.
Patients need to be aware that their doctors might not agree with them or feel they should discuss alternatives, said Dr. Farr A. Curlin, a general internist and ethicist at the University of Chicago.
"The only resolution that is going to be workable is to have a respectful negotiation" between doctors and paients, he said in an interview today. "Doctors need to be up-front and candid with their patients about their boundaries so they can work out accommodations as best they can."
Posted by Elizabeth Cooney at 05:18 PM
February 07, 2007
As nonprofit hospitals face financial pressures and competition from for-profit health-care providers, their business practices are being challenged in court and in the communities they serve, says a report in tomorrow's New England Journal of Medicine.
More than 100 lawsuits have been filed accusing hospitals of failing to meet their charitable commitments when they charge more to uninsured patients and pursue them for payments, the article said. State attorneys general and the Internal Revenue Service have looked harshly on hospitals that they say have turned into profit-seeking ventures.
Granted tax-exempt status in exchange for providing charitable care, nonprofit hospitals can't compete in the same way as for-profit hospitals when it comes to joint ventures such as free-standing surgery centers, said author Michelle M. Mello, who specializes in health law at the Harvard School of Public Health.
"The public has strong expectations of entities to which it gives tax-exempt status," Mello said. "One is that they are going to provide a community benefit, but also provide care that is just as high-tech as the for-profit hospital. Meeting those two expectations puts hospitals in a difficult position. They're being asked to do a great deal with less flexibility than for-profit hospitals."
Massachusetts has seen less competition between nonprofit and for-profit hospitals than other states because teaching hospitals dominate here. But nonprofits are still under pressure, said Daniel Moen, president and CEO of Heywood Hospital in Gardner and chairman of the board of the Massachusetts Hospital Association.
"It is certainly a very difficult environment for acute care hospitals, especially in Massachusetts, where the operating margins have been very tight or nonexistent," he said. "But in spite of that I am not pessimistic about the future for not-for-profit hospitals. The institutions I'm aware of have done a very good job balancing the whole charitable portion of their mission versus having enough business savvy to be able to make sure the hospital stays strong."
Posted by Elizabeth Cooney at 05:00 PM
February 07, 2007
Dr. Kayoko Kifuji, the psychiatrist who treated Rebecca Riley, a 4-year-old Hull girl whose parents have been charged with giving her a fatal overdose of prescription drugs, agreed today to immediately stop seeing patients while the state investigates her role in the case.
The Board of Registration in Medicine accepted the voluntary agreement from Kifuji, who works at Tufts-New England Medical Center. Such agreements "are one tool available to the Board to ensure the safety of the public during the pendency of an investigation," the board said in a statement. "Voluntary agreements are appreciated by the Board as a sign of cooperation on the part of a physician."
Nancy Achin Audesse, the board's executive director, said after the board's meeting: "Clearly this case and the attention it has garnered is very frightening to patients and to the public, and it raises a lot of questions. A voluntary agreement gives us time to gather information and decide what we need to do next."
Tufts-NEMC issued a statement saying that Kifuji is on a paid leave of absence.
The voluntary agreement does not detail any specific allegations against Kifuji. It states that it "is considered to be a disciplinary action" but that Kifuji does not waive her right to contest any allegations that may be brought against her by the board. "Nothing contained in this Agreement shall be construed as an admission or acknowledgement by me as to wrongdoing of any kind," Kifuji states in the document.
Kifuji began treating Riley in August 2004 and diagnosed her with attention deficit hyperactivity disorder and bipolar disorder. She prescribed the medications, including clonidine, a blood pressure drug for adults that is also sometimes given to children to reduce aggressiveness and help them sleep. Prosecutors allege that Riley's parents, Michael and Carolyn Riley, intentionally killed their daughter in December by giving her a clonidine overdose.
In an interview today, Kifuji's attorney, J.W. Carney Jr., said, "Dr. Kifuji's diagnosis of Rebecca, her prescribing of medication and the care provided was 100 percent appropriate under the circumstances."
Kifuji has been licensed to practice in Massachusetts since 1999. She is a 1981 graduate of Tokyo Women's Medical College and is board certified in pediatrics and psychiatry, including a subspecialty certification in child & adolescent psychiatry, acccording to the board of registration.
Posted by Gideon Gil at 04:11 PM
February 07, 2007
Brockton Hospital nurses voted to ratify a three-year contract yesterday, according to the Massachusetts Nurses Association.
The agreement, reached on a 174-14 vote, includes an across-the-board salary increase of 10 percent (half retroactive for 2006 and half for 2007), plus other adjustments that add up to total wage increases over the three years of between 13 percent and 23 percent, depending on a nurse's seniority.
The starting hourly wage will rise to $25.60, up from $22.50, and the top wage will be $47.96, up from $39.01. The contract also includes tuition reimbursements for nurses, and will step up the use of temporary nurses on nights and weekends.
"We are pleased to have reached an agreement that will provide a competitive pay scale with other area hospitals, which is an important step towards stemming the loss of nurses from this facility," said Kathy Metzger, an operating room nurse and co-chair of the nurses' local bargaining unit.
"We're very pleased to have reached this settlement," said hospital spokesman Rich Copp. "Our nurses are an integral part of this organization and the wages and benefits under this contract ensure they receive one of the most competitive compensation packages in the region."
Posted by Elizabeth Cooney at 12:26 PM
February 07, 2007
The first draft of the horse genome sequence has been completed by scientists at the Broad Institute in Cambridge, work that has implications for the study of human disease, the National Human Genome Research Institute announced today.
A team led by Kerstin Lindblad-Toh at the joint MIT-Harvard institute began sequencing the domestic horse genome in 2006, culminating a 10-year effort by international scientists called the Horse Genome Project.
Twilight, the mare whose genome was sequenced.
The horse whose DNA was used is a Thoroughbred named Twilight from Cornell University. Research done there by Doug Antczak has implications for research on reproduction, clinical organ transplantation and immune regulation, according to the NHGRI.
Posted by Elizabeth Cooney at 10:54 AM
February 07, 2007
The 10 federally funded Coalition of Cancer Cooperative Groups, which enroll nearly half of the patients in the nation who are participating in cancer trials, have begun to shut down trials and stop studying certain cancers amid funding concerns, according to a report in today's Wall Street Journal.
About 3,000 patient spots in clinical trials will be eliminated in 2007 at centers around the U.S., the group said. Although the decrease will affect all cancers, among the hardest-hit will be rarer cancers.
Posted by Elizabeth Cooney at 09:42 AM
February 07, 2007
A doctor's role is questioned in a girl's fatal overdose from powerful prescription drugs fed to her by her parents. Prosecutors would not say whether Dr. Kayoko Kifuji of Tufts-New England Medical Center is a target of a criminal investigation, but have forwarded details from the case to state medical licensing regulators.
News that Ascension Health plans to absorb six Caritas Christi hospitals operated by the Archdiocese of Boston triggered a debate yesterday about the future of Catholic healthcare in the region. Mayor Thomas M. Menino expressed trepidation about the fate of two Boston hospitals in the chain, Caritas St. Elizabeth's Medical Center in Brighton and Caritas Carney in Dorchester.
The Food and Drug Administration yesterday approved a genetic test that, when conducted soon after a woman learns she has breast cancer, can predict the odds of the disease returning and worsening. The test, called MammaPrint, analyzes tissue from a breast tumor to gauge the activity of 70 key genes and determines the likelihood of the cancer's recurrence.
A drug widely used to prevent excessive bleeding during heart surgery appears to raise the risk of dying in the five years afterward by nearly 50 percent, an international study found. The researchers said replacing the drug -- aprotinin, sold by Bayer AG under the brand name Trasylol -- with other, less expensive medications for a year would prevent 10,000 deaths worldwide over the next five years.
Posted by Elizabeth Cooney at 06:15 AM
February 06, 2007
A Seattle hospital has hired Dr. Lee Schwamm, director of acute stroke services, and his colleagues at Massachusetts General Hospital to help them build a remote stroke service for community hospitals in Washington state.
Many stroke patients do not get the best treatment available because time is of the essence and few community hospitals are staffed at all hours by brain doctors with the expertise to make treatment decisions. To address this problem, Massachusetts is among the first states where neurologists have begun to recommend treatment for stroke patients without seeing them in person. Using telemedicine, they read brain scans over the Internet at all hours and consult over live video hookups.
Fourteen community hospitals in Massachusetts have signed contracts with Mass. General's "telestroke" service, and Swedish Medical Center in Seattle is the first to hire the Mass. General team as consultants.
-- Liz Kowalczyk
Posted by Gideon Gil at 11:59 AM
February 06, 2007
More than half the U.S. population takes multivitamins, but there isn't a lot of evidence that they work, says a Tufts University researcher.
Almost 100 years after the first vitamins were named, we still need better advice on whether to take them, particularly when it comes to multivitamins, which "cry out for greater standardization," said Dr. Irwin Rosenberg, director of the Nutrition and Neurocognition Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging.
"The evidence regarding vitamin use for prevention of chronic disease is still quite rudimentary, especially for multivitamins," he said.
Rosenberg made his comments at a National Institutes of Health conference on multivitamins and mineral supplements. They appear in the January issue of the American Journal of Clinical Nutrition.
While scientists know a lot about individual vitamins, Rosenberg said, there is much less known about the effects of taking multiple vitamins together. He called for regulators to pay more attention to the content and labeling of supplements, as well as to how well they might provide adequate nutrients or prevent chronic disease.
"Information relating to individual vitamins or small combinations of vitamins to disease prevention is stronger than that for multivitamins, formulations that cry out for greater standardization," he said.
More than half (52 percent) of the people who take multivitamins say they do so to prevent disease, and more than one-third (38 percent) say they take them because they feel better, studies have shown. But studies also reveal that people who take multivitamins tend to be better educated, weigh less, do more physical activity and eat better diets.
"Since multivitamin users are generally healthier, it might not be feasible to attribute health outcomes to vitamin use until we have more information," he said. "The best source of vitamins is food."
Posted by Elizabeth Cooney at 11:24 AM
February 06, 2007
Cardinal Sean P. O'Malley and a tight circle of archdiocese leaders have made a tentative deal to transfer ownership of the six hospitals in the Caritas Christi Health Care system, including Caritas St. Elizabeth's Medical Center in Brighton, to the nation's largest Catholic hospital chain, St. Louis-based Ascension Health.
"Forgotten Genius" on NOVA tonight tells the story of Percy Julian, the black chemist whose work in the face of segregation led directly to the steroids that treat rheumatoid arthritis and indirectly to the birth control pill.
Posted by Elizabeth Cooney at 06:28 AM
February 06, 2007
An article by Dr. Thomas A. Gaziano of Brigham and Women's Hospital and Harvard Medical School, Lionel H. Opie of the University of Cape Town, and Milton C. Weinstein of the Harvard School of Public Health was among 23 original research articles nominated for "Paper of the Year 2006." Editors of the Lancet for the past three years have winnowed biomedical papers -- 700,000 in last year's case -- to pick the best medical research of the year.
The Gaziano paper was "Cardiovascular disease prevention with a multidrug regimen in the developing world: a cost-effectiveness analysis."
The winners for 2006 were trials of two rotavirus vaccines, published in the New England Journal of Medicine.
Posted by Elizabeth Cooney at 06:27 AM
February 05, 2007
The following was posted over the weekend on a website of the US Centers for Disease Control and Prevention:
Published: February 3, 2007
On Thursday morning, February 1, 2007, CDC staff became aware that CDC's Podcast site (www.cdc.gov/podcasts) had been hacked. As a precaution, CDC has removed the Podcast site and we anticipate the site will be down for the next few days. We are working to make sure that the Podcast site is safe, and we will repost it in a few days.
At this time, CDC does not have any evidence that sensitive information has been compromised in any way. However, it is possible that computers used by visitors to CDC's site may have been infected with a computer virus. Users that visited the site Thursday morning should ensure their computer has been scanned for viruses. Regular virus scans are an important precaution for all Internet users.
We apologize to CDC Web site users for any inconvenience.
Posted by Karen Weintraub at 05:06 PM
February 05, 2007
Joslin Diabetes Center has formed an affiliation with Frisbie Memorial Hospital in Rochester, N.H., where it will offer educational programs for patients with diabetes, one-on-one education classes for those who are newly diagnosed, and diabetes information groups.
Joslin has 25 affiliated programs in the United States and two international affiliates in the Kingdom of Bahrain and Canada.
Posted by Elizabeth Cooney at 04:13 PM
February 05, 2007
Noam Chomsky and 10 other professors at MIT are circulating a letter calling for an examination of the process that denied tenure to African-American stem cell scientist James L. Sherley, who began a hunger strike today.
Sherley is demanding that MIT say he was denied tenure because of racism.
The Chomsky letter questions "the integrity of the grievance process," not the tenure decision, highlighting allegations of conflict of interest, unfair lab space allocation, and the mishandling of a racial prejudice complaint, among other issues.
The full letter appears below.
A PLEA FOR FAIRNESS AT MIT
MIT, Sunday, February 1, 2007
Two years ago, in January 2005, Professor James Sherley, the only African-American faculty member ever appointed in the Division of Biological Engineering (BE), filed a letter of complaint about the division-level evaluation that resulted in the denial of his tenure in BE. Prof. Sherley’s complaints include charges of conflict of interest and racial discrimination. Provost Rafael Reif has now decided that, given the findings of the grievance review committee, Sherley’s tenure denial should stand.
Because charges of conflict of interest and racial discrimination cut at the very core of MIT’s community values, it is imperative that they be thoroughly pursued, wherever they lead. We are writing this letter because we believe that there remain several issues related to Prof. Sherley’s grievance process that need to be further examined. Our concern here is not, and could not be, about the scientific merits of Prof. Sherley’s tenure dossier, which is not available to us and about which we as a group would be in no position to opine. Our concern in this letter is with the integrity of the grievance process. We would like to highlight a sample of evidence that might help decide whether Prof. Sherley’s complaints were given fair, diligent and thorough consideration. The evidence surrounds the following topics:
+ conflict of interest in tenure review;
+ various sorts of unfair treatment to Prof. Sherley as a junior faculty member vis-à-vis:
- space allocation,
- space-related impediments and misinformation during recruitment and hiring,
- problems related to mentorship and tenure review,
- failure to acknowledge achievements;
+ mishandling of complaint of racial prejudice.
Conflict of interest:
The BE Division Head is married to a senior BE faculty member whose relationship with the candidate has been openly contentious. Given this relationship, it would have been appropriate for the BE Division Head to recuse himself from assembling and deciding Prof. Sherley’s tenure case. However, not only did the Division Head fail to recuse himself, but he solicited an internal letter from his wife to be included in the tenure file.
The Provost, in his 12/22/06 letter to Prof. Sherley, summarizing the Review Committee’s report (to which we do not have access), states: “The Committee found that it was appropriate for [the BE Division Head] to solicit an internal reference from [his wife], given the overlap in your research areas and the fact that you had not asked that she be excluded from the list of referees.” In other words the Provost here places the burden for identifying and preempting the conflict of interest on the candidate himself.
This seems to us highly problematic. A tenure candidate should not be expected to openly challenge the judgment of a senior faculty member who will play a key role in deciding the candidate’s tenure status. MIT’s Policies and Procedures (7.2) states: “While general responsibility for assuring adherence to these policies must rest with those responsible for appointments and assignments (principally academic and administrative department heads and laboratory and center directors), a particular responsibility for sensitivity to the potential conflicts falls on those whose family or personal relationships may give rise to them.” This makes it clear that the burden of action lies on department heads and on parties whose relationships may compromise (or give the appearance of compromising) due process in professional decision-making. Thus, as Head of BE and as spouse of a senior BE faculty in open conflict with the candidate, the BE Division Head was, in two distinct ways, responsible for avoiding any appearance or potential of conflict of interest. The BE Division Head failed to fulfill his responsibility. As a result, Prof. Sherley was not duly protected from the appearance of, and the potential for, conflict of interest.
Unfair treatment:
Space allocation and space-related impediments and misinformation during recruitment and hiring
In July 1998, Prof. Sherley was hired into a faculty slot reserved for under-represented minorities as established by a special Provost’s initiative to promote minority recruitment. Such a slot came with certain restrictions on laboratory space: any minority recruited in such a line would have to be given space that is already available from the hiring unit---not additional space by the Provost. As he was being recruited, Prof. Sherley was never told that he would be hired into a special-initiative minority-faculty slot or that such a slot came with restrictions on how space would be allocated to him. This was confirmed in exchanges both with Prof. Sherley and with senior BE faculty involved in his recruitment and hiring. These space restrictions have continued to plague Prof. Sherley throughout his career at MIT. We believe that these facts concerning Prof. Sherley’s recruitment and lab space raise a variety of questions, including questions about Prof. Sherley’s fair treatment as a new recruit and a junior faculty member, and questions about the reliability of the grievance committee’s findings vis-à-vis the size of Prof. Sherley’s independent laboratory space and how much control he could actually exert over this space.
For example, space loaned to Prof. Sherley by a senior faculty in BE has been listed as part of Prof. Sherley’s “independent” lab space. Yet Sherley’s dependence on others for lab space has been used to intimidate and pressure him. On July 3rd, 2006, Prof. Sherley received an email message in which the afore-mentioned senior BE faculty threatened to “formally request return of [this space] to [him].” The senior BE faculty wrote to Sherley: “Remember that it was I who gave you access to that lab.” In that email exchange, the senior faculty’s threat was explicitly stated in response to Prof. Sherley’s handling of a complaint by one of Sherley’s assistants who was feeling harassed by one of the senior faculty’s assistants. As far as can be gathered from the corresponding email exchanges, Prof. Sherley was handling this complaint in the most appropriate fashion, according to the relevant MIT guidelines.
Problems related to mentorship and tenure review
Various concerns also arise in the context of Prof. Sherley’s pre-tenure mentorship and subsequent tenure denial. In question here are descriptions in the Provost’s letters of the role of one Department Head in the School of Engineering, outside of BE, who according to the Provost’s 1/23/06 letter, was asked to “review” Prof. Sherley’s tenure case. As it turns out, this Department Head who was claimed in that letter to have “agreed with [the BE Division Head’s tenure-denial] decision” was subsequently identified as the Head of Aeronautics and Astronautics [Aero-Astro], and the sole African-American Department Head at MIT. The Aero-Astro Head is also the very mentor whom senior BE faculty had recommended to Prof. Sherley and whom Prof. Sherley had consulted about his tenure dossier, before and after the tenure-denial decision. On December 20, 2006, the Aero-Astro Head categorically stated that all he saw of Prof. Sherley’s tenure dossier is what Prof. Sherley himself had shown to him in his capacity of mentor. On that same occasion, the Aero-Astro Head unambiguously stated that it would have been “inappropriate” for him to “review” Prof. Sherley's case. Then and on another occasion (on January 4, 2006), he emphatically denied having done so. Be that as it may, in light of the identification of the Aero-Astro Head as the other Department Head who “reviewed” Prof. Sherley’s case, the Provost’s summary letters dated 1/23/06 and 12/22/06 display obfuscatory statements vis-à-vis the committee’s findings about the Aero-Astro Head’s role in Prof. Sherley’s tenure denial. In his 12/22/06 letter, the Provost states: “The Committee confirmed that [the Aero-Astro Head] did not see the tenure case for you that was presented to the BE faculty.” Whether he did or not, one is left to wonder if the integrity and fairness of Prof. Sherley’s mentorship and/or tenure review were in any way compromised by the Aero-Astro Head’s role therein.
An important aside is in order here with respect to MIT’s commitment to minority recruitment and retention. The above inconsistency in the Provost’s letters is all the more troubling, given the Aero-Astro Head’s stature in the minority-faculty community and the need for reliable mentorship therein. Any mishandling of these issues may have long-lasting effects on the quality of mentorship for younger minority faculty and on the recruitment and retention of minority faculty.
Failure to acknowledge achievements
Prof. Sherley charges that his stature, contributions, and awards have not been duly acknowledged by his senior colleagues and that, even when he demanded acknowledgment, this was denied. Sherley has provided a variety of examples of this pattern. But there’s one that is clearly documented, which relates to Prof. Sherley’s status as the first new faculty appointment in BE.
Prof. Sherley has complained to the Provost that the BE Division Head has never acknowledged his (Sherley’s) distinction as the first new faculty member hired into the newly formed Division of Bioengineering and Environmental Health in July 1998. In response to this complaint, the Provost, in his 12/22/06 letter, states: “While you [Sherley] feel that you should have been acknowledged as the first faculty member hired in BE, the Committee found that you were in fact hired in the Toxicology division, prior to the formation of BE.” However official MIT documents (e.g., Prof. Sherley’s initial appointment letter dated July 1st, 1998) contradict the findings of the committee vis-à-vis Prof. Sherley’s initial appointment at MIT. Prof. Sherley’s very first letter of appointment from MIT is dated July 1st, 1998, and lists his affiliation with Bioengineering and Environmental Health, and not with the Toxicology Division. The latter no longer existed as of July 1st, 1998: by then the faculty from the former Toxicology Division had become part of Bioengineering and Environmental Health. This simple fact, as straightforwardly documented by Prof. Sherley’s initial appointment letter from MIT and by the history of BE, raises questions concerning the reliability of the Review Committee’s findings as summarized by the Provost.
Prof. Sherley has asserted that such documented discrepancy about his MIT appointment--- in spite of his (and the BE Administrative Officer’s) attempts at correcting it---is one instance of a larger pattern of discrimination in BE. Statements to the effect that Prof. Sherley was not “the first faculty member hired in BE” do not simply downplay the significance of the facts, but they take away his place in the history of BE and his legacy to that Division. Though it may seem insignificant to some, Prof. Sherley’s place in BE’s history, especially given the fact that he’s still the only African-American faculty member in BE, is powerfully symbolic in the context of race relations at MIT and elsewhere. It is thus unfortunate that the Provost's 12/22/06 letter furthers the slight: it suggests that Prof. Sherley's “feel[ings]” are the source of the error rather than close attention to the facts whose documentation lies within the purview of the Provost’s office.
Mishandling of complaint of racial prejudice
Racial attitudes, as is well known, are usually complicated and deeply nuanced. When complaints about racial prejudice arise, every possible angle ought to be pursued to reach a reasonable understanding as to influence and impact. Committee members ought to be well versed in the problems involved through experience, knowledge and/or deep reflection and sensitivity. With these caveats in mind, consider the following statement from the Provost’s 12/22/06 letter to Prof. Sherley: “Although one personal opinion differed, the Committee found strong evidence that racial prejudice did not affect the evaluations of your tenure case among the BE faculty, and found no evidence (as opposed to that opinion) to the contrary”. The Provost’s statement that the committee found “strong evidence” that racial discrimination did not occur in this case leaves us wondering. While a committee could reasonably state that they uncovered no evidence of racial discrimination, for them to claim to have “found strong evidence that racial prejudice did not affect [said tenure] evaluations” strikes us as highly implausible, especially in this case. And what about that “one personal opinion” in opposition to the committee’s conclusion? Is that an opinion of a senior BE faculty? If so, it would plausibly be based on first-hand observations of two crucial sorts of data: interactions between Prof. Sherley and his BE colleagues, and comments about Prof. Sherley by his BE colleagues. Such “personal opinion” should not be so readily dismissed.
Taken all together, the above evidence calls into question the grievance committee’s findings and, by extension, the Provost’s decision to conclude Prof. Sherley’s tenure case on the basis of those findings. Furthermore the above facts suggest that it is impossible to separate the specifics and eventual resolution of Prof. Sherley's case from the “barriers that may exist for under-represented minority faculty members and [...] effects that race may play in the hiring, advancement and experience of under-represented minority faculty” (this is a quotation from the last paragraph in the Provost's 1/29/07 message to the MIT faculty about Professor Sherley’s grievance; this message is posted at http://web.mit.edu/provost/letters/letter01292007.html ).
In conclusion we are left doubtful as to whether the grievance review committee exercised due diligence in investigating, ferreting out, and interpreting evidence, and in distinguishing fact from opinion. We therefore believe that the following measures are in order:
All aspects of the grievance process should be reviewed by a committee composed of members from inside and outside of MIT to determine the adequacy and fairness of the process. Details of this review should be reported to the faculty in full and in a timely fashion.
Should the committee determine that the process was flawed or inadequate, then appropriate redress should be made to Prof. Sherley.
Last Friday (2/2/07) President Hockfield rehearsed the Provost’s announcement on 1/29/07 of “plans to undertake a comprehensive, rigorous, and systematic study of the impact of race on the hiring, advancement, and experience of minority faculty at the Institute” and “to take a position of leadership on this important issue.” Unfortunately, given the above and related evidence pertaining to Prof. Sherley’s grievance process, we feel obliged to point out that, while such an initiative is essential and long overdue, it appears to run counter to the administration’s actions vis-à-vis Prof. Sherley’s grievance.
Signers:
Noam Chomsky
Institute Professor
Department of Linguistics and Philosophy
Michel DeGraff
Associate Professor
Department of Linguistics and Philosophy
Junot Díaz
Associate Professor
Program in Writing and Humanistic Studies
Sally Haslanger
Professor
Department of Linguistics and Philosophy
Jonathan Alan King
Professor
Department of Biology
Melvin H. King
Senior Lecturer Emeritus
Department of Urban Studies and Planning
Helen Elaine Lee
Associate Professor
Program in Writing and Humanistic Studies
Ceasar L. McDowell
Professor of the Practice of Community Development
Department of Urban Studies and Planning
Chi-Sang Poon
Principal Research Scientist
Harvard-MIT Division of Health Sciences & Technology
Phillip J. Thompson
Associate Professor
Department of Urban Studies and Planning
Elizabeth Wood
Professor
History Faculty
Posted by Elizabeth Cooney at 10:46 AM
February 05, 2007
African-American stem cell scientist James L. Sherley started a hunger strike this morning, demanding that MIT offer him tenure, begin to address racism and censure the provost for his role in his case.
"How can we accept that we have so many well-trained people and so few are tenured?" he asked a group of about 30 professors, former students, family and friends who gathered just outside the offices of MIT President Susan Hockfield and Provost L. Rafael Reif this morning. "What I have discussed here is that if you are African-American, part of a minority group, it is acceptable for you to have insufficient lab space ... and it is allowable for your accomplishments to be ignored."
James Sherley, at right, begins his hunger strike in an MIT hallway.
(Photo by David L. Ryan, Globe staff)
Sherley vowed to stand outside the president/provost's office daily between 9 and 12 until the administration meets his demands.
MIT has said that a committee convened to review the tenure process for Sherley found that it was fair.
Supporters held signs and distributed fliers this morning listing his accomplishments and demanding "End racism at MIT."
Chancellor Phillip L. Clay called on the MIT community to respect Sherley's right to disagree publicly.
"We take seriously, and are gravely concerned by, Professor Sherley's intentions," he wrote in an email to students. "While we have encouraged him to seek other means to express his views, the Institute will respect his right, as a member of our community, to publicly express his disagreement in a manner that does not disrupt the work of the Institute or put others in the community at risk."
Noam Chomsky and 10 other MIT professors are asking for further examination of the situation.
"Because charges of conflict of interest and racial discrimination cut at the very core of MIT’s community values, it is imperative that they be thoroughly pursued, wherever they lead," they wrote in a letter called a "Plea for Fairness at MIT."
Sherley, one of 28 black professor at the time of the tenure decision, has been battling the university for two years. MIT has said repeatedly the decision is final. Sherley has also been controversial because he opposes using embryonic stem cells in research, believing it takes human life; he works with adult stem cells only.
"One of the things we have to recognize in America is that when we
are all free, we are all better off," Sherley said in closing this morning.
-- April Simpson and Elizabeth Cooney
Chancellor Clay's email:
To MIT Students:
This morning, Professor James L. Sherley has begun a fast to express his disagreement with the decision not to promote him to tenure and with the outcome of his grievance process. Three reviews have concluded that the tenure process in his case was fair and proper and that there is no evidence that race influenced the process. The Provost has reviewed the history of the case in a recent letter to the faculty, which is available at .
We take seriously, and are gravely concerned by, Professor Sherley's
intentions. While we have encouraged him to seek other means to express his views, the Institute will respect his right, as a member of our community, to publicly express his disagreement in a manner that does not disrupt the work of the Institute or put others in the community at risk.
I am writing to you for three reasons. First, I ask all of you to respect Professor Sherley's right to disagree publicly, regardless of your own views about the case. I also ask you to respect each other's views about the case. Respect for free expression is an important value in our community, and benefits all of us.
At the same time, I am aware that many members of our community do not
understand how the tenure process works. Over the next few days, we will provide a number of venues to discuss the tenure process and related matters. I invite those of you with concerns about the process to take advantage of these opportunities to take part in an important community dialogue.
Finally, I urge you to consider our community values. We are committed to creating and sustaining a community that is diverse in many important ways: in race and ethnicity, in gender, and in economic, cultural, and national backgrounds. While we have much to celebrate in these domains, we must continue to explore how we can do better and how we can maintain an environment in which we can all thrive and in which we can take pride. Your efforts to advance diversity, in your student communities and in your relationships, are important contributions to our community.
Thank you.
Sincerely,
Phillip L. Clay
Chancellor
Posted by Elizabeth Cooney at 09:15 AM
February 05, 2007
Cutting down on how much television adolescents watch doesn't necessarily translate into more physical activity, Harvard researchers report in today's issue of Pediatrics.
"Kids have other activities that they do if they turn off the TV," said Dr. Matthew W. Gillman, a professor at Harvard Medical School and director of an obesity prevention program at Harvard Pilgrim Health Care. "They don't necessarily go out and play or join a sports team."
Researchers tracked 10,000 10- to 15-year-old boys and girls for four years, asking them to report their TV habits and physical activity levels. The results ruled out any major association between the two.
Programs that work on sedentary behaviors like TV watching and physical activity as separate, independent elements hold more promise for helping children avoid excess weight during adolescence, the authors concluded.
They noted that adolescents may gain weight if they watch a lot of television because of what they also do in front of the TV set. There's some evidence that kids who watch TV ads for unhealthy foods wind up eating more of them. Or they just snack while they watch.
"If we want to get the greatest bang for our buck in terms of interventions to prevent obesity, we're going to have to work on both TV and physical activity independently," Gillman said.
Posted by Elizabeth Cooney at 06:00 AM
February 05, 2007
Many state residents will probably be able to buy basic health insurance for less than $300 a month to meet the new state mandate that everyone obtain coverage, insurers and observers said last week.
A Harvard researcher believes that humans have an innate sense of right and wrong, but others say morality is mostly learned.
Though most smokers try to quit without help, nicotine-free treatments including Chantix and longtime staples like nicotine gum and patches are more effective than trying to quit "cold turkey," according to experts and research.
The measure of a decent healthcare system is how well it honors its commitment to the sick, Marcia Angell writes. By that measure, we are not doing very well. We have shifted our focus from the sick to the well.
Posted by Elizabeth Cooney at 05:59 AM
February 05, 2007
Baystate Medical Center in Springfield is losing its chief neurosurgeon, creating a critical void at Western Massachusetts' major trauma center, the Republican reports today.
Dr. Paul M. Kanev has resigned, effective in March, to become joint neurosurgical chief of Hartford Hospital and its affiliated Children's Medical Center of Connecticut.
Posted by Elizabeth Cooney at 05:58 AM
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