Up to 1 in 5 children suffer from mental disorder: CDC

By Atossa Araxia Abrahamian

NEW YORK | Thu May 16, 2013 3:46pm EDT

NEW YORK (Reuters) - Up to 20 percent of children in the United States suffer from a mental disorder, and the number of kids diagnosed with one has been rising for more than a decade, according to a report released on Thursday by the U.S. Center for Disease Control and Prevention.

In the agency's first-ever study of mental disorders among children aged 3 to 17, researchers found childhood mental illnesses affect up to one in five kids and cost $247 billion per year in medical bills, special education and juvenile justice.

Children with mental disorders - defined as "serious deviations from expected cognitive, social, and emotional development" - often have trouble learning in school, making friends, and building relationships later in life, the report said.

They are more likely to have other chronic health problems, such as asthma and diabetes, and are at risk for developing mental illnesses as adults.

"This is a deliberate effort by CDC to show mental health is a health issue. As with any health concern, the more attention we give to it, the better. It's parents becoming aware of the facts and talking to a healthcare provider about how their child is learning, behaving, and playing with other kids," Dr. Ruth Perou, the lead author of the study, told Reuters in an interview.

"What's concerning is the number of families affected by these issues. But we can do something about this. Mental health problems are diagnosable, treatable and people can recover and lead full healthy lives," Perou added.

The study cited data collected between 1994 and 2011 that showed the number of kids with mental disorders is growing. The study stopped short of concluding why, but suggested improvements in diagnoses as one possible explanation

"Changes in estimated prevalence over time might be associated with an actual change in prevalence, changes in case definition, changes in the public perception of mental disorders, or improvements in diagnosis, which might be associated with changes in policies and access to health care," the study said.

Perou told Reuters more research was needed to determine the specific causes of mental disorders, and that greater awareness could lead to an uptick in diagnoses. A host of environmental factors, including chemical exposure and poverty, can also affect a child's mental health, she said.

Lead, for example, is known to be "one of the biggest toxins to impact behavior and learning," Perou said. Poor children are at a higher risk for developing certain conditions, according to the study.

The most prevalent mental health diagnosis, as reported by parents, was Attention Deficit/Hyperactivity Disorder (ADHD), which affects 6.8 percent of children. Also common were behavioral conduct problems (3.5 percent), anxiety, which consists mostly of fears and phobias (3 percent), depression (2.1 percent) and autism spectrum disorders (1.1 percent). Many of these disorders occur together, the report said.

Boys were found more likely to have most of the listed disorders except for depression and alcohol abuse, which affect more girls.

The study also noted that suicide, which can be precipitated by an untreated mental illness, was the second leading cause of death (after accidents) among children 12 to 17 years old.

The CDC report was based on multiple other studies that collected data and interviewed children and their guardians about their diagnoses, habits, behaviors and other factors.

(Reporting by Atossa Araxia Abrahamian; Editing by Daniel Trotta and Bob Burgdorfer)

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EU watchdog backs Bayer acne drug for certain patients

A general view shows the annual general meeting of Bayer AG in Cologne April 27, 2012.

Credit: Reuters/Ina Fassbender

LONDON | Fri May 17, 2013 8:26am EDT

LONDON (Reuters) - Bayer's acne pill Diane 35 and its generic versions are safe to use in certain women when other options have failed, the European Medicines Agency said on Friday.

Following a formal safety review, conducted at the request of French authorities, the agency concluded that the benefits outweighed the risks - provided measures were taken to minimize the chance of blood clots forming in veins and arteries.

The medicines should be used solely in the treatment of moderate to severe acne in women of reproductive age and only when alternative treatments, such as topical therapy and oral antibiotic treatment, have failed.

French authorities suspended sales of drugs in January after four deaths over the past 25 years were linked to their use. Bayer said at the time it was "surprised" by the suspension.

Diane 35 reduces acne by regulating hormones and blocking ovulation, and is often prescribed as a contraceptive even though it is not approved for this use.

(Reporting by Ben Hirschler; editing by Kate Kelland)

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Putting group fitness classes in the proper light

People practice Zumba during a meeting in Rimini, central Italy May 11, 2012.

Credit: Reuters/Stringer

By Dorene Internicola

NEW YORK | Mon May 20, 2013 2:03am EDT

NEW YORK (Reuters) - Fitness experts are shining a new light on group classes from Zumba to yoga because they believe the right lighting can transform the four walls of a fitness studio from a dance party to a meditation space, and back again.

"Because of the theatrical nature of group fitness classes, lighting is key to differentiate programming," said Donna Cyrus, senior vice president of programming at Crunch fitness centers.

Yellow or orange light boosts high-energy workouts, such as rebounding mini trampoline routines, circuit classes or sculpt programs, Cyrus said, while for yoga the light should be soft and soothing.

Lighting also enhances the musical experience, Cyrus said.

In a cycling class, accents of "club type" lighting pulse to the beat of the music, creating what she calls "a choreographed show."

According to the American College of Sports Medicine (ACSM) guidelines, adjustable light sources should be provided in group exercise areas.

Generally, the more hand-eye coordination an activity demands, the more illumination is required, according to Grace DeSimone, national director of group fitness at Plus One Health Management, which designs and manages fitness centers for corporations, hotels and community centers.

"If you're going to be moving around a lot you'll need a lot of light," DeSimone said. "You're not going to do a boot camp workout in a dark room."

But indoor cycling classes often combine high energy and low lighting.

"Spinning goes against the grain," DeSimone explained. "You can do some pretty cool things - make the room look like a night-time sky or light a disco ball - because once you're on that bike you're not going anywhere."

In a multi-purpose fitness room, she said, the lighting has to be able to change based on what's going on.

"With Pilates you want the lights on, but with yoga you can do a lot with colored lights," she said.

One reason light affects mood and alertness is that it cuts down on the sleep-inducing hormone melatonin, said Gregory Chertok, a sport psychology consultant for ACSM.

"In a dark room, the brain secretes melatonin," he explained.

Chertok, the director of mental training at The Physical Medicine & Rehabilitation Center in Englewood, New Jersey, said studies of factory workers have found that rooms with greater lighting will often yield greater productivity.

He also cited research that found some blue lighting, which is favored in some yoga and meditation classes, can be even more effective than white fluorescent light in suppressing melatonin.

"Sustaining blue-enriched light seems to help with concentrating on something for a long period," he said.

ACSM guidelines suggest efforts should be made to use natural light.

"We like to feel the sun," Chertok said, "so it's natural for gyms to try to simulate that."

Daylight not only brightens a room, he suggests, it conveys information.

"Perhaps daylight and natural lighting provide gym-goers with accurate weather and time information, which may be helpful in planning the length and duration of the workout," he said.

Chertok said research has demonstrated that the mind is generally sharper during daylight hours.

"A study in the late '90s found that even sleep-deprived people were sharper during the daylight hours," he said, adding that in another study, students in schools with natural lighting did better on performance tests.

Darkness, Chertok said, is more associated with letting go.

"Think of restaurants," he said. "Darkness can contribute to ordering more."

(Editing by Patricia Reaney)

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Saudi Arabia has another case of new coronavirus: WHO

LONDON | Sat May 18, 2013 5:43pm EDT

LONDON (Reuters) - Saudi Arabia has reported another case of infection in a concentrated outbreak of a new strain of a virus that emerged in the Middle East last year and spread into Europe, the World Health Organization (WHO) said on Saturday.

In a disease outbreak update issued from its Geneva headquarters, the WHO said the latest patient is an 81-year-old woman with multiple medical conditions. She became ill on April 28 and is in a critical but stable condition.

Worldwide, there have now been 41 laboratory-confirmed infections, including 20 deaths, since the new coronavirus was identified by scientists in September 2012.

The novel coronavirus, which had been known as by the acronym nCoV but which some scientific journals now refer to as Middle East Respiratory Syndrome coronavirus, or MERS, belongs to the same family as viruses that cause common colds and the one that caused a deadly outbreak of Severe Acute Respiratory Syndrome (SARS) in 2003.

MERS cases have so far been reported in Saudi Arabia, Jordan, Qatar, Britain, Germany and France, but Saudi Arabia has had the vast majority of cases.

The WHO said that latest patient was in the same clinic in eastern Saudi Arabia that has seen 22 cases, nine of them fatal, since April 8.

WHO experts visiting Saudi Arabia to consult with the authorities on the outbreak have said it seemed likely the new virus could be passed between humans, but only after prolonged, close contact.

(Reporting by Kate Kelland; Editing by Robin Pomeroy)

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Sanofi says will keep Toulouse research site

Chris Viehbacher, Chief Executive Officer of Sanofi, poses for the media before the company's 2012 annual results presentation in Paris February 7, 2013.

Credit: Reuters/Jacky Naegelen

PARIS | Fri May 17, 2013 8:19am EDT

PARIS (Reuters) - Sanofi said it would overhaul rather than exit its Toulouse research site, as it seeks to break an impasse with the French government which opposed the drugmaker's reorganization plans and the loss of jobs.

Sanofi has been regrouping its research operations around the world into regional hubs and closing some laboratories to cut costs as it grapples with the impact on revenues of patent loss on several top-selling drugs.

Chief Executive Chris Viehbacher plans to move research facilities in France to Paris, Lyon and Strasbourg, while closing other sites and cutting jobs.

The announcement last year to wield the axe in France incensed unions, which had predicted layoffs would run up to 2,500, and the newly elected socialist government as several other French companies announced big job cuts.

A government-commissioned report published earlier on Friday called for a reorganization of the Toulouse site that could preserve around 500 of the 612 staff employed there.

Sanofi said it would take on the recommendations for Toulouse while pressing ahead with its wider plans.

The company said it would retain the site during the next five years, during which it will support the creation of a center to provide research and development services to the company and other pharmaceutical groups, the establishment of local start-ups and the spin-off of some activities.

A Sanofi spokesman said the company was not committing itself to keeping a specific number of jobs at the Toulouse center.

(Reporting by Elena Berton and Noelle Mennella; Editing by Elaine Hardcastle)

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Virus found in Iowa hog population, possibly beyond

By Ros Krasny

WASHINGTON | Fri May 17, 2013 7:33pm EDT

WASHINGTON (Reuters) - A potentially fatal hog virus, porcine epidemic diarrhea, has been found in the United States for the first time, government and private industry officials said on Friday, posing a new threat for the country's struggling pork producers.

PEDV, an incurable condition that causes diarrhea, vomiting and dehydration in hogs, has been identified in Iowa, the largest producing state, and possibly beyond. The severity of the outbreak is not yet known.

The virus exists in much of the world but has not previously occurred in the western hemisphere.

The USDA's National Veterinary Services Laboratories has detected the virus in the Iowa hog population, a Department of Agriculture spokesman said.

Cindy Cunningham, spokeswoman for the National Pork Board in Des Moines, Iowa, said: "It may be a little bit more widespread than just with Iowa at this point ... we're still trying to understand that and determine where it all is."

Hog futures in Chicago fell sharply on Friday as rumors swirled the disease had been detected in Iowa and Minnesota.

PEDV is not a food safety concern and does not affect humans, the USDA spokesman said.

Officials with USDA's Animal and Plant Health Inspection Service (APHIS) held a call with livestock industry representatives on Friday to discuss the situation. There are currently no interstate trade restrictions related to PEDV for U.S. hogs and pigs.

PEDV has been seen in England, much of Europe, China, Taiwan and South Korea, according to Iowa State University.

"We don't know the orientation of this particular disease (PEDV) and how it first got here to the United States," Cunningham said.

Tom Burger, executive director of the American Association of Swine Veterinarians, said his group was getting "conflicting reports" on how the virus might have arrived.

There is no effective treatment for the virus other than good care and the provision of adequate water to combat dehydration, according to the university. Sanitary and quarantine measures can help to slow the spread of the virus.

"All ages of the swine can be affected. But the most severe clinical signs are seen in the very young and nursing baby pigs, the baby pigs that are still nursing," said Burger.

The current outbreak could be short lived. Pig herds typically develop a strong immunity to the virus over two to three weeks, at which point the virus disappears spontaneously.

Depending on how widespread the incidence, the virus could tighten U.S. pork supplies in about five to six months by causing the deaths of baby pigs, said Steve Meyer, president of the consulting firm Paragon Economics.

But Meyer said exports of U.S. pork would probably not be effected.

U.S. pork producers have been fighting back from record-high feed costs that followed the historic 2012 drought, which hurt their operating margins. Grain prices are headed down, giving incentives to producers to expand their herds.

(Additional reporting by Theopolis Waters, Tom Polansek and P. J. Huffstutter in Chicago; Editing by Chris Reese and Andre Grenon)

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Indonesia's nationwide healthcare plan stumbles at first hurdle

1 of 2. Patients rest in a hospital in Makassar, South Sulawesi province May 10, 2013.

Credit: Reuters/Yusuf Ahmad

By Randy Fabi and Nilufar Rizki

JAKARTA | Sun May 19, 2013 5:13pm EDT

JAKARTA (Reuters) - When a sick Indonesian baby died after 10 hospitals in Jakarta turned her family away in February, critics blamed a pilot health insurance scheme that had overwhelmed the city's public hospitals.

The program, introduced in November, gave health insurance to around 5 million people in Jakarta categorized as poor. Long queues quickly formed at already stretched hospital emergency rooms as many patients, some who were not even ill, sought to take advantage of being covered for the first time.

Some health experts said it was a sign of the chaos to come when the government begins rolling out a nationwide health insurance program early next year, especially since Jakarta, a city of 10 million people, has the country's best public hospitals and doctors.

"If Jakarta itself is not ready, I don't know how we can say other less advanced cities can be ready," said Palmira Bachtiar, senior researcher at Indonesia's private SMERU Research Institute, which focuses on health and poverty issues.

Lisa Darawati said her family sought treatment for her one-week old daughter Dera across the Indonesian capital over a four-day period. The 10 hospitals were either too crowded or lacked the equipment to treat Dera, who had been born one month premature, Darawati said. Dera later died from respiratory complications.

Her death triggered an outcry in local media, which listed the 10 hospitals. Some editorials said the pilot scheme had been implemented too hastily. Under the scheme, the poor are eligible for free or subsidized hospital care. Previously, patients without insurance had to pay for treatment on the spot.

Jakarta governor Joko Widodo and the Indonesian health minister have defended the program.

Widodo said thousands of people in Jakarta had been dying at home because the lack of insurance stopped them seeking medical treatment in the first place.

"If we did not start in November, there would be 500,000 people sick, but at home," Widodo told Reuters during a recent interview.

NATIONWIDE HEALTHCARE A "GAME-CHANGER"

The nationwide healthcare plan and the Jakarta pilot scheme has caught the attention of the private sector, which senses an opportunity to tap into demand for better health services from Indonesia's rapidly growing middle class.

Local companies with an interest in health care such as PT Lippo Karawaci and Kalbe Farma are investing in new private hospitals and clinics, anticipating that Indonesians who can afford it will pay more to avoid the queues and dilapidated equipment at public facilities when the national scheme gets under way.

"Universal healthcare is a game-changer ... and if companies are not prepared for that then they are going to lose out," said Emmanuel Wehry, chief Indonesia marketing officer for French insurer AXA Financial.

The nationwide program also includes a plan to sharply increase the number of hospitals beds. That would reverse decades of underfunding which has left Indonesia, a sprawling archipelago of 240 million people, with one of the worst ratios of hospital beds per capita in Asia.

The initial insurance roll-out begins in January, with the aim to cover all Indonesians by 2019 from the 52 percent who currently have some form of insurance.

The program will integrate various public healthcare schemes into one. It will give free or subsidized coverage to 86.4 million poor and so-called "near poor" Indonesians in 2014, 10 million more than who are covered now. Around 35 million Indonesians who get health insurance from employers, the military and police will also be included.

The World Bank estimates the insurance scheme would cost $13-$16 billion each year once it is fully implemented. The government has said it would double its spending on health to 16 trillion rupiah ($1.64 billion) next year to cover the poor and the "near poor".

GOVERNOR SAYS NEEDS MORE HOSPITAL BEDS

The Jakarta pilot scheme encourages residents to go to a clinic first, then get a referral from a doctor if they need to visit a hospital. The aim is to prevent hospital overcrowding.

But this had not been fully explained, said researcher Bachtiar, adding people were flocking to hospitals instead.

Governor Widodo acknowledged there was not enough beds in hospitals and clinics to meet the demand. He said he had asked hospitals to try to make more beds available to the poor.

"It is better to start it and then when there is a problem, we improve it," said Widodo, who won office last year in a landslide and is one of Indonesia's most popular politicians.

The number of patients at Jakarta's hospitals had jumped by up to 70 percent, local media quoted him as saying in March.

Dera was born at a small Jakarta hospital that didn't have the necessary neo-natal medical equipment. She died there after her family failed to get her treated at another hospital, Darawati, 20, told Reuters recently.

"At these other hospitals, we didn't know what actually was happening. I could have burst into anger but I would have felt bad with people around me. I had to let go," said Darawati, fighting back tears at her daughter's grave in a poor neighborhood in south Jakarta.

The local media attention on Dera's death has put pressure on Jakarta's hospitals, said Parulian Simanjuntak, executive director of the International Pharmaceutical Manufacturers Group, an industry body in Indonesia that represents multinational pharmaceutical firms.

A few weeks after Dera's death, local media reported that a teenage girl had died from an intestinal infection after hospitals in Jakarta denied her treatment because they were too crowded.

"If you look at what is happening after these deaths, hospitals are now afraid of it being reported that babies are not being well taken care of. It is quite chaotic," said Simanjuntak.

Jakarta's Cipto Mangunkusumo Hospital, one of Indonesia's top public hospitals, was one of the 10 that rejected Dera. It has only 10 beds in its intensive care unit and they were all being used when she was brought in, said its president director, Dr. C.H. Soejono.

The number of patients at Cipto had jumped more than 25 percent since the pilot program was introduced, he added.

Health Minister Dr Nafsiah Mboi said few patients were missing out on treatment.

"Not many patients have been turned away. More patients have received treatment and good treatment," Mboi said.

COMPANIES WANT TO CATER FOR THE WEALTHY TOO

Indonesia has six hospital beds for every 10,000 people, according to the World Bank. That is four times below the global average and less than the 42 beds in China and nine in India.

Out of 100 countries, Indonesia ranked ninth from bottom despite its strong economic growth. GDP growth this year is forecast at 6.2 percent, steady from 6.23 percent in 2012.

Indonesia wants to increase its bed capacity to 10 per 10,000 people by next year. That translates into 96,000 more beds. To meet global standards, U.S. business consultancy Frost & Sullivan estimated it would need to add 400,000 by 2015.

Private companies also have their eye on the 1.5 million Indonesians who seek medical treatment overseas each year, spending more than $11.5 billion, according to government and industry groups.

Indonesians were the biggest group of foreigners visiting Singapore hospitals, IHH Healthcare Berhad, Asia's largest hospital operator, said recently.

PT Lippo Karawaci's Siloam Hospitals, Indonesia's biggest private hospital operator, plans to invest $500 million by 2015 to build 20 hospitals, more than double its current number of 13. It plans to raise at least $200 million by listing its hospital division this quarter.

Kalbe Farma, Indonesia's largest listed pharmaceutical firm, plans to invest as much as 20 billion rupiah annually to build 20-25 clinics each year in Jakarta for the next five years.

For Darawati, it all comes too late.

Not long after Dera died, Cipto hospital admitted her twin sister Dara, who was also ill. She died a month later from a blood infection. ($1 = 9,737.5 Indonesian rupiah)

(Additional reporting by Andjarsari Paramaditha and Kanupriya Kapoor in Jakarta and Eveline Danubrata in Singapore; Editing by Alex Richardson and Dean Yates)

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