Kid’s Unlimited Welcome to Dr. Armand Rossi’s email newsletter:
Kid’s Unlimited
May 6, 2005
Kid’s Unlimited is a monthly, or semi-monthly, newsletter of various articles, funnies, tidbits and opinions relating to our children and chiropractic. My opinions will always be in red and italicized. Please feel free to share the appropriate articles with patients, friends, and other chiropractors. I never buy any lists or put names on my email list unless the names were submitted to me directly. If you wish to be removed from my list, just reply with the word “remove” in the subject line.
Thank you… Together we will make a difference.
Happy Mother`s Day! I am reminded about the special-ness of being a mother. What an incredible privilege and duty women have when they become mothers. They carry LIFE within them. They nurture, feed, protect and love more than most men. They understand that they have a responsibility for their child. I am truly amazed when I watch a mother at work. I`m not talking about the employment type of work. I`m talking about the caring, disciplining, loving, and day-to-day work that is part of being a mom. The closest I feel to being a mother is when I get to hold a little baby in my arms and adjust him/her. When I look into the child`s eyes and see the purity and reflection of God, I can almost sense the feeling of being a mother.
I honor all of you women who have been blessed with the ability to be a mother, even if you choose not to at this time. I honor your connection to God and the children you devoted your time to. I pray that each of you men get the opportunity to sense this "mothering" feeling and innate connection as well.
http://www.usatoday.com/news/health/2005-04-25-drug-lobby-cover_x.htm
USA Today
Posted 4/25/2005
Drugmakers go furthest to sway Congress
By Jim Drinkard, USA TODAY
WASHINGTON - When Sen. Bill Frist needed help in November for a quick tour celebrating the victories of newly elected Republican senators, he didn`t have to look far. A Gulfstream corporate jet owned by drugmaker Schering-Plough was ready to zip the Senate majority leader to stops in Florida, Georgia and the Carolinas. Frist`s political committee reimbursed the drugmaker $10,809, the equivalent of a first-class fare for the same trip on a commercial airline, as campaign rules require. The price, a fraction of the cost of a charter flight, was almost a wash for Frist; Schering had donated $10,000 to his committee in 2003-04. What he got was worth far more: the convenience, luxury and efficiency of flying on his own schedule.
The drug company`s friendly gesture toward the Senate`s most powerful member illustrates the political clout of the pharmaceutical industry. It will be needed in the months ahead as the industry faces the threat of increased federal regulation, brought on by mounting concerns about the safety of the nation`s drug supply.
The drug companies` corporate planes have been made available not only to Frist, but also for dozens of trips taken by other powerful lawmakers. House Speaker Dennis Hastert, R-Ill., took at least four trips to GOP fundraising events in the past two years aboard Pfizer`s Gulfstream.
Drug companies and their officials contributed at least $17 million to federal candidates in last year`s elections, including nearly $1 million to President Bush and more than $500,000 to his opponent, John Kerry. At least 18 members of Congress received more than $100,000 apiece.
The industry also liberally funds think tanks and patient-advocacy groups that don`t bear its name but often take its side; the National Patient Advocate Foundation, for instance, receives financial support from at least 10 drug companies.
And the industry isn`t above playing hardball, according to David Graham, a Food and Drug Administration scientist who got on its bad side.
Since 1998, drug companies have spent $758 million on lobbying - more than any other industry, according to government records analyzed by the Center for Public Integrity, a watchdog group. In Washington, the industry has 1,274 lobbyists - more than two for every member of Congress.
"They are powerful," says Sen. Chuck Grassley, R-Iowa, chairman of the Senate Finance Committee. "You can hardly swing a cat by the tail in that town without hitting a pharmaceutical lobbyist."
Over the years those lobbyists have been very successful, demonstrating that the industry knows politics as well as it knows chemistry. Drug companies won coverage for prescription drugs under Medicare in 2003 while blocking the government from negotiating prices downward. They have so far kept out imports of cheaper medicines from Canada and other countries. And they have protected a system that uses company fees to speed the drug-approval process.
"They win more than they should," says James Love, an industry critic who is director of the non- profit Consumer Project on Technology. "The one thing they have going for them is money."
The industry`s deep inroads into the government are rooted in its dependence on federal decisions. The government determines which products drug companies can market and how they`re labeled. The government buys massive quantities of drugs through Medicaid, the Veterans Administration and other programs. Once the new Medicare prescription drug benefit takes effect in 2006, the government will be paying 41% of Americans` drug bills, up from 24% now.
Billy Tauzin, a former Republican congressman from Louisiana who now heads the Pharmaceutical Research and Manufacturers of America (PhRMA), serves as testament to the industry`s power. He helped shepherd the Medicare prescription drug law to passage as chairman of the House Energy and Commerce Committee before joining PhRMA for a reported $1 million a year or more. PhRMA won`t confirm his pay.
Tauzin says the lobbying presence is needed to protect the U.S. marketing system for prescription drugs. The United States "is probably the last place on Earth which encourages innovation and discovery," he says, contending that it costs about $1 billion to invent each new drug. In other countries, he says, government-controlled pricing has robbed drug manufacturers of the profits that finance new drug development.
But now, the industry faces the possibility of increased regulation. Grassley and Sen. Chris Dodd, D-Conn., are pushing legislation that would force drug developers to release data from all clinical trials of a new medicine - including negative ones the companies don`t like to disclose. They also plan to introduce a bill that would strengthen the FDA`s ability to protect patients if safety problems crop up after a drug has been approved for sale.
Friendly skies
If Frist had chartered a jet for his victory lap last Nov. 3, it would have cost at least three times as much as he paid Schering. Many large companies make their planes available to lawmakers; campaign rules allow the lawmaker to pay the travel provider the relatively low cost of first-class airfare. In the days just before the election, Frist had been aboard Schering`s jet one other time and had flown twice on the jet owned by another drugmaker, Abbott Laboratories.
Companies that provide their jets often send a lobbyist along to seize the chance for private time with a member of Congress. Schering spokeswoman Rosemarie Yancosek declined to say if that happened on Frist`s trips. "We comply with all the laws regarding the use of the corporate jet," she said. Frist`s office declined to comment on the flights.
As the gatekeeper for legislation that comes to the
Senate floor, Frist, a Tennessee Republican and a heart surgeon, is a key lobbying target for the drug industry. Legislation to allow reimportation of lower-priced prescription drugs, previously passed by the House, faces its biggest test in the Senate. "If we ever get it to a vote in the Senate, it will pass," Grassley says.
Frist and Hastert are not the only lawmakers to take advantage of the convenience of drug companies` corporate jets. A spokesman for drugmaker Novartis, Sheldon Jones, confirmed that company lobbyists were aboard for three trips carrying lawmakers in 2003 and 2004. One, in June 2003, took Reps. Tom Reynolds, R-N.Y.; Mike Oxley, R-Ohio; and Mike Rogers, R-Mich., to a Republican fundraiser in New York City. Rep. Tom Davis, R-Va., and Sen. Chuck Hagel, R-Neb., also took trips on the Novartis Learjet.
Of the 1,274 people registered to lobby in Washington for drugmakers in 2003, according to the Center for Public Integrity, 476 are former federal officials - including 40 former members of Congress. "They are one of the strongest, most well-connected and most effective lobbies in Washington," says Amy Allina of the National Women`s Health Network. "Going up against them is more often than not a losing battle."
Financing other groups
Lobbyists aren`t the industry`s only voice. When witnesses lined up last month for a Senate hearing on the FDA`s drug-approval process, no representative from the pharmaceutical industry was present. But at least three witnesses on the six-member panel were from groups that get money from drugmakers.
The hearing was prompted by belated discoveries of health risks in drugs the agency had approved for sale: heart problems in patients taking Merck`s Vioxx and other so-called COX-2 inhibitors, used to relieve pain; suicidal thoughts in adolescents taking antidepressants; and muscle damage from drugs that reduce cholesterol. The committee, under Sen. Mike Enzi, R-Wyo., wanted to know if the FDA needs additional regulatory authority to protect public health.
Leadoff witness Nancy Davenport-Ennis warned against any "overemphasis on safety" that might delay availability of new cancer drugs, a position in line with that of the pharmaceutical industry. Among the companies funding her National Patient Advocate Foundation: Pfizer, Merck and GlaxoSmithKline.
Davenport-Ennis says the drug company grants come with no strings attached and amount to "a whole bunch less than half" of the group`s budget. "I don`t think there is a patient-advocacy group in America that does not receive some level of funding from a pharmaceutical company," she says.
Witness Scott Gottlieb of the American Enterprise Institute (AEI), a conservative think tank, also cautioned Enzi`s panel against lengthening the drug-approval process or making it more expensive. Veronique Rodman, an AEI spokeswoman, declined to say whether the organization gets drug-industry support. But one of Gottlieb`s AEI colleagues, John Calfee, disclosed in a book review he wrote for the journal Nature last June that AEI does get drug-industry money.
A third witness, child and adolescent psychiatrist David Fassler, called for greater public access to clinical trial data for drugs. But he expressed concern that FDA action last year to require a "black-box warning" on antidepressants prescribed for children and adolescents might deter families from seeking medications.
Fassler personally receives no industry money, but he represented the American Psychiatric Foundation and the American Academy of Child and Adolescent Psychiatry, both of which receive drug-industry contributions. Mary Crosby, the academy`s acting executive director, says drug-industry money accounts for about 12% of the group`s funding but has no influence on what their witnesses say.
Tauzin says such outside groups are the industry`s natural allies in the quest to cure more diseases. "This industry is doing a world of good for a lot of people, and they want to support us," he says.
More money channels
Health care consistently outspends other economic sectors on Washington lobbying, and the pharmaceutical industry makes up the largest component of that spending - $143 million in 2003.
Drugmakers also sell their message through TV advertising. Two of the top 10 ad spenders during the last session of Congress were pharmaceutical companies, GlaxoSmithKline and Pfizer. A study by the Annenberg Public Policy Center at the University of Pennsylvania found they spent a combined $45.1 million on advertising in 2003-04, the largest chunk of it to promote the expansion of Medicare to cover prescription drugs.
In addition, the industry pours growing amounts into political campaigns, favoring Republicans - who control the White House and Congress - over Democrats by about 2 to 1. In last year`s elections, the top Senate recipient of pharmaceutical campaign money was North Carolina GOP Sen. Richard Burr, a member of Enzi`s panel. He got $288,684, according to a tally by the non-partisan Center for Responsive Politics. In the House, Rep. Mike Ferguson, R-N.J., was the top recipient, with $264,560, roughly 10% of his total fundraising. He`s a member of the House Energy and Commerce Committee; it has jurisdiction over the drug industry, which has a heavy presence in his state.
Pharmaceutical makers also were among top donors to the national conventions last year. They gave $4.7 million to help put on the GOP event in New York and $2.6 million for the Democrats` gathering in Boston.
Drug companies court lawmakers and their aides by paying for trips to industry meetings or to tour company plants and other facilities. Dozens of such trips took place last year, disclosure records filed in the House and Senate show. For example, a group of sponsors including PhRMA and GlaxoSmithKline paid $8,810 to take Rep. William Lacy Clay, D-Mo., to Brazil on a "fact-finding mission." GlaxoSmithKline paid $1,079 to fly Sen. Orrin Hatch, R-Utah, to Houston for a speech.
Other favors are routinely sprinkled on the policymakers who control the industry`s fate. In 2003, when Congress worked late drafting the new Medicare prescription drug benefit, lobbyists sent in catered food. And when Bush was inaugurated on Jan. 20, AstraZeneca opened its fifth-floor offices overlooking Pennsylvania Avenue to select congressional staff for a parade-watching party.
Tougher tactics
The industry also can present a harder edge. David Graham, the FDA drug-safety official whose research contributed to Merck`s pain reliever Vioxx being taken off the market last year, says he was subjected to a whispering campaign in the days before he appeared at a Senate hearing in November.
He says industry lobbyists and his FDA superiors planted suggestions on Capitol Hill that he was testifying to establish himself as a highly paid expert witness who could testify in liability suits against the drug`s manufacturer. And he says they sought to undermine his credibility by alleging that his scientific conclusions were influenced by his devout Catholicism.
"It`s really ridiculous," Graham says. His testimony, he says, was "a matter of conscience."
The Government Accountability Office, Congress` investigative arm, is looking into the charges as part of a broader review of how the FDA deals with internal scientific disagreements. PhRMA`s Tauzin says he has no knowledge about the incidents Graham describes.
There also is evidence that the industry`s allies sought to dissuade Grassley from holding the Nov. 18 hearing. Grassley says he received entreaties from GOP colleagues worried about alienating an industry friendly to their party. He recalls: "I had one or two colleagues say to me, `Why would you want to have that hearing? The pharmaceutical industry is so helpful.` "
Pharmaceutical lobby spendings
$158 million*
Spending in 2004 to lobby the federal government.
$17 million
Campaign contributions in 2004 to federal candidates (67% to Republicans).
$7.3 million
Support for the 2004 political party conventions (64% to Republicans).
Sources: Center for Responsive Politics, Campaign Finance Institute, Center for Public Integrity
Pharmaceutical industry donations
Executives and employees of the pharmaceutical industry donated more than $17 million to candidates for federal office in the 2004 election, favoring Republicans 2-to-1. The top congressional recipients:
Senate
Richard Burr, R-N.C.
$288,684
Health, Education, Labor and Pensions
Arlen Specter, R-Pa.
$235,712
Appropriations; health subcommittee chair
Judd Gregg, R-N.H.
$171,000
Appropriations; Budget chair; Health, Education, Labor and Pensions
Evan Bayh, D-Ind.
$137,022
Special Committee on Aging
Chris Dodd, D-Conn.
$124,550
Health, Education, Labor and Pensions
House
Mike Ferguson, R-N.J.
$264,560
Energy and Commerce
Nancy Johnson, R-Conn.
$154,512
Ways and Means; health subcommittee chair
Dennis Hastert, R-Ill.
$153,500
Speaker of the House
Joe Barton, R-Texas
$150,276
Energy and Commerce chair
Anna Eshoo, D-Calif.
$114,481
Energy and Commerce
Source: USA TODAY research
The Washington Times
April 18, 2005
The Age of Autism: The Amish anomaly
By Dan Olmsted
UNITED PRESS INTERNATIONAL
Lancaster, PA, Apr. 18 (UPI) -- Part 1 of 2. Where are the autistic Amish?
Here in Lancaster County, heart of Pennsylvania Dutch country, there should be well over 100 with some form of the disorder.
I have come here to find them, but so far my mission has failed, and the very few I have identified raise some very interesting questions about some widely held views on autism. The mainstream scientific consensus says autism is a complex genetic disorder, one that has been around for millennia at roughly the same prevalence. That prevalence is now considered to be 1 in every 166 children born in the United States.
Applying that model to Lancaster County, there ought to be 130 Amish men, women and children here with Autism Spectrum Disorder. Well over 100, in rough terms. Typically, half would harbor milder variants such as Asperger`s Disorder or the catch-all Pervasive Development Disorder, Not Otherwise Specified -- PDD-NOS for short. So let`s drop those from our calculation, even though "mild" is a relative term when it comes to autism. That means upwards of 50 Amish people of all ages should be living in Lancaster County with full-syndrome autism, the "classic autism" first described in 1943 by child psychiatrist Leo Kanner at Johns Hopkins University. The full-syndrome disorder is hard to miss, characterized by "markedly abnormal or impaired development in social interaction and communication and a markedly restricted repertoire of activities and interests," according to the Diagnostic and Statistical Manual of Mental Disorders. Why bother looking for them among the Amish? Because they could hold clues to the cause of autism.
The first half-dozen articles in this ongoing series on the roots and rise of autism examined the initial studies and early accounts of the disorder, first identified by Kanner among 11 U.S. children born starting in 1931. Kanner wrote that his 1938 encounter with a child from Mississippi, identified as Donald T., "made me aware of a behavior pattern not known to me or anyone else theretofore." Kanner literally wrote the book on "Child Psychiatry," published in 1934. If Kanner was correct -- if autism was new and increasingly prevalent -- something must have happened in the 1930s to trigger those first autistic cases. Genetic disorders do not begin suddenly or increase dramatically in prevalence in a short period of time.
That is why it is worth looking for autistic Amish -- to test reasoning against reality. Largely cut off for hundreds of years from American culture and scientific progress, the Amish might have had less exposure to some new factor triggering autism in the rest of population. Surprising, but no one seems to have looked. Of course, the Amish world is insular by nature; finding a small subset of Amish is a challenge by definition. Many Amish, particularly Old Order, ride horse-and-buggies, eschew electricity, do not attend public school, will not pose for pictures and do not chat casually with the "English," as they warily call the non-Amish. Still, some Amish today interact with the outside world in many ways. Some drive, use phones, see doctors and send out Christmas cards with family photos. They all still refer to themselves as "Plain," but the definition of that word varies quite a bit. So far, from sources inside and outside the Amish community, I have identified three Amish residents of Lancaster County who apparently have full-syndrome autism, all of them children. A local woman told me there is one classroom with about 30 "special-needs" Amish children. In that classroom, there is one autistic Amish child. Another autistic Amish child does not go to school. The third is that woman`s pre-school-age daughter. If there were more, she said, she would know it.
What I learned about those children is the subject of the next column.This ongoing series aims to be interactive with readers and will take note of comment, criticism and suggestions. E-mail: dolmsted@upi.com
By LAURAN NEERGAARD
AP Medical Writer
Posted May 6 2005, 3:31 AM EDT
WASHINGTON -- What Merck & Co. calls good salesmanship -- emphasizing the positive in selling the painkiller Vioxx -- a Democratic congressman says is disinformation designed to deflect safety concerns. The public got an extraordinary glimpse Thursday into the world of drug marketing, as lawmakers released confidential Merck documents that detail how a sales army of 3,000 aggressively pushed the multibillion-dollar drug before it was pulled from the market last fall because of heart attack risks.
Instructions were as detailed as how long to shake a physician`s hand -- three seconds -- and how to eat bread when dining with doctors -- "one small bitesize piece at a time."
Sales representatives were offered $2,000 bonuses for meeting sales goals, and worked in campaigns with such code-names as "Project Offense" to try to boost sales even as regulators were about to increase warnings on the drug`s label.
Don`t bring up the heart risks, warns a Feb. 9, 2001, memo.
And when doctors asked about those risks, the Merck sales reps were to refer to a "cardiovascular card" with data suggesting that Vioxx could be safer than other anti-inflammatory drugs. Yet the card, also released Thursday, doesn`t include the very study that raised the first warning signal that Vioxx could harm.
"The Cardiovascular Card is an obstacle handling piece," says an April 2000 memo to Vioxx sales reps, written just after the first heart-related research began trickling in. It "will allow you to set the record straight with your physicians."
The documents were released at a hearing of the House Government Reform Committee.
Merck Vice President Dennis Erb defended the company`s handling of Vioxx, noting that it promptly released details of studies that first raised the specter of heart damage -- and followed up by performing the study that ultimately doomed the drug.
"We believed wholeheartedly in the safety of Vioxx and that Vioxx was an important treatment option," he said. "My own father was a regular user of Vioxx until we voluntarily withdrew it from the market."
But even as scientific debate about Vioxx`s heart risks began in 2000, sales of the painkiller steadily soared, to $2.5 billion in 2003.
"Why did doctors write so many Vioxx prescriptions even as evidence of harm mounted?" asked Rep. Henry Waxman, D-Calif.
Sales tactics in directly promoting the drug to doctors, he concluded: "When it comes to the one thing doctors most needed to know about Vioxx -- its health risks -- Merck`s answer seems to be disinformation and censorship."
Merck pulled Vioxx after a study showed it doubled the risk of heart attacks and strokes in patients using the drug for more than 18 months. Merck is facing more than 2,300 lawsuits from customers, and on Thursday its chief executive, Raymond V. Gilmartin, stepped down. Merck named Richard T. Clark to replace him.
But many people say Vioxx offered relief that other drugs haven`t. So Erb told lawmakers the company has begun discussions with the Food and Drug Administration about what it could do to return the drug to pharmacy shelves.
"We`re now in preliminary discussions," he said.
FDA`s scientific advisers in February narrowly voted that Vioxx might be able to come back onto the market under certain conditions, such as restricting its use to patients with severe pain or loading it with strong warnings about the heart risk.
That risk first appeared with research released in 2000 and 2001, showing certain Vioxx users suffered twice as many heart attacks and other cardiovascular problems as users of the older painkiller naproxen. In 2002, the FDA added warnings to Vioxx`s label.
At first, scientists thought it might be because Vioxx users weren`t getting a blood-thinning benefit that comes with many older painkillers. But by 2002, top specialists were worried that Vioxx might be the direct culprit -- and Merck`s own follow-up research prompted it to pull the drug.
FDA drug chief Dr. Steven Galson told lawmakers that the agency is taking steps to improve awareness by the public and doctors of potential drug risks as soon as they arise.
He said that what was happening with Vioxx wasn`t clear-cut until the research was completed last summer. He acknowledged, however, that it may have taken too long to put a new warning label on the drug.
We think we`ve addressed the sort of problems that happened here, and to make sure it won`t happen again," Galson said.
Waxman tried to focus attention on the sales representatives, arguing that "the goal was sales, not education."
Rep. Tom Davis, R-Va., the committee chairman, said the new documents raise questions about Merck`s handling of Vioxx. But he said he was not prepared to criticize the company without more information, noting that Merck made public results of its own studies that raised the concerns -- data subsequently widely published, in medical journals and newspapers.
"A wide-awake physician would have obviously known about this?" Davis asked.
"That is correct," Erb responded.
But another witness, Dr. Michael Wilkes, vice dean for medical education at the University of California-Davis, said physicians are busy and look for shortcuts to get information. "Doctors don`t read the medical literature," he said, and often rely on the salesman they meet in their office.
AP: Feds Tested AIDS Drugs on Foster Kids
By JOHN SOLOMON
WASHINGTON (AP) - To gain access to hundreds of HIV-infected foster children, federally funded researchers promised in writing to provide an independent advocate to safeguard the kids` well-being as they tested potent AIDS drugs. But most of the time, that special protection never materialized, an Associated Press review has found.
The research funded by the National Institutes of Health spanned the country. It was most widespread in the 1990s as foster care agencies sought treatments for their HIV-infected children that weren`t yet available in the marketplace.
The practice ensured that foster children - mostly poor or minority - received care from world-class researchers at government expense, slowing their rate of death and extending their lives. But it also exposed a vulnerable population to the risks of medical research and drugs that were known to have serious side effects in adults and for which the safety for children was unknown.
The research was conducted in at least seven states - Illinois, Louisiana, Maryland, New York, North Carolina, Colorado and Texas - and involved more than four dozen different studies. The foster children ranged from infants to late teens, according to interviews and government records.
Several studies that enlisted foster children reported that patients suffered side effects such as rashes, vomiting and sharp drops in infection-fighting blood cells, and one reported a ``disturbing`` higher death rate among children who took higher doses of a drug, records show.
The government provided special protections for child wards in 1983. They required researchers and their oversight boards to appoint independent advocates for any foster child enrolled in a narrow class of studies that involved greater than minimal risk and lacked the promise of direct benefit.
Some foster agencies, including those in Illinois and New York, required researchers to sign a document agreeing to provide the protection regardless of risks and benefits.
However, researchers and foster agencies told AP that foster children in AIDS drug trials often weren`t given such advocates even though research institutions many times promised in writing to do so.
Illinois officials believe none of their nearly 200 foster children in AIDS studies got independent monitors. New York City could find records showing 142 - less than a third - of the 465 foster children in AIDS drug trials got such monitors even though city policy required them. The city has asked an outside firm to investigate.
Likewise, research facilities including Chicago`s Children`s Memorial Hospital and Johns Hopkins University in Baltimore said they concluded they didn`t provide advocates for foster kids.
Some foster children died during studies, but state or city agencies said they could find no records that any deaths were directly caused by experimental treatments.
Researchers typically secured permission to enroll foster children through city or state agencies. And they frequently exempted themselves from appointing advocates by concluding the research carried minimal risk and the child would benefit directly because the drugs already had been tried in adults.
``Our position is that advocates weren`t needed,`` said Marilyn Castaldi, spokeswoman for Columbia Presbyterian Medical Center in New York.
If they decline to appoint advocates under the federal law, researchers and their oversight boards must conclude that the experimental treatment affords the same or better risk-benefit possibilities than alternate treatments already in the marketplace. They also must abide by any additional protections required by state and local authorities.
Arthur Caplan, head of medical ethics at the University of Pennsylvania, said advocates should have been appointed for all foster children because researchers felt the pressure of a medical crisis and knew there was great uncertainty as to how children would react to AIDS medications that were often toxic for adults.
``It is exactly that set of circumstances that made it absolutely mandatory to get those kids those advocates,`` Caplan said. ``It is inexcusable that they wouldn`t have an advocate for each one of those children.
``When you have the most vulnerable subjects imaginable - kids without parents - you really do have to come in with someone independent, who doesn`t have a dog in this fight,`` he said.
Those who made the decisions say the research gave foster kids access to drugs they otherwise couldn`t get. And they say they protected the children`s interest by carefully explaining risks and benefits to state guardians, foster parents and the children themselves.
``I understand the ethical dilemma surrounding the introduction of foster children into trials,`` said Dr. Mark Kline, a pediatric AIDS expert at Baylor College of Medicine. He enrolled some Texas foster kids in his studies, and doesn`t recall appointing advocates for them.
``To say as a group that foster children should be excluded from clinical trials would have meant excluding these children from the best available therapies at the time,`` he said. ``From an ethical perspective, I never thought that was a stand I could take.``
Illinois officials directly credit the decision to enroll HIV-positive foster kids with bringing about a decline in deaths - from 40 between 1989 and 1995 to only 19 since.
Some states declined to participate in medical experiments. Tennessee said its foster care rules generally prohibit enlisting children in such trials. California requires a judge`s order. And Wisconsin ``has absolutely never allowed, nor would we even consider, any clinical experiments with the children in our foster care system,`` spokeswoman Stephanie Marquis said.
Officials estimated that 5 percent to 10 percent of the 13,878 children enrolled in pediatric AIDS studies funded by NIH since the late 1980s were in foster care. More than two dozen Illinois foster children remain in studies today.
NIH, the government health research agency that funded the studies, did not track researchers to determine whether they appointed advocates. Instead, the decision was left to medical review boards made up of volunteers at each study site.
A recent Institute of Medicine study concluded those Institutional Review Boards (IRBs) were often overwhelmed, dominated by scientists and not focused enough on patient protections.
The U.S. Office for Human Research Protections, created to protect research participants after the notorious Tuskegee syphilis studies on black men in the 1930s, is investigating the use of foster children in AIDS research. The office declined to discuss the probe.
AP`s review found that if children were old enough - usually between 5 and 10 - they also were educated about the risks and asked to consent. Sometimes, foster parents or biological parents were consulted; other times not.
Research and foster agencies declined to make foster parents or children in the drug trials available for interviews, or to provide information about individual drug dosages, side effects or deaths, citing medical privacy laws.
Other families who participated in the same drug trials told AP their children mostly benefited but parents needed to carefully monitor potential side effects. Foster children, they said, need the added protection of an independent advocate.
``If they did not fulfill that requirement, how can you be sure the community participant really got the benefit and the informed consent that is needed,`` said Michelle Lopez, a New Jersey woman whose daughter has participated in drug trials.
``I was very concerned about that because the argument we are getting is the kids are getting better and we are enhancing their lives, but none of these drugs save these kids lives,`` she said.
Many studies that enlisted foster children involved early Phase I and Phase II research - the riskiest - to determine side effects and safe dosages so children could begin taking adult ``cocktails,`` the powerful drug combinations that suppress AIDS but can cause bad reactions like rashes and organ damage.
Some of those drugs were approved ultimately for children, such as stavudine and zidovudine. Other medicines were not.
Illinois officials confirmed two or three foster children were approved to participate in a mid-1990s study of dapsone. Researchers hoped the drug would prevent a pneumonia that afflicts AIDS patients.
Researchers reported some children had to be taken off the drug because of ``serious toxicity,`` others developed rashes, and the rates of death and blood toxicity were significantly higher in children who took the medicine daily, rather than weekly.
At least 10 children died from a variety of causes, including four from blood poisoning, and researchers said they were unable to determine a safe, useful dosage. They said the deaths didn`t appear to be ``directly attributable`` to dapsone but nonetheless were ``disturbing.``
``An unexpected finding in our study was that overall mortality while receiving the study drug was significantly higher in the daily dapsone group. This finding remains unexplained,`` the researchers concluded.
Another study involving foster children in the 1990s treated children with different combinations of adult antiretroviral drugs. Among 52 children, there were 26 moderate to severe reactions - nearly all in infants. The side effects included rash, fever and a major drop in infection-fighting white blood cells.
New York City officials defend the decision to enlist foster children en masse, saying there was a crisis in the early 1990s and research provided the best treatment possibilities. Nonetheless, they are changing their policy so they no longer give blanket permission to enroll children in preapproved studies.
``We learned some things from our experience,`` said Elizabeth Roberts, assistant commissioner for child and family health at the Administration for Children`s Services. ``It is a more individualized review we will be conducting.``
CHIROPRACTIC ACES
HOW MUCH MONEY DO YOU SPEND ON SEMINARS EACH YEAR IF ANY?
IF YOU DON`T ATTEND SEMINARS, HOW DO YOU STAY MOTIVATED, AND UP TO, THE FAST MOVING PACE OF MAINTAINING A VIABLE PRACTICE?
SOME OF THE SEMINARS ARE POORLY ATTENDED AND NOT VERY EXCITING OR MOTIVATING.
SOME ARE REALLY JUST COME-ONS TO JOIN ONE OF THE 40 TO 50 COACHING TYPE "CATCH AS YOU CAN" MEETINGS.
WHAT IF YOU COULD HAVE SEMINARS 24/7 ANYWHERE, ANY TIME, AT HOME, IN THE OFFICE, ON VACATION, OR WHERE EVER YOU PLEASE, AND WHEN YOU PLEASE, WITH TOPIC, AND SPEAKER OF CHOICE?
YOU CAN LISTEN TO 1/1/2 HOURS AT A TIME OR BREAK IT DOWN INTO 15 MIN. SEGMENTS.
WHAT IF YOU COULD HEAR DRS. ADJUSTING 2400 PER WEEK, OR 3000 PLUS PER WEEK, WOMEN CHIROPRACTORS ADJUSTING 600 T0 900 PER WEEK.
TALKS ON PHILOSOPHY, PROCEDURE, MARKETING, PRACTICE BUILDING TEACHERS, TECHNIQUE, OFFICE LAYOUT, TALKS ON ABUNDANCE, AND THINKING TO GROW RICH, OVERCOMING FEAR, AND NEGATIVE THINKING, COMMUNICATION SKILLS, DRS. TALKS TO NEW PATIENTS, REPORT OF FINDINGS THAT REALLY WORK, AND MUCH MORE.
SPEAKERS LIKE: PAULA HEDGLON, ROB SCHIFFMAN, HOBIE FURSHMAN, JIM SIGAFOOSE, SELINA SIGAFOOSE JACKSON, KEVIN JACKSON, TIM GAY, SHARON GORMAN , CHUCK RIBLEY, JOHN HOFFMAN, GIN KELLER, TONI ANN ROSES, RICHARD SANTO, ARMAND ROSSI, STEW BITTMAN, BOBBIE BRAILE ETC..
WE WILL ADD SPEAKERS EVERY FEW WEEKS AND THERE WILL BE NEW , FRESH INFO, AND REVIEW, IF DESIRED.
Check out www.ChiropracticAces.com
There was a young member of this church whose husband would travel to Baltimore once a week on business. She noticed that he always returned home a different person. He had more energy, more enthusiasm for life. This would last for 2 or 3 days, then he was his usual cranky self again. She became convinced that he was either having an affair or had fallen in love with someone else.
Turns out that he was seeing a chiropractor.
The Carpenter
Once upon a time, two brothers who lived on adjoining farms fell into conflict. It was the first serious rift in 40 years of farming side-by-side, sharing machinery and trading labor and goods as needed without a hitch.
Then the long collaboration fell apart. It began with a small misunderstanding and it grew into a major difference and finally, it exploded into an exchange of bitter words followed by weeks of silence.
One morning there was a knock on John`s door. He opened it to find a man with a carpenter`s toolbox. "I`m looking for a few days` work," he said. "Perhaps you would have a few small jobs here and there I could help with? Could I help you?"
"Yes," said the older brother. "I do have a job for you. Look across the creek at that farm. That`s my neighbor. In fact, it`s my younger brother! Last week there was a meadow between us. He recently took his bulldozer to the river levee and now there is a creek between us. Well, he may have done this to spite me, but I`ll do him one better. See that pile of lumber by the barn? I want you to build me a fence an 8-foot fence -- so I won`t need to see his place or his! face anymore."
The carpenter said, "I think I understand the situation. Show me the nails and the post-hole digger and I`ll be able to do a job that pleases you."
The older brother had to go to town, so he helped the carpenter get the materials ready and then he was off for the day. The carpenter worked hard all that day -- measuring, sawing and nailing. About sunset when the farmer returned, the carpenter had just finished his job.
The farmer`s eyes opened wide, his jaw dropped. There was no fence there at all.
It was a bridge .. a bridge that stretched from one side of the creek to the other! A fine piece of work, handrails and all! And the neighbor, his younger brother, was coming toward them, his hand outstretched..
"You are quite a fellow to build this bridge after all I`ve said and done."
The two brothers stood at each end of the bridge, and then they met in middle, taking each other`s hand. They turned to see the carpenter hoist his toolbox onto his shoulder.
"No, wait! Stay a few days. I`ve a lot of other projects for you," said the older brother.
"I`d love to stay on," the carpenter said, "but I have many more bridges to build."
Remember This... God won`t ask what kind of car you drove, but He`ll ask how many people you helped get where they needed to go.
God won`t ask the square footage of your house, but He`ll ask how many people you welcomed into your home.
God won`t ask about the clothes you had in your closet, but He`ll ask how many you helped to clothe.
God won`t ask how many friends you had, but He`ll ask how many people to whom you were a friend.
God won`t ask in what neighborhood you lived, but He`ll ask how you treated your neighbors.
God won`t ask about the color of your skin, but He`ll ask about the content of your character.
God won`t ask why it took you so long to seek Salvation, but He`ll lovingly take you to your mansion in Heaven, and not to the gates of hell.
God won`t ask how many people you forwarded this to, but He`ll ask why you were ashamed to pass it on to your friends...
PALM SUNDAY:
IT WAS PALM SUNDAY AND, BECAUSE OF A SORE THROAT, FIVE-YEAR-OLD JOHNNY STAYED HOME FROM CHURCH WITH A SITTER. WHEN THE FAMILY RETURNED HOME, THEY WERE CARRYING SEVERAL PALM BRANCHES. THE BOY ASKED WHAT THEY WERE FOR. "PEOPLE HELD THEM OVER JESUS` HEAD AS HE WALKED BY."
"WOULDN`T YOU KNOW IT," THE BOY FUMED, "THE ONE SUNDAY I DON`T GO, HE SHOWS UP!"
CHILDREN`S SERMON:
ONE EASTER SUNDAY MORNING AS THE MINISTER WAS PREACHING THE CHILDREN`S SERMON, HE REACHED INTO HIS BAG OF PROPS AND PULLED OUT AN EGG. HE POINTED AT THE EGG AND ASKED THE CHILDREN, "WHAT`S IN HERE?" "I KNOW!" A LITTLE BOY EXCLAIMED. "PANTYHOSE!"
SUPPORT A FAMILY:
THE PROSPECTIVE FATHER-IN-LAW ASKED, "YOUNG MAN, CAN YOU SUPPORT A FAMILY?"
THE SURPRISED GROOM-TO-BE REPLIED, "WELL, NO. I WAS JUST PLANNING TO
GRANDMA`S AGE:
LITTLE JOHNNY ASKED HIS GRANDMA HOW OLD SHE WAS.
GRANDMA ANSWERED, "39 AND HOLDING."
JOHNNY THOUGHT FOR A MOMENT, AND THEN SAID, "AND HOW OLD WOULD YOU BE IF YOU LET GO?"
FIRST TIME USHERS:
A LITTLE BOY IN CHURCH FOR THE FIRST TIME WATCHED AS THE USHERS PASSED AROUND THE OFFERING PLATES.
WHEN THEY CAME NEAR HIS PEW, THE BOY SAID LOUDLY, "DON`T PAY FOR ME DADD Y. I`M UNDER FIVE."
PRAYERS:
THE SUNDAY SCHOOL TEACHER ASKED, "NOW, JOHNNY, TELL ME, DO YOU SAY PRAYERS BEFORE EATING?" "NO SIR," HE REPLIED, "WE DON`T HAVE TO. MY MOM IS A GOOD COOK!"
CLIMB THE WALLS:
"OH, I SURE AM HAPPY TO SEE YOU," THE LITTLE BOY SAID TO HIS GRANDMOTHER ON HIS MOTHER`S SIDE. "NOW MAYBE DADDY WILL DO THE TRICK HE HAS BEEN PROMISING US."
THE GRANDMOTHER WAS CURIOUS. "WHAT TRICK IS THAT?" SHE ASKED.
"I HEARD HIM TELL MOMMY THAT HE WOULD CLIMB THE WALLS IF YOU CAME TO VISIT" THE LITTLE BOY ANSWERED.
THE WATER PISTOL:
WHEN MY THREE-YEAR-OLD SON OPENED THE BIRTHDAY GIFT FROM HIS GRANDMOTHER, HE DISCOVERED A WATER PISTOL. HE SQUEALED WITH DELIGHT AND HEADED FOR THE NEAREST SINK.
I WAS NOT SO PLEASED. I TURNED TO MOM AND SAID, "I`M SURPRISED AT YOU. DON`T YOU REMEMBER HOW WE USED TO DRIVE YOU CRAZY WITH WATER GUNS?"
MOM SMILED AND THEN REPLIED..... "I REMEMBER."
LIFE AFTER DEATH:
"DO YOU BELIEVE IN LIFE AFTER DEATH?" THE BOSS ASKED ONE OF HIS EMPLOYEES.
"YES, SIR," THE NEW EMPLOYEE REPLIED.
"WELL, THEN, THAT MAKES EVERYTHING JUST FINE," THE BOSS WENT ON. "AFTER YOU LEFT EARLY YESTERDAY TO GO TO YOUR GRANDMOTHER`S FUNERAL, SHE STOPPED IN TO SEE YOU!
Teaching vs. prison
Teaching VS Prison: Just in case you ever got the two mixed up, this should make misconceptions a bit clearer.
IN PRISON: You spend the majority of your time in a room with one other person who doesn`t want to cooperate.
AT SCHOOL: You spend the majority of the time in a room with 20-30 children who don`t want to cooperate.
IN PRISON: You get three free hot meals a day.
AT SCHOOL: You only get one meal, you pay for it and you get to wait in line for the microwave to heat it, so you can have about 3 = minutes left to eat it.
IN PRISON: You get time off for good behavior.
AT SCHOOL: You get more work for good behavior.
IN PRISON: The guard locks and unlocks all the doors for you.
AT SCHOOL: You must open all the doors for yourself while balancing all the papers you took home to grade.
IN PRISON: You can watch TV and play games.
AT SCHOOL: You get fired for watching TV and playing games.
IN PRISON: You get your own toilet.
AT SCHOOL: You have to share your bathroom with some idiot who tinkles on the seat.
IN PRISON: They allow your family and friends to visit.
AT SCHOOL: You can`t even speak to your family on the phone because you are usually too busy taking care of someone else`s family.
IN PRISON: The taxpayers pay all expenses with no work required.
AT SCHOOL: You get to pay all the expenses to go to work and then they deduct taxes from your salary to pay for prisoners.
IN PRISON: You must deal with sadistic wardens.
AT SCHOOL: They are called administrators.
Have a Great Day Teaching (if you are a teacher) and
THANK YOU for doing it!
1) When I die, I want to die like my grandfather-who died peacefully in his
sleep. Not screaming like all the passengers in his car." --Author Unknown
2) Advice for the day: If you have a lot of tension and you get a headache,
do what it says on the aspirin bottle: "Take two aspirin" and "Keep away
from children." --Author Unknown
3) "Oh, you hate your job? Why didn`t you say so? There`s a support group
for that. It`s called EVERYBODY, and they meet at the bar." --Drew Carey
4) "The problem with the designated driver program, it`s not a desirable
job, but if you ever get sucked into doing it, have fun with it. At the end
of the night, drop them off at the wrong house." --Jeff Foxworthy
5) "If a woman has to choose between catching a fly ball and saving an
infant`s life, she will choose to save the infant`s life without even
considering if there is a man on base." --Dave Barry
6) "Relationships are hard. It`s like a full time job, and we should treat
it like one. If your boyfriend or girlfriend wants to leave you, they should
give you two weeks` notice. There should be severance pay, the day before
they leave you, they should have to find you a temp." --Bob Ettinger
7) "My Mom said she learned how to swim when someone took her out in the
lake and threw her off the boat. I said, `Mom, they weren`t trying to teach
you how to swim.`" --Paula Poundstone
8) "A study in the Washington Post says that women have better verbal skills
than men. I just want to say to the authors of that study: "Duh." --Conan
O`Brien
9) "Why does Sea World have a seafood restaurant?? I`m halfway through my
fish burger and I realize, Oh my God.... I could be eating a slow learner."
--Lynda Montgomery
10) "I think that`s how Chicago got started. Bunch of people in New York
said, `Gee, I`m enjoying the crime and the poverty, but it just isn`t cold
enough. Let`s go west.`" --Richard Jeni
11) "If life were fair, Elvis would be alive and all the impersonators would
be dead." --Johnny Carson
12) "Sometimes I think war is God`s way of teaching us geography." --Paul
Rodriguez
13) "My parents didn`t want to move to Florida, but they turned sixty and
that`s the law." --Jerry Seinfeld
14) "Remember in elementary school, you were told that in case of fire you
have to line up quietly in a single file line from smallest to tallest. What
is the logic in that? What, do tall people burn slower?" --Warren Hutcherson
15) "Bigamy is having one wife/husband too many. Monogamy is the same."
--Oscar Wilde
16) "Suppose you were an idiot ... And suppose you were a member of
Congress... But I repeat myself." --Mark Twain
17) "Our bombs are smarter than the average high school student. At least
they can find Afghanistan." --A. Whitney Brown
18) "You can say any foolish thing to a dog, and the dog will give you a
look that says, `My God, you`re right! I never would`ve thought of that!`"
--Dave Barry
19) Do you know why they call it "PMS"? Because "Mad Cow Disease" was taken.
--Unknown, presumed deceased
Here are a list of my upcoming talks and seminars. Please note that these may change