Why should stay in good health over the next 30 years...

Cancer Cures Find Biology-Physics Convergence With MIT `Genius'
By Brian Kladko and John Taddei

Aug. 7 (Bloomberg) -- Angela Belcher, a materials engineer at the Massachusetts Institute of Technology, didn't plan on joining the war on cancer. That is, until she was drafted to work alongside the school's biologists.

Belcher, 40, a 2004 winner of a MacArthur Foundation genius award, tailors viruses that build microscopic electronic parts such as transistors. She was recruited by MIT's cancer scientists to uncover new ways to detect tumors early and deliver drugs more safely.

Biologists at MIT, in Cambridge, helped discover the genes that have led to a new generation of so-called targeted cancer medicines. MIT -- like Stanford University in California and Emory University in Atlanta -- now is deploying engineers for the first time to build on those successes. The approach is spurring interest from biotechnology company backers, said Terry McGuire, co-founder of Polaris Venture Partners, an investment company in nearby Waltham, Massachusetts.

``Investors are realizing that a combination of engineering and biology is going to yield greater products,'' McGuire said a telephone interview on July 28.

McGuire is an adviser to MIT's David H. Koch Institute for Integrative Cancer Research, funded partly with $100 million from Koch, a 68-year-old billionaire who has been under treatment for prostate cancer for 16 years. The Koch Institute is constructing an over-$200 million building, with 25 laboratories, scheduled to open in December 2010.

Cancer Survivor
``One only has to experience cancer personally to become a crusader for curing the disease,'' Koch, from the founding family at Wichita, Kansas-based Koch Industries Inc., said in a telephone interview on July 22. The partnership between biologists and engineers, he said, ``is incredibly powerful.''

Each of the seven floors will have biologists and engineers, ``equal partners in the battle against this disease,'' MIT President Susan Hockfield, a 57-year-old neuroscientist, told a gathering at the school in June. ``The building is explicitly designed to help people bump into each other --intellectually, that is.''

Biologist-engineer collaborations against cancer have also been initiated at the University of North Carolina in Chapel Hill, the Georgia Institute of Technology in Atlanta, Northwestern University in Evanston, Illinois, Washington University in St. Louis, the California Institute of Technology in Pasadena and the University of California, San Diego.

Billions for Research
The U.S. government will spend $4.8 billion on cancer studies in the year ending Sept. 30, almost twice the $2.5 billion a decade earlier, according to the National Cancer Institute in Bethesda, Maryland. About 75 percent of the Koch Institute's $50 million annual science budget comes from federal grants, said the center's director, Tyler Jacks, in a July 15 interview.

MIT biologists were involved in the original gene discoveries that led to the cancer drug Herceptin, made by South San Francisco-based Genentech Inc., and Gleevec, from Novartis AG in Basel, Switzerland. Herceptin, for breast cancer, generated $4.6 billion in revenue, according to Roche Holding AG, the Basel-based drugmaker that also markets the medicine.

The Koch Institute has an even split of biologists and engineers among the 24 faculty members. By comparison, no more than 5 percent of the 28,000 members of the American Association for Cancer Research, based in Philadelphia, specialize in the physical sciences, said Margaret A. Foti, the group's chief executive officer, in a telephone interview.

`Ahead of the Curve'
``We desperately need both physicists and engineers in the field of cancer research right now because of all the new delivery systems,'' Foti said. ``Centers like the one at MIT are really ahead of the curve.''

Belcher, a Texas native who won a grant from the John D. and Catherine T. MacArthur Foundation in Chicago, was recruited by MIT's Robert Langer, the drug-delivery pioneer who runs the world's largest academic biomedical-engineering lab.

``She's one of the most imaginative, creative researchers I've ever seen, and really one of the young superstars at MIT,'' said Langer, 59, who formerly headed the U.S. Food and Drug Administration's Science Board, in an interview on July 14.

Belcher's goal is to create viruses that when injected into the body can hone in on tumors, she said in a June 3 interview. The viruses can act like freight delivery agents, carrying chemicals that can make otherwise unseen tumors more visible to imaging scans, or conveying chemotherapy directly to malignant cells.

Earlier Detection
The idea is to create diagnostics that detect cancer early enough for treatment to be more effective, Belcher said. The viruses' drug-delivery would be more accurately targeted than standard chemotherapy, which releases toxins throughout the body, harming healthy tissue in addition to the tumor.

She is also investigating how fluorescent tags called quantum dots might piggyback on viruses, highlighting the size, shape and location of a malignancy. While quantum dots are currently made from cadmium, which is toxic to humans, Belcher is trying to make a safe version from gallium nitride.

Belcher, who earned a Ph.D. in chemistry at the University of California, Santa Barbara, has genetically engineered viruses that assemble microscopic electrode wires by combining molecules of cobalt oxide. The wires, which are one ten-thousandth the width of a human hair, could provide power for implantable medical devices or for tiny, unmanned flying vehicles that measure air quality, she said.

`Check Your Ego'
Now Belcher devotes about 20 percent of her time to the viruses' cancer-related applications, an area where she said she hadn't thought she had anything to contribute.

``Part of it was just out of ignorance -- not knowing the field, not knowing the people, and what was happening,'' she said. ``So I didn't run to it, I got pulled into it.''
The experience can be humbling.

``You have to check your ego at the door,'' she said. ``You have to walk in and say, `What does that mean? Back up.' I have no problem admitting that I don't know anything, and learning.''

To contact the reporters on this story: John Taddei in New York at jtaddei3@bloomberg.net Last Updated: August 7, 2008 00:01 EDT

I have previously posted on the future of medicine. I truly believe that if you can keep yourself healthy over the next 30 years... the future holds enormous promise to extend your life with quality. And a lot of credit will go to people like Angela Belcher and Mr. David Koch

Coffee, oh Coffee...

nytimes.com

August 5, 2008
Personal Health
Sorting Out Coffee’s Contradictions
By JANE E. BRODY

When Howard D. Schultz in 1985 founded the company that would become the wildly successful Starbucks chain, no financial adviser had to tell him that coffee was America’s leading beverage and caffeine its most widely used drug. The millions of customers who flock to Starbucks to order a double espresso, latte or coffee grande attest daily to his assessment of American passions.

Although the company might have overestimated consumer willingness to spend up to $4 for a cup of coffee — it recently announced that it would close hundreds of underperforming stores — scores of imitators that now sell coffee, tea and other products laced with caffeine reflect a society determined to run hard on as little sleep as possible.

But as with any product used to excess, consumers often wonder about the health consequences. And researchers readily oblige. Hardly a month goes by without a report that hails coffee, tea or caffeine as healthful or damns them as potential killers.

Can all these often contradictory reports be right? Yes. Coffee and tea, after all, are complex mixtures of chemicals, several of which may independently affect health.
Caffeine Myths

Through the years, the public has been buffeted by much misguided information about caffeine and its most common source, coffee. In March the Center for Science in the Public Interest published a comprehensive appraisal of scientific reports in its Nutrition Action Healthletter. Its findings and those of other research reports follow.

Hydration.
It was long thought that caffeinated beverages were diuretics, but studies reviewed last year found that people who consumed drinks with up to 550 milligrams of caffeine produced no more urine than when drinking fluids free of caffeine. Above 575 milligrams, the drug was a diuretic.

So even a Starbucks grande, with 330 milligrams of caffeine, will not send you to a bathroom any sooner than if you drank 16 ounces of pure water. Drinks containing usual doses of caffeine are hydrating and, like water, contribute to the body’s daily water needs.

Heart disease.
Heart patients, especially those with high blood pressure, are often told to avoid caffeine, a known stimulant. But an analysis of 10 studies of more than 400,000 people found no increase in heart disease among daily coffee drinkers, whether their coffee came with caffeine or not.
“Contrary to common belief,” concluded cardiologists at the University of California, San Francisco, there is “little evidence that coffee and/or caffeine in typical dosages increases the risk” of heart attack, sudden death or abnormal heart rhythms.

In fact, among 27,000 women followed for 15 years in the Iowa Women’s Health Study, those who drank one to three cups a day reduced their risk of cardiovascular disease by 24 percent, although this benefit diminished as the quantity of coffee rose.

Hypertension.
Caffeine induces a small, temporary rise in blood pressure. But in a study of 155,000 nurses, women who drank coffee with or without caffeine for a decade were no more likely to develop hypertension than noncoffee drinkers. However, a higher risk of hypertension was found from drinking colas. A Johns Hopkins study that followed more than 1,000 men for 33 years found that coffee drinking played little overall role in the development of hypertension.

Cancer.
Panic swept this coffee-dependent nation in 1981 when a Harvard study tied the drink to a higher risk of pancreatic cancer. Coffee consumption temporarily plummeted, and the researchers later concluded that perhaps smoking, not coffee, was the culprit.
In an international review of 66 studies last year, scientists found coffee drinking had little if any effect on the risk of developing pancreatic or kidney cancer. In fact, another review suggested that compared with people who do not drink coffee, those who do have half the risk of developing liver cancer.

And a study of 59,000 women in Sweden found no connection between coffee, tea or caffeine consumption and breast cancer.

Bone loss.
Though some observational studies have linked caffeinated beverages to bone loss and fractures, human physiological studies have found only a slight reduction in calcium absorption and no effect on calcium excretion, suggesting the observations may reflect a diminished intake of milk-based beverages among coffee and tea drinkers.

Dr. Robert Heaney of Creighton University says that caffeine’s negative effect on calcium can be offset by as little as one or two tablespoons of milk. He advised that coffee and tea drinkers who consume the currently recommended amount of calcium need not worry about caffeine’s effect on their bones.

Weight loss.
Here’s a bummer. Although caffeine speeds up metabolism, with 100 milligrams burning an extra 75 to 100 calories a day, no long-term benefit to weight control has been demonstrated. In fact, in a study of more than 58,000 health professionals followed for 12 years, both men and women who increased their caffeine consumption gained more weight than those who didn’t.

Health Benefits
Probably the most important effects of caffeine are its ability to enhance mood and mental and physical performance. At consumption levels up to 200 milligrams (the amount in about 16 ounces of ordinary brewed coffee), consumers report an improved sense of well-being, happiness, energy, alertness and sociability, Roland Griffiths of the Johns Hopkins School of Medicine reported, although higher amounts sometimes cause anxiety and stomach upset.

Millions of sleep-deprived Americans depend on caffeine to help them make it through their day and drive safely. The drug improves alertness and reaction time. In the sleep-deprived, it improves memory and the ability to perform complex tasks.

For the active, caffeine enhances endurance in aerobic activities and performance in anaerobic ones, perhaps because it blunts the perception of pain and aids the ability to burn fat for fuel instead of its carbohydrates.

Recent disease-related findings can only add to coffee’s popularity. A review of 13 studies found that people who drank caffeinated coffee, but not decaf, had a 30 percent lower risk of Parkinson’s disease.

Another review found that compared with noncoffee drinkers, people who drank four to six cups of coffee a day, with or without caffeine, had a 28 percent lower risk of Type 2 diabetes. This benefit probably comes from coffee’s antioxidants and chlorogenic acid.

Damn that shephard who first found the plant and damn the sheep who ate it. Because of them, I am now addicted. For those who're curious read how coffee was first discovered.

The Sojourner

from nytimes.com

August 5, 2008
Op-Ed Columnist
Where’s the Landslide?
By DAVID BROOKS

Why isn’t Barack Obama doing better? Why, after all that has happened, does he have only a slim two- or three-point lead over John McCain, according to an average of the recent polls? Why is he basically tied with his opponent when his party is so far ahead?

His age probably has something to do with it. So does his race. But the polls and focus groups suggest that people aren’t dismissive of Obama or hostile to him. Instead, they’re wary and uncertain.

And the root of it is probably this: Obama has been a sojourner. He opened his book “Dreams From My Father” with a quotation from Chronicles: “For we are strangers before thee, and sojourners, as were all our fathers.”

There is a sense that because of his unique background and temperament, Obama lives apart. He put one foot in the institutions he rose through on his journey but never fully engaged. As a result, voters have trouble placing him in his context, understanding the roots and values in which he is ineluctably embedded.

Last week Jodi Kantor of The Times described Obama’s 12 years at the University of Chicago Law School. “The young law professor stood apart in too many ways to count,” Kantor wrote.
He was a popular and charismatic professor, but he rarely took part in faculty conversations or discussions about the future of the institution. He had a supple grasp of legal ideas, but he never committed those ideas to paper by publishing a piece of scholarship.

He was in the law school, but not of it.

This has been a consistent pattern throughout his odyssey. His childhood was a peripatetic journey through Kansas, Indonesia, Hawaii and beyond. He absorbed things from those diverse places but was not fully of them.

His college years were spent on both coasts. He was a community organizer for three years but left before he could be truly effective. He became a state legislator, but he was in the Legislature, not of it. He had some accomplishments, but as Ryan Lizza of The New Yorker wrote, he was famously bored by the institution and used it as a stepping stone to higher things.

He was in Trinity United Church of Christ, but not of it, not sharing the liberation theology that energized Jeremiah Wright Jr. He is in the United States Senate, but not of it. He has not had the time nor the inclination to throw himself into Senate mores, or really get to know more than a handful of his colleagues. His Democratic supporters there speak of him fondly, but vaguely.
And so it goes. He is a liberal, but not fully liberal. He has sometimes opposed the Chicago political establishment, but is also part of it. He spoke at a rally against the Iraq war, while distancing himself from many antiwar activists.

This ability to stand apart accounts for his fantastic powers of observation, and his skills as a writer and thinker. It means that people on almost all sides of any issue can see parts of themselves reflected in Obama’s eyes. But it does make him hard to place.

When we’re judging candidates (or friends), we don’t just judge the individuals but the milieus that produced them. We judge them by the connections that exist beyond choice and the ground where they will go home to be laid to rest. Andrew Jackson was a backwoodsman. John Kennedy had his clan. Ronald Reagan was forever associated with the small-town virtues of Dixon and Jimmy Carter with Plains.

It is hard to plant Obama. Both he and his opponent have written coming-of-age tales about their fathers, but they are different in important ways. McCain’s “Faith of My Fathers” is a story of a prodigal son. It is about an immature boy who suffers and discovers his place in the long line of warriors that produced him. Obama’s “Dreams From My Father” is a journey forward, about a man who took the disparate parts of his past and constructed an identity of his own.
If you grew up in the 1950s, you were inclined to regard your identity as something you were born with. If you grew up in the 1970s, you were more likely to regard your identity as something you created.

If Obama is fully a member of any club — and perhaps he isn’t — it is the club of smart post-boomer meritocrats. We now have a cohort of rising leaders, Obama’s age and younger, who climbed quickly through elite schools and now ascend from job to job. They are conscientious and idealistic while also being coldly clever and self-aware. It’s not clear what the rest of America makes of them.

So, cautiously, the country watches. This should be a Democratic wipeout. But voters seem to be slow to trust a sojourner they cannot place.

from merriam-webster.com
sojourner
One entry found.
sojourn[2,intransitive verb]
Main Entry:
to sojourn
Function:
intransitive verb
Etymology:
Middle English, from Anglo-French sujurner, sejurner, from Vulgar Latin *subdiurnare, from Latin sub under, during + Late Latin diurnum day — more at up, journey
Date:
14th century
: to stay as a temporary resident

The "Dubya" Effect

from nytimes.com

August 5, 2008
G.O.P. Drops in Voting Rolls in Many States
By JENNIFER STEINHAUER

Well before Senators Barack Obama and John McCain rose to the top of their parties, a partisan shift was under way at the local and state level. For more than three years starting in 2005, there has been a reduction in the number of voters who register with the Republican Party and a rise among voters who affiliate with Democrats and, almost as often, with no party at all.

While the implications of the changing landscape for Mr. Obama and Mr. McCain are far from clear, voting experts say the registration numbers may signal the beginning of a move away from Republicans that could affect local, state and national politics over several election cycles. Already, there has been a sharp reversal for Republicans in many statehouses and governors’ mansions.

In several states, including the traditional battlegrounds of Nevada and Iowa, Democrats have surprised their own party officials with significant gains in registration. In both of those states, there are now more registered Democrats than Republicans, a flip from 2004. No states have switched to the Republicans over the same period, according to data from 26 of the 29 states in which voters register by party. (Three of the states did not have complete data.)

In six states, including Iowa, New Hampshire and Pennsylvania, the Democratic piece of the registration pie grew more than three percentage points, while the Republican share declined. In only three states — Kentucky, Louisiana and Oklahoma — did Republican registration rise while Democratic registration fell, but the Republican increase was less than a percentage point in Kentucky and Oklahoma. Louisiana was the only state to register a gain of more than one percentage point for Republicans as Democratic numbers declined.

Over the same period, the share of the electorate that registers as independent has grown at a faster rate than Republicans or Democrats in 12 states. The rise has been so significant that in states like Arizona, Colorado and North Carolina, nonpartisan voters essentially constitute a third party.

Swings in party registration are not uncommon from one year to the next, or even over two years. Registration, moreover, often has no impact on how people actually vote, and people sometimes switch registration to vote in a primary, then flip again come Election Day.

But for a shift away from one party to sustain itself — the current registration trend is now in its fourth year — is remarkable, researchers who study voting patterns say. And though comparable data are not available for the 21 states where voters do not register by party, there is evidence that an increasing number of voters in those states are also moving away from the Republican Party based on the results of recent state and Congressional elections, the researchers said.

“This is very suggestive that there is a fundamental change going on in the electorate,” said Michael P. McDonald, a senior fellow at the Brookings Institution and an associate professor of political science at George Mason University who has studied voting patterns.
Mr. McDonald added that, more typically, voting and registration patterns tended to even out or revert to the opposing party between elections.

Dick Armey, the former House majority leader and one of the designers of the so-called Republican Revolution of 1994, said: “Obviously, these are not good numbers for the party to be looking at. Democrats have always had extremely broad multifaceted registration programs.”
But in terms of the presidential election, Mr. Armey said the tea leaves were harder to read.
“I think the key in this one is, where do all these new independent voters break?” he said. “I think right now, you’ve got a guy in western Pennsylvania saying, ‘I am really disgusted right now and I’m not going to register as a Republican anymore, but I really don’t want this guy Obama elected.’ ”

Those in charge of state Democratic parties cite a national displeasure with the Bush administration as an impetus for the changing numbers, which run counter to a goal of Karl Rove, President Bush’s former top adviser, to create a permanent realignment in favor of Republicans.

“I think nationally and here, people are kind of tired of the way this administration has been conducting the policies of this country,” said Pat Waak, chairwoman of the Colorado Democratic Party.

Yet while an unpopular war, a faltering economy and a president held in low esteem have combined to hurt the Republican Party, Democrats are also benefiting from demographic changes, including the rise in the number of younger voters and the urbanization of suburbs, which has resulted in a different political flavor there, voting and campaign experts said. The party has also been helped by a willingness to run more pragmatic candidates, who have helped make the party more appealing to a broader swath of the electorate.

Among the 26 states with registration data, the percentage of those who have signed on with Democrats has risen in 15 states since 2004, and the percentage for Republicans has risen in six, according to state data. The number of registered Democrats fell in 11 states, compared with 20 states where Republican registration numbers fell.

In the 26 states and the District of Columbia where registration data were available, the total number of registered Democrats increased by 214,656, while the number of Republicans fell by 1,407,971.

The unsettled political ground has manifested itself in state and local elections. Twenty-three state legislatures are controlled by Democrats and 14 by Republicans, with 12 states with divided chambers (Nebraska has a nonpartisan legislature). After the 2000 election, 16 state legislatures were dominated by Democrats, and 17 by Republicans, with 16 divided.
It is a similar story in governors’ mansions. After the 2004 election, there were 28 Republican governors and 22 Democrats; those numbers are now reversed. After the 2000 election, there were only 19 Democratic governors.

Elected Democrats have made significant inroads even in places where Republicans have enjoyed a generation of dominance. In Colorado, for example, Democrats control the governorship and both houses of the Legislature for the first time in over four decades. Last year, Virginia Democrats gained a 21-to-19 majority over Republicans in the State Senate, the first time the party has controlled that body in a decade.

In New Hampshire, Democrats are in control of both the legislative and executive branches for the first time since 1874. In Iowa, Democrats have taken over the statehouse and the governor’s office simultaneously for the first time in a generation.

The changes in state government could have broad implications for Congressional redistricting and on policies like immigration, health care reform and environmental regulation, which are increasingly decided at the state level.

In many states, Democrats have benefited from a rise in younger potential voters, after declines or small increases in the number of those voters in the 1980s and ’90s. The population of 18- to 24-year-olds rose from about 27 million in 2000 to nearly 30 million in 2006, according to Census figures.

Mr. Obama’s candidacy has drawn many young people to register to vote, and some of the recent gains by Democrats have no doubt been influenced by excitement over his campaign. But even before Mr. Obama’s ascendancy among Democrats, younger voters were moving toward the Democratic Party, demographers said.

Dowell Myers, a professor of policy, planning and development at the University of Southern California, also noted that a younger, native-born generation of Latinos who have a tendency to support Democrats is coming of age.

Further, young Americans have migrated in recent years to high-growth states that have traditionally been dominated by Republicans, like Arizona, Colorado and Nevada, which may have had an impact on the changing registration numbers in those places.

The changing face of many American suburbs has also had in impact both in voter registration and voting patterns. In many major metropolitan areas, suburbs that were once largely white and Republican have become more mixed, as people living in cities have been priced out into surrounding areas, and exurban regions have absorbed those residents who once favored the close-in suburbs of cities.

“What we speculate is that density attracts Democrats,” said Robert Lang, director of the Metropolitan Institute at Virginia Tech who has researched voting patterns. “It is not that people move to those areas and change positions. It tends now to be a self-selection of singles, childless couples,” who tend to vote Democrat more than their married with children counterparts.

In the nation’s 50 largest metropolitan areas, Democrats carried nearly 60 percent of the Congressional vote in 2006 in inner suburbs, up from about 53 percent in 2002, according to Mr. Lang’s research.

This trend is particularly evident in places like St. Louis, southern Pennsylvania and Fairfax County, Va., which President Bush won in 2000 but lost in 2004.

Senator Claire McCaskill, Democrat of Missouri, who won her seat in 2006, picked up the large majority of voters in the St. Louis and Kansas City metropolitan areas, and Senator Jim Webb, also a Democrat, won his seat in a similar manner in Virginia, which has not voted for a Democrat for president since 1964.

Democrats have also succeeded, at least in part, by running centrist candidates where they are most needed. Bill Ritter, the Democratic governor of Colorado and former district attorney of Denver, opposes abortion rights. Among the men who flipped three of Indiana’s eight Congressional seats in the midterm election in 2006, two also oppose both abortion rights and gun control.

What the demographers, political scientists and party officials wonder now is whether the shift of the last few years will be sustained.

“Major political realignment is not just controlling the branches of government,” said Mr. McDonald of the Brookings Institution. “It is when you decisively do it. We haven’t seen that in modern generations.”

Rebecca Cathcart contributed reporting.

Pills or Therapy?

from http://www.theglobemail.com/ and the Aug issue of Archives of General Psychiatry
Pills taking over from psychotherapy
JULIE STEENHUYSEN
Reuters
August 4, 2008 at 4:30 PM EDT

CHICAGO — U.S. psychiatrists are trading in the analysis couch for a prescription pad, a study released on Monday says after finding that fewer psychiatrists offer psychotherapy.
The shift to briefer visits for medication management, reported in the Archives of General Psychiatry, appears to be linked to better psychiatric drugs and pressure from managed care companies, which offer richer financial incentives for brief office visits.

"Psychiatrists get more for three, 15-minute medication management visits than for one 45 minute psychotherapy visit," said Dr. Ramin Mojtabai of Johns Hopkins University in Baltimore and formerly of Beth Israel Medical Center in New York, where he did the research.

Various forms of psychotherapy, either alone or in combination with medications, are recommended to treat depression, post-traumatic stress disorder, bipolar disorder and other psychiatric illnesses.

Yet Dr. Mojtabai and colleagues, who analyzed data from national surveys of office-based psychiatrist visits from 1996 through 2005, found a significant drop in the number of office-based psychiatrists providing psychotherapy.

He said only 29 per cent of office-based visits to psychiatrists involved psychotherapy in 2004-5, down from 44 per cent in 1996-97.

One major impact is that patients who need to receive psychotherapy must obtain it from other professionals, if they can get it at all, dr. Mojtabai said in a telephone interview.

That can result in disjointed service, in which a patient sees a psychologist or social worker for therapy and a psychiatrist or a general physician for drugs.

"Whether it has any impact on the outcome of the disorder, we don't really know," Dr. Mojtabai said. "I don't think necessarily that it is harmful. It might not be as efficient."

Brain age
Dr. Eric Plakun, who leads an American Psychiatric Association committee on psychotherapy, said he noticed a shift away from psychotherapy beginning about 10 years ago, when more psychiatrists began to embrace "the age of the brain."

He said medical schools began to focus more on the biology of mental illness than on traditional psychotherapy and that is now reflected in practices across the United States.

Dr. Plakun said in a telephone interview that it is not clear if patients are getting therapy from other providers, or not at all.

"Either way, I'm worried about our patients," he said. "Patients need the best help we can give them."

For Dr. Plakun, that means offering a range of services, including psychotherapy, and not just medication.

"If all you have is a hammer, everything looks like a nail," he said.

Dr. Mojtabai thinks patients are getting therapy from others, but he said the focus probably is different from the analysis that psychiatrists have traditionally offered.

"Psychologists and social workers are more likely to provide short-term cognitive behavioural therapy," which focuses on changing harmful behaviours, he said.

As for the type of analysis featured in movies, particularly in Woody Allen films, it is available – to a very few.

"If you have some hard feelings about your childhood and you live in New York and have a lot of money, you can still find psychiatrists who provide long-term psychotherapy," Dr. Mojtabai said.

I was discussing this very topic recently in an interesting discussion with someone who had been a recipient of pills (speed, yes speed - yeah I know its called Ritalin - (http://www.pbs.org/merrow/repository/Television/Past/_attn/guide.html), for ADD in increasing doses and an antidepressant that killed her sex drive) from a psychiatrist. Now completely pill free, she had to literally fight to get her life and her mind back from those lost years. This article is just confirming what is already fairly well known in the general public. See a pyschologist first and only see a psychiatrist if what you have is truly a mental condition that can ONLY be treated by drugs.

Honey, Inflation ate my rebate check

from nytimes.com
August 5, 2008
Higher Prices Outpace June Spending by Consumers
By CATHERINE RAMPELL

Consumer spending increased in June, but those gains were outpaced by rising prices, the Bureau of Economic Analysis reported Monday.

The increase in spending was $57.1 billion, or 0.6 percent, from May, but prices rose 0.8 percent in the month. It was the highest inflation level in the monthly report since September 2005.

The decrease in consumer spending after accounting for inflation reversed the trend in May, when stimulus checks from the federal government helped produce a real increase in spending.
“This is a kind of ‘Honey, inflation ate my rebate check’ story,” said Jared Bernstein, senior economist at the Economist Policy Institute.

Inflation was driven primarily by food and energy prices. Excluding food and energy, prices rose 0.3 percent in June, compared with 0.2 percent in May. The prices of nondurable goods — propelled mostly by food and energy, but also including things like clothing and toiletries — were up 7.3 percent year over year, the highest level since July 1981.

Markets fell this morning in response to the news before recovering in midday, largely on news of a sharp one-day decline in oil prices.

Monday’s announcement followed a tepid report last week on economic growth, which showed a mild positive annual growth rate of 1.9 percent for the second quarter in gross domestic product.
While the numbers in the spending report were not as dire as many had forecast, they still indicate months of challenges to come.

“That real consumer spending is down two-tenths in June is not a good thing in and of itself, but it also is a bad thing for what it means for third-quarter consumption,” said Michael Feroli, an economist at JPMorgan Chase. “To get positive consumption growth in the third quarter is going to be very challenging, especially with things like auto sales down as much as they are.”

The real drop in spending from May could also be due to the dwindling effects of the Economic Stimulus Act of 2008, which rolled tax rebates in consumers’ pockets starting in April. Real consumer spending had risen 0.3 percent in May, according to revised estimates. Dean Maki, chief United States economist at Barclays, said he expects that rebates will continue to pump a minor boost for several months, however.

The decreasing effect of rebates also resulted in personal income and disposable personal income numbers heading in opposite directions.

Personal income increased in June by only 0.1 percent, and disposable personal income — which is personal income less taxes — decreased 1.9 percent. Adjusted for inflation, disposable personal income decreased 2.6 percent in June.

“What you had in the way rebates got counted was, for most people, a reduction in taxes,” Mr. Feroli said. “That reduction was bigger in May than in June. Effectively, that increased taxes, and was a negative on disposable income.” The federal government issued rebate payments of $1.9 billion in April, $48.1 billion in May, and $27.9 billion in June.

Say Wha homie? Hoocoodanode?

We're all subprime now...

from nytimes.com
August 4, 2008
Housing Lenders Fear Bigger Wave of Loan Defaults
By VIKAS BAJAJ

The first wave of Americans to default on their home mortgages appears to be cresting, but a second, far larger one is quickly building.

Homeowners with good credit are falling behind on their payments in growing numbers, even as the problems with mortgages made to people with weak, or subprime, credit are showing their first, tentative signs of leveling off after two years of spiraling defaults.
The percentage of mortgages in arrears in the category of loans one rung above subprime, so-called alternative-A mortgages, quadrupled to 12 percent in April from a year earlier. Delinquencies among prime loans, which account for most of the $12 trillion market, doubled to 2.7 percent in that time.

The mortgage troubles have been exacerbated by an economy that is still struggling. Reports last week showed another drop in home prices, slower-than-expected economic growth and a huge loss at General Motors. On Friday, the Labor Department reported that the unemployment rate in July climbed to a four-year high.

While it is difficult to draw precise parallels among various segments of the mortgage market, the arc of the crisis in subprime loans suggests that the problems in the broader market may not peak for another year or two, analysts said.

Defaults are likely to accelerate because many homeowners’ monthly payments are rising rapidly. The higher bills come as home prices continue to decline and banks tighten their lending standards, making it harder for people to refinance loans or sell their homes. Of particular concern are “alt-A” loans, many of which were made to people with good credit scores without proof of their income or assets.

“Subprime was the tip of the iceberg,” said Thomas H. Atteberry, president of First Pacific Advisors, a investment firm in Los Angeles that trades mortgage securities. “Prime will be far bigger in its impact.”

In a conference call with analysts last month, James Dimon, the chairman and chief executive of JPMorgan Chase, said he expected losses on prime loans at his bank to triple in the coming months and described the outlook for them as “terrible.”

Delinquencies on mortgages tend to peak three to five years after loans are made, said Mark Fleming, the chief economist at First American CoreLogic, a research firm. Not surprisingly, subprime loans from 2005 appear closer to the end of defaults than those made in 2007, for which default rates continue to rise steeply.

“We will hit those points in a few years, and that will help in many ways,” Mr. Fleming said, referring to the loans made later in the housing boom. “We just have to survive through this part of the cycle.”

Data on securities backed by subprime mortgages show that 8.41 percent of loans from 2005 were delinquent by 90 days or more or in foreclosure in June, up from 8.35 percent in May, according to CreditSights, a research firm with offices in New York and London. By contrast, 16.6 percent of 2007 loans were troubled in June, up from 15.8 percent.

Some of that reflects basic math. Over the years, some loans will be paid off as homeowners sell or refinance, and some homes will be foreclosed upon and sold. That reduces the number of loans from those earlier years that could default. Also, since the credit market seized up last year, lenders have become much more conservative and have stopped making most subprime loans and cut back on many other popular mortgages.

The resetting of rates on adjustable mortgages, which was a big fear of many analysts in 2006 and 2007, has become less problematic because the short-term interest rates to which many of those loans are tied have fallen significantly as the Federal Reserve has lowered rates. The recent federal tax rebates and efforts to modify more loans have also helped somewhat, analysts say.

What will sting borrowers more than rising interest rates, analysts say, is having to pay interest and principal every month after spending several years paying only interest or sometimes even less than that. Such loan terms were popular during the boom with alt-A and prime borrowers and appeared appealing while home prices were rising and interest rates were low.
But now, some borrowers could see their payments jump 50 percent or more, and they may not be able to sell their properties for as much as they owe.

Prime and alt-A borrowers typically had a five- or seven-year grace period before payments toward principal were required. By contrast, subprime loans had a two-to-three-year introductory period. That difference partly explains the lag in delinquencies between the two types of loans, said David Watts, an analyst with CreditSights.

“More delinquencies look like they are on the horizon because so few of them have reset,” Mr. Watts said about alt-A mortgages.

The wave of foreclosures is still rising in states like California, where many homeowners turned to creative mortgages during the boom. From April to June, mortgage companies filed 121,000 notices of default in California, up nearly 7 percent from the first quarter and more than twice as many as in the second quarter of 2007, according to DataQuick, a real estate data firm based in La Jolla, Calif. The firm said the median age of the loans increased to 26 months from 16 months a year earlier.

The mortgage giants Freddie Mac and Fannie Mae, which own or guarantee nearly half of all mortgages, are trying to stem that tide. Last week, they said they would pay more to the mortgage servicing companies that they hire to modify delinquent loans and avoid foreclosures.
Delinquencies in prime and alt-A loans are particularly challenging for banks because they hold more such loans on their books than they do subprime mortgages. Downey Financial, which owns a savings bank that operates in California and Arizona, recently reported that 11.2 percent of its loans were delinquent at the end of June, a big increase from the 6.1 percent that were past due at the end of last year.

The bank’s troubles stem from its $6.2 billion portfolio of so-called option adjustable-rate mortgages, which allow borrowers to pay less than the interest owed on their mortgage in the early years. The unpaid interest is added to the principal due on the loan, so over time borrowers can owe more than the initial loan amount. Eventually, when loans grow by 10 percent or 15 percent, the borrowers are required to start paying both the interest and principal due.

Many borrowers who got these loans during the boom had good credit scores, but many of them owe more than their homes are worth. Analysts believe that many will not be able to or want to make higher payments.

“The wave on the prime side has lagged the wave on the subprime side,” said Rod Dubitsky, head of asset-backed research at Credit Suisse. “The reset of option ARM loans is a big event that will drive the timing of delinquencies.”

and from calculatedrisk.com on this article.
-- By Calculated Risk
I think the second wave of foreclosures will be smaller in numbers, as compared to the largely subprime first wave, but the price of each home will be much higher. And the second wave will impact prices in the mid-to-high end areas, as opposed to the subprime foreclosures impacting prices in the low end areas.

No area is immune.