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Kiwis with autism and ADHD say health response slow, ‘out of date’ and stigmatising

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Kiwis with ADHD and autism say the New Zealand classification of their conditions is “out of date” and stigmatizing. Photo / 123rf

People with ADHD and autism say the New Zealand classification of their conditions creates barriers to access to diagnosis, treatment, and support.

A petition created by the New Zealand Disability Advisory Trust garnered over 1500 signatures online.

It called on the Ministry of Health to “reclassify ADHD / Autism as a neurodevelopmental disorder rather than a mental disorder” and argued that New Zealand’s approach to the disorders was “out of date” with “a serious lack of diagnostic support”.

The current categorization of these conditions overloads the mental health system and stigmatizes people with autism and ADHD, the Trust argued.

The NZ Disability Advisory Trust, navigator of the disability service Nick Stoneman, who has autism himself, said the ministry has claimed it does not classify autism and ADHD as mental illnesses, but people with these conditions end up in the mental health system far too often.

The main problem with this is the waiting time for a diagnosis, he said.

“It varies between DHBs, so it can take anywhere from three months to two years, depending on what their waiting list is,” he said

“And often the diagnosis is not made right … they give a diagnosis that says something like ‘global developmental delays’.

“The diagnosis will say something like that, and then the family will have to wait many months or years to get a correct assessment.”

The NZ Disability Advisory Trust believes that people with autism and ADHD end up in the mental health system far too often.  Photo / 123rf The NZ Disability Advisory Trust believes that people with autism and ADHD end up in the mental health system far too often. Photo / 123rf

The Trust wanted GPs to be empowered to diagnose and prescribe drugs for autism and ADHD with referrals to neurologists rather than the mental health system, which Stoneman said was minimal support.

“It will completely affect mental health and stop the diagnosis by psychiatrists,” he said.

“And actually giving the GP the power to do it – to procrastinate and say he needs to see a neurologist instead of dealing with mental health.”

“That would then give our people the means to make our diagnosis, and we have a number of experts in our field.”

The Department of Health’s chief clinical advisor on mental health and addiction, Arran Culver, said neither autism spectrum disorder (ASD) nor attention deficit hyperactivity disorder (ADHD) were classified as mental illnesses.

As a reference, the ministry used the International Classification of Diseases (the World Health Organization’s ICD 10 and 11), which classified both ASD and ADHD as neurodevelopmental disorders.

In either condition, people are likely to see a range of health practitioners, which could include mental health professionals, he said.

The Ministry of Health says it used the International Classification of Diseases as a reference, which classified both ASD and ADHD as neurodevelopmental disorders.  Photo / 123rfThe Ministry of Health says it used the International Classification of Diseases as a reference, which classified both ASD and ADHD as neurodevelopmental disorders. Photo / 123rf

“ASD and ADHD are separate diseases and have separate avenues of diagnosis and treatment, but all services should provide a multidisciplinary, evidence-based treatment response.

“Autistic children are generally referred to child development services or pediatric / child health services.

“ADHD is diagnosed and treated in a number of specialized settings, including pediatric / child health services, infant and adolescent mental health services, and adult mental health services.”

Robin Wynne-Williams has worked as a pediatric practice nurse with ADHD and autism patients for 30 years.

Although autism and ADHD can be officially classified as neurodevelopmental disorders by the ministry, she said that people’s experiences with these disorders suggest otherwise.

Patients were often referred to the mental health system where they could wait years for a diagnosis.

She also said that the Diagnostic and Statistical Manual of Mental Disorders (DSM) 5 – which many New Zealand practitioners might refer to – contains a classification of ADHD and autism.

She argued that GPs should be given authority to diagnose.

“We want ADHD / Autism back into proper GP care for overall drug care, diagnosis and approval, including the neurologists and general practitioners,” she said.

The Department of Health stated that it used ICD-10 rather than DSM-V, but acknowledged that clinicians in mental health services can use DSM-V for their own diagnostic purposes.

Wynne-Williams now leads the Christchurch ADHD Information Service, which provides post-diagnosis information to people and their families and highlights the service gap for people with ADHD / Autism.

“There is no mental health service, a lot of psychiatrists don’t believe adults have ADHD and they don’t know about autism,” she said.

“If the system worked, my service and the petition would not be required.”

She said the ministry’s response also reflected several key misconceptions about ADHD and autism, such as the notion that adults cannot have these disorders. For example, the department is referring to services for children with ADHD while failing to recognize the impact on adults.

“A lot of psychiatrists still think that adults don’t have ADD,” said Wynne-Williams.

“Over 25,000 patients I’ve had, from young children to large children [the big kids being adults]”I haven’t seen too many grow from it.”

Stoneman said diagnosing people with ADHD and autism in the health system has brought added shame and stigma and has reduced the resources available to the community itself.

“When the mental health system makes a diagnosis, the psychiatric system gets the money,” he said.

“The money for our community should be administered by us and come to us directly from the household.

“We need our children and adults to be diagnosed and we need to get it right the first time instead of having to wait.”

He also said there was not enough representation of people with autism and ADHD advising the ministry and the disability service (DSS).

“Parents of children on the Spectrum are often very committed to their children, forgetting that the autism and ADHD sector can provide good people,” he said.

“I would like more engagement, I would like to see a reform of the DSS and insist that someone with leadership qualities from the ASD community be on this body.

“It can’t be a parent, it has to be someone who has lived experience of being on the spectrum.”

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Investigating how the Massachusetts mental-health system was failing those who needed it most

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Spotlight editor Scott Allen looked through a window at the Globe office in Dorchester and saw protesters. There were dozens, maybe more than a hundred. And they were angry, not at the corruption or other outrage the Spotlight team had exposed, but at everyone and the reporters themselves. “I’ve never seen anything like it,” he says.

A few weeks earlier, on June 26, 2016, the Spotlight team released the first of a series of reports on how the Massachusetts mental health system is failing those who need it most. The article was invigorating and, as critics said, inflammatory. It was titled The Desperate and the Dead project and led with the agonizing report of Lee F. Chiero, a man with a mental illness who had killed his mother.

The article and the project itself were born from the team that saw a disturbing trend. In the 2010s, Massachusetts saw a spate of murders in which mental health appeared to be a factor. Sometimes the killer suffered from severe mental illness. In other cases, the victim, who was often killed by police officers, was in a psychiatric crisis. Spotlight reporter Michael Rezendes has put together a database of examples. Then the team went on a mission to answer one of the most basic journalistic questions: Why?

Why did so many serious mental illness cases end in tragedy in a state that boasted world-class health care?

During more than a year of coverage, the team found that the Massachusetts mental health system was more or less gone. Decades earlier, the state was littered with inpatient psychiatric hospitals. But these institutions had often been brutal, inhuman places, and the state had closed them. The result: people who urgently need help without turning.

The seven-part series documented the consequences of this story of neglect: relatives who had to work as unskilled caregivers, police officers who step in where social workers were needed, prisons that fill the void left by closed hospitals. The series also examined the types of modern, evidence-based mental health programs that Massachusetts may have but had not previously implemented.

The team intended that the series should serve as a call to action to get distracted policymakers to focus on an issue they had been ignoring for too long. But that’s not how some mental health advocates saw it. “The headline is incredibly dramatic and fear-driven,” says Sera Davidow, who helped organize the protest at the Globe. Fear, Davidow says, can lead policymakers to force mandatory treatment on people with severe mental illness. Fear of mental illness can also lead police officers and ordinary citizens to jump to violence, says Davidow: “These attitudes kill us.”

Some members of the Spotlight team took the protest harshly. “It has been difficult for respected people to say you do harm,” says Spotlight reporter Jenna Russell.

But there were also strong voices that supported the team’s reporting. Some families reprimanded activists who opposed mandatory outpatient treatment programs. One man whose stepdaughter relied on a New York State program to take her medication and get off the streets said of the activists, “I have a feeling these people are trying to kill them.”

Allen went outside to speak to the activists on the day of the protest. He listened to them, but also stood behind what the team found in their coverage that would later be named a finalist for the Pulitzer Prize. “If you want to talk about difficult things,” says Allen, “you have to say the hard things.”

Send comments to magazine@globe.com.

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Fry Construction Selected for a Major Medical Imaging and Radiotherapy Addition by The Center for Cancer and Blood Disorders, Arlington, TX

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CARROLLTON, Texas, September 22, 2021 / PRNewswire / – Fry Construction, a specialist in the precision design and construction of cancer treatments, medical imaging facilities, and surgical centers, has announced the award of one of its most demanding multi-modal medical construction projects.

Fry Construction, Inc. logo

TrueBeam variant

TrueBeam variant

The center will include a Varian TrueBeam LINAC and a GE CT on the first floor of a multi-story building with little clearance for pillar drilling, with all shaping and casting of the vault required after hours. A further complicating factor is that the ER access is located directly outside the investigation area and is housed in such a way that constant access is guaranteed.

“We are used to delivering the most demanding construction projects in the shortest possible time and we are proud that Fry Construction is repeatedly selected to overcome these obstacles to completion. Our 38 years of experience specializing in this highly focused sector of medical construction has taught us how to get our jobs done on time, on budget, and to build to the manufacturer’s strict specifications to meet device warranties. The criteria required by the CCBD are no exception, “said Ben Fry, President of Fry Construction.

The Center for Cancer & Blood Disorders was recently recognized through national certification through the Quality Oncology Practice Initiative (QOPI®) certification program, a member of the American Society of Clinical Oncology (ASCO). This expertise was acquired through adhering to strict cancer treatment standards – matched by only 23 oncology practices in the country. The CCBD requires the same level of experience and professionalism from its medical contractor.

Alex Carr, Varian’s Radiation Oncology Medical Device Planner, said, “By selecting Fry Construction, a Varian Preferred Contractor, to complete this complex project, CCBD has reassured Varian that the site is also preparing to the highest quality standards is deemed to be compliance with Varian’s Site Readiness Specifications as required by Varian’s infrastructure planning processes. Fry Construction has an excellent history of working not only with Varian but also with our shared customer base of cancer control specialists. I look forward to continuing this complicated and challenging project with this great team. ”

About Fry Construction Company, Inc.

Fry Construction is a leader in precision engineering of radiation therapy and imaging facilities throughout the Southwest. Fry pioneered the practice of precision medical engineering at the 1984 University of Texas Health Science Center and has since completed over 1,500 specialized facilities in nearly four decades. All have been signed with the major radiotherapy and imaging manufacturers in the United States while retaining their Preferred Contractor status.

Media contact:
Bruce Fry
[email protected]
214-334-3726

SOURCE Fry Construction, Inc.

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Here’s how to report your USA food problem directly to USDA or FDA

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Food Safety Month

Whenever you think you are seriously ill, see a doctor. And if you believe food caused your illness, make sure it is reported. Most foodborne illnesses are “reportable,” which means your doctor informs the local health department.

For example, if you had an outbreak in multiple states, you could become a “confirmed case”. Your confirmed test result will be reported to the health department, your name will be kept secret.

However, if you don’t want to take medical action, you can report your bad food experiences directly to federal regulators. Both the USDA’s Food Safety and Inspection Service and the US Food and Drug Administration welcome consumer reports of contaminated or adulterated food.

But how?
Both FSIS and FDA explain how on their websites. With Food Safety Month coming to an end in September, Food safety news forwards this information along with some explanations to help consumers find the right agency. The FSIS and the FDA are responsible for protecting various segments of the food supply. If you have a problem with a food, be sure to contact the relevant health authority.

To reach them by phone:

  • Food and Drug Administration (FDA) call 888-723-3366 (10 a.m. to 4 p.m. EDT. Closed on Thursdays 12:30 p.m. – 1:30 p.m. EDT.

Before calling FSIS or FDA, it is important that you understand how the responsibilities of federal agencies are divided among the various agencies. The FDA, which has the most authority in these areas, provides an overview of their breakdown.

In general, the FDA regulates foods and other products as follows:

  • Food supplements
  • bottled water
  • Food additives
  • Baby food
  • other foods (although the U.S. Department of Agriculture plays a leading role in regulating some meat, poultry, and egg products)

The FDA also regulates medications, including:

  • prescription drugs (both branded and generic)
  • non-prescription (over-the-counter) drugs

Biologics, including:

  • Vaccines for humans
  • Blood and blood products
  • Cell and gene therapy products
  • Tissue and tissue products
  • allergenic

Medical devices including:

  • simple items like tongue depressors and bed pans
  • complex technologies such as pacemakers
  • dental equipment
  • surgical implants and prosthetics

Electronic products that emit radiation, including:

  • Microwaves
  • X-ray machines
  • Laser products
  • Ultrasound therapy equipment
  • Mercury vapor lamps
  • sun lamps

Cosmetics, including:

  • Color additives in make-up and other personal care products
  • Moisturizers and cleansers for the skin
  • Nail polish and perfume

Veterinary products including:

  • fodder
  • Pet food
  • Veterinary medicines and devices

Tobacco Products Including:

  • Cigarettes
  • Cigarette tobacco
  • Roll tobacco yourself
  • smokeless tobacco

By subject and subject, the FDA also has “functions” that relate to these federal agencies:

  • Advertising – The Federal Trade Commission is a federal agency that regulates many types of advertising. The FTC protects consumers by stopping unfair, fraudulent, or fraudulent practices in the market. Consumers can write to FTC at 6th St. and Pennsylvania Ave., NW, Washington, DC 20580; Telephone 202-326-2222.
  • Alcohol – The Department of the Treasury’s Alcohol and Tobacco Tax and Trade Bureau (TTB) regulates aspects of alcohol production, import, wholesale distribution, labeling and advertising. Consumers can write to TTB, 1310 G St. NW, Box 12, Washington, DC 20005; Phone 202-453-2000 or visit the TTB contact page.
  • Consumer products The Consumer Product Safety Commission (CPSC) works to ensure the safety of consumer products such as toys, cribs, power tools, lighters, household chemicals, and other products that pose a fire, electrical, chemical, or mechanical hazard. Consumers can direct written inquiries to CPSC, Washington, DC 20207. CPSC operates a toll-free hotline at 800-638-2772 or TTY at 800-638-8270 to enable consumers to report unsafe products or receive product information and recalls.
  • Drugs of Abuse – The Department of Justice’s Drug Enforcement Administration (DEA) is committed to enforcing United States controlled substance laws and regulations, including the manufacture, distribution, and dispensing of legally manufactured controlled substances. Inquiries about DEA activities can be directed to the Drug Enforcement Administration, Office of Diversion Control 8701 Morrissette Drive Springfield, VA 22152; Telephone 202-307-1000.
  • Pesticides – The Environmental Protection Agency (EPA) regulates many aspects of pesticides. The EPA sets limits on how much of a pesticide can be used on food during cultivation and processing, and how much can be left on the food you buy. Public inquiries regarding EPA should be directed to the US Environmental Protection Agency, Office of Pesticide Programs Public Docket (7506C), 3404, 401M St., Washington, DC 20460; Telephone 202-260-2080.
  • Vaccines against animal diseases The Department of Agriculture’s Animal and Plant Health Inspection Service (APHIS), Center for Veterinary Biologics, regulates aspects of veterinary vaccines and other types of veterinary biologics. Public inquiries regarding APHIS’s Center for Veterinary Biologics should be mailed to Center for Veterinary Biologics, 1920 Dayton Ave, PO Box 844, Ames, Iowa, 50010; Phone 515-337-6100 or visit the APHIS contact page.
  • water The Environmental Protection Agency (EPA) regulates certain aspects of drinking water. EPA develops national standards for drinking water from municipal water supplies (tap water) to limit the level of contaminants.

The USDA’s Food Safety and Inspection Service regulates this the following:

FSIS regulates aspects of the safety and labeling of traditional (non-wild) meat, poultry, certain egg products and catfish. For a USDA investigation into an issue with these products, please provide:

  • The original container or packaging
  • Any foreign objects that you may have discovered in the product
  • Any part of the meal not eaten (chilling or freezing)

Here is the information the FSIS Hotline needs from you:

  1. Name, address and telephone number;
  2. Brand name, product name and manufacturer of the product
  3. The size and type of packaging
  4. Can or package codes (not UPC barcodes) and dates
  5. Establishment number (EST), usually found in a circle or sign next to the phrase “USDA passed and tested”;
  6. The name and location of the store and the date you purchased the product.
  7. You can complain to the store or the manufacturer of the product if you don’t file a formal complaint with the USDA.
  8. If an injury or illness is alleged to result from the use of a meat or poultry product, you must also inform the hotline staff about the nature, symptoms, time of occurrence and the name of the treating doctor (if applicable).

The FDA Center for Food Safety and Applied Nutrition, known as CFSAN, provides services to consumers, domestic and foreign industries, and other outside groups regarding field programs; Administrative tasks of the agency; scientific analysis and support; and policy, planning, and dealing with critical issues related to food, nutritional supplements, and cosmetics.

How to Report a Food Problem to the FDA

  • Please contact USDA for any questions or issues related to meat and poultry.
  • As a consumer, health professional or in the food industry, if you would like to voluntarily report a complaint or adverse event (illness or severe allergic reaction) related to a food, you have three options:
  • If you are a member of the food industry who is required to file a Reportable Food Register report when there is a reasonable likelihood that an article on food will cause serious health effects or death to people or animals, please visit the Reportable Food Register page.

How to Report Seafood Related Toxins and Sccombrotoxin Fish Poisoning Diseases

To help the FDA conduct effective investigations, remove unsafe seafood products from the market, and develop new prevention strategies, the FDA relies on disease reports from public health officials and health care providers. While most foodborne outbreaks are tracked through the FDA’s Coordinated Outbreak Response and Evaluation (CORE) network, seafood-related diseases caused by natural toxins have a unique reporting mechanism.

To contact the FDA by email:
US Food and Drug Administration
Center for Food Safety and Applied Nutrition
Mediation and information center
5001 campus drive, HFS-009
College Park, MD 20740-3835

The FDA requests that products not be sent to this address.

(To sign up for a free subscription to Food Safety News, click here.)

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