What can doctors do to help kids stay away from drugs?
There's not much evidence to say one way or the other, it turns out.
The U.S. Preventive Services Task Force, which issues guidelines on what doctors should and shouldn't do, said there aren't enough reliable studies around to come up with any solid advice. So the task force gave the interventions an "I" for insufficient evidence. The kids might call it an incomplete.
We only identified six studies that addressed this question in primary care settings or in ways that were applicable to primary care, says Carrie Patnode, a research associate at Kaiser Permanente Center for Health Research.
Some of the interventions that have been studied include brief counseling sessions during an office visit, sometimes combined with computer-based screening. Other studies looked at computer-based interventions accessed at home.
"Studies on these interventions were limited and the findings on whether interventions significantly improved health outcomes were inconsistent," the task force said in a summary. The review and the task force's conclusions were published in the latest Annals of Internal Medicine.
Carrie, who led the review of the evidence for the USPSTF, tells Shots that clinicians may still want to screen for substance abuse. None of the studies showed any harm in in it. Less than half of pediatricians are doing that now, she says.
The lack of evidence doesn't mean doctors should do nothing. "When there is a lack of evidence, doctors must use their clinical experience and judgment, and many clinicians may choose to talk with an adolescent to prevent or discourage risky behaviors, such as drug use," USPSTF member Susan Curry said in a statement.
But, of course, there's the question of what primary care doctors choose to do during their short visits with children and teens. There are only so many questions a doctor gets to ask.
The American Academy of Pediatrics recommends that pediatricians routinely screen adolescent patients for drug use, including alcohol and tobacco. One tool is a six-question list that asks, among other things, whether the child has ever ridden in car with someone who was on drugs or who had been drinking.
Libya's prime minister lost a vote of confidence and has been dismissed after his government was unable to stop a North Korean-flagged tanker from loading oil at a rebel-held port and reportedly breaking through a naval blockade.
Ali Zeidan was replaced temporarily by the country's defense minister, Abdallah al-Thinni, parliamentary spokesman Omar Hmeidan said.
Reuters reports that Libya's navy opened fire on the tanker as it tried to leave Sidra, one of three ports that has been in the hands of separatist forces since August.
NPR's Leila Fadel reports that:
"The militia bypassed the central government and made its first oil sale last weekend.
"Meanwhile militias that support the [central government] are reportedly mobilizing to take back control of the ports."
The BBC says that the rebels "are seeking a greater share of the country's oil revenues, as well as autonomy for the historic eastern region of Cyrenaica."
According to the news agency:
"The tanker - named Morning Glory - was reported to have taken on at least 234,000 barrels of crude at Sidra's oil terminal.
"It was the first vessel to have loaded oil from a rebel-held port since the separatist revolt against the central government in Tripoli erupted in July.
"Earlier, the government had claimed to have control of the vessel, but the militia denied that controls Sidra denied the reports."
"There was no word immediately available from [Zeidan] on his ouster, which raises anew the potential for armed conflict. Most politicians in Libya are backed by militias with regional or ideological allegiances, and many are not likely to accept his removal."
This week Felix and I are heading over to one of our favorite places in the whole world — Austin, Texas — to meet up with some of our favorite musicians, watch some great live shows and, if Tio Felix has his way, eat a lot of Tex-Mex. Later today we'll be DJing a little get-together, and one of the highlights of this trip will certainly be our show with Chilean rapper Ana Tijoux. She's one of the best and brightest in Latin music today, and she has a stellar new record coming out, which you can listen to exclusively here.
We hope you can make it to SXSW and hang out with us, but if you can't, we've got your back with this list of songs — a sample of what we'll be spinning at tonight's event.
And you can listen to Alt.Latino Radio via the link above.
The Senate's intelligence oversight panel had its computers searched by CIA workers, who also improperly removed some documents that had been provided to the panel, Sen. Dianne Feinstein said in a lengthy and scathing speech on the Senate floor Tuesday. She said some of the actions could be illegal or unconstitutional.
The computers in question had been provided by the CIA to the Senate Intelligence Committee, which Feinstein chairs, so it could review thousands of the agency's secret documents on a closed network.
Feinstein, D-Calif., says the CIA never asked the panel how it acquired a sensitive internal agency review that was among the records.
"In place of asking any questions, the CIA's unauthorized search of the committee computers was followed by an allegation — which we now have seen repeated anonymously in the press — that the committee staff had somehow obtained the document through unauthorized or criminal means," she said.
In a separate appearance in Washington today, CIA Director John Brennan said the agency had not hacked into the committee's computers.
"Nothing could be further from the truth," Brennan said at a Council on Foreign Relations event. "We wouldn't do that. I mean, that's just beyond the scope of reason."
Brennan added that there are "appropriate authorities" reviewing the incident, concerning both the CIA and other agencies.
"I defer to them to determine whether or not there was any violation of law or principle."
In the Senate, Feinstein told her colleagues that the situation is "a defining moment for our intelligence committee." She added that she's hoping to complete the panel's long-in-coming report on the CIA's interrogation program, parts of which she wants declassified.
From Foreign Policy:
"For years, the Senate panel has been researching and fine-tuning a 6,300 page report that's said to be highly critical of the agency's interrogation practices. In order to research the program, committee staffers had to use computers provided by the agency in a CIA facility."
In recent years, Feinstein says, the CIA executed "a true document dump" that inundated the Senate panel with millions of pages' worth of documents, without an index or other means of collating them. She said the staff asked the CIA to create a search tool, which was provided.
Roll Call has some of the recent background:
"During her speech, Sen. Dianne Feinstein said she learned in January that the Central Intelligence Agency improperly searched committee computer files, confirming several media reports. She said the incident has been referred to the Department of Justice for possible prosecution. But Feinstein was also riled by a separate referral by the CIA to the Department of Justice suggesting that the committee staff had improperly received classified information."
The CIA's move was "a potential effort to intimidate this staff," Feinstein said, after realizing the committee had obtained a version of the agency's internal review of its interrogation program, known as the Panetta review. The CIA seems to have come to that realization after Feinstein requested the full and complete version of the document, rather than the incomplete one the panel already had.
Feinstein also says the CIA removed hundreds of pages of documents from a special database that had been created under strict rules. They were removed, she said, "in violation of CIA agreements and White House assurances that the CIA would cease such activities."
Asked about the senator's allegations today, Brennan said, "We are not in any way, shape or form trying to thwart this report's progression [or] release." He later added, "We want this behind us."
He added that he had referred the matter to the agency's inspector general for review.
"When the facts come out on this," Brennan said, "I think a lot of people who are claiming that there has been this tremendous sort of spying and monitoring, and hacking, will be proved wrong."
Before launching into her Senate speech that lasted for nearly 40 minutes, Feinstein described how she had resisted recent media requests for interviews about the Senate panel's clash with the CIA.
"However, the increasing amount of inaccurate information circulating now cannot be allowed to stand unanswered," she said.
She then revisited a decade's worth of tension between the committee and the CIA, noting that there had been a gap between 2002 to 2006 before any members of the panel other than its two leaders were informed of the CIA's detention and interrogation program.
"In fact, we were briefed by then-CIA Director Hayden only hours before President Bush disclosed the program to the public," Feinstein said. She also recalled that the agency had destroyed video records of interrogations that had used "enhanced techniques."
That and other incidents were mentioned as forming a pattern of attempts to CIA to obfuscate details of its interrogation and detention program.
Here's an extended passage from Feinstein's speech today:
"In early January 2014, the CIA informed the committee it would not provide the internal Panetta review to the committee, citing the deliberative nature of the document.
"Shortly thereafter, on Jan. 15, 2014, CIA Director Brennan requested an emergency meeting to inform me and vice chairman [Rep. Saxby] Chambliss that without prior notification or approval, CIA personnel had conducted a search — that was John Brennan's word — of the committee computers at the offsite facility.
"This search involved not only a search of documents provided... by the CIA but also a search of the stand-alone and walled-off committee network drive, containing the committee's own internal work product and communications.
"According to Brennan, the computer search was conducted in response to indications that some members of the committee staff might already have had access to the internal Panetta review. The CIA did not ask the committee or its staff if the committee had access to the internal review, or how we obtained it.
"Instead, the CIA just went and searched the committee's computers. The CIA has still not asked the committee any questions about how the committee acquired the Panetta review. In place of asking any questions, the CIA's unauthorized search of the committee computers was followed by an allegation — which we now have seen repeated anonymously in the press — that the committee staff had somehow obtained the document through unauthorized or criminal means, perhaps to include hacking into the CIA's computer network."
"This is not true," Feinstein said. "The document was made available to the staff at the off-site facility, and it was located using a CIA-provided search tool," she said.
Deborah Hersman, known to many Americans because she's the face of the National Transportation Safety Board at the scene of plane crashes and other transportation-related disasters, is stepping down as head of the NTSB.
Chairman of the NTSB since 2009 and a member of its board since 2004, she is departing in late April to be president and CEO of the National Safety Council, a nonprofit group chartered by Congress and based in Itasca, Ill. The council describes its mission as "partnering with businesses, government agencies, elected officials and the public in areas that can make the most impact - distracted driving, teen driving, workplace safety, prescription drug overdoses and Safe Communities." It was formed in 1913.
NPR's Brian Naylor notes that as head of the NTSB, "Hersman was a familiar face at agency briefings on everything from the crash landing of an Asiana Airlines jet last summer to conferences on distracted driving."
"If you are lucky in life, you get a chance to have a dream job. If you are really lucky, you get to have more than one dream job. I look forward to continuing to improve the safety landscape with the Board of Directors and employees of the National Safety Council, another organization dedicated to saving lives and preventing injuries. And yes, I know how lucky I am."
Bloomberg News adds that "as chairman, Hersman broadened the board's mission to transportation risks such as drunk and drugged driving and fatigue across modes, rather than just responding to accidents."