kathleen.dickson

FOR DISTRIBUTION
========================================

conndcj@po.state.ct.us,
http://www.ct.gov/cjc/cwp/view.asp?a=1361&q=258270

Programs & Services

APPOINTMENT OF PROSECUTORS

The Criminal Justice Commission is responsible for the appointment of
all state prosecutors in Connecticut, with the exception of those
assigned to Juvenile Matters.

These appointments include the Chief State's Attorney, the Deputy
Chief State's Attorneys, the State's Attorneys and Deputy Assistant
State's Attorneys.
==================

Good, That means I can report this RICO case to the CT Criminal
Justice Commission, and I can report duh DCF's prosecutors to this
CT Criminal Justice Commission, as well as the fact that the DCF
invented that I intend to murder my kids. I will see what they think
is the potential harm in that. Especially as regards the effect that
it all had on the Town of Stonington.


I also discovered:
http://www.newlearningcenter.com/staff.htm

One of them was a Commissioner of duh DCF.

THAT should be good. I did not know this, I just chose
Lustig from her resume alone.
"Laura Lustig, Ph.D., L.M.F.T., President and founder of NLC. She is
a licensed psychologist and a licensed marriage and family therapist
in practice for 20 years, specializing in working with young children
and their families, as well as with ***families dealing with chronic
mental handicaps. *** She is approved by the American Association for
Marriage and Family Therapy to supervise other marriage and family
therapists."
======================
http://www.newlearningcenter.com/syndrome.htm

"Special Issues:
ADHD, NLD, Aspergers Syndrome, PDD

All of these syndromes impact a child's life in school and home,
social and family relationships. Adults working with these children
must have a realistic understanding of these challenges, appropriate
expectations, an solution-oriented appraisals.

The New Learning Center clinicians are experienced in working with
these children individually, in social skills groups, and in family
sessions. Please contact us for more information.

Click here to go back to the Children's Services menu..."
============

Interestingly, she did not know Autism was related to
Neurofibromatosis
although that is in all the Psychiatry Textbooks.

I had to mention that Asperger's is different from High Functioning
Autism.

http://www.currentpsychiatry.com/2002_07/07_02_autism.asp

"Autistic disorder is the prototypical PDD that is associated with
abnormalities in reciprocal social interaction, qualitative
impairments in communication, and narrow interests and repetitive
behaviors (Table 1). By definition, symptoms of the disorder manifest
by age 3.

Asperger's disorder has several features ***that distinguish it from
autistic disorder***:

* Children with Asperger's disorder do not have language delays.
By definition, a child who has not developed single words by age 2
cannot be diagnosed with Asperger's disorder.

* Early cognitive development in Asperger's disorder is normal.
Children with Asperger's disorder are much more likely to have normal
or above-average intellectual functioning than children with autistic
disorder.

* Cir***scribed interests and intense preoccupations are more
common than motor stereotypies.
* Affected children may show verbal abilities that greatly exceed
their visual-spatial skills. This may be apparent on individualized
intelligence testing (i.e., verbal IQ > performance IQ) and clinically
in the form of good language abilities but lagging fine-motor
development (e.g., clumsiness).

===========

And now Lustig will know more about ADD in CT:

http://www.actionlyme.com/actionlyme_children_with_lyme_di.htm

See the section by Brian Fallon, and the links at the end (and thanks
to those
groups for making that data available).

"Cognitive Deficits identified in Children with Chronic Lyme Disease
(12/1999).

Dr. Felice Tager of Columbia University reported at the International
Lyme Conference in Munich Germany in June 1999 that compared to age-\0
and education-matched controls, children with chronic Lyme Disease may
experience persistent problems with attention, mood, and behavior.
These results add to a small but growing body of published data
indicating that Lyme Disease may cause chronic cognitive problems in a
sub-group of children with Lyme Disease. This study examined children
with a well-do***ented history of Lyme Disease who were premorbidly
healthy but who had persistent neuropsychiatric complaints subsequent
to what is considered adequate treatment. The Lyme disease group,
compared to healthy controls, had more psychopathology and more
cognitive deficits. The psychopathology consisted primarily of higher
levels of depression and anxiety. Most troubling to these children was
that they felt ineffective: having to push to do schoolwork; doing
poorly in subjects that were previously not problematic; not being as
..good as the other kids; doing things incorrectly. The areas of
psychopathology most strongly affected had to do with the secondary
effects of a new onset cognitive problem. When the cognitive status
was examined, the children with Lyme Disease had deficits in overall
perception and organization, distractibility, general memory, and
verbal memory. A closer look at the pattern of deficits suggested that
these children with Lyme Disease had developed problems in visual and
auditory attention. ****This pattern might be mistakenly diagnosed as
one of primary Attention Deficit Disorder.**** Because these deficits
would be reversible after appropriate antibiotic therapy, Dr. Tager
emphasized the need for educators and parents to be aware of this
association . particularly when working or living in a Lyme endemic
area. "


Connecticut has the highest rate of Attention Deficit in the Country,
and according to duh DCF’s Karen Andersson: "Unfortunately it's
becoming more and more of a problem," said Karen M. Andersson, PhD,
director of mental health for the Department of Children and Families.
"More and more younger children are experiencing behavior
difficulties that are so extreme they're not able to function in the
preschool environment and home."-- April 2001

That would clearly be because there is an epidemic of Tick Borne
Diseases, according to Matthew Cartter: “The overall incidence rate
of Lyme disease in our sample of 1006 households showed that 29.4%
(n=296) indicated that at least one member of the household had
contracted Lyme disease.�

http://www.ucc.uconn.edu/www.ucc.uconn.edu/~wwwlyme/nera97.html

=============

I will approve uh duh DCF forwarding *all* my reports to this group,
since the DCF is too stupid to understand the meaning of this data
themselves. I will also request that all this data, along with my
communications to duh DCF *BEFORE* Congressman Simmons
assisted me with getting my records from the morons uh duh
DCF (and I discovered I was wasting my time, demonstrating how
one should care for children in this endemic area, who might be
misdiagnosed, because duh DCF is mentally incompetent), to all
the other State HIred PSych Guns, so that they all become aware
of the hazards of misdiagnosis and mistreatment.

FUNNIER STILL, duh NEW COMMISSIONER wanted this data
circulated. So, she is JUST AS STUPID AS THE REST OF THEM.

Lyme is RICO, and if a kid has WEstern Blot band 41, that is
associated
with neurologic disease, and is NOT a "Psychiatric" disorder, since
41 related to spirochetes, all of which are neurotropic.

And they need to be treated medically, since that is the
APA's Guideline:


http://www.lawandpsychiatry.com/html/practice%20guidelines.htm


As you can see, the APA took that off the web, for legal reasons
(like, Malpractice lawsuits), obviously but I have a full copy.


Grab a copy of this before it also goes off the web:
http://www.medscape.com/viewarticle/450046
2003 version:

"Carnes et al. point out that very few clinical trials have been
conducted that compare various pharmacological interventions for
managing acute delirium. Those that do exist have not focused on older
inpatients with delirium unrelated to alcohol or benzodiazepine
withdrawal. The results of this study, they assert, indicate an urgent
need to further explore the field of delirium and its treatments,
particularly different pharmacological agents."

"Far too many older adults in the hospital are probably getting
***drugs that exacerbate a condition that is associated with bad
clinical and economic outcomes," says Carnes. She suggests that to
improve the treatment strategy for elderly patients suffering delirium
and comorbid medical illness all offending, precipitating causes be
removed.***

***** Best Practices *****
Clinical Management of Delirium Not Standardized

from The Brown University Geriatric Psychopharmacology Update
Posted 03/05/2003


Researchers from the University of Wisconsin's Center of Women's
Health and Women's Health Research and Section of Geriatrics recently
published the first report assessing physicians' clinical preferences
in the management of delirium in elderly inpatients.

Molly Carnes, M.D., and colleagues conducted a cross-sectional mail
survey of members of the American Geriatrics Society and found that
lorazepam (Ativan) was the most commonly chosen treatent option, with
haloperidol (Haldol) also selected by more than half of the
responders.

The choice of a pharmacological therapy in itself is somewhat
disturbing, according to the authors, but the particular agents
selected raises concern, they added, as these medications have been
implicated as triggers for delirium.
Survey Details

Carnes, director of the Center, and colleagues created a two-part case
scenario of a 78-year old woman hospitalized with a hip fracture who
develops mild and then severe delirium; the authors then presented a
number of treatment options, including diagnostic tests and other
interventions as well as pharmacological agents. The diagnostic
choices included computed tomography (CT) of the head,
electroencephalography (EEG), magnetic resonance imaging (MRI) of the
head, lumbar puncture, none or other tests. Respondents were asked to
specify if the option "other" were chosen.

Pharmacological options included lorazepam, haloperidol, and a
combination of these two agents. Other interventions included
restraints, close observation and a bed-sitter or other, with a
request to specify if "other" was chosen. Respondents were allowed to
add interventions not included in the questionnaire. Should medication
be selected, respondents were asked to specify method of
administration (oral, intramuscular or intravenous) as well as initial
dose (less than 1 mg, 1 mg, 2 mg, 5 mg or 10 mg). Additionally, if
combination pharmacological therapy were chosen, respondents were
asked to indicate the initial dose of haloperidol.

The study was approved by the University of Wisconsin Human Subjects
Review Committee and the questionnaire was developed with a group of
24 members of the Wisconsin Association of Medical Directors. The
authors note that three responses considered "best practices" were
selected a priori. Those included no brain imaging, lumbar puncture,
or EEG for investigation of mild delirium in this setting, haloperidol
as a single initial agent for severe delirium, and an initial dose of
1 mg or less.

To locate an appropriate sample of physicians, Carnes et al. selected
every fifth name with a U.S. address from a membership list of the
American Geriatrics Society (N = 489). In January 1999, the surveys
were mailed and responses were accepted through the following January.
The final selection included 122 respondents (43%) who corresponded to
the a priori designation of "best practice."

Carnes notes that her team of researchers used literature, expert
opinion, the American Psychiatric Association's (APA) guidelines and
the results from their pilot study of approximately 25 nursing home
medical directors to establish "best practice" standards. After using
Fisher's exact two-tailed test to assess discrepancies, the authors
identified no significant differences in "best practice" between
clinical specialty - i.e., internal medicine, family practice,
psychiatry, other; ***; date of graduation; fellowship completion;
certificate status; practice setting - or major professional activity.
Responses Varied

The responses showed that 50 physicians chose an unnecessary
diagnostic test to evaluate simple mild delirium, including: 42 head
CT; two head MRI; two EEG; two EEG plus MRI; one CT plus lumbar
puncture and one lumbar puncture alone. Most respondents (74%),
however, opted to observe closely and provide a bedside attendant.
Forty-seven physicians (17%) selected pharmacologic intervention for
this stage of delirium. Thirty respondents chose haloperidol, 11
selected lorazepam, one preferred both concurrently and five wanted to
use another drug.

Once the scenario advanced to severe delirium, 66 percent of the
respondents chose an antipsychotic agent. Twelve (4%) chose no
pharmacological intervention and 180 (64%) selected haloperidol alone.


wrote in another drug.

Fifty-five (20%) chose mono-therapy with lorazepam and 23 (8%)
selected a combination of lorazepam and haloperidol. The seven
respondents who wanted haloperidol for severe delirium would also have
administered lorazepam for mild delirium. These results indicate that
85 (30%) respondents chose lorazepam, alone or in combination with
haloperidol for mild or severe delirium.

The authors report that of the 180 who selected haloperidol as
stand-alone therapy, 70 (39%) indicated less than 1 mg as the initial
dose, 75 (42%) chose 1 mg, 30 (17%) chose 2 mg and five (3%) chose 5
mg, while no one selected 10 mg. Also, of those who selected
haloperidol 1 mg for severe delirium, three chose a dose of 2 mg for
mild delirium.

Of the 85 who chose lorazepam, 27 (54%) chose a dose of at least 1 mg:
21 (42%) chose 1 mg, two (4%) chose 2 mg and no one chose a higher
initial dose. With regard to method of administration, 117 of the 180
selecting haloperidol (66%) opted for intramuscular injection; 29
(16%) chose an intravenous course, and 32 (18%) selected an oral
solution. Administration of lorazepam alone was split evenly with 18
(33%) each selecting intra-muscular, intravenous and oral methods.
Intramuscular administration of the combination of haloperidol and
lorazepam was selected by 17 (74%) of the respondents. Thirty-four
(12%) respondents chose restraints, 14 of whom selected vest, 14 wrist
and six both.
Areas of Concern

Carnes et al. report that the findings from this survey study raised
concern in some areas. Fewer than half of the responding physicians
with expertise in geriatrics provided answers congruent with current
expert recommendations. Additionally, many of those who replied
selected diagnostic tests that are generally considered unnecessary
for cases of mild delirium. Some of the tests, specifically
neuroimaging, do not contribute to and, in some cases, may confuse an
accurate diagnosis. Such unnecessary diagnostic testing may further
agitate the patient if sedation is necessary before placing him or her
in the CT or MRI apparatus and almost assuredly increases the cost of
heath care.

Nonpharmacological interventions for managing mild dementia, however,
were consistent with current recommendations. Pharmacological
management of severe delirium was also within current guidelines as
was respondent's preference for haloperidol. Although the choice of
pharmacological agent was appropriate, the initial dose selected was
higher than generally recommended for older patients.

One result of considerable concern is the selection of lorazepam as
monotherapy for the management of severe delirium. Twenty percent of
the respondents made this choice and four percent chose the same drug
for mild delirium. According to the APA, benzodiazepines "have been
shown to be ineffective" in general cases of delirium and "can
exacerbate symptoms of delirium." This survey suggests that even
geriatricians widely prescribe lorazepam for delirium.

Additionally, the combination therapy of haloperidol and lorazepam, as
selected by eight percent of those choosing pharmacological
intervention for severe delirium, finds little evidence to support the
decision, according to the authors.

The authors admit that this survey study does have its limitations. No
information on the non-responders was obtained, other than the fact
that they belong to the American Geriatrics Society. Nevertheless, had
the nonresponders chosen the expert recommendations of no drug
treatment for mild delirium and haloperidol alone for severe delirium,
19% (85/436) of the responders would still have chosen lorazepam,
alone or in combination with haloperidol for mild or severe delirium.
Thus, the conclusions would remain the same.

Carnes notes that very few psychiatrists responded to the survey, but
those that did provided answers more in line with "best practices."

She says, "I guess the bottom line is that they [psychiatrists] need
to do a better job of educating non-psychiatrists providing care to
older adults with delirium that benzodiazepines should be avoided,
except in very unusual cases, for instance, alcohol or benzodiazepine
withdrawal. This is in line with the APA guidelines on delirium."

She urges general caution when treating delirium in the elderly.

"Far too many older adults in the hospital are probably getting drugs
that exacerbate a condition that is associated with bad clinical and
economic outcomes," says Carnes. She suggests that to improve the
treatment strategy for elderly patients
sufferingdeliriumandcomorbidmedical illness all offending,
precipitating causes be removed.

"If that doesn't work," she says, "use small doses of haldol.
Depending on the size of the patient, a dose of 0.25 is not
unreasonable as a starting dose; 0.5 if the patient is bigger."

Carnes et al. point out that very few clinical trials have been
conducted that compare various pharmacological interventions for
managing acute delirium. Those that do exist have not focused on older
inpatients with delirium unrelated to alcohol or benzodiazepine
withdrawal. The results of this study, they assert, indicate an urgent
need to further explore the field of delirium and its treatments,
particularly different pharmacological agents.

The Brown University Geriatric Psychopharmacology Update 7(3):1, 4-5,
2003. © 2003 Manisses Communications Group, Inc.

greegor

RICO is Federal Law, Enforced by Feds, not state.


Prosecutors? Absolute Immunity. Sorry.
DCF? State Agency has absolute sovereign immunity. Sorry.
RICO is criminal so you're wasting your time going
after a state agency.

Best bet is a Ch 42 Section 1983 and 1985 Civil Rights suit.
Federal Court.

Name the individuals up and down the chain of command
from the caseworker up to the Governor. Name all of the
middle managers. Go for a couple hundred thousand.

Again, be diplomatic, follow proper form for court.


Did you ever look up Qui Tam Whistleblower law?