Category Archives: Pediatrics
EBOLA UPDATE: WHO Declares an International Health Emergency
(NewPublicHealth is monitoring the public health crisis in West Africa.)
The West African Ebola outbreak, which has now killed 961 people, has been deemed an “extraordinary event” and an international health risk by the World Health Organization (WHO). "The outbreak is moving faster than we can control it," said WHO Director-General Margaret, according to Reuters. "The declaration...will galvanize the attention of leaders of all countries at the top level. It cannot be done by the ministries of health alone." Read more on Ebola.
NGA Picks Four States to Study Improving Outcomes in the Juvenile Justice System
The National Governors Association has selected Arkansas, Indiana, Michigan and Tennessee to examine new ways to improve outcomes for kids in the juvenile justice system. The four states will “explore strategic recommendations, focusing on improving information sharing across youth-servicing systems, limiting involvement of low-risk youth in the juvenile justice system and expanding community based-alternatives to incarceration,” according to a release. The goals are to lower recidivism rates, reduce costs and improve public safety. Read more on pediatrics.
Study: HIV Diagnosis Rate Down by One-Third Over the Past Decade
The rate of diagnosed HIV infections has dropped by approximately one-third over the past decade, according to a new study in The Journal of the American Medical Association. In 2011, approximately 16 of every 100,000 people in the United States ages 13 and older were diagnosed with HIV; in 2002 the rate was approximately 24 in every 100,000. The rate increased for young gay and bisexual men, but decreased among men, women, blacks, whites, Hispanics, heterosexuals and users of injected drugs. Read more on HIV/AIDS.
EBOLA UPDATE: Nigeria Confirms Second Ebola Case
(NewPublicHealth is monitoring the public health crisis in West Africa.)
Nigeria today confirmed its second case of Ebola amidst an epidemic that has so far killed more than 700 people in West Africa. Liberia has also ordered the cremation of all bodies of people who die from Ebola, in response to communities concerned over having the bodies buried nearby. However, even as the virus continues to spread in West Africa, Anthony S. Fauci, MD, Director of the National Institute of Allergy and Infectious Diseases, has told NBC that the risk posed by the return of the Ebola-infected health workers to the United States is "infinitesimally small.” The second U.S. patient is scheduled to arrive for treatment tomorrow. Read more on infectious disease.
HHS: New Committee to Advise on Children’s Health During Disasters
The U.S. Department of Health and Human Services (HHS) has announced the formation of a new federal committee to advise on children’s health issues during natural and manmade disasters. The National Advisory Committee on Children and Disasters’ contributions will include comprehensive planning and policies to meet kids’ health needs before, during and after disasters and other public health emergencies. The committee, formed under the Pandemic and All-Hazards Preparedness Reauthorization Act of 2013, includes 15 members selected from 82 nominations. Seven are from outside the federal government and 8 are from within (the full list is available here). "Ensuring the safety and well-being of our nation's children in the wake of disasters is vital to building resilience in every community,” said HHS Secretary Sylvia M. Burwell, in a release. “We look forward to working with the committee toward this common goal." Read more on disasters.
Toledo Lifts Ban on Drinking Water; 400,000 Residents Affected Over the Weekend
The town of Toledo, Ohio, has lifted the ban on drinking water implemented over the weekend after dangerously high levels of algae were found in Lake Erie. The Great Lake provides much of the area’s drinking water. Approximately 400,000 residents were affected by the ban. Read more on water and air quality.
Harold W. “Bill” Kohl, PhD, a professor of epidemiology at the University of Texas School of Public Health is in the midst of a three-year appointment to the President’s Council on Fitness, Sports & Nutrition (PCFSN) Science Board. Kohl’s role is to provide recommendations in the areas of program development and evaluation, which is critical to the Council’s mission to engage, educate and empower all Americans across to adopt a healthy lifestyle that includes regular physical activity and good nutrition. During his time at the School of Public Health, Kohl has been researching effective uses of social networking to create demand for healthy lifestyles among youth and working with organizations to promote disease prevention, physical activity and exercise as a health priority.
NewPublicHealth recently spoke with Kohl about the work of the President’s Council.
NewPublicHealth: Is the current mission of the President’s Council different than it was in the past?
Bill Kohl: There has been a shift. The President’s Council started in the 1950s as the result of a small study that suggested that American kids are not as fit as kids in Eastern bloc countries—Russia, primarily. The President’s Council started under President Eisenhower and then President Kennedy’s administrating sought to increase kids’ fitness by doing fitness testing in schools and promoting physical activity and physical education.
That wound its way through the ‘60s and ‘70s. Then in the ‘80s there was a much bigger rush to health-related physical fitness rather than skill-related fitness activities—things that you can actually change and that are related to health outcomes compared to fitness skills you might be born with, such as the ability to run a 50-yard dash.
Then, most recently, the Council has included nutrition in his mission and been renamed.
NPH: How does your background inform your new role?
Kohl: As chair of the science board, my job is to make sure that the President’s Council has the most up-to-date science that’s relevant to its mission and advancing initiatives that are evidence-based.
Study: Families With Preschoolers Purchasing Fewer High-Calorie Drinks
Recent progress in stalling and perhaps even reversing the childhood obesity epidemic may be linked to fewer families with preschool-aged children purchasing high-calorie drinks, according to a new study in the American Journal of Preventive Medicine. Researchers used Nielsen Homescan data from approximately 43,000 U.S. households with young children from 2000 to 2011, identifying the top 20 foods and beverages purchased. “Decreases in purchases of fluid milks, soft drinks, juice and juice drinks, and grain-based desserts were the primary drivers of this change,” said lead author Christopher Ford, MPH, doctoral candidate in nutrition at the University of North Carolina’s Gillings School of Global Public Health. “These data suggest that these households may have purchased fewer calories from solid fats and added sugars.” Previous research shows that approximately 70 to 80 percent of a preschooler’s diet comes from food purchased at stores. Read more on nutrition.
Peace Corps Withdraws from Three West African Countries Due to Ebola Crisis
The Peace Corps announced yesterday that it was removing all 340 of its volunteers from Liberia, Sierra Leone and Guinea in reaction to the increasing spread of the Ebola virus in West Africa. The organization said it has been working closely with experts from the U.S. Centers for Disease Control and Prevention and the U.S. Department of State to monitor the health crisis and determine how it should respond. “The Peace Corps has enjoyed long partnerships with the government and people of Liberia, Sierra Leone and Guinea and is committed to continuing volunteers’ work there,” according to a Peace Corps release. “A determination on when volunteers can return will be made at a later date.” Read more on global health.
Study: Women Who Live Near Green Spaces Give Birth to Healthier Babies
Pregnant women who live near green spaces—such as parks, community gardens and even cemeteries—give birth to healthier babies with significantly higher birth weights, according to a new study in the journal Occupational and Environmental Medicine. Researchers analyzed data on approximately 40,000 single live births in Tel Aviv, Israel. "We found that overall, an increase of surrounding greenery near the home was associated with a significant increase of birth weight and decreased risk for low birth weight," said Michael Friger, PhD, of Ben-Gurion University of the Negev's Department of Public Health. "This was the first study outside of the United States and Europe demonstrating associations between greenery and birth weight, as well as the first to report the association with low birth weight." Read more on maternal and infant health.
FDA Approves New Oxycodone with Abuse-deterrent Properties
The U.S. Food and Drug Administration (FDA) has approved a new extended-release oxycodone with abuse-deterrent properties. Targiniq ER—which should be used to treat pain severe enough to require daily, around-the-clock, long-term opioid treatment—contains naloxone which blocks the euphoric effects of oxycodone when crushed and snorted, or crushed, dissolved and injected. The drug is consistent with the FDA’s 2013 draft guidance for industry, Abuse-Deterrent Opioids – Evaluation and Labeling. "The FDA is committed to combatting the misuse and abuse of all opioids, and the development of opioids that are harder to abuse is needed in order to help address the public health crisis of prescription drug abuse in the U.S.,” said Sharon Hertz, MD, deputy director of the Division of Anesthesia, Analgesia and Addiction Products in the FDA’s Center for Drug Evaluation and Research. “Encouraging the development of opioids with abuse-deterrent properties is just one component of a broader approach to reducing abuse and misuse, and will better enable the FDA to balance addressing this problem with meeting the needs of the millions of people in this country suffering from pain.” Read more on substance abuse.
HHS: 10.3 Million Adults Gained Coverage in the ACA’s First Open Enrollment Period
An estimated 10.3 million uninsured adults gained health care coverage following the first open enrollment period in the Health Insurance Marketplace, according to a new study from the U.S. Department of Health and Human Services appearing the New England Journal of Medicine. The study looked at insurance trends before and after the open enrollment period, finding that the uninsured rate for adults ages 18-64 dropped from 21 percent in September 2013 to 16.3 percent in April 2014, which corresponded to a 5.2 percentage-point change, or 10.3 million adults gaining coverage. Read more on the Affordable Care Act.
Study: Parents of Obese Kids Often Don’t Realize They’re Unhealthy
Parents of obese children often don’t see their child’s weight as unhealthy and are more likely to make changes in their eating habits than to increase exercise, according to a new study in the Journal of the Academy of Nutrition and Dietetics. In a survey of more than 200 families in 2008 and 2009 to evaluate their readiness to help their children lose weight, researchers found that 28 percent of the parents did not see their child's weight as a health problem and 31 percent thought their child’s health was excellent or very good. The study also found that while 61 percent said they were trying to improve eating habits, only 41 percent were attempting to increase their child's activity level. Read more on obesity.
A 2012 report from the Robert Wood Johnson Foundation (RWJF) and Trust for America’s Health concluded that if the adult and childhood obesity rates in 2011 continued to increase at their steady paces, then by 2030 nearly two-thirds of U.S. adults would be obese and every single state would have obesity rates above 44 percent.
Data now show that childhood obesity rates have stabilized. In fact, for the first time in a decade the obesity rates among young children from low-income families in many states is trending down.
Helping lead the way in this important public health issue has been the city of Philadelphia, Penn., which has worked to improve access to healthy foods and opportunities for physical activity.
“We were very fortunate in Philadelphia to have colleagues...who have developed a better understanding of childhood obesity,” said Don Schwarz, former Health Commissioner and Deputy Mayor for Health and Opportunity, City of Philadelphia, and will also soon take on the role of director for RWJF’s Demand Team. “What that has meant is that Philadelphia was able to take a body of knowledge and bring it to scale. The partnership in Philadelphia that has allowed that to happen goes across government and between government and the private sector and community organizations—just everyday Philadelphians. So that kind of partnership, that wonderful knowledge base, has I believed turned the corner on childhood obesity, particularly for children who are of disadvantaged communities.”
Schwarz’s comments came during the Tuesday, July 22 Google Hangout TEDMED Great Challenges: A Candid Conversation About Childhood Obesity. The panel was moderated by Richard Besser, Chief Health and Medical Editor for ABC News.
Every member of the panel echoed the importance of partnerships, and Besser succinctly explained their critical role in not just obesity prevention but all public health efforts.
“The more creatively you can think and the wider variety of partners you can pull in, the more likely you are to be successful,” he said.
At the heart of Philadelphia’s success has been the important role that schools play in that community partnership. According to Schwarz, for the past decade the city’s schools have worked to reshape how they approach children’s health and wellbeing, including comprehensive nutrition policies, a new food environment that emphasizes healthy choices and more opportunities for kids to be physically active. One can’t be successful without the other.
While more than 30 million children receive free or reduced-cost meals through the U.S. Department of Agriculture’s (USDA) National School Lunch Program during the school year, only about 3 million of those kids sign on for summer meals through the USDA’s Summer Food Service Program, according to agency statistics. While not all 30 million need the summer meals—many are enrolled in summer programs that offer food or have parents that are able to take responsibility for providing meals—USDA and hunger experts know that millions are going hungry each summer, impacting their day-to-day lives, the learning gains of the previous year and learning readiness for the next grade.
“Most of the reason eligible kids aren’t getting meals in the summer is simply because parents don’t know about them,” said Audrey Rowe, head of the USDA’s Food and Nutrition Service, which runs the meal programs.
Last year, USDA made increasing the number of kids getting summer meals (sites typically serve one meal and a snack or two meals) a top priority, according to a the report Summer Doesn’t Take a Vacation, published by the Food Research and Action Center (FRAC), a Washington, D.C.-based nonprofit aimed at ending child hunger. According to the report, the summer of 2013 marked the first major increase in the number of low-income children eating sponsored summer meals in 10 years, and the program grew last year to serve nearly three million children, an increase of 161,000 children or 5.7 percent from 2012. This represents the largest percentage increase since 2003.
To reach those increases, the USDA worked with organizations including FRAC, Feeding America, Share Our Strength, the YMCA and other national, state and local stakeholders to target states with high rates of poverty, food insecurity and low participation rates in summer food programs. Efforts ran from high-level conversations with state governors—some of whom had known nothing about summer meal programs—to dozens of webinars to teach officials and private partners the nuts and bolts of running the programs. For example, sites are eligible in communities where more than half the area children receive subsidized school meals.
Study: Low-income Teens in Better High Schools Engage in Fewer Risky Behaviors
Low-income teenagers attending “high-performing” high schools are less likely than their peers in lower-performing schools to engage in risky behaviors such as carrying a weapon, binge drinking, using drugs other than marijuana and having multiple sex partners, according to a new study in the journal Pediatrics. Researchers analyzed 521 students who were accepted into a high-performing charter school; when compared to 409 students who also applied to top charter schools but were not selected in a random lottery, the kids in the high-performing schools were less likely to engage in at least one of the identified “very risky” behaviors—36 percent, compared to 42 percent. There was no statistical difference for more common risky behaviors, such as lighter drinking and smoking cigarettes. Read more on education.
Too Few People At Risk for Heart Disease are Receiving Recommendations for Aspirin Therapy
Despite the important role it can play in preventing heart disease, only 40 percent of the people who are at high risk of cardiovascular disease reported receiving a doctor’s recommendation for aspirin therapy, according to a new study in the Journal of the American Heart Association. Approximately one-quarter of people at low risk received the recommendation. “Cardiovascular disease is a significant problem in the United States and the appropriate use of prevention strategies is particularly important,” said Arch G. Mainous III, PhD, the study’s lead investigator and chairman of the department of health services research, management and policy at the University of Florida’s College of Public Health and Health Professions, in a release. “Aspirin has been advocated as a prevention strategy but only for certain patients. There are health risks associated with the treatment. It is important that doctors are directing the right patients to get aspirin for cardiovascular disease prevention.” The U.S. Preventive Services Task Force recommends aspirin use to prevent heart attack and stroke in men ages 45-79 and women ages 55-79. Read more on heart health.
Study: Coping Skills Programs for Mothers of Children With Autism Helps All Involved
Mothers of children with autism who participated in coping skills programs saw reduced stress, illness and psychiatric problems—all of which they are at higher risk for—while also improving their connections with their children, according to a new study in the journal Pediatrics. Such programs also benefit their children, as these risk factors are associated with poorer health outcomes for the children. Researchers entered 243 mothers of children with disabilities (two-thirds of which were autism) into six weeks of either Mindfulness-Based Stress Reduction (mindfulness practice) or Positive Adult Development (positive psychology practice), finding that both reduced stress and other negative impacts. Read more on mental health.
Earlier this month, following the heatstroke death of a Georgia toddler who was left in a sweltering car for hours, Tennessee became the first state in the nation to pass a law that specifically protects people from liability for forcibly breaking into cars and rescuing kids they think are at risk of heatstroke. The law requires those individuals to call 911 first and follow instructions.
Many states have Good Samaritan laws that may protect people in such instances, but the specifics vary from state to state, according to Cristina M. Meneses, JD, MS, a staff attorney with the Network for Public Health Law’s Eastern Region. A recent Today show poll found that 88 percent of the 44,000 people asked would break into a car to rescue a child they thought was in danger, but specific laws can increase the response—and potentially remove penalties—while raising awareness of the issue. More such laws could soon follow. Janette Fennell, founder and head of KidsAndCars, a nonprofit based in Kansas City, Mo., which advocates for laws that will protect kids from heat in vehicles, said she’s received inquiries from two states about those laws since Tennessee’s law was passed. Another set of laws that KidsAndCars tracks are those that penalize adults for leaving kids in cars. Nineteen states currently have such laws on the books.
“It’s a good deterrent for anyone who might think, ‘Oh, I’ll just leave them in the car for a minute,’” said Fennell, “because it’s often that minute that turns into much longer and results in injury or death.”
According to the National Highway Traffic Safety Administration (NHTSA), more than 40 kids—often under age 2—die each year of “vehicular heatstroke.” Seventeen U.S. kids have died after being left or trapped in car since the beginning of 2014. Fennell and other experts say many people just don’t realize how quickly temperatures can climb in a car, even if the window is cracked open a bit—when outside temperatures are in the low 80's, the temperature inside a vehicle can reach deadly levels in only 10 minutes, even with a window rolled down two inches. Children's bodies, in particular, overheat easily; and infants and children under four years old are at the greatest risk for heat-related illness.
NHTSA research shows that heatstroke deaths and injuries often occur after a child gets into an unlocked vehicle to play without a parent or caregiver's knowledge. Other incidents can occur when a parent or caregiver who is not used to transporting a child as part of their daily routine inadvertently forgets a child sleeping in the back.
Last week, KidsAndCars launched a petition drive to encourage NHTSA to require technology in all cars that would remind a driver that there is a child in the back. There are devices parents can install, but a 2012 study by NHTSA found that none that the agency studied were consistently effective.
“You get a warning if you don't buckle your seatbelt, leave a car door open, your gas is low or you leave your headlights on,” said Fennell. “If a child is left behind then you absolutely need a warning.”
Guidelines from NHTSA and other safety experts aimed at never leaving a child unattended in a car include:
- Make a habit of looking in the vehicle—front and back—before locking the door and walking away
- Ask childcare providers to call if a child doesn't show up for care as expected
- Put items in the back seat you’ll have to retrieve such as a purse or briefcase, or put a stuffed animal in sight of the driver to indicate there’s a child in the car.
Study: Common Asthma Treatment Suppresses Growth in Children
A common treatment for asthma may suppress growth in children, according to a new review of two studies that was published in The Cochrane Library journal. The studies included 45 trials on corticosteroid drugs, which are delivered via inhalers to both children and adults with asthma and generally used as first-line treatments for persistent asthma. "The evidence... suggests that children treated daily with inhaled corticosteroids may grow approximately half a centimeter less during the first year of treatment," said Linjie Zhang at the Federal University of Rio Grande in Brazil, according to Reuters. "But this effect is less pronounced in subsequent years, is not cumulative, and seems minor compared to the known benefits of the drugs for controlling asthma." The World Health Organization estimates that there are approximately 235 million people living with asthma. Read more on pediatrics.
Study: Busiest ERs Often Provide the Best Care
People with life-threatening emergencies have better odds of survival when treated at busier emergency departments, according to a new study in the Annals of Emergency Medicine. The study found that patients admitted to a hospital after an emergency had a 10 percent lower chance of dying in the hospital if they initially went to one of the nation's busiest emergency departments; that people with sepsis had a 26 percent lower death rate at the busiest emergency centers; and that lung failure patients had a 22 percent lower death rate. The researchers behind the study estimate that if all emergency patients received the level of care provided by the busiest emergency departments then approximately 24,000 fewer people would die each year. "It's too early to say that based on these results, patients and first responders should change their decision about which hospital to choose in an emergency," said Keith Kocher, MD, MPH, the lead author of the new study and a University of Michigan Health System emergency physician, in a release. "But the bottom line is that emergency departments and hospitals perform differently, there really are differences in care and they matter." Read more on health disparities.
HHS: $11M Toward Integrating HIV Services into Primary Care
As part of the ongoing National HIV/AIDS Strategy, the U.S. Department of Health and Human Services is making $11 million available for the integration of HIV services into primary care services in Florida, Massachusetts, Maryland and New York. The funds will go toward innovative partnerships between health centers and those states’ health departments. They are part of Partnerships for Care: Health Departments and Health Centers Collaborating to Improve HIV Health Outcomes, a multi-agency project that includes the U.S. Centers for Disease Control and Prevention and the Health Resources and Services Administration. Read more on HIV/AIDS.