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Aug 29 2014
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School-Based Health Centers Help Remove Barriers to Care

It’s no secret that kids perform better in school when they are healthy and feel motivated to learn. But not all kids have access to the quality health care that can help them get healthy, stay healthy or treat any chronic health conditions they have. That’s where school-based health centers come in.

School-based health centers are partnerships between schools and community health organizations. They help students get the preventive care they need—including flu shots, annual physicals, dental exams, vision exams and mental health counseling—right where they spend most of their daytime hours: On school grounds. There are currently more than 2,000 school-based health centers across the country. Besides removing barriers to health care that many families face, school-based health centers help reduce inappropriate visits to emergency departments by up to 57 percent, research has found. They also help lower Medicaid expenditures, decrease student absences from school and do a better job of getting students with mental health issues the services they need.

Moreover, with growing recognition that health disparities affect academic achievement, school-based health clinics help close the gap by providing crucial access to health care for students who might not otherwise get it. A study by researchers at the University of Washington, Seattle, found that high school students who used school-based health centers experienced greater academic improvements over the course of five semesters than students who didn’t use these centers; the effect was especially pronounced among those who took advantage of mental-health services. Another study found that high school students who were moderate users of school-based health centers had a 33 percent lower dropout rate in an urban setting that has a high dropout rate.

The exact services offered by these centers vary by community. At Santa Maria High School in Santa Maria, Calif., the health center’s offerings include crisis intervention sessions; a grief group for students dealing with loss; and ongoing opportunities for students to build important social skills and skills that will help them maintain a healthy lifestyle. In Oakland, Calif., the Native American Health Center offered at a middle school and a high school provides medical care, dental care, mental health services and a peer health education program in one setting. At the Maranacook Health Center in central Maine, kids can get support for chronic health problems (such as asthma, diabetes, or seizures), medications they need, counseling or other mental-health evaluations and services.

The ultimate goal behind these centers is for all children to enjoy and benefit from good health and school success.

“Children and adolescents are at the heart of the mission,” said John Schlitt, president of the School-Based Health Alliance, based in Washington, D.C. But the “scope of the health center’s influence extends beyond the clinic walls to the entire school, its inhabitants, climate, curriculum, and policies. The school is transformed as a hub for community health improvement.”

Aug 29 2014
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Public Health News Roundup: August 29

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WHO: 20,000 Could Be Infected Before Ebola is Under Control
The World Health Organization (WHO) now estimates that the ongoing Ebola outbreak in West Africa could infect as many as 20,000 people before public health officials are able to get it under control. The latest numbers on the disease place the number of infected at 3,069, with 1,552 deaths. Also yesterday, an article in the journal Science reported that the virus has mutated repeatedly during the outbreak, making it even more difficult to manage. Five of the report’s 50 co-authors have died of Ebola. Read more on Ebola.

CDC: Majority of Parents Have their Children Vaccinated
The majority of parents have their children receive routinely recommended vaccinations, according to the latest Morbidity and Mortality Report from the U.S. Centers for Disease Control and Prevention. The report found that in 2013:

  • More than 90 percent of babies were vaccinated against measles, mumps, and rubella (MMR); poliovirus; hepatitis B; and varicella
  • 73 percent were vaccinated against rotavirus
  • 83 percent were vaccinated against Hepatitis A
  • 74 percent were vaccinated against Hepatitis B
  • Less than 1 percent of children received no vaccines

“I want to personally recognize the hard work of doctors and nurses coping with many challenges in the course of clinical work, and commend parents who, despite competing responsibilities, continue to prioritize immunization to keep their children healthy and safe,” said Anne Schuchat, MD, director of the National Center for Immunization and Respiratory Diseases. “These people are central in keeping young children healthy by ensuring they receive the recommended vaccines on schedule.” Read more on vaccines.

Study: Conflict Between Parents Also Causes Conflict with Children
Conflict between parents in a marriage also has a negative impact on parents’ relationships with their children, according to a new study in the Journal of Family Psychology. Researchers had parents in more than 200 families write daily diary entries for 15 days, then had each parent rate the quality of both their marriage and their relationships with their kids. They found that days with conflict between parents also had increased cases of problems between the parents and their children. "We see from the findings that the marriage is a hub relationship for the family. The quality of that relationship spills over into each parent's interactions with the child. So if mom and dad are fighting, it will show up initially—and in some cases on the second day—in a poorer quality relationship with their kids,” said study author Chrystyna Kouros, an assistant professor in the psychology department at Southern Methodist University, Dallas, in a university news release. Read more on pediatrics.

Aug 28 2014
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Reducing Environmental Risks for Kids in Schools

Most parents send their children off to school expecting they’ll have their minds enriched and expanded—they don’t expect that their kids’ health to be jeopardized.

But the reality is that the environmental conditions in aging or deteriorating school facilities can harm kids’ health and compromise their ability to learn. This is partly because children may be exposed to a variety of environmental hazards—such as lead, asbestos, molds, radon and volatile organic compounds—as well as toxic chemicals and pesticides at school. Half of U.S. schools have problems with indoor air quality, according to the Environmental Protection Agency (EPA), and research suggests that the poorest children in the poorest neighborhoods have schools that are in the worst condition.

Sixty percent of kids suffer health and learning problems that stem from the conditions of their schools, according to the Coalition for Healthier Schools’ Towards Healthy Schools 2015 report. Children are especially vulnerable because they’re smaller; their organs are still developing; they spend more time on the ground; and they breathe more air and drink more water per pound of body weight than do adults, according to the EPA. They also may not be able to identify obvious hazards and move away from them.

Reducing environmental risks in schools offers significant payoffs in multiple domains. Improving indoor air quality can reduce asthma attacks by nearly 40 percent and upper respiratory infections by more than 50 percent, according to the 2006 report Greening America’s Schools: Costs and Benefits. What’s more, a study weighing the costs and benefits of developing green schools for Washington State estimated a 15 percent reduction in absenteeism and a 5 percent increase in test scores, according to the Towards Healthy Schools 2015 report.

“A healthy school has a building that promotes health and learning—it will be clean, dry, and quiet. It will have good control of dust and particulate matter. It will provide good ventilation and good air quality,” said Claire Barnett, founder and executive director of the Healthy Schools Network Inc., a non-profit organization dedicated to children’s environmental health and safety in schools. “This also assumes there’s no lead in the pipes, no PCBs in lighting or other old building materials, and no routine spraying of pesticides indoors or out. It shouldn’t be hard to have a building that meets these standards but it is. Parents shouldn’t take it for granted that a school facility is healthy.”

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Aug 28 2014
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Public Health News Roundup: August 28

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EBOLA UPDATE: Death Toll Passes 1,500 as Outbreak Accelerates
(NewPublicHealth is monitoring the public health crisis in West Africa.)
The West African Ebola outbreak continues to accelerate, according to the World Health Organization (WHO), which today announced there have so far been 3,069 probable and confirmed cases; 1,552 people have died. While most cases remain concentrated in only a few localities, WHO estimates that more than 40 percent of the total cases have occurred within the past 21 days.

In other Ebola news:

  • Earlier this week, IDV Solutions released an infographic showing how this Ebola outbreak—the largest in history—compares to previous outbreaks of the disease.
  • The National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health, will begin initial human testing of an Ebola investigational vaccine next week.

Read more on Ebola.

Teens Who Don’t Get Enough Sleep Are at Increased Risk of Obesity
Teenagers who don’t get enough sleep are at increased risk of being obese by age 21, according to a new study in Journal of Pediatrics. Researchers at Columbia’s Mailman School of Public Health analyzed health information on more than 10,000 teens and young adults at the ages of 16 and 21, finding that the 16-year-olds who reported less than six hours of sleep per night were 20 percent more likely to be obese by age 21. Potential reasons for the link include appetite changes and cravings due to daytime sleepiness and fatigue. The U.S. Centers for Disease Control and Prevention recommends nine to ten hours of sleep per night for teenagers. Read more on pediatrics.

Study: ‘Rules of Thumb’ on Pouring Help Reduce Excessive Drinking
Curbing a person’s excessive drinking may be as simple as thinking about how much is poured into each glass, according to a new study in the International Journal of Drug Policy. Researchers from Iowa State University and Cornell University had 74 college students pour red or white wine in a variety of settings, finding that those students who use a “rule of thumb” to dictate their pours—such as only filling half the glass or leaving space equivalent to two fingers at the top—poured less, regardless of their BMI or gender. “About 70 percent of the people in the sample used the half-glass rule, and they poured significantly less by about 20 percent,” said Laura Smarandescu, lead author and an assistant professor of marketing at Iowa State, in a release. “It’s a big difference. We would suggest using a rule of thumb with pouring because it makes a big difference in how much people pour and prevents them from overdrinking.” Read more on alcohol.

Aug 27 2014
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On the Ball: Promoting the Need for Concussion Prevention in Youth Sports

The start of the school year also means a return to team sports. There’s no question that playing a team sport provides clear benefits for kids, including the opportunity to develop physical fitness and other healthy habits, good sportsmanship, self-esteem and self-discipline. Kids who play sports are also less likely to engage in risky behaviors such as smoking or substance abuse.

But there is a potential dark side: An increased risk of sports-related injuries, with concussions at the top of the list of current concerns. Each year nearly 250,000 kids go to emergency departments for suspected sports-related concussions and there’s growing recognition that continuing to play with a concussion can lead to long-term effects on the brain, especially for kids. Girls also now have a higher rate of sports-related concussions than do boys, according to the Children’s Safety Network.

Because of all of these reasons there’s a major push underway to prevent concussions in all youth sports, not just in football, since concussions also commonly occur in girls’ and boys’ soccer, lacrosse, basketball and other sports, according to the American Academy of Pediatrics. In May, the White House hosted the first-ever Healthy Kids & Safe Sports Concussion Summit to promote and expand research on sports-related concussions among kids and raise awareness of steps that can be taken to help prevent, identify and respond to concussions in young athletes.

Meanwhile, the U.S. Centers for Disease Control and Prevention (CDC) launched the Heads Up: Concussion in High School Sports initiative to help coaches, athletes and parents take steps to prevent concussions and respond appropriately if they occur. Among the prevention measures being introduced are modifications to protective gear (including new helmet technology for various sports), rule changes (such as limits on heading drills in soccer practices and tackling drills in football), identifying athletes who are at risk (by looking for genetic markers of risk) and educating everyone involved with youth sports about the dangers of concussions.

There are also stricter guidelines about when it’s appropriate for athletes to return to play after a concussion, based on their physical and cognitive symptoms; concussion history; and adherence to a step-by-step process for returning to the field or court. The CDC now recommends that coaches and parents consider whether their league or school should conduct baseline testing—a pre-season exam to assess an athlete’s balance and brain function—so that if a concussion is suspected to have occurred, the baseline results can help establish the extent of the head injury.

“Players, coaches and parents are demanding that we find a way to reduce concussion risk in sports,” said Michael Sims, head athletic trainer for football at Baylor University and a board member of the National Operating Committee on Standards for Athletic Equipment. “But equipment can’t do it alone. It’s critical that safe play and return to play practices are enforced.”

Aug 27 2014
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Public Health News Roundup: August 27

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EBOLA UPDATE: Roundup of the Latest News Out of West Africa
(NewPublicHealth is monitoring the public health crisis in West Africa.)
As the death toll continues to rise, here’s a look at some of the latest news on the ongoing Ebola outbreak in West Africa.

Read more on Ebola.

Study: Significant Time Spent Playing Violent Video Games Increases the Risk for Depression in Kids
Significant time spent playing violent video games is linked to a greater risk for depression in preadolescent youth, according to a new study in the journal Cyberpsychology, Behavior and Social Networking. Researchers from The University of Texas Health Science Center at Houston (UTHealth) examined 5,147 fifth grade students in three major cities and found that kids who play such games for more than two hours per day showed significantly more depression symptoms, including lack of pleasure, lack of interest in activities, concentration difficulties, low energy, low self-worth and suicidal ideation over the past year. “Previous studies have observed how aggression relates to video games, but this is the first to examine the relationship between daily violent video game exposure and depression,” said Susan Tortolero, PhD, principal investigator and director of the Prevention Research Center at the UTHealth School of Public Health, in a release. Read more on mental health.

WHO Calls for Stronger Regulation of E-Cigarettes
The World Health Organization (WHO) has joined the American Heart Association and other organizations in calling for stronger regulation of e-cigarettes, which are a $3 billion worldwide industry. WHO is now recommending that their indoor use be banned until they are proven harmless to bystanders; the international health organization is also calling for its 194 member states to ban the sale of e-cigarettes to minors, as well as to ban or minimize their advertising. According to the agency, regulation "is a necessary precondition for establishing a scientific basis on which to judge the effects of their use, and for ensuring that adequate research is conducted and the public health is protected and people made aware of the potential risks and benefits." Read more on tobacco.

Aug 26 2014
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The Walking School Bus: A Safe and Active Way to Get Kids to School

With research indicating that fewer children are walking or biking to school than in decades past—and with the childhood obesity epidemic in full swing—health experts have been brainstorming solutions that would address both issues. In recent years, a simple but effective concept has been gaining traction at the grass-roots level: Why not organize a “Walking School Bus”—a group of kids who walk to school with one or more adults, so that kids can get exercise on their way to and from school?

A Walking School Bus is “just like a regular school bus, but without the walls and seats, and instead of wheels, we use our feet,” explained LeeAnne Fergason, education director for the Bicycle Transportation Alliance in Portland, Ore., which has a thriving Walking School Bus program. Other communities around the country that have well-established Walking School Bus programs include Chapel Hill, N.C.; Sacramento, Calif.; Burlington, Vt.; Columbia, Mo.; and Duluth, Ga. In the Fall of 2014, many more schools—including Grand View Elementary in Manhattan Beach, Calif.; Greenacres Elementary in Scarsdale, N.Y.; Madison Elementary in Redondo Beach, Calif.; and several elementary schools in Spokane, Wash.—will be joining the trend.

Created by the National Center for Safe Routes to School, these programs help kids sneak some extra physical activity into their day while also addressing parents’ concerns about getting their kids to school safely. It can be as simple as a few neighborhood families taking turns walking their kids to school. Or it can be more elaborate, with prearranged routes, timetables and stops along the way to pick up more “passengers”; with this model, there’s usually an adult “driver” at the front and an adult “conductor” bringing up the rear. A variation on this theme, the bicycle train, in which two or more adults accompany and supervise kids as they ride their bikes to school, has also become popular.

Viewed as a way to fight childhood obesity, improve school attendance rates and ensure that kids get to school safely, the Walking School Bus concept is garnering positive reviews from public health experts. In July 2013, Michelle Obama voiced her support of these programs in her remarks to mayors gathered at the White House.

“I've heard more and more of this kind of walking school bus happening all over the country—so that kids can get exercise on the way to school, kind of like we did when we were growing up," she said. “It’s about people all across this country coming together to take action to support the health of our kids.”

Besides providing an opportunity for movement, the Walking School Bus also allows kids to socialize with their peers, gain a bit of independence and learn important road safety skills. All of these benefits are also important for children’s health and wellbeing.

Aug 26 2014
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Public Health News Roundup: August 26

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EBOLA Update: RWJF Gives $1M to the CDC Foundation’s Global Disaster Response Fund
(NewPublicHealth is monitoring the public health crisis in West Africa.)
In order to assist the U.S. Centers for Disease Control and Prevention’s (CDC) ongoing efforts to combat the Ebola outbreak in West Africa, the Robert Wood Johnson Foundation (RWJF) has given a $1 million grant to the CDC Foundation’s Global Disaster Response Fund. The CDC has activated its Emergency Operations Center and deployed more than 70 public health experts in response to the outbreak, which so far has killed more than 1,400 people. “The spread of the Ebola virus in West Africa represents a global public health crisis,” said Risa Lavizzo-Mourey, MD, MBA, president and CEO of the Robert Wood Johnson Foundation, in a release. “We are privileged to assist CDC in its heroic efforts to contain this outbreak, and we are confident of their ability to control this scourge—provided they have the support required to do the job. Additional resources are urgently needed, and we encourage other funders to respond as well.” Read more on Ebola.

CDC: More than a Quarter-Million Youth Who Never Smoked Used E-Cigarettes in 2013
More than a quarter-million middle school and high school students who had never smoked regular cigarettes used electronic cigarettes—or e-cigarettes—in 2013, according to a new U.S. Centers for Disease Control and Prevention (CDC) study appearing in the journal Nicotine and Tobacco Research. The study found that youth who had never smoked traditional cigarettes, but had tried e-cigarettes, were twice as likely to intend to smoke traditional cigarettes than were youth who had never used e-cigarettes. “We are very concerned about nicotine use among our youth, regardless of whether it comes from conventional cigarettes, e-cigarettes or other tobacco products. Not only is nicotine highly addictive, it can harm adolescent brain development.” said Tim McAfee, MD, MPH, Director of CDC’s Office on Smoking and Health, in a release. Read more on tobacco.

U.S. Veteran Homelessness Down 33 Percent Since 2010
There has been a 33 percent decline in U.S. veteran homelessness and a 40 percent decline in the number of veterans who sleep on the street since 2010, according to new national estimates from the U.S. Department of Housing and Urban Development (HUD); the U.S. Department of Veterans Affairs (VA); and the U.S. Interagency Council on Homelessness (USICH). The agencies credited evidenced-based practices such as Housing First and other federal programs for the declines. There were an estimated 49,933 homeless veterans in American in January 2014. “We have an obligation to ensure that every veteran has a place to call home,” said HUD Secretary Julián Castro, in a release. “In just a few years, we have made incredible progress reducing homelessness among veterans, but we have more work to do. HUD will continue collaborating with our federal and local partners to ensure that all of the men and women who have served our country have a stable home and an opportunity to succeed.” Read more on the military.

Aug 25 2014
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Universities Adopt New Initiatives to Prevent Sexual Assaults on Campuses

Sexual assaults on college campuses have grabbed headlines in recent months and for good reason: One in five U.S. women are raped or otherwise sexually assaulted during their college years, often during their freshman or sophomore year and often by someone they know. Last winter, President Obama established the White House Task Force to Protect Students from Sexual Assault. This marked a call to action to help prevent sexual assaults on campuses; to help schools respond effectively when an assault does occur; and strengthen federal enforcement efforts, including the launch of a website to make with various resources for students and schools.

Meanwhile, various colleges and universities have stepped up their own sexual assault prevention efforts. The Indiana Campus Sexual Assault Primary Prevention Project guides Indiana colleges and universities in the prevention of sexual violence through education and technical assistance; as well as the promotion of bystander intervention skills and healthy, respectful relationships.

Earlier this year, the University of Massachusetts Amherst launched a program called UMatter at UMass, which promotes “active bystander intervention” to prevent sexual assaults. The program uses “Three Ds” to help someone who witnesses a situation where a sexual assault is threatened know what to do:

  • “Direct": Stepping in and confronting dangerous behavior in a direct and clear—but non-confrontational—way
  • “Distract”: Using tactics that will divert behavior before it becomes violent or harmful
  • “Delegate”: Enlisting help from acquaintances or law enforcement professionals to help prevent an assault

“Our simple starting point was our determination to build a more caring community, cementing the idea that we care about each other at UMass and that we demonstrate that care without first having a crisis or tragedy,” said Enku Gelaye, vice chancellor for student affairs and campus life at UMass. “With active bystanders, we want to reinforce a culture of active engagement. This is a very specific concept. The idea is that students have to take an active role in monitoring their environment and being engaged and caring about each other.”

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Aug 25 2014
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Public Health News Roundup: August 25

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EBOLA UPDATE: Japan Willing to Provide Experimental Treatment Without WHO Approval
(NewPublicHealth is monitoring the public health crisis in West Africa.)
Japan would be open to providing access to an experimental Ebola treatment before the World Health Organization (WHO) rules on whether to approve the drug, known as T-705 or favipiravir. "I am informed that medical professionals could make a request for T-705 in an emergency even before a decision (on approval) by the WHO. In that case, we would like to respond under certain criteria," said Chief Cabinet Secretary Yoshihide Suga at a news conference. The death toll for the West African outbreak climbed to more than 1,400 over the weekend. Read more on Ebola.

AAP Calls on Later School Opening Times for Students Ages 10 and Older
The American Academy of Pediatrics (AAP) is calling for all U.S. schools with students aged 10 to 18 to open no earlier than 8:30 a.m. in order to help kids better manage changes to their body clocks during puberty. Currently only 15 percent of such schools start after that time. “Chronic sleep loss in children and adolescents is one of the most common—and easily fixable—public health issues in the U.S. today,” said pediatrician Judith Owens, MD, FAAP, lead author of the policy statement, “School Start Times for Adolescents,” in a release. “The research is clear that adolescents who get enough sleep have a reduced risk of being overweight or suffering depression, are less likely to be involved in automobile accidents, and have better grades, higher standardized test scores and an overall better quality of life.” Read more on pediatrics.

AHA: E-Cigarettes Should Be Regulated Like Tobacco Products
E-cigarettes should be regulated the same as any tobacco product, according to the American Heart Association’s first policy statement on the products. The statement said that e-cigarettes target young people, can keep people hooked on nicotine and threaten to “re-normalize” tobacco use. “Over the last 50 years, 20 million Americans died because of tobacco. We are fiercely committed to preventing the tobacco industry from addicting another generation of smokers,” said Nancy Brown, CEO of the American Heart Association, in a release. “Recent studies raise concerns that e-cigarettes may be a gateway to traditional tobacco products for the nation’s youth, and could renormalize smoking in our society.” Read more on tobacco.