Category Archives: Pediatrics
FDA Proposes Rule for Regulation of E-cigarettes
The U.S. Food and Drug Administration (FDA) today released its long-expected proposed new rule that would expand its authority to include the regulation of e-cigarettes. Under the proposed rule, FDA would also be able to regulate products that meet the statutory definition of a tobacco product, including cigars, pipe tobacco, nicotine gels, waterpipe (or hookah) tobacco and dissolvables not already under the agency’s authority. “This proposed rule is the latest step in our efforts to make the next generation tobacco-free,” said U.S. Department of Health and Human Services Secretary Kathleen Sebelius. Read more on tobacco.
Study: 1 in 13 U.S. Kids Take Prescription Drugs for Emotional or Behavioral Issues
One in 13 U.S. schoolchildren take medication for emotional or behavioral issues, with more than half of the parents of these children reporting that the drugs have helped “a lot,” according to a new report from the U.S. National Center for Health Statistics. Only about one in five parents said the medication had not helped at all. The report also found that among youth ages 6-17 years, a higher percentage of children insured by Medicaid or the Children's Health Insurance Program used such prescribed medication than did children with private health insurance or no health insurance, and that a higher percentage of children in families having income below 100 percent of the poverty level used prescribed medication for emotional or behavioral difficulties than did children in families at 100 percent to less than 200 percent of the poverty level. Read more on prescription drugs.
Study: Genetic Risk for Obesity Rises as Kids Age
The genetic risk for obesity rises as children age, according to a new study in the journal Obesity. Researchers analyzed data on 2,556 pairs of twins in England and Wales at ages 4 and 10, finding that the influence of genetic variants rose as they got older, with genes accounting for about 43 percent of the difference in size among the four-year-olds, but 82 percent of the difference at the age of 10. "Our results demonstrate that genetic predisposition to obesity is increasingly expressed throughout childhood," said study co-leader Clare Llewellyn, MD, of the department of epidemiology and public health at University College London, in a release. "This underlines the importance of intervening at an early age to try to counteract these genetic effects and reduce childhood obesity.” Read more on obesity.
Study: Monday the Best Time to ‘Reset’ and Improve Personal Health Regimens
People are more likely to think about their health earlier in the week, which could help researchers and officials determine how to better improve public health strategies, according to a new study in the American Journal of Preventive Medicine. Researchers from San Diego State University (SDSU), the Santa Fe Institute, Johns Hopkins University and the Monday Campaigns analyzed Google searches that utilized the term “healthy” and were health-related in the United States from 2005 to 2012, finding searches for healthy topics were 30 percent more frequent at the beginning of the week than later in the week; Saturday saw the fewest searches. The findings correspond with previous research indicating Mondays offered the opportunity for a “heath reset”—a chance to get back into healthy habits. "Many illnesses have a weekly clock with spikes early in the week," said SDSU's John W. Ayers, lead author of the study. "This research indicates that a similar rhythm exists for positive health behaviors, motivating a new research agenda to understand why this pattern exists and how such a pattern can be utilized to improve the public's health.” Read more on prevention.
Despite Recommendations Against, Codeine Still Prescribed to Many Kids During ER Visits
Codeine is often prescribed by emergency room physicians to treat coughs and other pains for children, even though the powerful opioid is not recommended for use in children by groups such as the American Academy of Pediatrics (AAP) and American College of Chest Physicians (ACCP), according to a new study in the journal Pediatrics. For the new study, the researchers used data from 189 million ER visits by children and teens between the ages of three and 17 years old. The visits took place between 2001 and 2010. Researchers from the University of California, San Francisco analyzed data from 189 million ER visits for youth ages 3-17, finding that while emergency room prescriptions were down slightly from 2001 to 2010, as many as 877,000 children are still taking the drug each year. Codeine can slow breathing and breaks down differently in children of different ethnicities, increasing the chance of overdose. Read more on prescription drugs.
Rates of Childhood Obesity Keeps Rising, Especially Among the Most Obese
A recent study out of the University of North Carolina (UNC) finds that childhood obesity is up for all classes of obesity in U.S. children over the past 14 years, with more severe forms of obesity—a body mass index (BMI) 120 to 140 percent higher than the averages—seeing the greatest increase. The study appeared in JAMA Pediatrics. “An increase in more severe forms of obesity in children is particularly troubling,” said Asheley Cockrell Skinner, PhD, lead author of the study and assistant professor of pediatrics in the UNC School of Medicine, in a release. “Extreme obesity is more clearly associated with heart disease and diabetes risk in children and adolescents, and is more difficult to treat.” Researchers analyzed data on 26,690 children ages 2-19 years from 1999 to 2012 collected as part of the National Health and Nutrition Examination Survey (NHANES). Read more on obesity.
Study: More ‘Masculine’ and ‘Feminine’ Youth at Higher Risk for Cancer-risk Behaviors
The most “feminine” girls and the most “masculine” boys are also the most likely to engage in behaviors that pose cancer risks, according to a new study in the Journal of Adolescent Health. Researchers at the Harvard School of Public Health (HSPH) analyzed data on 9,354 adolescents in the ongoing Growing Up Today Study, finding that cancer-risk behaviors such as tobacco use, indoor tanning and physical inactivity were significantly more common in adolescents who more closely adhered to the traditional societal norms of masculinity and femininity. "Our findings indicate that socially constructed ideas of masculinity and femininity heavily influence teens' behaviors and put them at increased risk for cancer,” said lead author Andrea Roberts, research associate in the Department of Social and Behavioral Sciences at HSPH. “Though there is nothing inherently masculine about chewing tobacco, or inherently feminine about using a tanning booth, these industries have convinced some teens that these behaviors are a way to express their masculinity or femininity." Read more on cancer.
Study: Casual Marijuana Use Can Cause Dangerous Changes in Youths’ Brains
Casual marijuana use in young people can lead to potentially harmful changes in the brain, according to a new study in the Journal of Neuroscience. Researchers from Northwestern University's medical school, Massachusetts General Hospital and Harvard Medical School determined that casual marijuana smoking—defined as one to seven joints per week—could lead to changes to the nucleus accumbens and the nucleus amygdale, which help regulate emotion and motivation. "What we're seeing is changes in people who are 18 to 25 in core brain regions that you never, ever want to fool around with," said co-senior study author Hans Beiter, PhD, professor of psychiatry and behavioral sciences at Northwestern University, according to Reuters, adding, "Our hypothesis from this early work is that these changes may be an early sign of what later becomes amotivation, where people aren't focused on their goals.” Read more on substance abuse.
CDC: ‘Herd Immunity’ Helped Reduce H1N1 Flu Strain’s Impact This Season
While the H1N1 influenza strain was the predominant strain in the United States this past flu season, prior widespread exposure and its inclusion in the current flu vaccine meant it did not have nearly the impact it did in 2009, according to the U.S. Centers for Disease Control and Prevention (CDC). According to Michael Jhung, MD, a medical officer in the CDC’s influenza division, an overall “herd immunity” helped stop this season from turning into the worldwide pandemic seen in 2009. "This year, not only do we have a vaccine that works well, but millions of people have already been exposed to the H1N1 virus," he said, according to HealthDay. The flu strain also hit differently this season, peaking earlier, although once again younger adults were affected more than the elderly. Read more on the flu.
Study: Mean Devices Approved for Pediatric Use Never Tested on Kids
The majority of medical devices recently approved for pediatric use were never actually tested on kids, but rather only on people ages 18 and older, according to a new study in the journal Pediatrics. Researchers analyzed the clinical data used to get each device approved, finding that 11 of 25 examined devices were not tested on any patient age 21 and younger, and that only four had been tested on patients under the age of 18; three devices were specifically approved for patients under age 18, while the test were approved for people ages 18 to 21. "Children are not simply 'small adults,' and a device found to be safe and effective in adults may have a very different safety and effectiveness profile when used in a pediatric population," said Brigham and Women's Hospital and Harvard Medical School research fellow Thomas J. Hwang, one of the study’s authors, according to Reuters. "Without this data, it is difficult for clinicians and parents to make informed treatment decisions that weigh the risks and benefits of a particular treatment.” Read more on pediatrics.
Kaiser Report Examines Employer-Sponsored Retiree Health Benefits
A new report from the Kaiser Family Foundation on employer-sponsored retiree health benefits for pre-65 and Medicare-eligible retirees finds that the percentage of employers sponsoring retiree health coverage has declined, while employers that offer coverage are redesigning their plans almost annually in response to rising health care costs. The report, Retiree Health Benefits At the Crossroads, also examines the effect of recent legislation on retiree health coverage, such as the Medicare drug benefit and the Affordable Care Act. Read more on aging.
Study: Fewer Blood Transfusions Would Mean Fewer Infections
The increased use of blood transfusions in hospitals also leads to the increased risk of infection, according to a new study in the Journal of the American Medical Association. In a review of 21 randomized control trials, researchers from the University of Michigan School of Public Health determined that for every 38 patients considered for a red blood cell transfusion, the reduction of transfusions would mean one patient did not develop a serious infection, with the elderly undergoing hip and knee surgeries benefiting the most. “The fewer the red blood cell transfusions, the less likely hospitalized patients were to develop infections, “ says lead author Jeffrey M. Rohde, MD, assistant professor of internal medicine in the division of general medicine at the U-M Medical School, in a release. “This is most likely due to the patient’s immune system reacting to donor blood (known as transfusion-associated immunomodulation or TRIM). Transfusions may benefit patients with severe anemia or blood loss; however, for patients with higher red blood cell levels, the risks may outweigh the benefits.” Read more on prevention.
CDC: 1 in 68 U.S. Children on Autism Spectrum
The U.S. Centers for Disease Control and Prevention (CDC) has significantly increased its estimates of the number of U.S. children with an autism spectrum disorder (ASD). According to a new surveillance summary report, approximately 1 in 68 children—or 14.7 per 1,000 eight-year-olds—are on the spectrum. The new estimate is about 30 percent higher than previous CDC estimates. The report also found that ASD continue to be five times more common among boys than girls; more common among white children than Black of Hispanic children; and that most children are still not diagnosed until after age 4, despite the fact that ASD can be diagnosed as early as age 2. “The number of children identified with autism continues to increase and the characteristics of these children have changed over time,” said Coleen A. Boyle, PhD, MS, director of CDC’s National Center on Birth Defects and Developmental Disabilities, in a release. “While progress has been made, there is an urgent need to continue the search for answers and provide help now for people living with autism.” Read more on pediatrics.
New Cancer Cases Dropped Slightly from 2009 to 2010
Rates of new cancer cases dropped slightly for both men and women in the United States from 2009 to 2010, according to the new U.S. Centers for Disease Control and Prevention report, Invasive Cancer Incidence—United States, 2010. The report saw the incidence rate drop to 446 per 100,000 persons from 459 per 100,000 persons. Rates varied by state, from a high of 511 to a low of 380. The rate was higher for men than it was for women, with the highest rate of all among black Americans. Read more on cancer.
HHS Releases New Security Risk Assessment Tool for Small-to-Medium-Sized Health Care Organizations
The U.S. Department of Health and Human Services (HHS) has released a new security risk assessment (SRA) tool to help health care providers in small-to-medium sized offices conduct risk assessments of their organizations. A collaborative effort of the HHS Office of the National Coordinator for Health Information Technology (ONC) and Office for Civil Rights (OCR), the tool enables the organizations to conduct and document a thorough risk assessment at their own pace by allowing them to assess the information security risks under the Health Insurance Portability and Accountability Act (HIPAA) Security Rule. The SRA tool’s website contains a User Guide and Tutorial video to help providers begin using the tool. Videos on risk analysis and contingency planning are available at the website to provide further context. The tool is available for both Windows and operating systems and iOS iPads. Read more on technology.
Study: School Hearing Tests Cannot Detect Adolescent High-Frequency Hearing Loss
School-administered hearing tests cannot detect the sort of adolescent high-frequency hearing loss associated with exposure to loud noises, according to a new study in the Journal of Medical Screening. Researchers at Penn State College of Medicine compared the results for 282 11th graders of a special hearing screening designed to detect noise-related high-frequency hearing loss with the results of the standard Pennsylvania school hearing test. Each tests for the ability to hear a tone at a specific loudness. "More participants failed the initial screening than we predicted," said study author Deepa Sekhar, assistant professor of pediatrics, in a release, "Even with the effort and care put in by school nurses across the state, the current Pennsylvania school screen just isn't designed to detect high-frequency hearing loss in adolescents," adding "The results of this study have the potential to reach schools across the nation, as many use screens similar to those used in Pennsylvania schools." Read more on pediatrics.
HUD Gives $1.8B to Support 3,100 Public Housing Authorities
The U.S. Department of Housing and Urban Development (HUD) has awarded almost $1.8 billion to approximately 3,100 public housing authorities across all 50 states, as well as the District of Columbia, Guam, Puerto Rico and the U.S. Virgin Islands. The grants, which come through HUD’s Capital Fund Program, will go toward building, repairing, renovating and modernizing public housing, from large scale improvements such as replacing roofs or smaller tasks such as energy-efficient upgrades. “This funding is critically important to public housing agencies as they work to provide the best housing possible for their residents,” said HUD Secretary Shaun Donovan. There are 1.1 million public housing units in the United States. Read more on housing.
New Heart Health Guidelines Would Increase Adults Eligible for Statins to 12.8M
New guidelines from the American College of Cardiology and the American Heart Association (ACC–AHA) for the treatment of cholesterol would increase the number of adults who would be eligible for statin therapy by 12.8 million, according to a new study in the New England Journal of Medicine. Roughly half of the U.S. population between 40 and 75 years of age—or 56 million people—would be eligible. Most of the increase would be among older adults without cardiovascular disease. Read more on heart health.
Today is the 19th annual Kick Butts Day. Organized by the Campaign for Tobacco-Free Kids and sponsored by the United Health Foundation, Kick Butts Day is a day of activism to empower young adults to help decrease tobacco use in the United States. According to Tobacco-Free Kids, tobacco use is the number one cause of preventable death in the United States, killing 480,000 people and costing the nation at least $289 billion in health care bills and other economic losses each year.
This year, Kick Butts Day comes just weeks after the 50thanniversary of the first Surgeon General’s Report on Smoking and Health. A new Surgeon General’s report found that smoking is even more hazardous than previously thought—without urgent action to prevent kids from starting to smoke, 5.6 million U.S. children alive today will die prematurely from smoking-caused deaths.
Nationwide, tobacco companies spend $8.8 billion a year—one million dollars each hour—to market cigarettes and smokeless tobacco products, according to Tobacco-Free Kids. In particular, tobacco companies target youth with magazine ads; store ads and discounts; and fruit- and candy-flavored small cigars that look just like cigarettes.
The United States has cut high school smoking rates by more than half since 1997, but 18.1 percent of high school students still smoke and more than 3,000 kids try their first cigarette each day.
In observance of Kick Butts Day, more than 1,000 events will be held in schools and communities across the country, including:
- A walking tobacco audit in Bellingham, Washington, which lets young people chart how many tobacco retailers and ads they see on their way to school.
- A numbers campaign in Howe, South Dakota to visually display how many people die of tobacco-related causes.
- “They put WHAT in a cigarette?” event in Limestone, Maine to display products such as batteries and hair spray that also contain some of the 7,000 chemicals found in cigarettes.
Actions that encourage young people and adults to stop or never start smoking can happen all year, not just on Kick Butts Day. for Tobacco-Free Kids has a range of activities schools and communities can prepare and present, most at little cost.
>>Bonus Link: A tobacco timeline from the Robert Wood Johnson Foundation highlights important milestones in the fight against tobacco since the release of the first Surgeon General’s report on Smoking and Health fifty years ago.
County Health Rankings & Roadmaps — Transforming Public Schools in Baltimore: Q&A with Robert English
Years of research shows that school facilities in poor condition—including faulty heating and cooling systems, poor indoor air quality, and deficient science labs—significantly reduce academic achievement and graduation rates. On the other hand, new and renovated school buildings that are equipped with modern science labs; art and music resources; and other amenities lead to improved educational outcomes. Research has also shown that when students attend high-quality schools they are more likely to be engaged in school and have higher attendance, test scores and graduation rates.
The public schools in Baltimore, Md., have the lowest graduation rates and oldest facilities in the state. A recent report described 85 percent of Baltimore’s 162 public school buildings as being in either poor or very poor condition.
While graduation rates in Baltimore public schools have increased significantly in recent years, thanks to better funding and other academic-focused efforts, Baltimoreans United in Leadership Development (BUILD) aims to further improve the graduation rate, educational outcomes, overall health and economic prosperity of Baltimore residents. The goal is to integrate the rebuilding and renovation of every city school into the district’s education reform efforts. BUILD and its partners, ACLU of Maryland and Child First, want to change state and city policies to support school construction and renovation.
BUILD is the recipient of a County Health Rankings & Roadmaps community health grant to educate and engage parents, school leaders, and leaders from other sectors such as business, the community and faith leaders about the need for updated schools to get the best education outcomes for Baltimore’s students. NewPublicHealth recently spoke with Robert English, BUILD’s lead organizer, about the group’s recent successful efforts.
>>How healthy is your county? Join the live webcast event on March 26 to celebrate the launch of the 2014 County Health Rankings and to spotlight communities taking action to build a culture of health across America.
NPH: What’s the link between improving the school infrastructure and improving the graduation rates?
English: A leading indicator of students graduating from high school is that they feel safe and challenged in their schools. We’ve talked to thousands of students and families in Baltimore City and by the time students here in Baltimore get into the 9th grade and 10th grade, they have often lost interest in high school and many of them have said that it’s because of the facilities. We didn’t have science labs in many cases or other core components of a quality education to send kids to college.
This campaign is about building the 21st century learning environments that can prepare young people not only to graduate, but to go to college. For BUILD this is not a bricks-and-mortar campaign—this is about providing the educational space where every child has an opportunity to learn, and then secondly this is about bringing people together around creating high expectations for students. We’ve continued to organize in the schools that are in year one through year three of school construction, and the constituency we are building will be here to hold our schools accountable to providing real results.
Study: Prescriptions for Opioids Steadying After Nearly Tripling over Two Decades
After nearly tripling from 1991 to 2010—from 76 million annually to 210 million annually—prescriptions for opioid analgesics in the United States are stabilizing, according to a new reporting in the journal Public Health Reports. Researchers at Columbia University’s Mailman School of Public Health attributed much of the success to stopping the soaring number of prescriptions to state-implemented prescription drug monitoring programs (PDMPs). “We found that PDMPs administered by state health departments appeared to be more effective than those administered by other government agencies, such as the bureau of narcotics and the board of pharmacy, ” said senior author Guohua Li, MD, professor of epidemiology and director of the Center for Injury Epidemiology and Prevention. Read more on prescription drugs.
Study: Mother’s Monitoring of Kids’ Media Consumption Tied to Changes in Weight
Children whose mothers pay more attention to their kids’ media habits—how much time they spend watching television or playing video games—are more likely to weigh less than children who do not receive the same sort of supervision, according to a new study in JAMA Pediatrics. Researchers found that kids with mothers who monitored their media consumption were thinner at age seven and gained less weight over the following few years. While the authors said they cannot point to the exact reason for the relationship, possibilities include vigilant mothers who encourage more physical activity and the fact that the kids are exposed to fewer food advertisements. The study used a questionnaire to asses 112 mothers, 103 fathers and their 213 children; media monitoring by fathers was not linked to weight gain or loss. Stacey Tiberio, the study's lead author from the Oregon Social Learning Center in Eugene, told Reuters Health that the results emphasize the important role that early adolescence plays with weight. "It's basically a one-way door," she said. "If you are obese by middle childhood, you have an increased likelihood of staying in that group." Read more on obesity.
Finding Unlisted Milk Protein, FDA Announces Recall of Certain Simply Lite Chocolate Products
The U.S. Food and Drug Administration (FDA) has announced a recall of certain lots of Simply Lite brand dark chocolate bars after finding significant amounts of milk protein, which the product does not list as an ingredient. FDA testing found more than 3,500 parts per million of milk protein in single 3-ounce bars of the chocolate—or the equivalent found in about 4 teaspoons of whole milk. People with milk allergies or sensitivity to milk could have serious or even life-threatening reactions to the product. Consumers with questions about food safety can contact the FDA at 1-888-SAFEFOOD Monday through Friday between 10 a.m. and 4 p.m. Eastern Daylight Time. Go here for complete information on the recall. Read more on food safety.
New Report on US Cancer Care Finds Significant Cost and Quality Challenges
A new report from the American Association of Clinical Oncology (ASCO) finds that several factors including an aging population and poor lifestyle habits in the United States have resulted in an increase in annual cancer cases at the same time many smaller oncology practices are closing because of financial pressures. "We're facing a collection of challenges, each one of which could keep cancer treatment advances out of reach for some individuals," said ASCO President Clifford A. Hudis, MD.
ASCO’s recommendations include:
- Support for novel cancer care delivery efforts.
- Development of new healthcare delivery and payment models to help ensure the viability of small community practices while encouraging high-quality care.
- Support for quality initiatives that will speed up dissemination of cancer treatment breakthroughs and changes.
Read more on cancer.
Spring Break Highlights Dangers of Binge Drinking
The average male Spring Breaker reports drinking 18 alcoholic drinks per day during the week-long festivity, while the average female reports up to 10 drinks, according to the American College of Health. Five or more drinks within two hours qualify as “binge drinking” for men and four or more qualifies for women. Each year 1,825 college students ages 18-24 die from alcohol-related unintentional injuries, with alcohol poisoning among the biggest causes. Signs of alcohol poisoning include irregular breathing, vomiting, confusion and unconsciousness, and should be met with an immediate trip to the emergency room.
Among the other unintentional injuries:
- Assault — More than 690,000 students between the ages of 18 and 24 are assaulted by another student who has been drinking.
- Sexual Abuse — More than 97,000 students between the ages of 18 and 24 are victims of alcohol-related sexual assault or date rape.
- Injury — 599,000 students between the ages of 18 and 24 receive unintentional injuries while under the influence of alcohol.
Read more on alcohol.
Mass Analysis Confirms Link Between Bullying, Suicidal Thoughts
A new review of 43 previous studies seems to confirm the link between bullying and an increase in suicidal thoughts, with cyber bullying linked the most strongly. The study appears in JAMA Pediatrics and included data on approximately 350,000 youths. Approximately half of students in grades 4-12 report being bullied within the previous month, with one-third saying they were bullies themselves. While the new analysis does not demonstrate causation, it does indicate a more complex connection, perhaps even showing that kids with suicidal thoughts in the first place are more likely to be bullied. Read more on violence.