Category Archives: Pediatrics
FDA: Pregnant Women Should Eat More Fish Lower in Mercury
Pregnant women should be eating more fish that is lower in mercury, according to new draft advice from the U.S. Food and Drug Administration (FDA) and the U.S. Environmental Protection Agency (EPA). According to the FDA, pregnant women should eat 8-12 ounces (2-3 servings) per week of fish that are lower in mercury to support fetal growth and development. “For years many women have limited or avoided eating fish during pregnancy or feeding fish to their young children,” said Stephen Ostroff, MD, the FDA’s acting chief scientist. “But emerging science now tells us that limiting or avoiding fish during pregnancy and early childhood can mean missing out on important nutrients that can have a positive impact on growth and development as well as on general health.” The draft advice also includes new guidelines for breastfeeding women, those who might become pregnant and young children. Read more on maternal and infant health.
Study: Direct, Indirect Costs of Autism are Substantial
It costs an average of $2.4 million to support a person with an autism spectrum disorder (ASD) and an intellectual disability throughout the course of their life in the United States and $1.4 million to support someone with an ASD but without an intellectual disability, according to a new study in the journal JAMA Pediatrics. With children, the largest contributors to that total are special education services and parental productivity loss. For adults, the largest contributors are residential care or supportive living accommodation and individual productivity loss; adult medical costs are also much higher. According to the researchers, these substantial direct and indirect economic effects illustrate the need to develop more effective interventions to alleviate the strain on families. Read more on pediatrics.
CDC: 29M People in the U.S. have Diabetes—and One in Four Don’t Realize It
More than 29 million people in the United States have diabetes—and one in four don’t even realize it, according to the U.S. Centers for Disease Control and Prevention (CDC). The total estimate is up from 26 million in 2010. According to the CDC, one in three U.S. adults (86 million) have prediabetes, meaning their sugar levels are high, but not high enough to be classified as type 2 diabetes; an estimated 15-30 percent of these people will develop type 2 diabetes within 5 years unless they lose weight and increase their physical activity. “These new numbers are alarming and underscore the need for an increased focus on reducing the burden of diabetes in our country,” said Ann Albright, PhD, RD, director of CDC’s Division of Diabetes Translation. “Diabetes is costly in both human and economic terms. It’s urgent that we take swift action to effectively treat and prevent this serious disease.” Read more on diabetes.
NIH Researchers Publish Review of Key Marijuana Adverse Health Effects
As more states consider legalizing marijuana, researchers at the National Institute on Drug Abuse (NIDA)—a division of the National Institutes of Health—have published a review of adverse health effects of the drug, including impaired driving. The review was published last week in the New England Journal of Medicine and the study authors consider a number of key concerns including:
- Rising marijuana potencies
- Possible health consequences of secondhand marijuana smoke
- Long-term impact of prenatal marijuana exposure
- According to the reviewers, research suggests that marijuana impairs critical thinking and memory functions during use and that these deficits persist for days after using
- A long-term study showed that regular marijuana use in the early teen years lowers IQ into adulthood, even if users stopped smoking marijuana as adults.
“It is important to alert the public that using marijuana in the teen years brings health, social, and academic risk,” said lead author and NIDA Director Nora D. Volkow, MD. NIDA offers additional information on the consequences of marijuana here. Read more on substance abuse.
Social Media is a Largely Untapped Communications Tool for Health Policy Researchers
As social media use continues to expand, it also presents a growing opportunity for health policy researchers to communicate with both the public and policy makers. However, few of these researchers appear to be using social media to the best of its potential in this field, according to a new study in the journal Health Affairs. The study, which was funded by the Robert Wood Johnson Foundation, examined 325 health policy researchers, finding that only 14 percent of participants reported tweeting and only 21 percent noted blogging about their research in the past year. Many cited fears that social media would not be compatible with their research, the creation of professional risks and the lack of respected it is given by their peers or their academic institutions as obstacles to social media use. “Historically, the communication gap between researchers and policy makers has been large,” concluded the authors. “Social media are a new and relatively untested tool, but they have the potential to create new communication channels between researchers and policy makers to help narrow that gap.” Read more on technology.
Study: Many Preschool-aged Children Spending Too Much Time in Front of TVs, Computers
Many three- and four-year-olds are spending more than twice the recommended amount of time—two hours—in front of computers and television screens, according to a new study in the journal Child Indicators Research. Utilizing data on 2,221 preschool-aged children from the 2007 Head Start Family and Child Experiences Survey, researchers found that 55.7 percent of children had a television in their bedroom and 12.5 percent had high home screen time, defined as more than four hours each weekday. They also found that 56.6 percent of children had access to a computer at home and 37.5 percent had used it on the last typical weekday. In addition, 49.4 percent of children used a classroom computer for more than one hour each week and 14.2 percent played computer games at school for more than five hours each week. “This research should be used as a foundation for additional studies-- particularly those that look at educational screen time versus entertainment screen time,” said Erica Fletcher, a PhD student at Ohio State’s College of Public Health and lead on the project. “It’s a critical time to dive deeper into that. Since the data were collected, devices with screens like tablets and smart phones have become more affordable and are increasingly being used in the classroom. That has helped narrow the economic ‘digital divide’ on accessibility.” Read more on pediatrics.
Overly Clean Homes Can Increase Child’s Risk of Asthma, Allergies
Living in an overly clean home can actually increase an infant’s risk of developing allergies or asthma as they grow older, as their bodies are not given the chance to develop appropriate responses, according to a new study in the Journal of Allergy and Clinical Immunology. The researchers behind the study were surprised by the results, as they had been looking deeper into data that found that exposure to roach, mouse and pet droppings and other allergens increased asthma risk. "What we found was somewhat surprising and somewhat contradictory to our original predictions," said study co-author Robert Wood, MD, chief of the Division of Allergy and Immunology at the Johns Hopkins Children's Center in Baltimore, according to HealthDay. "It turned out to be completely opposite—the more of those three allergens you were exposed to, the less likely you were to go on to have wheezing or allergy." Approximately 40 percent of the allergy- and wheeze-free children in the study were raised in homes with high amounts of allergens and bacteria, while only 8 percent who suffered from both conditions had been exposed to allergens and bacteria while infants. Read more on pediatrics.
Study: Prenatal Medicaid Policy Reduces Smoking, But Doesn’t Improve Preterm Birthweights
While a Medicaid policy that fast-tracks applications of pregnant women helps reduce smoking during pregnancy, it has no significant effect on improving preterm birth rates or low birth weights, according to a new study in the journal Health Affairs. The study specifically looked at Medicaid’s presumptive eligibility and unborn-child option, which provides coverage for prenatal care. “Although the prevalence of prenatal smoking in the United States has declined in recent decades, it is nearly twice as high among low-income women enrolled in Medicaid than it is in the U.S. population as a whole,” said Marian Jarlenski, PhD, lead author of the paper. “Our research shows that Medicaid’s presumptive eligibility policy led to a nearly 8 percentage-point decrease in smoking during pregnancy, but neither policy significantly improved rates of preterm birth or babies born small for their gestational age.” Read more on maternal and infant health.
CDC: Watercress Tops ‘Powerhouse’ Fruits and Vegetables List
With a “nutrient density score” or 100.00, watercress tops the U.S. Centers for Disease Control and Prevention’s (CDC) new list of “powerhouse” fruits and vegetables. The list of 41 foods was created as a tool for nutrition education and dietary guidance. The study defined “powerhouse” as foods most strongly associated with reduced chronic disease risk, which are often green leafy, yellow/orange, citrus and cruciferous items. Chinese cabbage, chard, beet green and spinach rounded out the top five. The full list is available here. Read more on nutrition.
Study: Medicaid Patients Receive Poorer Cancer Care
People on Medicaid receive poorer cancer care than people with private insurance, according to three new studies presented at the American Society of Clinical Oncology annual meeting in Chicago. Researchers determined that Medicaid patients are less likely to have their cancer caught at an earlier, more treatable phase, as well as far more likely to die from cancer. One of the factors contributing to this disparity is the fact that Medicaid patients have less experience navigating the health care system. "Research has shown that we can screen more patients, but that they get dropped along the way to treatment. We don't give them full access into curative therapy," said Jyoti Patel, MD, an oncologist at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University in Chicago, who's also a spokeswoman for the American Society of Clinical Oncology. "We need to do a better job to make sure that people who aren't savvy or can't advocate for themselves have that helping hand." Read more on health disparities.
CDC: Norovirus is the Leading Cause of Disease Outbreaks from Contaminated Food
Norovirus is the leading cause of disease outbreaks from contaminated food in the United States, according to the latest Vital Signs report from the U.S. Centers for Disease Control and Prevention (CDC). Approximately 20 million people in the United States are sickened by norovirus annually. According to the CDC, because infected workers are often the source of these outbreaks, the food service industry can help prevent outbreaks by enforcing safety practices, including:
- Making sure food service workers practice proper hand washing and use utensils and single-use disposable gloves to avoid touching ready-to-eat foods with bare hands
- Certifying kitchen managers and training food service workers in food safety practices
- Establishing policies that require food service workers to stay home when sick with vomiting and diarrhea and for at least 48 hours after symptoms stop
Read more on food safety.
N.C. Program Successful in Expanding Dental Care to Young, Low-income Children
A North Carolina program to reduce cavities in young, low-income children, has significantly increased the number of children under the age of four receiving preventive dental care since the program began in 2000, according to a new study in the journal Pediatrics. The program works to train physicians in basic dental screening and preventive techniques that can be provided quickly and effectively during regular office visits. “Evaluation studies conducted since the initiation of the program in 2000 have found it to substantially increase access to preventive dental services for young, high-risk children who otherwise would be unlikely to use these services in dental offices, reduce caries-related treatments and costs, avert hospitalizations and improve oral health status,” said study was co-author R. Gary Rozier, DDS, MPH, professor of health policy and management at the UNC Gillings School of Global Public Health, in a release. Read more on pediatrics.
Mental Health Patients with Primary Care Physicians are Better at Managing their Health
Mental health patients who receive primary care from a physician’s office are generally more engaged in the active management of their mental health than are people who rely on outpatient clinics or emergency departments, according to a new study in the journal Health Education & Behavior. Using data from a large nationally representative survey, researchers assessed patient activation among patients diagnosed with depression in relation to variables such as the site of their usual source of care, community characteristics and other demographic characteristics. “Patients with mental disorders are less engaged in their health care than patients with other chronic diseases, so it is important to activate this group,” said Jie Chen, PhD, assistant professor in the department of health services administration at the University of Maryland School of Public Health. “In communities where patient activation is low, such as low-income communities with a large population of foreign-born individuals, there is an even greater need for interventions at mental health care institutions to engage residents in their health.” Read more on mental health.
Study: Low Cost of Food a Contributor to U.S. Obesity Epidemic
One of the driving factors in America’s growing obesity epidemic may very well be the increased access to cheap food, according to a new study. The average American spends only about one-tenth of their disposable income on food, compared to the 1930s, when the rate was about one-quarter. In addition, the average per capita consumption of calories has climbed approximately 20 percent since 1970. “Not only has food been getting cheaper, but it is easier to acquire and easier to prepare,” said Roland Sturm, lead author of the report and a senior economist at RAND, a nonprofit research organization. “It's not just that we may be eating more high-calorie food, but we are eating more of all types of food.” Possible public health solutions for this trend include imposing taxes on foods with low-nutritional value, as well as subsidies or discounts for healthier foods, according to the researchers. Read more on nutrition.
Expensive Co-pays a Barrier for Some Kids to Proper Asthma Treatments
Parents with higher health insurance co-pays report using less expensive asthma drugs, giving their children less medication than prescribed and even putting off doctor visits or trips to the emergency department for the respiratory disorder, according to a new study in the journal JAMA Pediatrics. Approximately 1 in 10 U.S. children suffer from asthma, and the prevalence of the illness is greater in low-income populations. "It is concerning that the children we deal with are sometimes more vulnerable in areas we didn't recognize," said Jefry Biehler, MD, chairman of pediatrics at Miami Children's Hospital in Florida. "We have to be careful that we don't create a void for those families that can't afford all the things they need for their child, but who are above the financial level that gives them government insurance that will provide everything at no or minimal cost.” Read more on pediatrics.
Data on thirdhand smoke—tobacco smoke left on surfaces, walls and floors—was first published in 2009. The data has raised significant concerns that the smoke can linger for months or longer, as well as combine with indoor air compounds to possibly form new carcinogens. In the last few months researchers from the California Thirdhand Smoke Consortium, funded by the University of California’s Tobacco-Related Disease Research Program (TDRP), have been presenting and publishing data that indicates that thirdhand smoke is linked to serious health risks in animals and humans—though more research is needed to better measure thirdhand smoke constituents and their health impact.
Consortium researchers published the first animal study on thirdhand smoke in January in the journal PLOS One, finding that mice exposed to thirdhand smoke developed a range of medical conditions, including liver damage and hyperactivity. Research published last year, as well as presented at the annual meeting of the American Chemical Society a few weeks ago, finds that thirdhand smoke likely causes damage to human DNA.
And last month several of the Consortium scholars presented their findings at a tobacco conference n California.
“The potential health risks of what we call thirdhand smoke are only now being studied. This is a new frontier,” said Georg Matt, a Consortium member and psychology professor of at San Diego State University who focuses on policies to protect nonsmokers. “We don’t yet know the degree of risk, but we are already finding that indoor smoking leaves a nearly indelible imprint. We need to find out what risk this pollution poses.”
Severe Weather Wreaking Havoc Across the U.S. Today
At least 35 people have been killed during severe weather in the past week in the South and Southwest. Severe weather, including significant flooding is expected to continue through much of the country today. Click here for today’s weather alerts for the entire United States from the National Weather Service.
AAP Recommends Precautions to Prevent High Rate of ACL Injuries in children
The American Academy of Pediatrics (AAP) issued a report yesterday on preventing and treating knee injuries in kids. According to the AAP, pediatricians have been seeing an increase in the last twenty years in tears to the anterior cruciate ligament (ACL) which provides stability for the knee as more kids—in particular girls—play sports. According to the AAP, research shows that specific types of physical training can reduce the risk of ACL injury by as much as 72 percent and the Academy now recommends strengthening exercises to reduce athletes’ risks of being injured, and encourages coaches and school sports programs to learn about the programs. The AAP is also advising that surgeries be done by trained surgeons using less-invasive surgery techniques that protect the developing growth plates in kids and teenagers.
According to the AAP, the effects of an ACL tear can be long-lasting and impactful beyond an end to playing a sport. Injured athletes who leave a sport and its social network can experience depression, and time away from school for treatments can impact academic performance. And research shows that athletes with ACL injuries are up to 10 times more likely to develop early-onset degenerative knee osteoarthritis and chronic pain. Read more on injury prevention.
NHTSA Awards Grants to Reduce Pedestrian Deaths
The National Highway Traffic Safety Administration (NHTSA) today announced that Louisville, Philadelphia and New York City will receive grants totaling over $1 million for public education and enforcement initiatives to improve pedestrian safety. The new grants are part of the Department’s Everyone Is a Pedestrian campaign to help communities reduce the rising number of pedestrian deaths and injuries that occurred from 2009 through 2012.
According to NHTSA, the three winners are among the cities with some of the highest rates of pedestrian fatalities nationwide:
- Louisville was awarded $307,000 and will use the funds to create a pedestrian education program for school-aged children and create safe walking routes for senior citizens. In addition, the funds will be used to conduct law enforcement training and crosswalk enforcement activities. In Louisville, a total of six pedestrians were killed in motor vehicle crashes during 2012, representing 10 percent of the city’s total traffic fatalities.
- Philadelphia was awarded $525,000 and will use the funds to address pedestrian safety in downtown areas by increasing police visibility and ticketing during high risk hours in 20 high-crash locations. The grant will also be used for marketing to reach pedestrians in these areas and to train officers on pedestrian safety. In Philadelphia, a total of 31 pedestrians were killed in motor vehicle crashes during 2012, representing 29 percent of the city’s total traffic fatalities.
- New York City was awarded $805,801 and will use the funds to address speeding drivers and drivers who do not yield to pedestrians in crosswalks. The city will work on reaching the demographic most likely to be in pedestrian crashes—young men—through social media and enforcement activities in high-crash areas. In New York City, a total of 127 pedestrians were killed in motor vehicle crashes during 2012, representing 47 percent of the city’s total traffic fatalities.
Read more on transportation.
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.