Category Archives: Pediatrics
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.
Majority of Youth C. Difficile Infections Linked to Doctor Visits
Antibiotics prescribed in a doctor’s office for other conditions are associated with the majority of Clostridium difficile infections, according to a new study in the journal Pediatrics. Researchers from the U.S. Centers for Disease Control and Prevention (CDC) determined that 71 percent of the cases for youth ages 1-17 were linked to the visits, rather than to overnight stays in health care facilities; two-thirds of adult cases are linked to hospital stays. The findings raise the profile of ongoing efforts to reduce unnecessary prescriptions. “Improved antibiotic prescribing is critical to protect the health of our nation’s children,” said CDC Director Tom Frieden, MD, MPH. “When antibiotics are prescribed incorrectly, our children are needlessly put at risk for health problems including C. difficile infection and dangerous antibiotic resistant infections.” Read more on prescription drugs.
Study: Even Slightly Elevated Blood Pressure Can Do Cardiovascular Damage Over Time
Even slightly elevated blood pressure that does not rise to the clinical definition of hypertension can do cardiovascular damage over time, according to a new study in the Journal of the American Medical Association. Researchers at the University of Oklahoma Health Sciences Center analyzed blood pressure data on more than 4,600 participants, all of whom had their readings tracked over 25 years from young adulthood to middle age. They placed the participants in five blood pressure trajectory categories:
- Low-stable: blood pressure that starts low and stays low
- Moderate-stable: blood pressure that begins only slightly elevated and stays that way
- Moderate-increasing: blood pressure begins only slightly elevated and increases over time
- Elevated-stable: blood pressure that starts at elevated levels, but does not increase
- Elevated-increasing: blood pressure that begins elevated and increases over time
The study determined that participants in the moderate-stable group were 44 percent more likely to have coronary artery calcification than those in the low-stable group. Read more on heart health.
Study: Men Die Earlier in More Patriarchal Societies
Gender differences when it comes to mortality rates are higher in more patriarchal societies, meaning women’s rights are good for men’s health, according to a new study in the American Psychological Association’s Evolutionary Behavioral Sciences. Utilized sociodemographic and mortality data from the World Health Organization, researchers from the University of Michigan (UM) School of Public Health found that men living in the top 25 percent most-patriarchal societies were 31 percent more likely to die than men in the least patriarchal quartile, compared to mortality rates for women. Researchers noted that the study only included societies with infrastructures capable of providing reliable data, so the difference could be even more pronounced. Possible explanations include:
- Males in societies where they are more socially dominant tend to engage in riskier behaviors that can lead to death.
- These societies tend to have more resources and social status concentrated in a smaller group of elite men, and men with greater control of resources and social status historically have had more reproductive success.
- In their quest for social dominance, men will go up against other men to gain power and engage in forms of competitive, and sometimes dangerous, behavior.
"Gender inequality is inherently related to inequality in general, and this is bad for both men and women's health, though especially harmful to men in increasing the risk of death," said UM researcher Daniel Kruger. Read more on health disparities.
A recent report from the Institute of Medicine found that young athletes in the United States face a "culture of resistance" to reporting when they might have a concussion and to complying with treatment decisions. That culture can result in students heading back to school too quickly—when they should be resting their brains to prevent short- and long-term complications.
"The findings of our report justify the concerns about sports concussions in young people," said Robert Graham, chair of the committee and director of the national program office for Aligning Forces for Quality, at George Washington University, Washington, D.C. (Aligning Forces is a program of the Robert Wood Johnson Foundation.) "However,” says Graham, “there are numerous areas in which we need more and better data. Until we have that information, we urge parents, schools, athletic departments, and the public to examine carefully what we do know, as with any decision regarding risk, so they can make more informed decisions about young athletes playing sports."
Recently, Righttime Medical Care, a chain of urgent care centers in Maryland, opened a number of HeadFirst sports injury and concussion centers in the state, staffed with health professionals who can assess injuries for concussions as well as evaluate students for return to play—in consolation with a team of experts who work with HeadFirst staff. HeadFirst will this year be presenting and publishing data on the more than 10,000 youth it has examined and treated for concussion in just the past two years.
NewPublicHealth recently spoke with Robert Graw, MD, head of Righttime and HeadFirst, about the need for better prevention, evaluation and treatment of concussions to prevent long-term health problems and disability.
NewPublicHealth: Why did Righttime add concussion care to the services provided?
Robert Graw: My son is an orthopedic surgeon and talked to me about the number of injuries he was seeing. We decided a few years ago that we’d learn as much as we could about preventing head injury and the consequences of head injury, and then promote that information through Righttime’s call center and through the visits that people made to our sites.
In the process of learning as much as we could we realized that the knowledge base of how people evaluate and manage concussions had changed drastically in the last five years as people have done more research. So, we then gathered together a group of consultant physicians and neuropsychologists to determine best practices. We met with them frequently, and then had them train our provider staff so that all of them became much more informed about what a concussion really is, the best way to evaluate them and the guidelines for management going forward.
Georgia State University College of Law Names Ten Faculty Fellowships to Promote Public Health Law Education
The Georgia State University College of Law and its Center for Law Health & Society have announced ten faculty fellows to participate in the Future of Public Health Law Education: Faculty Fellowship Program. “This fellowship program is an extraordinary opportunity to promote innovative teaching, create a supportive community of practice and share best practices in teaching public health law,” said Charity Scott, JD, MSCM, Catherine C. Henson Professor of Law and director of the Center for Law, Health & Society. “The fellows’ projects will serve as models for innovation in public health law education and the resources developed will be shared with other law and public health faculty nationally.” The program is funded by the Robert Wood Johnson Foundation. Among the five faculty members serving as mentors will be Mary Crossley, JD, professor of law at the University of Pittsburgh School of Law, who NewPublicHealth previously spoke with about her role in the Scholars in Residence program. Read more on public health law.
Study: Better Boundaries, Enforcing Rules Can Improve Kids’ Sleep Health
Parents can improve their children’s sleep habits and overall health by setting boundaries around electronics use, enforcing rules and setting a good example, according to new findings from the National Sleep Foundation’s (NSF) Sleep in America poll. The annual study began in 1991, with the 2014 poll focusing on sleep practices and beliefs of the modern family with school-aged children. “For children, a good night’s sleep is essential to health, development and performance in school,” said Kristen L. Knutson, PhD, University of Chicago. “We found that when parents take action to protect their children’s sleep, their children sleep better.” The NSF recommends that children ages 6-10 get 11 hours of sleep per night, although the poll found that parents estimate their kids in that age group only get about 8.9 hours. The poll also found averages of 8.2 hours for kids ages 11-12, 7.7 hours for ages 13-14 and 7.1 hours ages 15-17; NSF recommends between 8.5 and 9.5 hours for each of those groups. Read more on pediatrics.
Stress of Racism Tied to Obesity in Black Women
Frequent experiences of racism are associated with a higher risk of obesity among African-American women, according to a new study in the American Journal of Epidemiology. Researchers analyzed data from the Black Women's Health Study, a longitudinal study of approximately 59,000 African-American women who were tracked beginning in 1995, finding that the psychosocial stress associated with long-term experience with racism can result in dysregulation of neuroendocrine functions that influence the accumulation of excess body fat. Yvette C. Cozier, DSc, MPH, assistant professor of epidemiology at Boston University who led the analyses, said in a release that work-place- and community-based programs to combat racism and interventions to reduce racism-induced stress could help prevent and combat obesity in high-risk communities. Approximately half of African-American women are obese, which raises their risk factors for cardiovascular diseases, type 2 diabetes, orthopedic problems, and death. Read more on health disparities.
Labor Department Announces Grants to help Adults Transition from Prison to Workforce
The U.S. Department of Labor has announced close to $30 million in grants to help men and women participating in state or local prison work-release programs get the job skills needed for “in demand” jobs. Grants will be awarded to implementing partners that provide qualifying services in areas with high-poverty and high-crime rates, including communities that have a large proportion of returning citizens that typically experience higher rates of recidivism. Read more on community health.
Combining Online Games, Betting and Social Interaction Can Help People Lose Weight
A study by researchers at the Miriam Hospital in Providence, Rhode Island finds that a web-based commercial weight loss program that pairs financial incentives with social influence resulted in significant weight loss for many of the study participants. The results were published in JMIR Serious Games.
Players joined a game to lose weight while betting money on themselves and had four weeks to lose four percent of their starting weight. At the end of week four, all players who lost at least four percent of their initial body weight were deemed winners and split the pool of money collected at the start of the game. The researchers studied nearly 40,000 players over seven months and found that winners lost an average of 4.9 percent of their initial body weight and won an average of $59 in four weeks. Factors associated with winning the game included betting more money, sharing on Facebook, completing more weigh-ins, and engaging in more social interactions with the other players. Read more on obesity.
New SAMHSA Guide Provides Resources to Help Families Support Their LGBT Children
The Substance Abuse and Mental Health Services Administration (SAMHSA) has released a Resource Guide to help health care and social service practitioners provide guidance to families on how to support their children who are coming out or identifying themselves as lesbian, gay, bisexual and transgender (LGBT). According to SAMHSA, with greater access to more information about sexual orientation, gender identity and LGBT resources through the internet and other media, more young people have been coming out than ever before and at younger ages, and the family-oriented approach offered by the guide can provide useful information during a critical period. Read more on pediatrics.
‘America Saves Week’ Promotes Health Financial Habits for Kids
Next Monday begins America Saves Week. Running through March 1, the week is an annual opportunity for organizations to promote good savings behavior for individuals and to urge people to assess their savings status. According to America Saves:
- Only 54 percent of Americans say they have a savings plan with specific goals.
- Only 43 percent of Americans say they have a spending plan that allows them to save enough money to achieve the goals of their savings plan.
- Only 66 percent of Americans have sufficient emergency funds for unexpected expenses like car repairs or a doctor’s visit.
The annual event places a special emphasis on helping people learn and adopt good savings behaviors while they’re young, with educators and youth organizations urging students to join as a Young America Saver on-line and open or add to an account at a local financial institution. “The importance of saving cannot be over-emphasized, as saving is one of the critical building blocks to financial success,” said Gail Cunningham, spokesperson for the National Foundation for Credit Counseling, one of the week’s participating organizations. “Financial stability cannot exist without a healthy savings account.” Read more on budgets.
Physical, Mental Effects of Bullying Can Compound Over Time
The negative physical and mental effects of bullying during youth can compound over time and follow someone into adulthood, according to a new study in the journal Pediatrics. Researchers analyzed data from the Healthy Passages study, which surveyed 4,297 students in Alabama, California and Texas about bullying. Approximately one-third reported being regularly bullied at some point. The study found that those who had been bullied in the past scored better on measures of physical and mental health than those who were still being bullied. Teens bullied throughout their school careers scored the worse. "I think this is overwhelming support for early interventions and immediate interventions and really advancing the science about interventions," Laura Bogart, from Boston Children's Hospital. Read more on violence.
Study: STD Education Should Start Early
Prevention of sexually transmitted diseases (STDs) is about more than safe sex education—it’s also about established a stable home life early on that encourages responsible behavior, according to a new study in the Journal of Adolescent Health. "Kids don't engage in risky behaviors in a vacuum. There are environmental opportunities that have to be created," said study lead author Marina Epstein, of the University of Washington. Using data on approximately 2,000 Seattle-area participants, researchers determined that about one-third of those who became sexually active before age 15 had an STD, compared with 16 percent of those who started having sex at a later age. They also found that having more sexual partners and having sex after drinking alcohol or using drugs were tied to greater incidence of STDs. Epstein said funding for programs that emphasize abstinence until marriage would be better spend on preparing kids to make health and responsible choices. "We already have good programs that have been shown to be effective at improving parent-child relationships and intervening with at-risk youth," Epstein said. "We should use our prevention dollars on programs that we know work and that show effects on a range of behaviors, including risky sex practices." Read more on sexual health.
FEMA Issues Advisories as Severe Weather Hits Parts of the U.S.
The Federal Emergency Management Agency (FEMA) has begun issuing advisories for states across the Southern United States expected to be impacted by severe weather.
According to the National Weather Service, a major winter storm is impacting the South and Southeast ahead of moving up the Eastern Seaboard on Wednesday.
FEMA is encouraging both residents and visitors in the track of the storms to follow the instructions of state, local and tribal officials, and monitor NOAA Weather Radio and their local news for updates and directions provided by local officials. Residents can find trusted sources for weather and preparedness information via Twitter on FEMA’s social hub.
Weather Emergency Alerts (WEA) are currently being sent directly to many cell phones on participating wireless carrier networks. These alerts are sent by public safety offices such as the National Weather Service about imminent threats like severe weather. They look like a text message and show the type and time of the alert, any action you should take and the agency issuing the alert. Check your cellular carrier to determine if your phone or wireless device is WEA-enabled. Read more on preparedness.
Dozens of Bills Introduced in Recent Years to Increase School Vaccine Exemptions
From 2009 to 2012, 36 bills were introduced in 18 states to change school immunization mandates, with the majority aimed at expanding exemptions, according to a recent review in JAMA by researchers from Emory University. None of the bills passed, but the researchers say continued efforts to change state vaccine rules are concerning. Among 36 bills introduced, 15 contained no administrative requirements, seven bills had one or two administrative requirements, and the remaining 14 contained between up to five administrative requirements in order for parents to exempt their children from school vaccine rules in a given state.
"Exemptions to school immunization requirements continue to be an issue for discussion and debate in many state legislatures," according to the study authors. Read more on vaccines.
Being in a Good Mood Can Lead to Safer Sex
HIV-positive men are more likely to have save sex when their mood improves, according to a new study by researchers at the Mailman School of Public Health at Columbia University. The study, published in the journal Psychology, included 106 sexually active, HIV-positive men who have sex with men who completed weekly surveys over six weeks that asked about their sexual behavior, depression, and wellbeing during the prior week. Overall, 66 percent of study participants reported having unprotected intercourse in the prior two months; 81 percent had multiple partners. Three-quarters of the study participants were black and Latino men, a group disproportionately affected by HIV.
The researchers found that the men who reported an increase in their wellbeing in a given week were more likely to have safe sex (66%), while those who reported higher-than-usual levels of depression were more likely to engage in the risk behaviors (69%). The researchers are now studying potential interventions that might help address risky behaviors during depressive phases. Read more on sexual health.
In reaching teens, crisis hotlines have had to adapt not only to what they say, but how they say it. While counseling teens by phone is still the dominant method of communication, texting has become a popular way for teens to contact crisis centers in their times of need. A recent story in The New York Times takes a look at what Crisis Text Line and other centers have accomplished in the field of helping teens using their preferred medium of communication.
For troubled teens, texting offers a critical element of privacy if they feel threatened by someone nearby and allows them to look and feel more natural if they are in a public space. Benefits for crisis counselors include the ability to deal with more than one person at a time and to introduce experts into the conversation without a lapse in contact. Organizations such as Crisis Text Line that offer text counseling report receiving messages from teens who might not have otherwise contacted the hotline by phone. People who text hotlines for help receive the same services as callers—risk assessment, emotional validation and problem solving—but the interactions are often longer and more direct than phone calls.
In addition to offering an effective way to communicate with teens, texting provides data and trends about people in different types of crises. “My dream is that public health officials will use this data and tailor public policy solutions around it,” says Nancy Lublin, founder of Crisis Text Line. The organization plans to compile the data and make it available to the public this spring.
The use of texting has extended beyond crisis centers. The four largest phone companies in the United States recently promised to make 911 texting possible by May for local response services that request the option.
Read more at The New York Times.
Decrease in Pediatric Antibiotic Leveling Off
The number of children taking antibiotics has decreased over the past decade, but that decrease has stalled in recent years in certain age groups and geographic locations, according to a study in Pediatrics. Researchers reviewed pharmacy and outpatient claims over a 10-year period (2000 to 2010) in three health plans located in three different geographic locations to determine the number of antibiotics dispensed each year for children ages 3 months to 18 years. Although the overall antibiotic-dispensing rate in each age group and health plan was lower in 2009-2010 than in 2000-2001, the rate of decline in antibiotic use has slowed. The highest rate of antibiotic use was in children age 3 months to less than 24 months of age in all years of the study.
The study authors say the previous downward trend in antibiotic use in children may have reached a plateau, and continued improvements in judicious antibiotic dispensing are needed. Read more on pediatrics.
NHTSA Gives Okay for Vehicle to Vehicle Communication to Help Prevent Crashes
The National Highway Traffic Safety Administration has announced that it will begin taking steps to allow vehicle-to-vehicle (V2V) communication technology for light vehicles, which will allow vehicles to "talk" to each other and ultimately avoid many crashes by exchanging basic safety data, such as speed and position, ten times per second.
The safety applications currently being developed provide warnings to drivers so that they can prevent imminent collisions, but do not automatically operate any vehicle systems, such as braking or steering, although NHTSA is also considering future actions on active safety technologies that rely on on-board sensors.
V2V communications can provide the vehicle and driver with 360-degree situational awareness to address additional crash situations — including those, for example, in which a driver needs to decide if it is safe to pass on a two-lane road (potential head-on collision), make a left turn across the path of oncoming traffic, or in which a vehicle approaching at an intersection appears to be on a collision course. In those situations, V2V communications can detect threats hundreds of yards from other vehicles that cannot be seen, often in situations in which on-board sensors alone cannot detect the threat. Read more on transportation.
Many Hospital ICUs Don't Follow Infection Prevention Rules
While most hospitals have evidence-based guidelines in place to prevent health care-associated infections in intensive care units (ICUs), clinicians often fail to follow them according to new research from the Columbia University School of Nursing published in the American Journal of Infection Control. The study, on over 1600 ICUs, found lax compliance in intensive care units where patients are more likely to be treated with devices linked to preventable infections – such as central lines, urinary catheters and ventilators.
The study focused on three of the most common preventable infections — central line-associated bloodstream infections, ventilator-associated pneumonia, and catheter-associated urinary tract infections and determined that despite decades of research, establishing best practices for prevention of these infections, approximately one in 10 hospitals lack checklists to prevent bloodstream infections, and one in four lack checklists to help avoid pneumonia in ventilator patients, and that in hospitals with checklists, they are followed only about half of the time.
Health care-associated infections kill an estimated 100,000 Americans a year and result in over $30 billion in excess medical costs, according to the Centers for Disease Control and Prevention. Read more on injury prevention.