By Genevra Pittman
NEW YORK (Reuters Health) - More parents of teen girls not fully vaccinated against human papillomavirus (HPV) are intending to forgo the shots altogether - a trend driven by vaccine safety concerns, new research suggests.
That's despite multiple studies showing the vaccine isn't tied to any serious side effects but does protect against the virus that causes cervical cancer, researchers said.
'There were a lot of very sensationalized anecdotal reports of (girls) having bad reactions to the vaccine,' said pediatrician and vaccine researcher Dr. Amanda Dempsey from the University of Colorado Denver.
'Safety concerns have always risen to the top of the pile, in terms of being one of the main reasons people don't get vaccinated, which is unfortunate because this is one of the most well-studied vaccines in terms of safety and is extremely safe,' Dempsey, who wasn't involved in the new research, told Reuters Health.
The U.S. Centers for Disease Control and Prevention recommends that all kids - both boys and girls - receive three HPV shots as preteens.
Researchers led by Dr. Paul Darden from the University of Oklahoma Health Sciences Center in Oklahoma City got their data from a national immunization survey that involved phone calls to almost 100,000 parents.
They found that from 2008 to 2010, the percentage of teens who were up to date on their Tdap (tetanus, diphtheria and pertussis), MCV4 (meningococcal) and HPV vaccines all increased slightly.
Still, about three-quarters of girls ages 13 to 17 were not up to date on their HPV series in 2010. And the proportion of parents of those girls who said they didn't plan to get their daughters the rest - or any - of their HPV shots rose from 40 percent to 44 percent, the research team wrote Monday in Pediatrics.
At the same time, the proportion who cited safety concerns as their reason for abstaining from getting the HPV vaccine increased from less than five percent to 16 percent.
For all three vaccines asked about in the survey, other reasons parents gave for skipping their teenagers' shots included not thinking they were necessary, not having had a specific vaccine recommended by a doctor and, for the HPV vaccine, believing their child was not sexually active.
'These are wonderful vaccines preventing severe diseases,' Darden told Reuters Health in an email. 'HPV is the first vaccine that will prevent cancer which is a tremendous health benefit.'
Dempsey said past research has suggested that although more girls are being vaccinated against HPV, vaccine rates haven't increased as quickly as for other shots, such as Tdap.
Darden reports having been a consultant for Pfizer, and one of his co-authors is on a safety monitoring board for vaccine studies funded by Merck, which makes Gardasil, one of the HPV vaccines.
Parents shouldn't rely on the media or Internet to learn about vaccines, according to Dempsey, since it's hard to tell what information is legitimate.
'If they have questions or concerns, they should trust their provider to give them accurate information about the vaccine,' she said.
SOURCE: http://bit.ly/cxXOG Pediatrics, online March 18, 2013.
Monday, March 18, 2013
Wednesday, March 13, 2013
Be cautious of mind-altering drugs for kids: doctors
By Genevra Pittman
NEW YORK (Reuters Health) - Doctors warn about the ethical and medical implications of prescribing attention-boosting and mood-altering medications to healthy kids and teens, in a new statement from the American Academy of Neurology.
Focusing on stimulants typically used to treat attention deficit hyperactivity disorder, or ADHD, researchers said the number of diagnoses and prescriptions have risen dramatically over the past two decades.
Young people with the disorder clearly benefit from treatment, lead author Dr. William Graf emphasized, but the medicines are increasingly being used by healthy youth who believe they will enhance their concentration and performance in school.
According to the National Institute on Drug Abuse, 1.7 percent of eighth graders and 7.6 percent of 12th graders have used Adderall, a stimulant, for nonmedical reasons.
Some of those misused medicines are bought on the street or from peers with prescriptions; others may be obtained legally from doctors.
'What we're saying is that because of the volume of drugs and the incredible increase. the possibility of overdiagnosis and overtreatment is clearly there,' said Graf, from Yale University in New Haven, Connecticut.
In their statement, published in the journal Neurology, he and his colleagues say doctors should not give prescriptions to teens who ask for medication to enhance concentration against their parents' advice.
Prescribing attention- or mood-enhancing drugs to healthy kids and teens in general cannot be justified, for both legal and developmental reasons, Graf and his co-authors conclude.
'You're giving amphetamines to kids. I think we have to be worried about how that affects the brain, mood, rational thought. and we don't have enough data about that yet,' he told Reuters Health.
Almut Winterstein, a pharmacy researcher from the University of Florida in Gainesville, agreed that not much is known about the effects of long-term stimulant use - another reason to be careful and make sure they're really necessary for a specific child. In the short term, stimulants increase heart rate and blood pressure.
'If you have a child who actually can sit still and doesn't seem to have a problem focusing on a task, a stimulant won't do a thing, and definitely won't improve school performance,' said Winterstein, who didn't work on the new statement.
'I am concerned personally that many parents believe that if their child doesn't do well in school, they must have ADHD,' and therefore need stimulants, she told Reuters Health.
The new statement is also endorsed by the Child Neurology Society and the American Neurological Association.
Graf noted that childhood is changing in the United States: kids are being challenged in school, but also spending more and more time in front of screens.
'The majority still has to agree that we're not going to give a pill for every problem in childhood,' he said. 'We're talking about healthy kids.'
SOURCE: http://bit.ly/Q5TNl Neurology, online March 13, 2013.
NEW YORK (Reuters Health) - Doctors warn about the ethical and medical implications of prescribing attention-boosting and mood-altering medications to healthy kids and teens, in a new statement from the American Academy of Neurology.
Focusing on stimulants typically used to treat attention deficit hyperactivity disorder, or ADHD, researchers said the number of diagnoses and prescriptions have risen dramatically over the past two decades.
Young people with the disorder clearly benefit from treatment, lead author Dr. William Graf emphasized, but the medicines are increasingly being used by healthy youth who believe they will enhance their concentration and performance in school.
According to the National Institute on Drug Abuse, 1.7 percent of eighth graders and 7.6 percent of 12th graders have used Adderall, a stimulant, for nonmedical reasons.
Some of those misused medicines are bought on the street or from peers with prescriptions; others may be obtained legally from doctors.
'What we're saying is that because of the volume of drugs and the incredible increase. the possibility of overdiagnosis and overtreatment is clearly there,' said Graf, from Yale University in New Haven, Connecticut.
In their statement, published in the journal Neurology, he and his colleagues say doctors should not give prescriptions to teens who ask for medication to enhance concentration against their parents' advice.
Prescribing attention- or mood-enhancing drugs to healthy kids and teens in general cannot be justified, for both legal and developmental reasons, Graf and his co-authors conclude.
'You're giving amphetamines to kids. I think we have to be worried about how that affects the brain, mood, rational thought. and we don't have enough data about that yet,' he told Reuters Health.
Almut Winterstein, a pharmacy researcher from the University of Florida in Gainesville, agreed that not much is known about the effects of long-term stimulant use - another reason to be careful and make sure they're really necessary for a specific child. In the short term, stimulants increase heart rate and blood pressure.
'If you have a child who actually can sit still and doesn't seem to have a problem focusing on a task, a stimulant won't do a thing, and definitely won't improve school performance,' said Winterstein, who didn't work on the new statement.
'I am concerned personally that many parents believe that if their child doesn't do well in school, they must have ADHD,' and therefore need stimulants, she told Reuters Health.
The new statement is also endorsed by the Child Neurology Society and the American Neurological Association.
Graf noted that childhood is changing in the United States: kids are being challenged in school, but also spending more and more time in front of screens.
'The majority still has to agree that we're not going to give a pill for every problem in childhood,' he said. 'We're talking about healthy kids.'
SOURCE: http://bit.ly/Q5TNl Neurology, online March 13, 2013.
Tuesday, March 12, 2013
Hard to find good info on drug safety in pregnancy
WASHINGTON (AP) - Nearly every woman takes a medication at some point during pregnancy. Yet there's disturbingly little easy-to-understand information about which drugs pose a risk to her baby, and what to do about it.
Need some pain relief? In the fine print is the warning that painkillers like Advil aren't for the third trimester. Left unsaid is whether to worry if you took them earlier.
An awful cold? Don't panic if you used decongestant pills, but doctors advise a nasal spray in early pregnancy.
And don't abandon antidepressants or epilepsy medicines without talking to your doctor first. Some brands are safer during pregnancy than others - and worsening depression or seizures aren't good for a mom-to-be or her baby.
'To come off of those medications is often a dangerous thing for the pregnancy itself,' warns Dr. Sandra Kweder of the Food and Drug Administration. 'They need information on what to expect, how to make those trade-offs.'
A new study shows how difficult that information is to come by.
Women often turn to the Internet with pregnancy questions. But researchers examined 25 pregnancy-related websites and found no two lists of purportedly safe drugs were identical. Twenty-two products called safe on one site were deemed risky on another.
Worse, specialists couldn't find evidence to back up safety claims for 40 percent of the drugs listed, said Cheryl Broussard of the Centers for Disease Control and Prevention, who led the recent study.
'The reality is that for most of the medications, it's not that they're safe or not that's the concern. The concern is that we just don't know,' she said.
Broussard experienced some of that confusion during her own two pregnancies - when different doctors handed over different lists of what was safe to use.
It's a growing dilemma. The CDC says medication use during the first trimester - especially vulnerable for birth defects because fetal organs are forming - has jumped 60 percent in the last three decades. Plus, women increasingly are postponing pregnancy until their 30s, even 40s, more time to develop a chronic health condition before they're expecting.
The CDC is beginning a Treating for Two program to explore how to get better information, and the FDA plans to revamp prescription drug labels with more details on what's known now. But people want an easy answer - use it or don't - and for many drugs, they won't get one anytime soon.
'Women agonize over it,' said Dr. Christina Chambers of the University of California, San Diego. She helps direct California's pregnancy risk information hotline that advises thousands of worried callers every year.
Some drugs pose particular birth-defect risks. For example, the FDA requires versions of the acne drug isotretinoin, first marketed as Accutane, to be sold under special tight controls. Similarly, last year FDA said women who want to use a new weight-loss drug, Qsymia, need testing first to be sure they're not pregnant.
Other medications are considered safe choices. Obstetricians say pregnant women need a flu shot, for example. A recent massive study in Denmark offered reassurance that taking the anti-nausea drug Zofran for morning sickness won't hurt the baby.
But many drug labels bear little if any details about pregnancy. Drugmakers shy from studying pregnant women, so it can take years for safety information to accumulate. Moreover, the CDC says 1 in 33 babies has some type of birth defect regardless of medication use. It can be hard to tell if a drug adds to that baseline risk.
Consider antidepressants, used by about 5 percent of pregnant women. Certain brands are suspected of a small risk of heart defects. Studies suggest a version called SSRIs may increase risk of a serious lung problem at birth - from 1 in 3,000 pregnancies to 3 in 3,000 pregnancies, Chambers said. Also, some babies go through withdrawal symptoms in the first days of life that can range from jitteriness to occasional seizures.
Women have to weigh those findings with the clear risks of stopping treatment, she said.
'The time to be thinking about all this is when you're not pregnant,' when your doctor can consider how to balance mom's and baby's health and might switch brands, Chambers said.
That's what heart attack survivor Kelli Tussey of Columbus, Ohio, did. The 34-year-old takes a variety of heart medications, including a cholesterol-lowering statin drug that the government advises against during pregnancy.
So when Tussey wanted a second child, she turned to doctors at Ohio State University who specialize in treating pregnant heart patients. They stopped the statin and switched her to a safer blood thinner.
'They said my heart could take it,' Tussey said. Now four months pregnant, 'it seems everything's fine.'
Sometimes it's a question of timing. That painkiller ibuprofen, sold as Advil and other brands, isn't for the third trimester but isn't a big concern earlier on, said Dr. Siobhan Dolan, an adviser to the March of Dimes.
And women should watch out for over-the-counter drugs with multiple ingredients, like decongestants added to allergy medicines, Dolan said. While any potential risk from decongestant pills seems small, 'the question is, 'Do you really need it?'' she asked, advising a nasal spray instead.
Ask your doctor about the safest choices, Dolan said. Also, check the Organization of Teratology Information Specialists, or OTIS - www.otispregnancy.org - for consumer-friendly drug fact sheets or hotlines to speak with a specialist.
Stay tuned: The FDA has proposed big changes to drug labels that now just say if animal or human data suggest a risk. Kweder said adding details would help informed decision-making: How certain are those studies? What's the risk of skipping treatment? Is the risk only during a certain trimester?
___
Online:
www.otispregnancy.org
http://www.cdc.gov/pregnancy/meds/index.html
Need some pain relief? In the fine print is the warning that painkillers like Advil aren't for the third trimester. Left unsaid is whether to worry if you took them earlier.
An awful cold? Don't panic if you used decongestant pills, but doctors advise a nasal spray in early pregnancy.
And don't abandon antidepressants or epilepsy medicines without talking to your doctor first. Some brands are safer during pregnancy than others - and worsening depression or seizures aren't good for a mom-to-be or her baby.
'To come off of those medications is often a dangerous thing for the pregnancy itself,' warns Dr. Sandra Kweder of the Food and Drug Administration. 'They need information on what to expect, how to make those trade-offs.'
A new study shows how difficult that information is to come by.
Women often turn to the Internet with pregnancy questions. But researchers examined 25 pregnancy-related websites and found no two lists of purportedly safe drugs were identical. Twenty-two products called safe on one site were deemed risky on another.
Worse, specialists couldn't find evidence to back up safety claims for 40 percent of the drugs listed, said Cheryl Broussard of the Centers for Disease Control and Prevention, who led the recent study.
'The reality is that for most of the medications, it's not that they're safe or not that's the concern. The concern is that we just don't know,' she said.
Broussard experienced some of that confusion during her own two pregnancies - when different doctors handed over different lists of what was safe to use.
It's a growing dilemma. The CDC says medication use during the first trimester - especially vulnerable for birth defects because fetal organs are forming - has jumped 60 percent in the last three decades. Plus, women increasingly are postponing pregnancy until their 30s, even 40s, more time to develop a chronic health condition before they're expecting.
The CDC is beginning a Treating for Two program to explore how to get better information, and the FDA plans to revamp prescription drug labels with more details on what's known now. But people want an easy answer - use it or don't - and for many drugs, they won't get one anytime soon.
'Women agonize over it,' said Dr. Christina Chambers of the University of California, San Diego. She helps direct California's pregnancy risk information hotline that advises thousands of worried callers every year.
Some drugs pose particular birth-defect risks. For example, the FDA requires versions of the acne drug isotretinoin, first marketed as Accutane, to be sold under special tight controls. Similarly, last year FDA said women who want to use a new weight-loss drug, Qsymia, need testing first to be sure they're not pregnant.
Other medications are considered safe choices. Obstetricians say pregnant women need a flu shot, for example. A recent massive study in Denmark offered reassurance that taking the anti-nausea drug Zofran for morning sickness won't hurt the baby.
But many drug labels bear little if any details about pregnancy. Drugmakers shy from studying pregnant women, so it can take years for safety information to accumulate. Moreover, the CDC says 1 in 33 babies has some type of birth defect regardless of medication use. It can be hard to tell if a drug adds to that baseline risk.
Consider antidepressants, used by about 5 percent of pregnant women. Certain brands are suspected of a small risk of heart defects. Studies suggest a version called SSRIs may increase risk of a serious lung problem at birth - from 1 in 3,000 pregnancies to 3 in 3,000 pregnancies, Chambers said. Also, some babies go through withdrawal symptoms in the first days of life that can range from jitteriness to occasional seizures.
Women have to weigh those findings with the clear risks of stopping treatment, she said.
'The time to be thinking about all this is when you're not pregnant,' when your doctor can consider how to balance mom's and baby's health and might switch brands, Chambers said.
That's what heart attack survivor Kelli Tussey of Columbus, Ohio, did. The 34-year-old takes a variety of heart medications, including a cholesterol-lowering statin drug that the government advises against during pregnancy.
So when Tussey wanted a second child, she turned to doctors at Ohio State University who specialize in treating pregnant heart patients. They stopped the statin and switched her to a safer blood thinner.
'They said my heart could take it,' Tussey said. Now four months pregnant, 'it seems everything's fine.'
Sometimes it's a question of timing. That painkiller ibuprofen, sold as Advil and other brands, isn't for the third trimester but isn't a big concern earlier on, said Dr. Siobhan Dolan, an adviser to the March of Dimes.
And women should watch out for over-the-counter drugs with multiple ingredients, like decongestants added to allergy medicines, Dolan said. While any potential risk from decongestant pills seems small, 'the question is, 'Do you really need it?'' she asked, advising a nasal spray instead.
Ask your doctor about the safest choices, Dolan said. Also, check the Organization of Teratology Information Specialists, or OTIS - www.otispregnancy.org - for consumer-friendly drug fact sheets or hotlines to speak with a specialist.
Stay tuned: The FDA has proposed big changes to drug labels that now just say if animal or human data suggest a risk. Kweder said adding details would help informed decision-making: How certain are those studies? What's the risk of skipping treatment? Is the risk only during a certain trimester?
___
Online:
www.otispregnancy.org
http://www.cdc.gov/pregnancy/meds/index.html
Whooping cough vaccine protection wanes as kids age
(Reuters) - Protection against whooping cough starts to weaken a few years after preschool children get their final shot, according to a U.S. study, meaning that some children may be at risk of developing the disease before they can get a booster shot.
The U.S. Centers for Disease Control and Prevention (CDC) recommends a booster shot at age 11 or 12. The usual practice is to give five doses of diphtheria, tetanus and pertussis (DTaP) shots, the last at age four to six.
'This evaluation reports steady increase in risk of pertussis in the years after completion of the 5-dose DTaP vaccines,' wrote lead author Sara Tartof in the study, which appeared in Pediatrics.
Tartof, who is from Southern California Permanente Medical Group in Pasadena, and her team used immunization records and state-wide whooping cough data to track more than 400,000 children in the states of Minnesota and Oregon. All were born between 1998 and 2003 and received the recommended series of five shots.
Over the following years, 458 children from Minnesota came down with whooping cough. The rate of new cases rose from 16 per 100,000 in the first year after their most recent shot, to 138 per 100,000 in year six. In Oregon, there were 89 cases - six per 100,000 in the first year and 24 per 100,000 in the sixth.
'What has become apparent is there's a fairly dramatic and startling increase in pertussis in children in the seven- to 10-year-old age group,' said H Cody Meissner, a pediatrician from Tufts University School of Medicine who did not take part in the study.
Meissner and other researchers think that trend results from a change in the 1990s to a new type of pertussis vaccine, called an acellular vaccine, which comes with fewer side effects than the original whole-cell version.
But researchers also said that switching back to the whole-cell version, at least for the first couple of shots, could improve protection as children get older. But even though the side effects for that shot were mild, that is unlikely to happen.
The CDC could also move up the booster shot to ages eight to 10, but it's harder to get children into the office at that point. The current booster is given at the same time as a number of other recommended adolescent vaccines.
'An important thing to remember is the kids who do receive all five doses on time generally have milder (whooping cough) than those who are under-vaccinated or unvaccinated,' Tartof told Reuters Health. 'Even though there is waning immunity ... getting the five doses on time is still the best protection you can give your kid.' SOURCE: http://bit.ly/jsoh2P
(Reporting from New York by Genevra Pittman at Reuters Health; editing by Elaine Lies)
The U.S. Centers for Disease Control and Prevention (CDC) recommends a booster shot at age 11 or 12. The usual practice is to give five doses of diphtheria, tetanus and pertussis (DTaP) shots, the last at age four to six.
'This evaluation reports steady increase in risk of pertussis in the years after completion of the 5-dose DTaP vaccines,' wrote lead author Sara Tartof in the study, which appeared in Pediatrics.
Tartof, who is from Southern California Permanente Medical Group in Pasadena, and her team used immunization records and state-wide whooping cough data to track more than 400,000 children in the states of Minnesota and Oregon. All were born between 1998 and 2003 and received the recommended series of five shots.
Over the following years, 458 children from Minnesota came down with whooping cough. The rate of new cases rose from 16 per 100,000 in the first year after their most recent shot, to 138 per 100,000 in year six. In Oregon, there were 89 cases - six per 100,000 in the first year and 24 per 100,000 in the sixth.
'What has become apparent is there's a fairly dramatic and startling increase in pertussis in children in the seven- to 10-year-old age group,' said H Cody Meissner, a pediatrician from Tufts University School of Medicine who did not take part in the study.
Meissner and other researchers think that trend results from a change in the 1990s to a new type of pertussis vaccine, called an acellular vaccine, which comes with fewer side effects than the original whole-cell version.
But researchers also said that switching back to the whole-cell version, at least for the first couple of shots, could improve protection as children get older. But even though the side effects for that shot were mild, that is unlikely to happen.
The CDC could also move up the booster shot to ages eight to 10, but it's harder to get children into the office at that point. The current booster is given at the same time as a number of other recommended adolescent vaccines.
'An important thing to remember is the kids who do receive all five doses on time generally have milder (whooping cough) than those who are under-vaccinated or unvaccinated,' Tartof told Reuters Health. 'Even though there is waning immunity ... getting the five doses on time is still the best protection you can give your kid.' SOURCE: http://bit.ly/jsoh2P
(Reporting from New York by Genevra Pittman at Reuters Health; editing by Elaine Lies)
Monday, March 11, 2013
Pet frogs linked to salmonella outbreak in kids: CDC
NEW YORK (Reuters Health) - Small water frogs marketed and sold as pets are linked to an outbreak of Salmonella infections from 2008 to 2011, according to a report from the U.S. Centers for Disease Control and Prevention (CDC).
The report published in Pediatrics on Monday found the infection sickened 376 people in 44 U.S. states and sent 29 percent of those infected to the hospital - mostly children.
'This was the first Salmonella outbreak associated with aquatic frogs, and in this case the frogs are often marketed as good pets for kids,' said Shauna Mettee Zarecki, the study's lead author from the CDC in Atlanta.
'The majority of people didn't realize there were any risks from these amphibians or other amphibians, like turtles and snakes,' she added.
While most people hear about Salmonella-contaminated food, Zarecki said reptiles and amphibians also carry the bacteria. Humans can become infected after handling the animals, cleaning their containers or coming in contact with contaminated water.
People infected with Salmonella can have prolonged diarrhea, cramps, vomiting and a persistent fever. The infection can be deadly if it's left untreated, and it's most dangerous in the young, elderly and people with weak immune systems.
Previous research has found that reptiles and amphibians are responsible for about 74,000 Salmonella infections in the U.S. every year.
In the new report, Zarecki and her colleagues write that researchers from the CDC - along with state and local health departments - investigated an outbreak of Salmonella infections, mostly among children, in 2008.
By early 2009, the number of cases returned to normal before the researchers could find a cause. The investigation was started again when five more children were infected with the same strain of Salmonella in Utah later that year.
To find what was behind the outbreak, the researchers interviewed people who were infected with that strain of Salmonella from January 2008 through December 2011. They asked each person what animals and food they were exposed to in the week before they got sick.
They then compared the data from 18 people with that strain of the bacteria to 29 people who were infected with a different type of Salmonella.
Overall, they found 67 percent of the people in the new outbreak were exposed to frogs during the week before their illness, compared to 3 percent in the comparison group.
The majority of people who came in contact with a frog during the week before they got sick remembered the type - an African dwarf frog.
'Everything really linked these frogs with the illnesses,' said Zarecki.
The investigation eventually led to an African dwarf frog breeding facility in Madera County, California. There, researchers found the same strain of the bacteria in the facility's tank water, tank cleaning equipment, water filters and floor drains.
The facility started distributing frogs again in June 2011, after the owner voluntarily shut down the operation and instituted cleaning measures.
The researchers write, however, that African dwarf frogs can live for five to 18 years, which means infected frogs may still be in homes and continue to cause illness.
'The important consideration with any aquatic pet is to provide adequate filtration to keep the water clean and perform regular partial water changes,' said Dr. Nicholas Saint-Erne, a veterinarian for PetSmart, Inc., in a statement to Reuters Health.
Saint-Erne, who was not involved with the new report, added that people with questions should ask veterinarians who specialize in aquatic animals or reptiles to help 'ensure their pets are healthy and being given the proper care and nutrition.'
'If these aquariums are in homes, children under five (years old) shouldn't be allowed to clean the aquarium,' said Zarecki, adding that also applies to people with weakened immune systems.
'Pets are wonderful. We think they're a great learning tool for children, but some pets just aren't appropriate for children or individuals,' she added.
SOURCE: http://bit.ly/HjQ8dI Pediatrics, online March 11, 2013.
The report published in Pediatrics on Monday found the infection sickened 376 people in 44 U.S. states and sent 29 percent of those infected to the hospital - mostly children.
'This was the first Salmonella outbreak associated with aquatic frogs, and in this case the frogs are often marketed as good pets for kids,' said Shauna Mettee Zarecki, the study's lead author from the CDC in Atlanta.
'The majority of people didn't realize there were any risks from these amphibians or other amphibians, like turtles and snakes,' she added.
While most people hear about Salmonella-contaminated food, Zarecki said reptiles and amphibians also carry the bacteria. Humans can become infected after handling the animals, cleaning their containers or coming in contact with contaminated water.
People infected with Salmonella can have prolonged diarrhea, cramps, vomiting and a persistent fever. The infection can be deadly if it's left untreated, and it's most dangerous in the young, elderly and people with weak immune systems.
Previous research has found that reptiles and amphibians are responsible for about 74,000 Salmonella infections in the U.S. every year.
In the new report, Zarecki and her colleagues write that researchers from the CDC - along with state and local health departments - investigated an outbreak of Salmonella infections, mostly among children, in 2008.
By early 2009, the number of cases returned to normal before the researchers could find a cause. The investigation was started again when five more children were infected with the same strain of Salmonella in Utah later that year.
To find what was behind the outbreak, the researchers interviewed people who were infected with that strain of Salmonella from January 2008 through December 2011. They asked each person what animals and food they were exposed to in the week before they got sick.
They then compared the data from 18 people with that strain of the bacteria to 29 people who were infected with a different type of Salmonella.
Overall, they found 67 percent of the people in the new outbreak were exposed to frogs during the week before their illness, compared to 3 percent in the comparison group.
The majority of people who came in contact with a frog during the week before they got sick remembered the type - an African dwarf frog.
'Everything really linked these frogs with the illnesses,' said Zarecki.
The investigation eventually led to an African dwarf frog breeding facility in Madera County, California. There, researchers found the same strain of the bacteria in the facility's tank water, tank cleaning equipment, water filters and floor drains.
The facility started distributing frogs again in June 2011, after the owner voluntarily shut down the operation and instituted cleaning measures.
The researchers write, however, that African dwarf frogs can live for five to 18 years, which means infected frogs may still be in homes and continue to cause illness.
'The important consideration with any aquatic pet is to provide adequate filtration to keep the water clean and perform regular partial water changes,' said Dr. Nicholas Saint-Erne, a veterinarian for PetSmart, Inc., in a statement to Reuters Health.
Saint-Erne, who was not involved with the new report, added that people with questions should ask veterinarians who specialize in aquatic animals or reptiles to help 'ensure their pets are healthy and being given the proper care and nutrition.'
'If these aquariums are in homes, children under five (years old) shouldn't be allowed to clean the aquarium,' said Zarecki, adding that also applies to people with weakened immune systems.
'Pets are wonderful. We think they're a great learning tool for children, but some pets just aren't appropriate for children or individuals,' she added.
SOURCE: http://bit.ly/HjQ8dI Pediatrics, online March 11, 2013.
Saturday, March 9, 2013
Buckle up during pregnancy: study
NEW YORK (Reuters Health) - Despite some women's worry that seat belts or air bags could harm a baby in utero in the case of an accident, expectant mothers who are not wearing a seatbelt during a car crash are more likely to lose the pregnancy than restrained mothers, according to a new study.
The results reinforce the findings of other studies that link seat belts with better chances of keeping both mother and baby alive.
'The worst thing you can do is have the mother get hurt, and the best way to protect the mother and protect the baby is to have the mother wear a seatbelt,' said Kathleen DeSantis Klinich, a researcher at the University of Michigan Transportation Research Institute, who was not part of the study.
Thousands of pregnant women are hospitalized each year after motor vehicle accidents.
'One thing we're always concerned about is (educating) patients on seatbelt use,' said Dr. Haywood Brown, the chair of Obstetrics and Gynecology at Duke University Medical Center and senior author of the new study.
'Nonetheless, like all individuals, some choose and some do not choose to wear their seatbelt,' he added.
To get a better sense of which women don't use restraints and how that affects the outcome of their pregnancies, Brown and his colleagues searched through a trauma registry at Duke University Hospital.
They found 126 cases of women in their second and third trimesters who had been in a car crash and cared for at the hospital between 1994 and 2010.
Three fetuses - or 3.5 percent - died among the 86 mothers who were wearing a seatbelt during the accident.
Another three fetuses - 25 percent in this case - died among the 12 mothers who were not wearing a seatbelt.
'The bottom line is, you've got to wear your restraint because it decreases the risk not only for your injuries but injury to your child,' Brown told Reuters Health.
The American College of Obstetricians and Gynecologists recommends that seat belts should be worn at all times, and the lap belt should be fitted low across the hip bones, below the belly.
Women without a seatbelt were more likely to be first-time mothers than those who wore a seatbelt.
Brown said it's possible that the habit of buckling in children might prompt mothers to put on their own seatbelt.
Airbags came out in 17 of the accidents, and in those cases the mother was more likely to experience the placenta separating from the uterus - a condition that can be fatal for the mother or the fetus.
Catherine Vladutiu, a researcher at the University of North Carolina who was not involved with this research, said it's likely the airbag itself is not to blame for such serious consequences.
'I think the airbag is a function of how severe the crash was, so it's hard to tease out whether that had any direct effect on fetal demise. I would err on the side of (considering it) an indicator of crash severity,' Vladutiu told Reuters Health.
Brown said some women will disarm the airbag for fear that it will damage the baby in case of a crash, but 'it's not the smart thing to do because it will save your life if the airbag comes out.'
Klinich agreed.
In her own research, 'we found that airbags, if anything, are beneficial because they help protect the mother,' said Klinich.
Another study, from researchers in Washington state, found that airbags did not increase the risk of most pregnancy-related injuries (see Reuters Health story of December 22, 2009 here: reut.rs/jdVDeD).
Brown said he's following up on his study with a survey exploring why some pregnant women don't wear seatbelts, in an effort to identify those women at risk and help them to change their behavior.
SOURCE: http://bit.ly/10eypd8 American Journal of Obstetrics and Gynecology, online February 25, 2013.
The results reinforce the findings of other studies that link seat belts with better chances of keeping both mother and baby alive.
'The worst thing you can do is have the mother get hurt, and the best way to protect the mother and protect the baby is to have the mother wear a seatbelt,' said Kathleen DeSantis Klinich, a researcher at the University of Michigan Transportation Research Institute, who was not part of the study.
Thousands of pregnant women are hospitalized each year after motor vehicle accidents.
'One thing we're always concerned about is (educating) patients on seatbelt use,' said Dr. Haywood Brown, the chair of Obstetrics and Gynecology at Duke University Medical Center and senior author of the new study.
'Nonetheless, like all individuals, some choose and some do not choose to wear their seatbelt,' he added.
To get a better sense of which women don't use restraints and how that affects the outcome of their pregnancies, Brown and his colleagues searched through a trauma registry at Duke University Hospital.
They found 126 cases of women in their second and third trimesters who had been in a car crash and cared for at the hospital between 1994 and 2010.
Three fetuses - or 3.5 percent - died among the 86 mothers who were wearing a seatbelt during the accident.
Another three fetuses - 25 percent in this case - died among the 12 mothers who were not wearing a seatbelt.
'The bottom line is, you've got to wear your restraint because it decreases the risk not only for your injuries but injury to your child,' Brown told Reuters Health.
The American College of Obstetricians and Gynecologists recommends that seat belts should be worn at all times, and the lap belt should be fitted low across the hip bones, below the belly.
Women without a seatbelt were more likely to be first-time mothers than those who wore a seatbelt.
Brown said it's possible that the habit of buckling in children might prompt mothers to put on their own seatbelt.
Airbags came out in 17 of the accidents, and in those cases the mother was more likely to experience the placenta separating from the uterus - a condition that can be fatal for the mother or the fetus.
Catherine Vladutiu, a researcher at the University of North Carolina who was not involved with this research, said it's likely the airbag itself is not to blame for such serious consequences.
'I think the airbag is a function of how severe the crash was, so it's hard to tease out whether that had any direct effect on fetal demise. I would err on the side of (considering it) an indicator of crash severity,' Vladutiu told Reuters Health.
Brown said some women will disarm the airbag for fear that it will damage the baby in case of a crash, but 'it's not the smart thing to do because it will save your life if the airbag comes out.'
Klinich agreed.
In her own research, 'we found that airbags, if anything, are beneficial because they help protect the mother,' said Klinich.
Another study, from researchers in Washington state, found that airbags did not increase the risk of most pregnancy-related injuries (see Reuters Health story of December 22, 2009 here: reut.rs/jdVDeD).
Brown said he's following up on his study with a survey exploring why some pregnant women don't wear seatbelts, in an effort to identify those women at risk and help them to change their behavior.
SOURCE: http://bit.ly/10eypd8 American Journal of Obstetrics and Gynecology, online February 25, 2013.
Thursday, March 7, 2013
Move Over, Kids: Digital Games Found Good for Seniors
Youngsters may be just as likely to find video game systems at their grandparents' homes as at their own, but not necessarily intended for the pleasure of the youngest family members only. If grandpa and grandma don't already own a video game system, gifting such a system to them may be in their best interest, health-wise.
According to research results provided by North Carolina State University , baby boomers and seniors who reported playing video games even occasionally scored higher levels of well-being than people in the same age group who did not play any such games.
Research Method and Conclusions into Digital Game-Playing and Measures of Successful Aging
The purpose of the study was to determine any differences in psychological functioning between people age 63 years and older who played digital games and people in the same age group who did not play digital games. Analyses of psychological functioning differences were measured in areas of well-being, affect, social functioning and depression.
The study involved independently-living older adults, at least 63 years of age and with an average age of 77. The 140 participants were sectioned into three groups; those individuals who said they played digital games regularly, those who played occasionally and those who don't play digital games at all. Roughly the breakdown of the three groups was of equal numbers. People who played at least once a week were termed regular players and those who played video games less than once a week were termed occasional players.
Overall, the older adults who participated in video gaming scored better in the psychological functioning tests than did their non-playing counterparts. Researchers concluded that the findings suggest digital game playing may serve as a 'positive activity associated with successful aging.'
Plans for Future Research About the Effects of Digital Gaming on Aging
While the research completed suggested a link between digital gaming and the emotional aspects of aging, more research is needed to definitely associate the two. Lead author and associate professor of psychology at NCSU Dr. Jason Allaire explained that plans are in the works to develop research to determine definitively whether digital game playing affects the mental and emotional health of older adults.
Additional Research on Value of Digital Game Playing
In a Febuary article published in PLOSOne.org , researchers suggest that use of the Nintendo Wii system, assessed by earlier research to improve eye-hand coordination and spatial attention, may be a useful, inexpensive and entertaining tool to use in the training of young surgeons who will be performing laparoscopic surgery after graduation, in addition to the usual surgical training.
In the study performed in Italy, post-graduate students trained in other areas of surgery, but not yet in laparoscopic surgery, were assigned to play specific Wii games that involved use of both hands for one hour daily, five days per week. After four weeks, the group who had played the Wii games showed more improvement in laparoscopic techniques than the students who did not.
Bottom Line
Digital gaming has been part of American culture for decades. Once thought to be the domain of adolescents and young adults, video gaming may prove to be as much of a boon for all ages as it is sometimes the bane of completed homework.
The American Heart Association endorsed the Wii in 2010 as part of a heart-healthy physical activity regimen. Maybe in the near future, health care providers and mental health professionals may be endorsing digital gaming for older adults as part of a successful aging regiment; future research may point the way.
According to research results provided by North Carolina State University , baby boomers and seniors who reported playing video games even occasionally scored higher levels of well-being than people in the same age group who did not play any such games.
Research Method and Conclusions into Digital Game-Playing and Measures of Successful Aging
The purpose of the study was to determine any differences in psychological functioning between people age 63 years and older who played digital games and people in the same age group who did not play digital games. Analyses of psychological functioning differences were measured in areas of well-being, affect, social functioning and depression.
The study involved independently-living older adults, at least 63 years of age and with an average age of 77. The 140 participants were sectioned into three groups; those individuals who said they played digital games regularly, those who played occasionally and those who don't play digital games at all. Roughly the breakdown of the three groups was of equal numbers. People who played at least once a week were termed regular players and those who played video games less than once a week were termed occasional players.
Overall, the older adults who participated in video gaming scored better in the psychological functioning tests than did their non-playing counterparts. Researchers concluded that the findings suggest digital game playing may serve as a 'positive activity associated with successful aging.'
Plans for Future Research About the Effects of Digital Gaming on Aging
While the research completed suggested a link between digital gaming and the emotional aspects of aging, more research is needed to definitely associate the two. Lead author and associate professor of psychology at NCSU Dr. Jason Allaire explained that plans are in the works to develop research to determine definitively whether digital game playing affects the mental and emotional health of older adults.
Additional Research on Value of Digital Game Playing
In a Febuary article published in PLOSOne.org , researchers suggest that use of the Nintendo Wii system, assessed by earlier research to improve eye-hand coordination and spatial attention, may be a useful, inexpensive and entertaining tool to use in the training of young surgeons who will be performing laparoscopic surgery after graduation, in addition to the usual surgical training.
In the study performed in Italy, post-graduate students trained in other areas of surgery, but not yet in laparoscopic surgery, were assigned to play specific Wii games that involved use of both hands for one hour daily, five days per week. After four weeks, the group who had played the Wii games showed more improvement in laparoscopic techniques than the students who did not.
Bottom Line
Digital gaming has been part of American culture for decades. Once thought to be the domain of adolescents and young adults, video gaming may prove to be as much of a boon for all ages as it is sometimes the bane of completed homework.
The American Heart Association endorsed the Wii in 2010 as part of a heart-healthy physical activity regimen. Maybe in the near future, health care providers and mental health professionals may be endorsing digital gaming for older adults as part of a successful aging regiment; future research may point the way.
Friday, March 1, 2013
Rewards get kids active, but don't improve health
NEW YORK (Reuters Health) - Children will meet activity goals to earn rewards, but the extra effort doesn't necessarily affect their weight and health, according to a new study.
The findings reinforce earlier research showing that incentives work to get kids more physically active, but the goal might need to be more challenging to show any health benefits.
'If I had to do it again I would do it at a higher level. It was too easy,' said Eric Finkelstein at the Duke-National University of Singapore, who led the new study.
Inactivity among kids is a pressing concern in the U.S. and abroad (see Reuters Health story of March 29, 2010 here: http://reut.rs/jTEfxv).
'Kids are known to be inactive, getting five hours a day of screen time,' said Gary Goldfield, a scientist with the Healthy Active Living and Obesity research group at the Children's Hospital of Eastern Ontario, who was not involved in the study.
Finkelstein and his colleagues designed a program meant to encourage more physical activity among elementary school-age kids.
All of the children in the study wore a pedometer for an average of nine months to measure how many steps they took each day.
One group of 138 kids was told to aim for a minimum of 8,000 steps per day (for an adult that's about four miles).
Each month, the kids who met this goal for at least half of the days received a Toys-R-Us gift card worth about $24.
In addition, this group was encouraged to attend outdoor events with enticements to win theme park or zoo tickets.
The researchers compared this group of children to another group of 113 kids who wore a pedometer, but were not given any incentives or offers to participate in outdoor activities.
At the beginning and the end of the study the researchers collected the kids' height and weight, heart rate and other physical and mental health measures.
They found that the kids who were offered incentives were more active, logging an average of 8,660 steps per day, compared to 7,767 steps per day in the other group.
'The results are not whopping,' Goldfield said.
The modest difference in activity between the groups might explain why the researchers didn't see any differences in body mass index (BMI) - a measure of weight relative to height - or in their overall health at the end of the study.
'I don't think that's enough to see differences in BMI and other health indicators,' Goldfield told Reuters Health.
Despite the lack of health benefits, the findings demonstrate that incentives can work to get kids more active, he added.
'If you look at the percentage of people who met the 8,000 steps per day goal, then you get larger effects,' Goldfield said.
Just two percent of the kids in the no-rewards group reached 8,000 steps each day, compared to 24 percent in the rewards group, the researchers report in The Journal of Pediatrics.
'Incentives are important for the adoption of behaviors,' and starting out with easily-attainable goals is not a bad idea, Goldfield said.
Finkelstein said his group is planning to do a study with a more challenging goal.
Finkelstein attributes the increased activity to the rewards the children were given, and not to the outdoor activities they were offered.
That's because far fewer families attended the outdoor activities by the end of the study, but many kids continued to meet their steps-per-day goals.
He also said that it's possible even modestly increasing the levels of activity could have longer term benefits - such as a slowing of weight gain - that would not be picked up in a study that lasted nine months.
'There are benefits to getting them active while they're young, they just won't accrue until they're older,' he told Reuters Health.
Although there is a cost to implementing such a program, Finkelstein and his colleagues argue that it's worthwhile if it could curb obesity rates.
'To me, $25 to keep kids active is a small price to pay. If you can do it and it works, I think this is the sort of thing that should be fostered,' he said.
SOURCE: http://bit.ly/Z0uxtO The Journal of Pediatrics, online February 18, 2013.
The findings reinforce earlier research showing that incentives work to get kids more physically active, but the goal might need to be more challenging to show any health benefits.
'If I had to do it again I would do it at a higher level. It was too easy,' said Eric Finkelstein at the Duke-National University of Singapore, who led the new study.
Inactivity among kids is a pressing concern in the U.S. and abroad (see Reuters Health story of March 29, 2010 here: http://reut.rs/jTEfxv).
'Kids are known to be inactive, getting five hours a day of screen time,' said Gary Goldfield, a scientist with the Healthy Active Living and Obesity research group at the Children's Hospital of Eastern Ontario, who was not involved in the study.
Finkelstein and his colleagues designed a program meant to encourage more physical activity among elementary school-age kids.
All of the children in the study wore a pedometer for an average of nine months to measure how many steps they took each day.
One group of 138 kids was told to aim for a minimum of 8,000 steps per day (for an adult that's about four miles).
Each month, the kids who met this goal for at least half of the days received a Toys-R-Us gift card worth about $24.
In addition, this group was encouraged to attend outdoor events with enticements to win theme park or zoo tickets.
The researchers compared this group of children to another group of 113 kids who wore a pedometer, but were not given any incentives or offers to participate in outdoor activities.
At the beginning and the end of the study the researchers collected the kids' height and weight, heart rate and other physical and mental health measures.
They found that the kids who were offered incentives were more active, logging an average of 8,660 steps per day, compared to 7,767 steps per day in the other group.
'The results are not whopping,' Goldfield said.
The modest difference in activity between the groups might explain why the researchers didn't see any differences in body mass index (BMI) - a measure of weight relative to height - or in their overall health at the end of the study.
'I don't think that's enough to see differences in BMI and other health indicators,' Goldfield told Reuters Health.
Despite the lack of health benefits, the findings demonstrate that incentives can work to get kids more active, he added.
'If you look at the percentage of people who met the 8,000 steps per day goal, then you get larger effects,' Goldfield said.
Just two percent of the kids in the no-rewards group reached 8,000 steps each day, compared to 24 percent in the rewards group, the researchers report in The Journal of Pediatrics.
'Incentives are important for the adoption of behaviors,' and starting out with easily-attainable goals is not a bad idea, Goldfield said.
Finkelstein said his group is planning to do a study with a more challenging goal.
Finkelstein attributes the increased activity to the rewards the children were given, and not to the outdoor activities they were offered.
That's because far fewer families attended the outdoor activities by the end of the study, but many kids continued to meet their steps-per-day goals.
He also said that it's possible even modestly increasing the levels of activity could have longer term benefits - such as a slowing of weight gain - that would not be picked up in a study that lasted nine months.
'There are benefits to getting them active while they're young, they just won't accrue until they're older,' he told Reuters Health.
Although there is a cost to implementing such a program, Finkelstein and his colleagues argue that it's worthwhile if it could curb obesity rates.
'To me, $25 to keep kids active is a small price to pay. If you can do it and it works, I think this is the sort of thing that should be fostered,' he said.
SOURCE: http://bit.ly/Z0uxtO The Journal of Pediatrics, online February 18, 2013.
BPA Exposure Linked To Asthma In Kids
The list of adverse health effects from BPA exposure continues to grow.
Bisphenol A, or BPA, is commonly used to line food and beverage cans, and helps to keep plastics flexible, but studies suggest the compound can leach into the foods we eat. High levels of BPA in the urine have been tied to behavior problems, obesity, hormone abnormalities and even kidney and heart problems. Now, new research from scientists at the Columbia Center of Children's Environmental Health is linking the compound to an increased risk for asthma.
(MORE: More Health Harms for Children Exposed to BPA)
"Asthma prevalence has increased dramatically over the past 30 years, which suggests that some as-yet-undiscovered environmental exposures may be implicated. Our study indicates that one such exposure may be BPA," lead author Dr. Kathleen Donohue, an assistant professor of Medicine at Columbia University College of Physicians and Surgeons and an investigator at the Center for Children's Environmental Health said in a statement.
Donohue and her colleagues followed 568 women participating in the Mothers & Newborns study on environmental exposures. They measured the BPA levels in the women's urine during their third trimester of pregnancy, and also tested their kids' urine for BPA when they were aged 3, 5 and 7. At ages five and 12, based on their symptoms, tests and medical history, their physicians diagnosed the children who met the criteria for asthma with the respiratory disorder.
(MORE: BPA Linked With Obesity in Kids and Teens)
Each time the children were evaluated, more than 90% of the kids had detectable levels of BPA. The higher their BPA levels, the more wheezing and asthma the researchers found. But higher levels of BPA in pregnant moms during the third trimester of pregnancy were associated with lower rates of wheezing in children at age 5. That confirms previous work that showed that the timing of exposure to the chemical may be important when it comes to asthma risk. In that study, expectant moms with higher BPA levels early on in pregnancy were more likely to have children who developed asthma.
The current study, however, raises concerns about how much BPA infants are exposed to after birth, possibly from plastic bottles and sippy cups, and the role this exposure may have in raising their risk of asthma. "We found that post-natal BPA exposure is associated with increased odds of wheeze and asthma in young children. Specifically, that BPA exposure measured at child ages three, five and seven years was associated with increased odds of wheeze at ages five, six and seven years, and increased odds of asthma between ages five and twelve years," says Donohue in an email response to questions about the findings. "At a population level, our study suggests that BPA may be an important and understudied environmental risk factor for child asthma." In July 2012, the Food and Drug Administration (FDA) banned BPA use in baby bottles and sippy cups, but this study was conducted prior to the change.
(MORE: How BPA May Disrupt Brain Development)
How BPA might affect respiratory development and raise the risk of asthma isn't clear. "We did see evidence that exposure to higher levels of BPA was associated with higher levels of exhaled nitric oxide, a biomarker of airway inflammation," says Donohue. "The current study found no evidence that exposure to BPA increased the risk that the immune system would develop more antibodies to common airborne allergens. Other possible pathways may include changes to the innate immune system, but this remains an open question."
While the FDA deemed BPA unsafe in baby bottles, it says the evidence doesn't support a wider ban on its use in food packaging. The National Institute of Environmental Health Sciences (NIEHS), however, advises avoiding plastic containers marked with recycle codes 3 and 7, which are more likely to contain BPA. Avoiding canned food and choosing glass, porcelain or stainless steal containers for hot foods and liquids can also reduce your risk of exposure to the chemical.
Bisphenol A, or BPA, is commonly used to line food and beverage cans, and helps to keep plastics flexible, but studies suggest the compound can leach into the foods we eat. High levels of BPA in the urine have been tied to behavior problems, obesity, hormone abnormalities and even kidney and heart problems. Now, new research from scientists at the Columbia Center of Children's Environmental Health is linking the compound to an increased risk for asthma.
(MORE: More Health Harms for Children Exposed to BPA)
"Asthma prevalence has increased dramatically over the past 30 years, which suggests that some as-yet-undiscovered environmental exposures may be implicated. Our study indicates that one such exposure may be BPA," lead author Dr. Kathleen Donohue, an assistant professor of Medicine at Columbia University College of Physicians and Surgeons and an investigator at the Center for Children's Environmental Health said in a statement.
Donohue and her colleagues followed 568 women participating in the Mothers & Newborns study on environmental exposures. They measured the BPA levels in the women's urine during their third trimester of pregnancy, and also tested their kids' urine for BPA when they were aged 3, 5 and 7. At ages five and 12, based on their symptoms, tests and medical history, their physicians diagnosed the children who met the criteria for asthma with the respiratory disorder.
(MORE: BPA Linked With Obesity in Kids and Teens)
Each time the children were evaluated, more than 90% of the kids had detectable levels of BPA. The higher their BPA levels, the more wheezing and asthma the researchers found. But higher levels of BPA in pregnant moms during the third trimester of pregnancy were associated with lower rates of wheezing in children at age 5. That confirms previous work that showed that the timing of exposure to the chemical may be important when it comes to asthma risk. In that study, expectant moms with higher BPA levels early on in pregnancy were more likely to have children who developed asthma.
The current study, however, raises concerns about how much BPA infants are exposed to after birth, possibly from plastic bottles and sippy cups, and the role this exposure may have in raising their risk of asthma. "We found that post-natal BPA exposure is associated with increased odds of wheeze and asthma in young children. Specifically, that BPA exposure measured at child ages three, five and seven years was associated with increased odds of wheeze at ages five, six and seven years, and increased odds of asthma between ages five and twelve years," says Donohue in an email response to questions about the findings. "At a population level, our study suggests that BPA may be an important and understudied environmental risk factor for child asthma." In July 2012, the Food and Drug Administration (FDA) banned BPA use in baby bottles and sippy cups, but this study was conducted prior to the change.
(MORE: How BPA May Disrupt Brain Development)
How BPA might affect respiratory development and raise the risk of asthma isn't clear. "We did see evidence that exposure to higher levels of BPA was associated with higher levels of exhaled nitric oxide, a biomarker of airway inflammation," says Donohue. "The current study found no evidence that exposure to BPA increased the risk that the immune system would develop more antibodies to common airborne allergens. Other possible pathways may include changes to the innate immune system, but this remains an open question."
While the FDA deemed BPA unsafe in baby bottles, it says the evidence doesn't support a wider ban on its use in food packaging. The National Institute of Environmental Health Sciences (NIEHS), however, advises avoiding plastic containers marked with recycle codes 3 and 7, which are more likely to contain BPA. Avoiding canned food and choosing glass, porcelain or stainless steal containers for hot foods and liquids can also reduce your risk of exposure to the chemical.
Thursday, February 28, 2013
Arkansas bans most abortions after 20 weeks of pregnancy
LITTLE ROCK, Arkansas (Reuters) - Arkansas joined seven other U.S. states on Thursday in banning most abortions after 20 weeks of pregnancy as the Republican-controlled state Senate voted to override a veto of the legislation by Democratic Governor Mike Beebe.
Arkansas senators also gave final approval to a proposal that would ban most abortions once a fetal heartbeat could be detected by a standard ultrasound, or about 12 weeks into pregnancy, and forwarded that bill to Beebe.
Senators voted 19 to 14 along party lines to override Beebe's veto of the 20-week ban, which followed a 53 to 28 vote by the Republican-controlled state House. In Arkansas, lawmakers can override a veto by a simple majority vote.
The law to ban most abortions after 20 weeks provides exceptions only in cases of rape, incest or to save a mother's life. It does not include an exemption for any lethal fetal disorders.
The heartbeat bill includes similar exceptions and calls for the state medical board to revoke the licenses of doctors who violate it.
The ACLU of Arkansas believes the new 20-week ban law and the proposed fetal heartbeat bill are unconstitutional, said Bettina Brownstein, cooperating attorney for the organization.
Brownstein said the ACLU may challenge the 20-week ban law and was preparing a challenge to the heartbeat bill.
'If it becomes law, it will be the most draconian anti-abortion bill in the country and affect many, many women,' Brownstein said of the heartbeat bill.
Republican state Representative Andy Mayberry, the primary sponsor, said the 20-week ban law was modeled after a similar law in Nebraska and he believes it is constitutional.
'Maybe there will be lawsuits, but lawmakers don't always let the criticisms of their opponents influence their votes,' Republican state Senator David Sanders said on Thursday of the rare vote to override the governor's veto.
The chief executive of Planned Parenthood of the Heartland, Jill June, said the so-called 'heartbeat' bill would be the most stringent restriction on abortion in the country.
Governor Beebe had said he vetoed the 20-week ban because he believed it contradicted the U.S. Supreme Court's Roe versus Wade decision that legalized abortion, and it would be costly to defend the law from legal challenges.
Late-term abortions remain relatively rare. Most of the recent state laws banning most abortions after 20 weeks are based on controversial medical research suggesting that a fetus feels pain starting at 20 weeks of gestation.
(Editing by David Bailey, Greg McCune and Leslie Adler)
Arkansas senators also gave final approval to a proposal that would ban most abortions once a fetal heartbeat could be detected by a standard ultrasound, or about 12 weeks into pregnancy, and forwarded that bill to Beebe.
Senators voted 19 to 14 along party lines to override Beebe's veto of the 20-week ban, which followed a 53 to 28 vote by the Republican-controlled state House. In Arkansas, lawmakers can override a veto by a simple majority vote.
The law to ban most abortions after 20 weeks provides exceptions only in cases of rape, incest or to save a mother's life. It does not include an exemption for any lethal fetal disorders.
The heartbeat bill includes similar exceptions and calls for the state medical board to revoke the licenses of doctors who violate it.
The ACLU of Arkansas believes the new 20-week ban law and the proposed fetal heartbeat bill are unconstitutional, said Bettina Brownstein, cooperating attorney for the organization.
Brownstein said the ACLU may challenge the 20-week ban law and was preparing a challenge to the heartbeat bill.
'If it becomes law, it will be the most draconian anti-abortion bill in the country and affect many, many women,' Brownstein said of the heartbeat bill.
Republican state Representative Andy Mayberry, the primary sponsor, said the 20-week ban law was modeled after a similar law in Nebraska and he believes it is constitutional.
'Maybe there will be lawsuits, but lawmakers don't always let the criticisms of their opponents influence their votes,' Republican state Senator David Sanders said on Thursday of the rare vote to override the governor's veto.
The chief executive of Planned Parenthood of the Heartland, Jill June, said the so-called 'heartbeat' bill would be the most stringent restriction on abortion in the country.
Governor Beebe had said he vetoed the 20-week ban because he believed it contradicted the U.S. Supreme Court's Roe versus Wade decision that legalized abortion, and it would be costly to defend the law from legal challenges.
Late-term abortions remain relatively rare. Most of the recent state laws banning most abortions after 20 weeks are based on controversial medical research suggesting that a fetus feels pain starting at 20 weeks of gestation.
(Editing by David Bailey, Greg McCune and Leslie Adler)
No clear benefits for kids' blood pressure checks
NEW YORK (Reuters Health) - There's no evidence that checking kids' and teens' blood pressure - and treating them if it's high - can reduce their heart risks in adulthood, according to a new analysis.
What's more, researchers found blood pressure tests may not always be accurate among young people, or consistent from one reading to the next.
'At this point, the jury is out. We just don't know if this is worth doing or not,' said Dr. Matthew Thompson, who led the new research at Oxford University in the UK.
'We desperately need research on how to diagnose kids with high blood pressure, which kids should be treated and what are the most effective treatments.'
Thompson said although most U.S. children have their blood pressure measured at routine checkups, those readings are never taken on healthy kids in the UK.
His team reviewed the latest evidence on childhood blood pressure tests for the government-backed U.S. Preventive Services Task Force.
Thompson and his colleagues analyzed 34 studies covering diagnosis, treatment and long-term effects of high blood pressure in kids and teens. None of those answered the researchers' central question - whether screening can help prevent or delay cardiovascular disease in adults.
Accuracy of blood pressure readings from one measurement to the next was 'modest at best,' according to Thompson.
'The false positive rate. means that most children who screen positive won't actually have high blood pressure,' he told Reuters Health.
Among studies that tracked children and teens over time, researchers found anywhere from 19 to 65 percent of youth with high blood pressure also had hypertension as adults.
Seven studies tested seven different drugs for kids with hypertension and found they typically weren't any better at lowering blood pressure than a drug-free placebo pill. But those studies lasted only a few weeks - and children with hypertension would likely take the drugs for years.
'That's really not good enough evidence to know if they're effective and safe for decades,' Thompson said.
Programs aiming to change young people's lifestyle, such as by encouraging them to be more active or eat less salt, also didn't have a clear effect, the researchers wrote this week in Pediatrics.
'PART OF STANDARD CARE'
Based on the findings, the Task Force concluded in a draft recommendation that there isn't enough evidence to balance the benefits and harms of screening young people to prevent future disease.
The draft is available online for public comment for the next month here: http://bit.ly/uRZqMF.
The U.S. National Heart, Lung, and Blood Institute recommends all children routinely get their blood pressure measured. But another recent review also concluded there isn't enough evidence to support blood pressure checks for kids, further stoking controversy on the issue (see Reuters Health story of Jan 7, 2013 here: http://reut.rs/V5FY63.)
Dr. Bonita Falkner, a pediatrician at Thomas Jefferson University in Philadelphia who has studied hypertension, said she doesn't think the findings should change practice.
'It remains unknown how much hypertension in childhood contributes to (adult high blood pressure), but there is evidence it begins in childhood,' Falkner, who wasn't involved in the review, told Reuters Health.
The researchers agreed there's a need for more studies to address the information gaps related to childhood blood pressure checks.
'It's been recommended for some time now that pediatricians measure blood pressure in children, starting at age three, as part of routine health assessments,' she said. 'It's pretty much become part of standard care.'
Thompson said until more research is done, it's unclear what the right answer is on blood pressure checks for youth.
'To me, the evidence shows that it's not clear that screening or not screening is good or bad,' he said.
SOURCE: http://bit.ly/WtBzqF Pediatrics, online February 25, 2013.
What's more, researchers found blood pressure tests may not always be accurate among young people, or consistent from one reading to the next.
'At this point, the jury is out. We just don't know if this is worth doing or not,' said Dr. Matthew Thompson, who led the new research at Oxford University in the UK.
'We desperately need research on how to diagnose kids with high blood pressure, which kids should be treated and what are the most effective treatments.'
Thompson said although most U.S. children have their blood pressure measured at routine checkups, those readings are never taken on healthy kids in the UK.
His team reviewed the latest evidence on childhood blood pressure tests for the government-backed U.S. Preventive Services Task Force.
Thompson and his colleagues analyzed 34 studies covering diagnosis, treatment and long-term effects of high blood pressure in kids and teens. None of those answered the researchers' central question - whether screening can help prevent or delay cardiovascular disease in adults.
Accuracy of blood pressure readings from one measurement to the next was 'modest at best,' according to Thompson.
'The false positive rate. means that most children who screen positive won't actually have high blood pressure,' he told Reuters Health.
Among studies that tracked children and teens over time, researchers found anywhere from 19 to 65 percent of youth with high blood pressure also had hypertension as adults.
Seven studies tested seven different drugs for kids with hypertension and found they typically weren't any better at lowering blood pressure than a drug-free placebo pill. But those studies lasted only a few weeks - and children with hypertension would likely take the drugs for years.
'That's really not good enough evidence to know if they're effective and safe for decades,' Thompson said.
Programs aiming to change young people's lifestyle, such as by encouraging them to be more active or eat less salt, also didn't have a clear effect, the researchers wrote this week in Pediatrics.
'PART OF STANDARD CARE'
Based on the findings, the Task Force concluded in a draft recommendation that there isn't enough evidence to balance the benefits and harms of screening young people to prevent future disease.
The draft is available online for public comment for the next month here: http://bit.ly/uRZqMF.
The U.S. National Heart, Lung, and Blood Institute recommends all children routinely get their blood pressure measured. But another recent review also concluded there isn't enough evidence to support blood pressure checks for kids, further stoking controversy on the issue (see Reuters Health story of Jan 7, 2013 here: http://reut.rs/V5FY63.)
Dr. Bonita Falkner, a pediatrician at Thomas Jefferson University in Philadelphia who has studied hypertension, said she doesn't think the findings should change practice.
'It remains unknown how much hypertension in childhood contributes to (adult high blood pressure), but there is evidence it begins in childhood,' Falkner, who wasn't involved in the review, told Reuters Health.
The researchers agreed there's a need for more studies to address the information gaps related to childhood blood pressure checks.
'It's been recommended for some time now that pediatricians measure blood pressure in children, starting at age three, as part of routine health assessments,' she said. 'It's pretty much become part of standard care.'
Thompson said until more research is done, it's unclear what the right answer is on blood pressure checks for youth.
'To me, the evidence shows that it's not clear that screening or not screening is good or bad,' he said.
SOURCE: http://bit.ly/WtBzqF Pediatrics, online February 25, 2013.
First lady announces effort to help kids exercise
CHICAGO (AP) - Imagine students learning their ABCs while dancing, or memorizing multiplication tables while doing jumping jacks.
Some schools are using both methods of instruction, and Michelle Obama would like to see more of them use other creative ways to help students get the recommended hour of daily exercise.
In Chicago on Thursday, the first lady was announcing a new public-private partnership to help schools do just that. 'Let's Move Active Schools' starts with a website, www.letsmoveschools.org , where school officials and others can sign up to get started.
Mrs. Obama said too many penny-pinched schools have either cut spending on physical education or eliminated it outright to put the money toward classroom instruction. But the first lady who starts most days with a workout - and other advocates of helping today's largely sedentary kids move their bodies - say that's a false choice, since studies that show exercise helps youngsters focus and do well in school.
The effort is one of the newest parts of Mrs. Obama's 3-year-old campaign against childhood obesity, known as 'Let's Move,' which she has spent the week promoting.
'With each passing year, schools feel like it's just getting harder to find the time, the money and the will to help our kids be active. But just because it's hard doesn't mean we should stop trying,' the first lady said in her prepared remarks. 'It means we should try harder. It means that all of us - not just educators, but businesses and nonprofits and ordinary citizens - we all need to dig deeper and start getting even more creative.'
She was being joined for the announcement at McCormick Place in her hometown by several Olympians, including gymnasts Dominique Dawes and Gabby Douglas, sprinter Allyson Felix, tennis player Serena Williams and decathlete Ashton Eaton, along with San Francisco 49ers quarterback Colin Kaepernick and triathlete Sarah Reinertsen, whose left leg was amputated above the knee when she was a child. Thousands of students from city middle schools also were being brought in for the event.
Research shows that daily exercise has a positive influence on academic performance, but kids today spend too much time sitting, mostly in school but also outside the classroom while watching TV, playing video games or surfing the Internet. Federal guidelines recommend that children ages 6-17 get at least 60 minutes of exercise daily, which can be racked up through multiple spurts of activity throughout the day.
The White House says the most current data, from 2007, shows that just 4 percent of elementary schools, 8 percent of middle schools and 2 percent of high schools provided daily physical education.
Education Secretary Arne Duncan said he's proof of the link between exercise and academic performance. As a boy, he said, he had a hard time sitting still in class but that exercise helped him focus.
'What's true for me is true for many of our nation's children,' he said in an interview.
Duncan, who played basketball professionally in Australia, said the choice is not between physical activity or academics, especially with about one-third of U.S. kids either overweight or obese and at higher risk for life-threatening illnesses like heart disease or diabetes.
'It's got to be both,' he said. Duncan cited the examples of students learning the alphabet while dancing or memorizing multiplication tables while doing jumping jacks.
Mrs. Obama called on school staff, families and communities to help get 50,000 schools, about half the number of public schools in the U.S., involved in the program over the next five years.
The President's Council on Fitness, Sports & Nutrition, the American Alliance for Health, Physical Education, Recreation & Dance, and the Alliance for a Healthier Generation will oversee the program. Funding and other resources will come from Nike Inc., the GENYOUth Foundation, ChildObesity180, Kaiser Permanente and the General Mills Foundation.
Under the new initiative, modest grants will be available from the Education Department to help some programs get started. The GENYOUth Foundation and ChildObesity180 also will be awarding grants.
Nike has committed $50 million to the effort over the next five years; the remaining groups together have pledged more than $20 million.
Williams said it's important to structure the activity so that it doesn't feel like a workout.
'I had fun and I didn't realize it was work,' she said about her years of practice before become one of America's top tennis players.
___
Online:
Let's Move: http://www.letsmove.gov
___
Follow Darlene Superville on Twitter: http://www.twitter.com/dsuperville
Some schools are using both methods of instruction, and Michelle Obama would like to see more of them use other creative ways to help students get the recommended hour of daily exercise.
In Chicago on Thursday, the first lady was announcing a new public-private partnership to help schools do just that. 'Let's Move Active Schools' starts with a website, www.letsmoveschools.org , where school officials and others can sign up to get started.
Mrs. Obama said too many penny-pinched schools have either cut spending on physical education or eliminated it outright to put the money toward classroom instruction. But the first lady who starts most days with a workout - and other advocates of helping today's largely sedentary kids move their bodies - say that's a false choice, since studies that show exercise helps youngsters focus and do well in school.
The effort is one of the newest parts of Mrs. Obama's 3-year-old campaign against childhood obesity, known as 'Let's Move,' which she has spent the week promoting.
'With each passing year, schools feel like it's just getting harder to find the time, the money and the will to help our kids be active. But just because it's hard doesn't mean we should stop trying,' the first lady said in her prepared remarks. 'It means we should try harder. It means that all of us - not just educators, but businesses and nonprofits and ordinary citizens - we all need to dig deeper and start getting even more creative.'
She was being joined for the announcement at McCormick Place in her hometown by several Olympians, including gymnasts Dominique Dawes and Gabby Douglas, sprinter Allyson Felix, tennis player Serena Williams and decathlete Ashton Eaton, along with San Francisco 49ers quarterback Colin Kaepernick and triathlete Sarah Reinertsen, whose left leg was amputated above the knee when she was a child. Thousands of students from city middle schools also were being brought in for the event.
Research shows that daily exercise has a positive influence on academic performance, but kids today spend too much time sitting, mostly in school but also outside the classroom while watching TV, playing video games or surfing the Internet. Federal guidelines recommend that children ages 6-17 get at least 60 minutes of exercise daily, which can be racked up through multiple spurts of activity throughout the day.
The White House says the most current data, from 2007, shows that just 4 percent of elementary schools, 8 percent of middle schools and 2 percent of high schools provided daily physical education.
Education Secretary Arne Duncan said he's proof of the link between exercise and academic performance. As a boy, he said, he had a hard time sitting still in class but that exercise helped him focus.
'What's true for me is true for many of our nation's children,' he said in an interview.
Duncan, who played basketball professionally in Australia, said the choice is not between physical activity or academics, especially with about one-third of U.S. kids either overweight or obese and at higher risk for life-threatening illnesses like heart disease or diabetes.
'It's got to be both,' he said. Duncan cited the examples of students learning the alphabet while dancing or memorizing multiplication tables while doing jumping jacks.
Mrs. Obama called on school staff, families and communities to help get 50,000 schools, about half the number of public schools in the U.S., involved in the program over the next five years.
The President's Council on Fitness, Sports & Nutrition, the American Alliance for Health, Physical Education, Recreation & Dance, and the Alliance for a Healthier Generation will oversee the program. Funding and other resources will come from Nike Inc., the GENYOUth Foundation, ChildObesity180, Kaiser Permanente and the General Mills Foundation.
Under the new initiative, modest grants will be available from the Education Department to help some programs get started. The GENYOUth Foundation and ChildObesity180 also will be awarding grants.
Nike has committed $50 million to the effort over the next five years; the remaining groups together have pledged more than $20 million.
Williams said it's important to structure the activity so that it doesn't feel like a workout.
'I had fun and I didn't realize it was work,' she said about her years of practice before become one of America's top tennis players.
___
Online:
Let's Move: http://www.letsmove.gov
___
Follow Darlene Superville on Twitter: http://www.twitter.com/dsuperville
Wednesday, February 27, 2013
Friday, February 22, 2013
Thursday, February 21, 2013
Experts issue guidelines for gene tests in kids
NEW YORK (Reuters Health) - Groups representing pediatricians and geneticists issued new recommendations on Thursday to provide doctors with guidance about when to test a child's DNA for genetic conditions.
The recommendations are the first collaboration between the American Academy of Pediatrics and the American College of Medical Genetics and Genomics. Neither organization has issued guidelines for genetic testing of kids in over a decade, according to one of the study's lead authors.
'What we're trying to show is a unified and consistent message about genetic testing in children,' said Dr. Lainie Friedman Ross, the Carolyn and Matthew Bucksbaum Professor of Clinical Ethics at the University of Chicago.
'The first thing is what hasn't changed and the most important thing is (that) what is best for the child should be front and center for everything in pediatrics,' Ross said.
That includes offering every parent the opportunity to screen their newborn children for treatable genetic conditions - such as sickle-cell disease, which can lead to chronic health problems as well as fatal sickle-cell 'crises.'
Newborn screening 'shouldn't just be offered. It should be strongly encouraged, because the benefits far outweigh the risks,' Ross said.
Testing children for diseases that don't affect people until adulthood, however, should be discouraged unless a childhood treatment may decrease the risk of complications or death, according to the experts.
For example, the new policy would recommend against girls being screened for the BRCA1 and BRCA2 gene mutations, which put adult women at a higher risk for breast and ovarian cancer.
About one in 600 women in the U.S. carry the mutations, and those women may decide to have their breasts and ovaries removed later in life.
There is no reason to test babies or children for those types of mutations because the results would not change how doctors treat the child, according to Ross.
'That's something you get pretty universal agreement on from the geneticist side, to not test children for adult onset conditions,' said Dr. David Sweetser, chief of medical genetics at MassGeneral Hospital for Children in Boston.
'Giving that kind of information makes us all uneasy - especially if it's something you can't do anything about it, or if it's a test that's not 100 percent accurate,' added Sweetser, who was not involved with the new recommendations.
But the experts agreed that an exception can be made if it will relieve the emotional burden of not knowing whether or not the child has a condition.
'Our feeling is, we should educate them and counsel them against it, but if they tell us its overwhelming.. We should respect that,' Ross said.
The guideline authors urge that adopted children should be treated just like biological children in situations where testing is being considered. And they discourage the use of at-home genetic tests kits.
The recommendations also address the need for experts to help patients and doctors understand the results of genetic testing and screening.
Sweetser said that's an important point, because test results are often more complicated than a simple answer.
'It's not uncommon to get a patient transferred to us. to explain what the results are because the physician wasn't aware they could get such an ambiguous result,' he said.
The experts also said that children being tested as possible tissue donors should have access to an advocate 'or similar mechanism' to protect the child's interests.
Ross said the current statement does not address genetic testing or screening for research purposes, or analyzing a child's entire genome.
'I thought it was a well thought out policy statement. It does have some clear recommendations that I agree with. It's not overly restrictive, and it does allow a bit of latitude,' said Sweetser.
Ross added that these are just recommendations, and they are not requirements.
'These are guidelines, neither organization is telling people how to practice medicine, but they're important (recommendations) because they combine the knowledge of pediatricians, geneticists and ethicists,' she said.
The recommendations were published simultaneously in the journals Pediatrics and Genetics in Medicine.
SOURCE: http://bit.ly/UMHfjb Pediatrics, online February 21, 2013.
The recommendations are the first collaboration between the American Academy of Pediatrics and the American College of Medical Genetics and Genomics. Neither organization has issued guidelines for genetic testing of kids in over a decade, according to one of the study's lead authors.
'What we're trying to show is a unified and consistent message about genetic testing in children,' said Dr. Lainie Friedman Ross, the Carolyn and Matthew Bucksbaum Professor of Clinical Ethics at the University of Chicago.
'The first thing is what hasn't changed and the most important thing is (that) what is best for the child should be front and center for everything in pediatrics,' Ross said.
That includes offering every parent the opportunity to screen their newborn children for treatable genetic conditions - such as sickle-cell disease, which can lead to chronic health problems as well as fatal sickle-cell 'crises.'
Newborn screening 'shouldn't just be offered. It should be strongly encouraged, because the benefits far outweigh the risks,' Ross said.
Testing children for diseases that don't affect people until adulthood, however, should be discouraged unless a childhood treatment may decrease the risk of complications or death, according to the experts.
For example, the new policy would recommend against girls being screened for the BRCA1 and BRCA2 gene mutations, which put adult women at a higher risk for breast and ovarian cancer.
About one in 600 women in the U.S. carry the mutations, and those women may decide to have their breasts and ovaries removed later in life.
There is no reason to test babies or children for those types of mutations because the results would not change how doctors treat the child, according to Ross.
'That's something you get pretty universal agreement on from the geneticist side, to not test children for adult onset conditions,' said Dr. David Sweetser, chief of medical genetics at MassGeneral Hospital for Children in Boston.
'Giving that kind of information makes us all uneasy - especially if it's something you can't do anything about it, or if it's a test that's not 100 percent accurate,' added Sweetser, who was not involved with the new recommendations.
But the experts agreed that an exception can be made if it will relieve the emotional burden of not knowing whether or not the child has a condition.
'Our feeling is, we should educate them and counsel them against it, but if they tell us its overwhelming.. We should respect that,' Ross said.
The guideline authors urge that adopted children should be treated just like biological children in situations where testing is being considered. And they discourage the use of at-home genetic tests kits.
The recommendations also address the need for experts to help patients and doctors understand the results of genetic testing and screening.
Sweetser said that's an important point, because test results are often more complicated than a simple answer.
'It's not uncommon to get a patient transferred to us. to explain what the results are because the physician wasn't aware they could get such an ambiguous result,' he said.
The experts also said that children being tested as possible tissue donors should have access to an advocate 'or similar mechanism' to protect the child's interests.
Ross said the current statement does not address genetic testing or screening for research purposes, or analyzing a child's entire genome.
'I thought it was a well thought out policy statement. It does have some clear recommendations that I agree with. It's not overly restrictive, and it does allow a bit of latitude,' said Sweetser.
Ross added that these are just recommendations, and they are not requirements.
'These are guidelines, neither organization is telling people how to practice medicine, but they're important (recommendations) because they combine the knowledge of pediatricians, geneticists and ethicists,' she said.
The recommendations were published simultaneously in the journals Pediatrics and Genetics in Medicine.
SOURCE: http://bit.ly/UMHfjb Pediatrics, online February 21, 2013.
Adults cut back fast food, but U.S. kids still eat too much fat: CDC
WASHINGTON (Reuters) - American adults have made a little progress in recent years in cutting back on calories from fast food, but children are still consuming too much fat, U.S. health researchers say.
French fries, pizza and similar items accounted for about 11 percent of U.S. adults' caloric intake from 2007 to 2010, on average, down from about 13 percent between 2003 and 2006, the Centers for Disease Control and Prevention said in one of two reports released on Thursday.
Younger adults, black Americans and those who are already obese consumed the highest amounts of such food, which is often high in fat, salt and calories that can doom waistlines.
The CDC found in a separate report that while American children, on average, are consuming fewer calories overall than they used to, the percentage of their calories from artery-clogging saturated fat was still above optimal levels.
Recommended U.S. guidelines suggest that no more than 10 percent of one's daily calories should come from such fat, but American youth took in between 11 percent and 12 percent from 2009 to 2010, data from the CDC's National Center for Health Statistics showed.
Americans' diets and weight is a source of constant scrutiny and research in a country where two-thirds of the population is considered overweight or obese. According to the CDC, 36 percent of U.S. adults, or 78 million, and 17 percent of youth, or 12.5 million, are obese. Another third are overweight.
The slight decline in fast food consumption among adults reflects a growing trend toward healthier options. Many food and beverage companies have revamped their products or created new, healthier options to account for the shift in consumer tastes.
Still, Americans lead the world in calorie consumption. Portion sizes also have increased over the years, coupled with an increasingly sedentary lifestyle, have added up to extra pounds. Complications from obesity include diabetes, heart disease, arthritis and some cancers.
'Previous studies have reported that more frequent fast-food consumption is associated with higher energy and fat intake and lower intake of healthful nutrients,' CDC wrote.
Young black adults are especially a concern. Those aged 20 to 39 get more than one-fifth, or 21 percent, of their calories from fast food versus whites and Hispanics in the same age group who get about 15 percent from such foods, CDC found.
Obese and overweight adults also ate more fast food, it added.
Healthy weight is calculated by measuring body mass index, or BMI, using height and weight. For example, a 5-foot, 6-inch (1.7 meter) woman weighing 186 pounds (84 kilograms) would be considered obese as would a 6-foot (1.8 meter) man weighing 221 pounds (100 kilograms).
The CDC also said that American boys aged 2 to 19 took in about 2,100 calories daily during 2009 and 2010, a drop from 2,258 calories in 1999-2000. Girls saw their daily caloric intake fall to 1,755 from 1,831 during the same timeframe.
It is not yet clear how the recent change has affected childhood obesity rates, the agency added.
Among the other findings:
* The consumption of calories from fast food 'significantly decreased' with age;
* Fast food consumption was about the same for low-income and higher-income adults;
* More children are eating more protein, except for black girls;
* Carbohydrate consumption is lower among white boys and girls as well as black boys.
(Editing by Doina Chiacu)
French fries, pizza and similar items accounted for about 11 percent of U.S. adults' caloric intake from 2007 to 2010, on average, down from about 13 percent between 2003 and 2006, the Centers for Disease Control and Prevention said in one of two reports released on Thursday.
Younger adults, black Americans and those who are already obese consumed the highest amounts of such food, which is often high in fat, salt and calories that can doom waistlines.
The CDC found in a separate report that while American children, on average, are consuming fewer calories overall than they used to, the percentage of their calories from artery-clogging saturated fat was still above optimal levels.
Recommended U.S. guidelines suggest that no more than 10 percent of one's daily calories should come from such fat, but American youth took in between 11 percent and 12 percent from 2009 to 2010, data from the CDC's National Center for Health Statistics showed.
Americans' diets and weight is a source of constant scrutiny and research in a country where two-thirds of the population is considered overweight or obese. According to the CDC, 36 percent of U.S. adults, or 78 million, and 17 percent of youth, or 12.5 million, are obese. Another third are overweight.
The slight decline in fast food consumption among adults reflects a growing trend toward healthier options. Many food and beverage companies have revamped their products or created new, healthier options to account for the shift in consumer tastes.
Still, Americans lead the world in calorie consumption. Portion sizes also have increased over the years, coupled with an increasingly sedentary lifestyle, have added up to extra pounds. Complications from obesity include diabetes, heart disease, arthritis and some cancers.
'Previous studies have reported that more frequent fast-food consumption is associated with higher energy and fat intake and lower intake of healthful nutrients,' CDC wrote.
Young black adults are especially a concern. Those aged 20 to 39 get more than one-fifth, or 21 percent, of their calories from fast food versus whites and Hispanics in the same age group who get about 15 percent from such foods, CDC found.
Obese and overweight adults also ate more fast food, it added.
Healthy weight is calculated by measuring body mass index, or BMI, using height and weight. For example, a 5-foot, 6-inch (1.7 meter) woman weighing 186 pounds (84 kilograms) would be considered obese as would a 6-foot (1.8 meter) man weighing 221 pounds (100 kilograms).
The CDC also said that American boys aged 2 to 19 took in about 2,100 calories daily during 2009 and 2010, a drop from 2,258 calories in 1999-2000. Girls saw their daily caloric intake fall to 1,755 from 1,831 during the same timeframe.
It is not yet clear how the recent change has affected childhood obesity rates, the agency added.
Among the other findings:
* The consumption of calories from fast food 'significantly decreased' with age;
* Fast food consumption was about the same for low-income and higher-income adults;
* More children are eating more protein, except for black girls;
* Carbohydrate consumption is lower among white boys and girls as well as black boys.
(Editing by Doina Chiacu)
Tuesday, February 19, 2013
First Person: Choosing Natural Products, Giving My Kids a Healthier Future
A report released Tuesday says the man-made chemicals in products we use every day-toys, perfumes, beverage containers and more-are likely responsible for at least some cancers, birth defects and psychiatric problems. How do parents approach the use of chemicals in their homes? Yahoo News asked for some perspectives. Here's one.
FIRST PERSON | For 28 years, I didn't pay attention to the chemicals I put on and in my body. Then, in 2008, my daughter was born. I started reading about man-made chemicals in products marketed towards children. The more research I did, the more I realized that many of the teethers, lotions and cups my daughter was using were laced with possible endocrine disruptors and carcinogens.
As a 33-year-old mom in Los Angeles, California raising two children, I am aware that my kids are exposed to environmental chemicals. After all, L.A. isn't exactly known for its clean air. However, until I move to a location with fewer pollutants, I'm doing my best to avoid personal products with harmful chemicals. My daughter is almost 5. My son just turned 1. I strongly believe that my actions will help my kids lead a healthier life.
Since having children, our entire family has switched to shampoos, lotions and body washes that are paraban- and phthalate-free. If I do use a fragranced product, the scent comes from natural sources such as almond oil. In general, I avoid any children's products that contain things like formaldehyde and 1,4 dioxane.
I have also altered the way I clean. For years, I used bleach to whiten. Then, I realized that baking soda and vinegar were just as effective. I also switched from harsh detergent to plant based cleaners. I don't want the clothes my children wear and the bath they sit in to be coated in chemicals. Finally, I make sure my children's teethers and cups are BPA-free.
I could choose to ignore studies that say these man-made chemicals are dangerous. Some people think I am wasting my money. I just think I'm investing in my family's future.
Monday, February 18, 2013
Study: Better TV might improve kids' behavior
SEATTLE (AP) - Teaching parents to switch channels from violent shows to educational TV can improve preschoolers' behavior, even without getting them to watch less, a study found.
The results were modest and faded over time, but may hold promise for finding ways to help young children avoid aggressive, violent behavior, the study authors and other doctors said.
'It's not just about turning off the television. It's about changing the channel. What children watch is as important as how much they watch,' said lead author Dr. Dimitri Christakis, a pediatrician and researcher at Seattle Children's Research Institute.
The research was to be published online Monday by the journal Pediatrics.
The study involved 565 Seattle parents, who periodically filled out TV-watching diaries and questionnaires measuring their child's behavior.
Half were coached for six months on getting their 3-to-5-year-old kids to watch shows like 'Sesame Street' and 'Dora the Explorer' rather than more violent programs like 'Power Rangers.' The results were compared with kids whose parents who got advice on healthy eating instead.
At six months, children in both groups showed improved behavior, but there was a little bit more improvement in the group that was coached on their TV watching.
By one year, there was no meaningful difference between the two groups overall. Low-income boys appeared to get the most short-term benefit.
'That's important because they are at the greatest risk, both for being perpetrators of aggression in real life, but also being victims of aggression,' Christakis said.
The study has some flaws. The parents weren't told the purpose of the study, but the authors concede they probably figured it out and that might have affected the results.
Before the study, the children averaged about 1½ hours of TV, video and computer game watching a day, with violent content making up about a quarter of that time. By the end of the study, that increased by up to 10 minutes. Those in the TV coaching group increased their time with positive shows; the healthy eating group watched more violent TV.
Nancy Jensen, who took part with her now 6-year-old daughter, said the study was a wake-up call.
'I didn't realize how much Elizabeth was watching and how much she was watching on her own,' she said.
Jensen said her daughter's behavior improved after making changes, and she continues to control what Elizabeth and her 2-year-old brother, Joe, watch. She also decided to replace most of Elizabeth's TV time with games, art and outdoor fun.
During a recent visit to their Seattle home, the children seemed more interested in playing with blocks and running around outside than watching TV.
Another researcher who was not involved in this study but also focuses his work on kids and television commended Christakis for taking a look at the influence of positive TV programs, instead of focusing on the impact of violent TV.
'I think it's fabulous that people are looking on the positive side. Because no one's going to stop watching TV, we have to have viable alternatives for kids,' said Dr. Michael Rich, director of the Center on Media and Child Health at Children's Hospital Boston.
____
Online:
Pediatrics: http://www.pediatrics.org
___
Contact AP Writer Donna Blankinship through Twitter (at)dgblankinship
This article is sponsored by real estate news.
The results were modest and faded over time, but may hold promise for finding ways to help young children avoid aggressive, violent behavior, the study authors and other doctors said.
'It's not just about turning off the television. It's about changing the channel. What children watch is as important as how much they watch,' said lead author Dr. Dimitri Christakis, a pediatrician and researcher at Seattle Children's Research Institute.
The research was to be published online Monday by the journal Pediatrics.
The study involved 565 Seattle parents, who periodically filled out TV-watching diaries and questionnaires measuring their child's behavior.
Half were coached for six months on getting their 3-to-5-year-old kids to watch shows like 'Sesame Street' and 'Dora the Explorer' rather than more violent programs like 'Power Rangers.' The results were compared with kids whose parents who got advice on healthy eating instead.
At six months, children in both groups showed improved behavior, but there was a little bit more improvement in the group that was coached on their TV watching.
By one year, there was no meaningful difference between the two groups overall. Low-income boys appeared to get the most short-term benefit.
'That's important because they are at the greatest risk, both for being perpetrators of aggression in real life, but also being victims of aggression,' Christakis said.
The study has some flaws. The parents weren't told the purpose of the study, but the authors concede they probably figured it out and that might have affected the results.
Before the study, the children averaged about 1½ hours of TV, video and computer game watching a day, with violent content making up about a quarter of that time. By the end of the study, that increased by up to 10 minutes. Those in the TV coaching group increased their time with positive shows; the healthy eating group watched more violent TV.
Nancy Jensen, who took part with her now 6-year-old daughter, said the study was a wake-up call.
'I didn't realize how much Elizabeth was watching and how much she was watching on her own,' she said.
Jensen said her daughter's behavior improved after making changes, and she continues to control what Elizabeth and her 2-year-old brother, Joe, watch. She also decided to replace most of Elizabeth's TV time with games, art and outdoor fun.
During a recent visit to their Seattle home, the children seemed more interested in playing with blocks and running around outside than watching TV.
Another researcher who was not involved in this study but also focuses his work on kids and television commended Christakis for taking a look at the influence of positive TV programs, instead of focusing on the impact of violent TV.
'I think it's fabulous that people are looking on the positive side. Because no one's going to stop watching TV, we have to have viable alternatives for kids,' said Dr. Michael Rich, director of the Center on Media and Child Health at Children's Hospital Boston.
____
Online:
Pediatrics: http://www.pediatrics.org
___
Contact AP Writer Donna Blankinship through Twitter (at)dgblankinship
This article is sponsored by real estate news.
Wednesday, February 13, 2013
Evidence lacking on how to help kids after trauma
NEW YORK (Reuters Health) - There's no good evidence to say what types of treatment might help ward off anxiety and stress disorders in kids and teens exposed to traumatic events, according to a new analysis.
Researchers said that a few psychological interventions, including talk therapy and school-based programs, 'appear promising' for helping young people cope with the kind of trauma stemming from accidents, mass shootings and natural disasters. But so far, there are too many holes in the data to know what to recommend for children's long-term health and wellbeing, according to Meera Viswanathan from RTI International in Research Triangle Park, North Carolina, and her colleagues.
Nicole Nugent, who has studied stress disorders in kids at Warren Alpert Medical School of Brown University in Providence, Rhode Island, said one difficulty is that children get exposed to many different types of trauma, and as a result have many different treatment needs.
Nonetheless, 'We can't just say, 'Let's just not address it until we know more about the interventions that are effective,'' Nugent, who wasn't involved in the new review, told Reuters Health.
'One thing that we know doesn't work is nothing,' she said.
'Something horrible happens, and (kids) think, 'If I don't think about it, if I don't talk about it, it will go away.' And that absolutely doesn't happen.'
So-called nonrelational trauma is different from interpersonal trauma, which stems from acts committed by a person the child knows, such as sexual abuse or maltreatment by a friend or family member.
The young victim in the recent Alabama hostage drama, a six-year-old known only as Ethan, who was held in an underground bunker for six days, could have suffered nonrelational trauma because he didn't have a prior relationship with his kidnapper, Viswanathan said.
In an interview today on the 'Dr. Phil' television show, Ethan's mother talked about the boy's emotional state since being rescued, including his difficulty sleeping - a symptom common among both kids and adults following trauma.
Viswanathan's team analyzed 25 studies in which children who had been exposed to nonrelational trauma were assigned to a particular treatment intervention or a comparison group.
Depending on the trial, some of those children were already experiencing anxiety and other symptoms related to the trauma.
Treatment programs varied in their methods - from medication to talk therapy - as well as in their intensity and how long they lasted.
None of the studies testing medications such as antidepressants found they had a positive effect on children's mental health, according to the findings published Monday in Pediatrics.
On the other hand, youth who went through some type of talk therapy tended to do better than others who weren't treated at all - though Viswanathan called that pattern a 'weak signal.'
Researchers said some of what has been learned helping children who experience interpersonal trauma can be applied to young survivors of accidents and natural disasters as well.
'In the absence of other evidence,' Viswanathan told Reuters Health, 'certainly don't ignore the problem. Provide children with the support that can be available, and also tailor it for the needs of the children.'
She urged for more research looking at how kids respond to nonrelational trauma, in particular.
'Sadly, the shootings in Newtown are unlikely to be the last that we see, and we don't want to be in a position that we wish we had better evidence' on how to help children move on.
SOURCE: http://bit.ly/XAOQ3Z Pediatrics, online February 11, 2013.
This article is sponsored by free dating site.
Researchers said that a few psychological interventions, including talk therapy and school-based programs, 'appear promising' for helping young people cope with the kind of trauma stemming from accidents, mass shootings and natural disasters. But so far, there are too many holes in the data to know what to recommend for children's long-term health and wellbeing, according to Meera Viswanathan from RTI International in Research Triangle Park, North Carolina, and her colleagues.
Nicole Nugent, who has studied stress disorders in kids at Warren Alpert Medical School of Brown University in Providence, Rhode Island, said one difficulty is that children get exposed to many different types of trauma, and as a result have many different treatment needs.
Nonetheless, 'We can't just say, 'Let's just not address it until we know more about the interventions that are effective,'' Nugent, who wasn't involved in the new review, told Reuters Health.
'One thing that we know doesn't work is nothing,' she said.
'Something horrible happens, and (kids) think, 'If I don't think about it, if I don't talk about it, it will go away.' And that absolutely doesn't happen.'
So-called nonrelational trauma is different from interpersonal trauma, which stems from acts committed by a person the child knows, such as sexual abuse or maltreatment by a friend or family member.
The young victim in the recent Alabama hostage drama, a six-year-old known only as Ethan, who was held in an underground bunker for six days, could have suffered nonrelational trauma because he didn't have a prior relationship with his kidnapper, Viswanathan said.
In an interview today on the 'Dr. Phil' television show, Ethan's mother talked about the boy's emotional state since being rescued, including his difficulty sleeping - a symptom common among both kids and adults following trauma.
Viswanathan's team analyzed 25 studies in which children who had been exposed to nonrelational trauma were assigned to a particular treatment intervention or a comparison group.
Depending on the trial, some of those children were already experiencing anxiety and other symptoms related to the trauma.
Treatment programs varied in their methods - from medication to talk therapy - as well as in their intensity and how long they lasted.
None of the studies testing medications such as antidepressants found they had a positive effect on children's mental health, according to the findings published Monday in Pediatrics.
On the other hand, youth who went through some type of talk therapy tended to do better than others who weren't treated at all - though Viswanathan called that pattern a 'weak signal.'
Researchers said some of what has been learned helping children who experience interpersonal trauma can be applied to young survivors of accidents and natural disasters as well.
'In the absence of other evidence,' Viswanathan told Reuters Health, 'certainly don't ignore the problem. Provide children with the support that can be available, and also tailor it for the needs of the children.'
She urged for more research looking at how kids respond to nonrelational trauma, in particular.
'Sadly, the shootings in Newtown are unlikely to be the last that we see, and we don't want to be in a position that we wish we had better evidence' on how to help children move on.
SOURCE: http://bit.ly/XAOQ3Z Pediatrics, online February 11, 2013.
This article is sponsored by free dating site.
Hyper-parents can make college aged children depressed-study
LONDON (Reuters) - Turbo-charged parents still running their university-aged children's schedules, laundry and vacations could be doing more harm than good with a study on Wednesday showing these students were more likely to be depressed and dissatisfied with life.
Researcher Holly Schiffrin from the University of Mary Washington in Virginia found so-called helicopter parenting negatively affected college students by undermining their need to feel autonomous and competent.
Her study found students with over-controlling parents were more likely to be depressed and less satisfied with their lives while the number of hyper-parents was increasing with economic fears fuelling concerns over youngsters' chances of success.
'You expect parents with younger kids to be very involved but the problem is that these children are old enough to look after themselves and their parents are not backing off,' Schiffrin, an associate professor of psychology, told Reuters.
'To find parents so closely involved with their college lives, contacting their tutors and running their schedules, is something new and on the increase. It does not allow independence and the chance to learn from mistakes.'
Schiffrin's study, published in Springer's Journal of Child and Family Studies, was based on an online survey of 297 U.S. undergraduate students in which students described their mothers' parenting behavior and their own autonomy and researchers assessed their happiness and satisfaction levels.
The study comes as debate rises over how much parents should run their children's lives to make them succeed.
Schiffrin said the increase in technology had changed the involvement of parents in their children's college lives as the once-a-week phone call home was replaced with regular texting, emails and messaging.
The competitive marketplace and jostling for top college slots and the best jobs has also boosted the involvement of parents in college lives.
She said to counteract this, rising numbers of universities were starting to run parental orientation days parallel to events for students to help encourage parents to give their children more freedom.
LEARN FROM MISTAKES
In the UK, a housemaster from top British public school, Eton College, is involved in a campaign to get parents to slow down a little, arguing that hyper-parenting may in fact demotivate a child and even cause psychological damage.
Mike Grenier said the increase in helicopter parenting in the past 10 years had accompanied a changing attitude towards childhood, with more anxiety and fear over youngsters now seen as being at risk and vulnerable if confronted with failure.
The greater focus on testing and success at exams has fuelled this and raised anxiety levels further.
'There is a very fine line between the helicopter parent and the committed and caring parent while at the other end of the spectrum is the negligent parent which can be more dangerous,' Grenier told Reuters.
'But this time of austerity seems to be ratcheting up the tension with more competition for jobs.'
Grenier said it was disconcerting to see parents putting children as young as 3 or 4 into tutoring to ensure they get into the best schools and remain in the best schools to get top university places.
'There is the fear that if they don't get the right school and don't get the right university then they won't get the opportunity to fight for the best jobs,' he said. 'The stakes are higher in people's minds.'
Grenier is an advocate of a movement called 'slow education', a concept adapted from the Italian culinary movement that has prompted a wider philosophical approach to travel, business, living and now schooling.
'The real danger of hyper-parenting is that it is intrusive and parents don't let their children make their own decisions, take risks and learn for themselves,' he said.
(Reporting by Belinda Goldsmith, editing by Paul Casciato)
This article is sponsored by technology.
Researcher Holly Schiffrin from the University of Mary Washington in Virginia found so-called helicopter parenting negatively affected college students by undermining their need to feel autonomous and competent.
Her study found students with over-controlling parents were more likely to be depressed and less satisfied with their lives while the number of hyper-parents was increasing with economic fears fuelling concerns over youngsters' chances of success.
'You expect parents with younger kids to be very involved but the problem is that these children are old enough to look after themselves and their parents are not backing off,' Schiffrin, an associate professor of psychology, told Reuters.
'To find parents so closely involved with their college lives, contacting their tutors and running their schedules, is something new and on the increase. It does not allow independence and the chance to learn from mistakes.'
Schiffrin's study, published in Springer's Journal of Child and Family Studies, was based on an online survey of 297 U.S. undergraduate students in which students described their mothers' parenting behavior and their own autonomy and researchers assessed their happiness and satisfaction levels.
The study comes as debate rises over how much parents should run their children's lives to make them succeed.
Schiffrin said the increase in technology had changed the involvement of parents in their children's college lives as the once-a-week phone call home was replaced with regular texting, emails and messaging.
The competitive marketplace and jostling for top college slots and the best jobs has also boosted the involvement of parents in college lives.
She said to counteract this, rising numbers of universities were starting to run parental orientation days parallel to events for students to help encourage parents to give their children more freedom.
LEARN FROM MISTAKES
In the UK, a housemaster from top British public school, Eton College, is involved in a campaign to get parents to slow down a little, arguing that hyper-parenting may in fact demotivate a child and even cause psychological damage.
Mike Grenier said the increase in helicopter parenting in the past 10 years had accompanied a changing attitude towards childhood, with more anxiety and fear over youngsters now seen as being at risk and vulnerable if confronted with failure.
The greater focus on testing and success at exams has fuelled this and raised anxiety levels further.
'There is a very fine line between the helicopter parent and the committed and caring parent while at the other end of the spectrum is the negligent parent which can be more dangerous,' Grenier told Reuters.
'But this time of austerity seems to be ratcheting up the tension with more competition for jobs.'
Grenier said it was disconcerting to see parents putting children as young as 3 or 4 into tutoring to ensure they get into the best schools and remain in the best schools to get top university places.
'There is the fear that if they don't get the right school and don't get the right university then they won't get the opportunity to fight for the best jobs,' he said. 'The stakes are higher in people's minds.'
Grenier is an advocate of a movement called 'slow education', a concept adapted from the Italian culinary movement that has prompted a wider philosophical approach to travel, business, living and now schooling.
'The real danger of hyper-parenting is that it is intrusive and parents don't let their children make their own decisions, take risks and learn for themselves,' he said.
(Reporting by Belinda Goldsmith, editing by Paul Casciato)
This article is sponsored by technology.
Tuesday, February 12, 2013
Should toddlers be screened for lazy eye?
NEW YORK (Reuters Health) - Screening one- and two-year-olds for lazy eye can reliably detect children at risk for vision problems, a new study suggests.
Researchers found tests by trained volunteers correctly caught a similar proportion of toddlers and older preschoolers with the early signs of lazy eye - also known as amblyopia - who were then referred to an ophthalmologist for treatment.
'If you find a child (with vision problems) at five, it's theoretically possible if you treat them that they will get better. It's just that most people believe that waiting until they're three or four or five is a long time, because amblyopia is set in,' said Dr. Susannah Longmuir, an ophthalmologist who led the new study at the University of Iowa in Iowa City.
'Finding it early is generally believed to be better,' she told Reuters Health.
However, not all researchers and policymakers agree screening very young kids for vision problems is definitely worthwhile.
The U.S. Preventive Services Task Force, a government-backed panel, recommended in 2011 that kids age three to five be screened at least once for lazy eye.
But for babies and toddlers under three years old, the panel said there wasn't enough evidence to weigh the possible benefits and harms of vision screening.
Dr. Michael LeFevre, co-vice chair of the USPSTF and a family doctor at the University of Missouri School of Medicine in Columbia, said the new study doesn't change that.
'The principal research gap really related to after one identifies abnormalities, whether treatment affects the development of amblyopia,' LeFevre, who wasn't involved in the new research, told Reuters Health.
'We had evidence that treatment in the three- to five-year age range prevents long term vision loss, but we didn't have any evidence in the younger age range.'
A PATCH AT TWO?
Treatment for lazy eye - when one eye loses the ability to see details - usually involves covering up the good eye or making it blurry with drops so the child is forced to use the bad eye instead. Sometimes, children with amblyopia also need glasses to improve their vision.
'You can imagine taking your two-year-old and having them run around with a patch on their eye, how easy it is,' LeFevre said. 'It's hard enough at age three to five.'
For the new study, Longmuir and her colleagues analyzed the records of more than 200,000 Iowa preschoolers who were screened for signs of lazy eye between 2000 and 2011. One-fifth of those kids were younger than three years at the time of testing.
Among babies less than one year old, a quarter of screening tests were unreadable, the researchers found. But when they compared one- and two-year-olds only with the older preschoolers, there was no difference in screening accuracy, according to findings published Monday in Pediatrics.
Between three and five percent of kids were referred to an ophthalmologist for further testing and treatment, based on the free screening.
Doctors confirmed that as many as 90 percent of those positive screeners needed treatment.
Some states offer free vision screening for toddlers, but the idea of eye checks in that age group is 'a very debatable topic' given the resources involved, according to Longmuir.
Still, she and her colleagues said parents should take advantage of those programs where they exist - even if their child is younger than three years old.
'If the opportunity exists, go ahead and do it,' Longmuir said.
SOURCE: http://bit.ly/X5dOFk Pediatrics, online February 11, 2013.
Researchers found tests by trained volunteers correctly caught a similar proportion of toddlers and older preschoolers with the early signs of lazy eye - also known as amblyopia - who were then referred to an ophthalmologist for treatment.
'If you find a child (with vision problems) at five, it's theoretically possible if you treat them that they will get better. It's just that most people believe that waiting until they're three or four or five is a long time, because amblyopia is set in,' said Dr. Susannah Longmuir, an ophthalmologist who led the new study at the University of Iowa in Iowa City.
'Finding it early is generally believed to be better,' she told Reuters Health.
However, not all researchers and policymakers agree screening very young kids for vision problems is definitely worthwhile.
The U.S. Preventive Services Task Force, a government-backed panel, recommended in 2011 that kids age three to five be screened at least once for lazy eye.
But for babies and toddlers under three years old, the panel said there wasn't enough evidence to weigh the possible benefits and harms of vision screening.
Dr. Michael LeFevre, co-vice chair of the USPSTF and a family doctor at the University of Missouri School of Medicine in Columbia, said the new study doesn't change that.
'The principal research gap really related to after one identifies abnormalities, whether treatment affects the development of amblyopia,' LeFevre, who wasn't involved in the new research, told Reuters Health.
'We had evidence that treatment in the three- to five-year age range prevents long term vision loss, but we didn't have any evidence in the younger age range.'
A PATCH AT TWO?
Treatment for lazy eye - when one eye loses the ability to see details - usually involves covering up the good eye or making it blurry with drops so the child is forced to use the bad eye instead. Sometimes, children with amblyopia also need glasses to improve their vision.
'You can imagine taking your two-year-old and having them run around with a patch on their eye, how easy it is,' LeFevre said. 'It's hard enough at age three to five.'
For the new study, Longmuir and her colleagues analyzed the records of more than 200,000 Iowa preschoolers who were screened for signs of lazy eye between 2000 and 2011. One-fifth of those kids were younger than three years at the time of testing.
Among babies less than one year old, a quarter of screening tests were unreadable, the researchers found. But when they compared one- and two-year-olds only with the older preschoolers, there was no difference in screening accuracy, according to findings published Monday in Pediatrics.
Between three and five percent of kids were referred to an ophthalmologist for further testing and treatment, based on the free screening.
Doctors confirmed that as many as 90 percent of those positive screeners needed treatment.
Some states offer free vision screening for toddlers, but the idea of eye checks in that age group is 'a very debatable topic' given the resources involved, according to Longmuir.
Still, she and her colleagues said parents should take advantage of those programs where they exist - even if their child is younger than three years old.
'If the opportunity exists, go ahead and do it,' Longmuir said.
SOURCE: http://bit.ly/X5dOFk Pediatrics, online February 11, 2013.
Monday, February 11, 2013
Teen Pregnancy Rates Drop to Historic Lows in U.S
The teen birth rate in the U.S. fell to a historic low in 2011, according to statistics released Monday by the Centers for Disease Control and Prevention. The numbers were part of an 'Annual Summary of Vital Statistics: 2010-2011' published online by the journal Pediatrics ahead of its March issue.
The report detailed fertility, birth, and delivery statistics across all groups of women considered to be of childbearing age. Overall, the U.S. birth rate among younger women declined, while the birth rate among older women increased.
Here are some of the statistics that were released as part of the CDC's report.
8: The number of teen births in the U.S. declined a dramatic 8 percent between 2010 and 2011.
1991: As Reuters noted on Monday, the teen pregnancy and birth rate in the U.S. has been falling gradually for more than two decades. The highest teen birth rate recorded in the U.S. in recent years was in 1991.
31.3: For every 1,000 teens between the ages of 15 and 19, the U.S. recorded 31.3 births in 2011, which equals out to just more than 3 percent of all teenagers.
63.2: Overall, the U.S. marked 63.2 births per 1,000 women across all age groups in 2011, which was a 1 percent decline over 2010, and as noted by the article in Pediatrics, the 'lowest rate ever recorded.'
40.7: Births to unmarried mothers declined by a slight 0.1 percent between 2010 and 2011, and accounted for 40.7 percent of all births in the U.S. in 2011.
3.6: Dr. Ed McCabe, who is the senior vice president and medical director for the March of Dimes, told HealthDay News on Monday that if teen pregnancy rates had remained close to the 61.8 births per 1,000 teenagers that it was in 1991, more than 3.6 million more babies would have been born to teen moms.
11.7: The percentage of preterm births dropped to 11.7 percent in 2011, a decline of more than 1.1 percent over the 12.8 percent recorded in 2006.
50: The teen birth rates among non-Hispanic blacks and Hispanics have seen the most significant decreases since 1991, of more than 50 percent apiece. In 1991, the teen pregnancy rate among non-Hispanic blacks was 118.2 per 1,000 teens, while the rate for Hispanic teens was 104.6 per 1,000. In 2011, those rates had dropped to 47.4 per 1,000 teens and 49.4 per 1,000 teens, respectively.
Vanessa Evans is a musician and freelance writer based in Michigan, with a lifelong interest in health and nutrition issues.
The report detailed fertility, birth, and delivery statistics across all groups of women considered to be of childbearing age. Overall, the U.S. birth rate among younger women declined, while the birth rate among older women increased.
Here are some of the statistics that were released as part of the CDC's report.
8: The number of teen births in the U.S. declined a dramatic 8 percent between 2010 and 2011.
1991: As Reuters noted on Monday, the teen pregnancy and birth rate in the U.S. has been falling gradually for more than two decades. The highest teen birth rate recorded in the U.S. in recent years was in 1991.
31.3: For every 1,000 teens between the ages of 15 and 19, the U.S. recorded 31.3 births in 2011, which equals out to just more than 3 percent of all teenagers.
63.2: Overall, the U.S. marked 63.2 births per 1,000 women across all age groups in 2011, which was a 1 percent decline over 2010, and as noted by the article in Pediatrics, the 'lowest rate ever recorded.'
40.7: Births to unmarried mothers declined by a slight 0.1 percent between 2010 and 2011, and accounted for 40.7 percent of all births in the U.S. in 2011.
3.6: Dr. Ed McCabe, who is the senior vice president and medical director for the March of Dimes, told HealthDay News on Monday that if teen pregnancy rates had remained close to the 61.8 births per 1,000 teenagers that it was in 1991, more than 3.6 million more babies would have been born to teen moms.
11.7: The percentage of preterm births dropped to 11.7 percent in 2011, a decline of more than 1.1 percent over the 12.8 percent recorded in 2006.
50: The teen birth rates among non-Hispanic blacks and Hispanics have seen the most significant decreases since 1991, of more than 50 percent apiece. In 1991, the teen pregnancy rate among non-Hispanic blacks was 118.2 per 1,000 teens, while the rate for Hispanic teens was 104.6 per 1,000. In 2011, those rates had dropped to 47.4 per 1,000 teens and 49.4 per 1,000 teens, respectively.
Vanessa Evans is a musician and freelance writer based in Michigan, with a lifelong interest in health and nutrition issues.
What heals traumatized kids? Answers are lacking
CHICAGO (AP) - Shootings and other traumatic events involving children are not rare events, but there's a startling lack of scientific evidence on the best ways to help young survivors and witnesses heal, a government-funded analysis found.
School-based counseling treatments showed the most promise, but there's no hard proof that anxiety drugs or other medication work and far more research is needed to provide solid answers, say the authors who reviewed 25 studies. Their report was sponsored by the federal Agency for Healthcare Research and Quality.
According to research cited in the report, about two-thirds of U.S. children and teens younger than 18 will experience at least one traumatic event, including shootings and other violence, car crashes and weather disasters. That includes survivors and witnesses of trauma. Most will not suffer any long-term psychological problems, but about 13 percent will develop symptoms of post-traumatic stress, including anxiety, behavior difficulties and other problems related to the event.
The report's conclusions don't mean that no treatment works. It's just that no one knows which treatments are best, or if certain ones work better for some children but not others.
'Our findings serve as a call to action,' the researchers wrote in their analysis, published online Monday by the journal Pediatrics.
'This is a very important topic, just in light of recent events,' said lead author Valerie Forman-Hoffman, a researcher at the University of North Carolina-Chapel Hill.
She has two young children and said the results suggest that it's likely one of them will experience some kind of trauma before reaching adulthood. 'As a parent I want to know what works best,' the researcher said.
Besides the December massacre at Sandy Hook Elementary School in Connecticut, other recent tragedies involving young survivors or witnesses include the fatal shooting last month of a 15-year-old Chicago girl gunned down in front of a group of friends; Superstorm Sandy in October; and the 2011 Joplin, Mo., tornado, whose survivors include students whose high school was destroyed.
Some may do fine with no treatment; others will need some sort of counseling to help them cope.
Studying which treatments are most effective is difficult because so many things affect how a child or teen will fare emotionally after a traumatic event, said Dr. Denise Dowd, an emergency physician and research director at Children's Mercy Hospitals and Clinics in Kansas City, Mo., who wrote a Pediatrics editorial.
One of the most important factors is how the child's parents handle the aftermath, Dowd said.
'If the parent is freaking out' and has difficulty controlling emotions, kids will have a tougher time dealing with trauma. Traumatized kids need to feel like they're in a safe and stable environment, and if their parents have trouble coping, 'it's going to be very difficult for the kid,' she said.
The researchers analyzed 25 studies of treatments that included anti-anxiety and depression drugs, school-based counseling, and various types of psychotherapy. The strongest evidence favored school-based treatments involving cognitive behavior therapy, which helps patients find ways to cope with disturbing thoughts and emotions, sometimes including talking repeatedly about their trauma.
This treatment worked better than nothing, but more research is needed comparing it with alternatives, the report says.
'We really don't have a gold standard treatment right now,' said William Copeland, a psychologist and researcher at Duke University Medical Center who was not involved in the report. A lot of doctors and therapists may be 'patching together a little bit of this and a little bit of that, and that might not add up to the most effective treatment for any given child,' he said.
___
Online:
Pediatrics: http://www.pediatrics.org
School-based counseling treatments showed the most promise, but there's no hard proof that anxiety drugs or other medication work and far more research is needed to provide solid answers, say the authors who reviewed 25 studies. Their report was sponsored by the federal Agency for Healthcare Research and Quality.
According to research cited in the report, about two-thirds of U.S. children and teens younger than 18 will experience at least one traumatic event, including shootings and other violence, car crashes and weather disasters. That includes survivors and witnesses of trauma. Most will not suffer any long-term psychological problems, but about 13 percent will develop symptoms of post-traumatic stress, including anxiety, behavior difficulties and other problems related to the event.
The report's conclusions don't mean that no treatment works. It's just that no one knows which treatments are best, or if certain ones work better for some children but not others.
'Our findings serve as a call to action,' the researchers wrote in their analysis, published online Monday by the journal Pediatrics.
'This is a very important topic, just in light of recent events,' said lead author Valerie Forman-Hoffman, a researcher at the University of North Carolina-Chapel Hill.
She has two young children and said the results suggest that it's likely one of them will experience some kind of trauma before reaching adulthood. 'As a parent I want to know what works best,' the researcher said.
Besides the December massacre at Sandy Hook Elementary School in Connecticut, other recent tragedies involving young survivors or witnesses include the fatal shooting last month of a 15-year-old Chicago girl gunned down in front of a group of friends; Superstorm Sandy in October; and the 2011 Joplin, Mo., tornado, whose survivors include students whose high school was destroyed.
Some may do fine with no treatment; others will need some sort of counseling to help them cope.
Studying which treatments are most effective is difficult because so many things affect how a child or teen will fare emotionally after a traumatic event, said Dr. Denise Dowd, an emergency physician and research director at Children's Mercy Hospitals and Clinics in Kansas City, Mo., who wrote a Pediatrics editorial.
One of the most important factors is how the child's parents handle the aftermath, Dowd said.
'If the parent is freaking out' and has difficulty controlling emotions, kids will have a tougher time dealing with trauma. Traumatized kids need to feel like they're in a safe and stable environment, and if their parents have trouble coping, 'it's going to be very difficult for the kid,' she said.
The researchers analyzed 25 studies of treatments that included anti-anxiety and depression drugs, school-based counseling, and various types of psychotherapy. The strongest evidence favored school-based treatments involving cognitive behavior therapy, which helps patients find ways to cope with disturbing thoughts and emotions, sometimes including talking repeatedly about their trauma.
This treatment worked better than nothing, but more research is needed comparing it with alternatives, the report says.
'We really don't have a gold standard treatment right now,' said William Copeland, a psychologist and researcher at Duke University Medical Center who was not involved in the report. A lot of doctors and therapists may be 'patching together a little bit of this and a little bit of that, and that might not add up to the most effective treatment for any given child,' he said.
___
Online:
Pediatrics: http://www.pediatrics.org
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