Category Archives: Pediatrics
HealthCare.gov: After Fixes, More Enroll in First Two Days of December than Did in All of October
The five weeks spent working on many of the problems of the HealthCare.gov website seem to have been time well spent, with more people signing up for the new health insurance in the first two days of December than were able to enroll in all of October. About 29,000 signed up for the insurance, made possible by the Affordable Care Act, on Sunday and Monday; only about 27,000 people signed up in October when the site first went live. While the final numbers have not been released, about 100,000 are estimated to have signed up via the site in November. The website is used in 36 states, with fourteen states and Washington, D.C. running their own sites. Read more on the Affordable Care Act.
Boston Adds Rentable Bicycle Helmets to Bikeshare System
Boston is working to improve the safety of people who use Hubway, the city’s popular bikeshare system, by installing the first vending machine for renting bicycle helmets. The HelmetHub street kiosk will be located at the Boylston Street and Massachusetts Avenue Hubway Station. Riders will be able to rent a helmet for 24 hours for $2, or purchase one to keep for $20; they will be sanitized and inspected after each use. The city intends for this test kiosk to be the first of many throughout Boston. Read more on safety.
Study: Social Ties, More than Biology, Responsible for Changes in Teen Sleep Times
Social ties—especially with parents and friends—may be more responsible than biology for whether a teenager gets enough sleep. While past studies have linked biological development factors to why children tend to sleep less as they age into teenagers, a new study in the Journal of Health and Social Behavior ties the trend more closely to the quality of the teen’s social ties. In an analysis of data on almost 1,000 kids ages 12 to 15—during with the average sleep time drops from 9 hours per school night to 8 hours—researchers concluded that teens who felt that they were a part of school, who were close to their friends and especially who had parents who were active in their life were more likely to get more sleep. "Research shows that parents who keep tabs on their kids are less likely to see them get into trouble or use drugs and alcohol," said David Maume, a sociology professor at the University of Cincinnati. "My findings suggest a similar dynamic with sleep. Parents who monitor their children's behavior are more likely to have kids that get adequate rest. Given that children generally get less sleep as they become teenagers, parents should be ever more vigilant at this stage.” Read more on pediatrics.
As colder weather begins to set in, a new story on the homeless from Atlantic Cities is particularly striking: According to the U.S. Department of Education, the number of homeless students in the United States has hit a record high number.
For the 2011 school year—the latest year for which the department has data—1,168,354 homeless children were enrolled in U.S. schools from nursery through 12th grade. Nationally, that is a 10 percent jump over the previous school year, and a whopping 72 percent increase since the recession began in 2008. More striking numbers: more than 40 states showed a rise in homelessness among kids and ten states saw the number of kids without a space to call their own rise more than 20 percent since 2008.
The lack of a safe home and limited access to health care leaves America’s homeless at especially high risk for a large number of health problems. According to a fact sheet from the National Health Care for the Homeless Council, “Without homes, people are exposed to the elements, disease, violence, unsanitary conditions, malnutrition, stress and addictive substances. Consequently, their rates of serious illnesses and injuries are three to six times the rates of other people. These conditions are frequently co-occurring, with a complex mix of severe physical, psychiatric, substance use and social problems.”
>>Bonus link: Continue reading even after the numbers jump out at you to learn about a ten year old girl, reported by the San Jose Mercury News, who rides a bus with her father in Santa Clara County, Calif., each night since the $70 monthly pass makes it an affordable option. The fact that the young girl is having “one of her best years so far in school,” according to her father, is all the more remarkable considering they have to get off and reboard that bus about every two hours.
Chicago Announces Trio of Anti-tobacco Initiatives to Curb Youth Smoking
The city of Chicago and Mayor Rahm Emanuel this morning announced a trio of anti-tobacco initiatives designed to reduce youth access to tobacco. The first would regulate e-cigarettes as tobacco products, while the second would restrict the sale of flavored tobacco products near schools and the third would work to educate the public on the dangers of menthol-flavored cigarettes. Further details:
- By defining “tobacco products” as products that are made of tobacco or include tobacco-derived nicotine, the city would be able to regulate e-cigarettes as they do any other tobacco product. This would mean that under the Chicago Clean Indoor Air Act, e-cigarette use would be restricted everywhere where smoking is restricted, including almost all public places and places of employment.
- Flavored tobacco products, including menthol products, could not be sold within 500 feet of schools, and existing stores would not be grandfathered in. This would be the first regulation of menthol-flavored cigarettes anywhere at the federal, state or local levels.
- Understanding that menthol-cigarettes are often—and wrongly—viewed as less unhealthy than other tobacco products, as well as that fact that the flavoring makes them more appealing to kids, the city is launching a public service advertising campaign on the realities of the products.
“E-cigarettes, as well as flavored products, are gateway tobacco products targeted at our kids,” said Emanuel. “The tobacco industry has spent years developing products that are aimed at hooking our youth on nicotine and getting them smoking for their entire life.” Read more on tobacco.
FDA to Investigate Reports on Weight-related Problems with the Morning-After-Pill
Following yesterday’s report that the European equivalent of the Plan B One-Step “morning after pill,” Norlevo, is less effective for women who weigh 165 pounds or more and ineffective for women who weigh 176 pounds or more, the U.S. Food and Drug Administration (FDA) has announced it will perform its own investigation into the product. The agency is "currently reviewing the available and related scientific information on this issue, including the publication upon which the Norlevo labeling change was based," said FDA spokeswoman Erica Jefferson said in a Monday statement. "The agency will then determine what, if any, labeling changes to approved emergency contraceptives are warranted." By law, the morning-after pill is available to all U.S. women of child-bearing age, over the county and with no point-of-sale restrictions. Read more on sexual health.
Concerns Over Cost, Sexual Activity Keep Many Parents From Having Kids Vaccinated Against HPV
Costs and parental concern over their kids’ sexual activity may be the reason that so view children—both girls and boys—are not being vaccinated against the human papillomavirus (HPV), according to a new review of 55 studies appearing in JAMA Pediatrics. HPV vaccines protect against the strains of genital warts that cause approximately 70 percent of cervical cancers, and they are recommended for girls aged 11 to 12. Boys are recommended to receive the vaccine as young as age 11, as it protects not just against genital warts, but also oral, penis and rectal cancers. However, the review found that many parents put off the vaccination either because they believe their child is not sexually active—so doesn’t “need” the vaccine—or because they fear it will encourage them to become sexually active. Researchers determined that a physician’s recommendation was one of the strongest motivators toward deciding to accept the vaccination, although this did not happen nearly enough. The researchers recommended improving these statistics by educating doctors and parents on the importance of the vaccine. Read more on cancer.
FDA Approves Vaccine for H5N1 Strain of Avian Flu
The U.S. Food and Drug Administration (FDA) has approved the first adjuvanted pandemic influenza vaccine for the prevention of the H5N1 strain of the avian flu, also known as bird flu. While most influenza A viruses do not infect people, H5N1 does and has demonstrated a 60 percent mortality rate when a person becomes infected. The U.S. Department of Health and Human Services has added the vaccine to the National Stockpile. “This vaccine could be used in the event that the H5N1 avian influenza virus develops the capability to spread efficiently from human to human, resulting in the rapid spread of disease across the globe,” said Karen Midthun, MD, director of the FDA’s Center for Biologics Evaluation and Research. “Vaccines are critical to protecting public health by helping to counter the transmission of influenza disease during a pandemic.” Read more on infectious diseases.
Study: Excessive Television Watching Equals Excess Weight in Kids
Children and teenagers who spend excessive amounts of time watching television or in front of other screens are also more inclined to be overweight or obese, according to a new study in the journal Pediatrics. Researchers analyzed data on nearly 8,000 boys and girls, ages 9-16, finding that each additional hour a day spent watching television was linked to a body mass index (BMI) scale increase of about 0.1 points, or about half a pound. Kids who watch television or play video/computer games are not only for the most part physically idle, but also more likely to snack. While many parents believe their kids spend a reasonable amount of time in front of screens, the reality is that most kids in the United States and Canada surpass the recommended daily limit of two hours. "We don't pay attention to the fact that it's half an hour here, half an hour there, an hour here, an hour there," said Mark Tremblay, director of Healthy Active Living and Obesity Research at the Children's Hospital of Eastern Ontario Research Institute in Ottawa, Canada, who was not a part of the study. Read more on obesity.
Study: One in 10 U.S. Kids has ADHD
About one in 10 U.S. children have attention-deficit/hyperactivity disorder (ADHD), according to a new study in the Journal of the American Academy of Child and Adolescent Psychiatry. A 2011 poll of more than 95,000 parents found 11 percent of kids ages 4-17 had ADHD, up from 9.5 percent in 2007. The number of kids on ADHD medication also climbed about 1 percent, with research showing that half the kids with ADHD are diagnosed before the age of 6. "This finding suggests that there are a large number of young children who could benefit from the early initiation of behavioral therapy, which is recommended as the first-line treatment for preschool children with ADHD," study author and U.S. Centers for Disease Control and Prevention (CDC) researcher Susanna Visser. The study also found that while the number of kids with ADHD is still climbing, it is no longer climbing as fast—the rate was increasing about 6 percent a year in the mid-2000s, but was only 4 percent a year from 2007 to 2011. Read more on pediatrics.
CDC Releases ‘Winnable Battles Progress Report 2010-2015’
The U.S. Centers for Disease Control and Prevention (CDC) has released its Winnable Battles Progress Report 2010-2015, which details the progress made in key areas where CDC has determined that progress is possible. The individual reports detail what’s been accomplished, and what still needs to be accomplished, to reach these goals by 2015. They include healthcare-associated infections; tobacco; nutrition, physical activity and obesity; food safety; motor vehicle safety; teen pregnancy; and HIV prevention. “By implementing the programs with the greatest potential impact, we are addressing Americans’ biggest health challenges while we try to get the most health bang for precious resources,” said CDC Director Tom Frieden, MD, MPH. Read more on the CDC.
Study: One-third of Kids’ Calories from Schools, Stores, Fast Food Restaurants are ‘Empty Calories’
In the battle to improve nutrition for kids, parents need to look beyond just fast food restaurants and take a closer look at food from grocery stores and at schools. A new study in the Journal of the Academy of Nutrition and Dietetics found that roughly a third of the calories consumed from each of these three sources constituted “empty calories” coming from added sugar or solid fat. The 2010 Dietary Guidelines for Americans recommends between 8 and 19 percent of calories should be “empty” for both kids and adults; excessive empty calories can lead to weight gain and obesity. While all three sources offered high counts of empty calories, they did so for different reasons, demonstrating the need to tailor health efforts to meet their particular obstacles. "Our study found that 20 percent of pizza and 22 percent of high-fat milk consumed by kids are provided by schools, and 72 percent of sugar-sweetened beverages like sodas, fruit drinks, sports drinks and energy drinks consumed by kids are obtained from grocery stores," said study author Jennifer M. Poti, a doctoral candidate in nutritional epidemiology at the University of North Carolina at Chapel Hill. Read more on nutrition.
American Headache Society: New Guidelines on Treating Migraines, Limiting Unnecessary Treatments
The American Headache Society has issued new guidelines on how physicians can better treat patients with migraines while limiting unnecessary or even risky treatments. For example, because of their serious long-term risks, opiod painkillers such as OxyContin and Vicodin, as well as the barbiturate butalbital, should not be the first treatments prescribed. Also, CT scans should only be limited to non-emergency situations when possible, as MRIs are both able to diagnose more conditions and do not expose patients to radiation. "Our aim is to encourage doctors and patients to think carefully about medical care that can be harmful or unnecessary," said Elizabeth Loder, MD, president of the American Headache Society. "We didn't approach this with cost uppermost in mind. The goal is to help address the problems of low-value care." Approximately 12 percent of Americans are estimated to suffer from migraines. Read more on migraines.
Kids Today Slower, Less Fit than Their Parents as Kids
An average child in 1975 in a one-mile race with an average child today would win by an average of a minute and a half, according to new research. Kids today are also about 15 percent less aerobically fit, with heart endurance falling an average of 6 percent per decade from 1970 to 2000. That means today’s kids are more likely to be unhealthy in adulthood, with weaker hearts, thinner bones and overall lower quality of life. Grant Tomkinson, a senior lecturer in the University of South Australia's School of Health Sciences, pointed to a number of factors, including communities designed to discourage walking, bicycling and backyard play; reduced or even completely absent physical education in schools; and the prevalence of television, computer, tablet and smartphone screens that keep kids indoors. "We all live in an environment that's toxic for exercise, and our children are paying the price," Tomkinson said. Tomkinson said in order to reverse this trend, kids need at least 60 minutes of serious physical exercise a day, such as running, swimming or cycling. "You want exercise to be fun, but there needs to be some huff and puff there as well," he said. "It needs to make them somewhat tired." Read more on physical activity.
Study: Symptoms of ‘Sudden’ Cardiac Arrest Can Be Seen Up to a Month Earlier
Symptoms of “sudden” cardiac arrest can be seen up to a month beforehand in middle-age men, according to new findings presented this week at the annual scientific sessions of the American Heart Association, held this year in Dallas. Researchers looked at the medical records of 567 men, ages 35-65, who had out-of-hospital heart attacks, finding that approximately 53 percent showed symptoms beforehand. They included chest pain (56 percent); shortness of breath (13 percent); and dizziness, fainting or palpitations (4 percent). Sumeet Chugh, senior author of the study and associate director for genomic cardiology at the Cedars-Sinai Heart Institute in Los Angeles, said the “entirely unexpected” findings show that people may be able to prevent heart attacks if they seek treatment earlier for these symptoms. "The findings were entirely unexpected," said "We never thought more than half of these middle-aged men would have had warning signs so long before their cardiac arrests,” Chugh said. “Previously we thought most people don't have symptoms so we can't do anything about it." Read more on heart health.
ACS Tips on Quitting Tobacco for Tomorrow’s ‘Great American Smokeout’
Tomorrow is the American Cancer Society (ACS) Great American Smokeout, held every year on the third Thursday of November. The annual event was founded to encourage people to quit using tobacco—perhaps to stop smoking on that day, or to make a plan on how to quit at a later date—and to provide the tools and resources that can help the decision stick. According to ACS, research shows that people are most successful at quitting tobacco when they have support, and recommends combing two or more of the following tactics to improve the odds:
- Telephone smoking-cessation hotlines
- Stop-smoking groups
- Online quit groups
- Nicotine replacement products
- Prescription medicine to lessen cravings
- Guide books
- Encouragement and support from friends and family members
>>NewPublicHealth continues a new series to highlight some of the best public health education and outreach campaigns every month. Submit your ideas for Public Health Campaign of the Month to info@newPublichealth.org.
Glass thermometers. Compact fluorescent light (CFL) bulbs. Medical equipment. Gauges and other science equipment. Thermostats, switches and other electrical devices.
Mercury lives in all of these devices—and all can be found in schools. While it may be common, mercury is also incredibly dangerous. Mercury poisoning can negatively impact the nervous system, lungs and kidneys. It can even lead to brain damage or death.
Often mercury poisoning is the result of a kid thinking it’s “cool”— taking it, playing with, passing it around to friends. Metallic mercury easily vaporizes into a colorless, odorless, hazardous gas.
The Agency for Toxic Substances and Disease Registry (ATSDR), part of the U.S. Centers for Disease Control and Prevention (CDC), has released a new website that brings together a suite of tools to educate kids, teachers, school administrators and parents about the dangers of mercury poisoning. They include an interactive human body illustration and facts sheets, as well as a 30-second “Don’t Mess With Mercury” animated video to raise awareness about the dangers of mercury.
Construction Workers Frequently Impacted by Pain and Stress
Construction workers are frequently stressed about work-related injuries and pain, but often fail to get help for either, putting themselves at risk for additional injuries and mental health issues, according to a new study in the Journal of Occupational and Environmental Medicine. The researchers, based at the Harvard School of Public Health, reviewed data compiled by the School’s Center for Work, Health and Wellbeing and found that the construction industry has one of the highest rates of work-related injuries and suicides in the U.S. workplace, as well as a high prevalence of musculoskeletal pain among its workers. The researchers also conducted a mental health survey of 172 New England construction workers at four construction sites. Sixteen percent of the workers reported being distressed, 75 percent had experienced musculoskeletal pain over the previous three months and 42 percent reported one or more work injuries in the preceding month. A follow-up survey found that more than half of those who previously said they felt distressed had not sought professional help—likely, say the researchers, because of fear of stigmatization or job loss. Read more on injury prevention and mental health.
USPSTF: Cannot Recommend For, or Against, Vitamin Supplements to Help Prevent Cancer, Heart Disease
Citing the fact that there is simply too little evidence to make a conclusion either way, the U.S. Preventive Services Task Force (USPSTF) has concluded at this time that it can’t recommend for or against taking vitamin and mineral supplements to help prevent cancer and heart problems. In a draft statement, the panel also ruled that neither beta-carotene nor vitamin E should be taken to prevent heart disease or cancer; beta-carotene was previously found to exacerbate the risk of lung cancer for people who were already at high risk. The researchers analyzed data from 26 studies between January 2005 and January 2013, which included people across an array of demographics, finding no difference between those who took the supplements and those who took placebos. Vitamin supplements are a $12 billion per year industry in the United States. Read more on prevention.
Study: Simple Urine Test Could Identify Young Type 1 Diabetes Patients with Highest Risk of Heart, Kidney Disease
A basic urine test could help doctors prevent heart and kidney disease in kids who are at higher risk due to their type 1 diabetes, according to a new study in the journal Diabetes Care. As many as 40 percent of youth with type 1 diabetes may be at increased risk for the health problems. Researchers at the University of Cambridge, in England, analyzed data on more than 3,300 diabetes patients between the ages of 10 and 16; an estimated 490,000 kids worldwide have type 1 diabetes. "Managing type 1 diabetes is difficult enough without having to deal with other health problems," study lead author David Dunger. "By using early screening, we can now identify young people at risk of heart and kidney disease. The next step will be to see if drugs used to treat heart and kidney disease—such as statins and blood-pressure-lowering drugs—can help prevent kidney and heart complications in this young, potentially vulnerable population.” Read more on pediatrics.
BSR: New Ways U.S. Companies Can Improve Population Health
U.S. companies can improve population health by improving how they engage with employees, customers, local communities, suppliers and the general public, according to a new BSR report supported by a grant from the Robert Wood Johnson Foundation. BSR interviewed 40 leading authorities on health and wellness, public health, corporate social responsibility and corporate affairs, as well as reviewed more than 35 corporate CSR reports across 10 industries and surveyed nearly 30 U.S.-based BSR member companies about their current activities on health and wellness. The report emphasizes how CSR teams can help lead the charge in improving population health. “Within business, the corporate social responsibility (CSR) teams are well-positioned to lead this work—helping their companies look carefully at the positive as well as negative impacts on health and wellness, and helping them identify opportunities to deliver better business results and health outcomes,” said Mark Little, BSR’s healthcare director. Read more on business.
CDC: Colorectal Cancer Screening Rate Remains Low
Despite continued research showing that colorectal cancer screening tests saves lives, as many as one in three adults ages 50 to 75 have not been tested, according to a new Vital Signs report from the U.S. Centers for Disease Control and Prevention (CDC). The cancer type is the second-leading cause of death for both men and women in the United States, and screening can help prevent it or even detect it early, when treatment is more effective. “There are more than 20 million adults in this country who haven’t had any recommended screening for colorectal cancer and who may therefore get cancer and die from a preventable tragedy,” said CDC Director Tom Frieden, MD, MPH. “Screening for colorectal cancer is effective and can save your life.” the United States Preventive Services Task Force recommends that all adults age 50 and older be screened by at least one of three tests, which can variously be performed at home or by a doctor, and once every year, three years or decade. Read more on cancer.
Study: Eating Disorders in Young Men Often Different Than Those in Women
While not as widely discussed or researched, young men—just like young women—can become obsessed with their appearance and develop dangerous eating disorders, according to a new study in the journal JAMA Pediatrics. The problem can resemble a traditional eating disorder such as anorexia nervosa or bulimia nervosa, or involve the use of drugs and supplements. The disorders are often paired with depression, binge drinking and recreational drug use. The researchers’ survey of 5,527 boys, ages 12-18, found that 31 percent had at some point binged on food or purged, 9 percent had a high level of concern with their body's muscularity and about 2 percent were both concerned about muscularity and had used some type of supplement, growth hormone derivative or anabolic steroid to enhance it. "The results of our studies would suggest we need to be thinking more broadly about eating disorders and consider males as well," said Alison Field, the study's lead author and an associate professor of pediatrics at Boston Children's Hospital. "For a lot of males, what they're striving for is different than females. They're probably engaged in something different than purging." Read more on pediatrics.
The U.S. Department of Transportation’s (DOT) National Highway Traffic Safety Administration (NHTSA) has launched a new campaign that challenges parents to discuss with their teen drivers five practices that can prevent serious injuries and even deaths in the event of a crash:
- No cell phone use or texting while driving
- No extra passengers
- No speeding
- No alcohol
- No driving or riding without a seat belt
NHTSA data show motor vehicle crashes are the leading cause of death for teenagers 14-18 years-old in the United States. In 2011, 2,105 teen drivers were involved in fatal crashes. Of those teens involved in fatal crashes, 1,163 (55 percent) survived and 942 (45 percent) died in the crash.
"Safety is our highest priority, especially when it comes to teens, who are often our least experienced drivers," said DOT Secretary Anthony Foxx. "The ‘5 to Drive’ campaign gives parents and teens a simple, straightforward checklist that can help them talk about good driving skills and most importantly, prevent a tragedy before it happens."
The list of precautions matches the top causes of death in teen crashes:
- In 2011, over half of the teen occupants of passenger vehicles who died in crashes were unrestrained
- Speeding was a factor in 35 percent of fatal crashes involving a teen driver
- Twelve percent of teen drivers involved in fatal crashes were distracted at the time
- In 2011, 505 people nationwide died in crashes in which drivers ages 14-18 years had alcohol in their systems, despite the fact that all states have Zero Tolerance Laws for drinking under age 21
NHTSA research also finds that peer pressure is a contributing factor in teen crash deaths. When the teen driver in a fatal crash was not wearing a seat belt, almost four-fifths of that driver’s teen passengers were also unrestrained. And a teenage driver was 2.5 times more likely to engage in risky behaviors when driving with one teenage passenger, but three times more likely when driving with multiple teenager passengers.
Additional NHTSA research found that poor decisions among teen drivers can lead to crashes and fatalities at any time of the day, but that they were most frequent between 3 p.m. and 8 p.m., and remained high until midnight.
>>Bonus Link: NHTSA provides a wealth of resources on safe driving for teens.