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RELATING TO CHILDREN, YOUTH AND FAMILIES —
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August 2006
Intense workouts make for fitter children
Sustained, vigorous exercise may be more effective than lower-intensity activity in helping children avoid obesity and stay fit, a new study shows. Both obesity and poor cardiovascular fitness are growing problems among children worldwide, Dr Michael Sjostrom of the Karolinska Institute in Huddinge, Sweden and colleagues note. Physical activity is proven to fight both of these epidemics. Evidence is mounting that more intense activity may be more effective in preventing excess weight gain, they add.
To investigate how the amount and intensity of activity might be related to obesity and fitness in kids, the researchers looked at 780, 9- and 10-year-old children, measuring their activity levels over four consecutive days using a device called an accelerometer. The children who engaged in vigorous physical activity for more than 40 minutes daily had less body fat than those who were this active for just 10 to 18 minutes a day, and also had higher cardiovascular fitness, the researchers found.
There was no association between the total amount of a child's daily physical activity and his or her levels of body fat, but kids who were active for a longer amount of time each day did have greater cardiovascular fitness. "Our results suggest that vigorous-intensity physical activity may have a greater impact in preventing obesity in children than lower physical activity intensity levels, whereas both total and at least moderate to vigorous physical activity may improve children's cardiovascular fitness," the researchers conclude. They acknowledge that vigorous activity may be more difficult for overweight and obese children and teens. The doctors suggest that these individuals begin with moderate activity and gradually increase both the intensity and amount of exercise.
SOURCE: American Journal of Clinical Nutrition
30 August 2006
http://www.iol.co.za/index.php?click_id=31&art_id=qw1156885921763B243&set_id=
Excessive exercise common in anorexia
Excessive exercise is one of the general warning signs of an eating disorder, but the problem may be particularly common among anorexic women who vomit or use laxatives to lose weight, a study shows. Women such as these may be at particular risk of dangerously low weight and potentially fatal consequences, according to the study authors. Targeting the anxiety and obsessive tendencies so common in these women might aid in treating the eating disorder, they report in the International Journal of Eating Disorders.
Doctors have known that excessive exercise is a common feature of eating disorders like anorexia and bulimia, but it hasn't been clear which women are most likely to have the problem. For the current study, researchers led by Dr. Cynthia M. Bulik of the University of North Carolina-Chapel Hill used data from three international studies of women with anorexia, bulimia or both.
The women completed standard questionnaires on eating disorder symptoms, personality traits and exercise habits. Excessive exercise was defined as exercising more than 3 hours a day or being otherwise obsessed with daily physical activity -- letting it interfere with other aspects of life, for example, or exercising even when injured or ill. Although excessive exercise was common regardless of the type of eating disorder, the study found, it was most common among anorexic women who purged. Of these 336 women, more than half exercised excessively.
Women with high levels of anxiety, obsessiveness and perfectionism were also particularly likely to exercise to an extreme degree, the study found. Such personality traits are common among anorexics who purge to control their weight. It makes sense that these women would be particularly likely to "use all available methods in their drive for thinness and control," according to Bulik. The findings could aid in treatment, she told Reuters Health, by helping doctors know which eating disorder patients need to be more extensively screened for extreme exercise habits. "Clinically," she explained, "we know that when we send people back home and they have a strong drive to exercise that it can negatively impact on their ability to maintain the weight that they worked so hard to gain in hospital."
Excessive exercise is a symptom that "requires more vigilance and understanding," Bulik said, so that patients can be taught how to include healthy exercise levels in their lives, without losing any gains they've made in controlling the eating disorder.
SOURCE: International Journal of Eating Disorders
September 2006.
Amy Norton
Researchers warn of perils of gender imbalance
Researchers have expressed alarm about cultures that favor male babies, saying sex-ratio imbalances could destabilize society because more men will remain unmarried, raising the risks of anti-social and violent behavior. In a paper published in the Proceedings of the National Academy of Sciences, they said parts of China and India would have 12 percent to 15 percent more men over the next 20 years -- many of them rural peasants with limited education.
"The growing number of young men with a lack of family prospects will have little outlet for sexual energy," wrote Zhu Weixing of China's Zhejian Normal University and Therese Hesketh of the Institute of Child Health at University College London. "This trend would lead to increased levels of anti-social behavior and violence, as gender is a well-established correlate of crime, and especially violent crime," they said, adding the trend would threaten stability and security in many societies.
Sex ratios were already distorted in large parts of Asia and North Africa, and sex-selective abortion and discrimination in healthcare for girls have led to higher female mortality. "There are now an estimated 80 million missing females in India and China alone," they wrote.
China introduced a one-child policy in 1979 to control population growth, but it has led to a rise in the male-to-female ratio from 1.11 in 1980-89 to 1.23 in 1996-2001, according to a study published this month in the British Medical Journal. In 2004, 48.6 percent and 48.7 percent of the population in China and India, respectively, were female. In contrast, females comprised 49.1 percent of the total population in East Asia, and 52.1 percent in all of Europe and Central Asia, according to figures from the World Bank.
The authors called in the paper for measures to reduce sex selection and an urgent change in cultural attitudes, or dire consequences could follow. "When single young men congregate, the potential for more organised aggression is likely to increase substantially and this has worrying implications for organized crime and terrorism," they said.
SOURCE: Proceedings of the National Academy of
Sciences
29 August 2006
Switch off TV and switch on your memory
Turning off the television, picking up a crossword and eating more fish could be the key to a better memory, an Australian survey has found. Results of the on-line survey of almost 30,000 people, conducted as part of Australia's science week, also found people who read fiction had better memories than those who don't, while heavy drinkers found it more difficult to recall names.
But neuro-psychologist Nancy Pachana said television was not necessarily bad for memory, with wider health and diet and an active lifestyle more crucial to a good memory. "Your memory is dependent on good health and good mental health," Pachana, from the University of Queensland's school of psychology, told Reuters Monday.
Dubbed the National Memory Test, the quiz attracted 29,500 people who were tested on tasks such as remembering a shopping list, recalling names, faces and occupations, long-term recall and spotting differences between two photographs. Those who took part in the test were asked to fill in a survey on a range of habits, such as alcohol consumption, television viewing and reading habits.
The results found no differences between men and women, with the same scores for both groups on all the tasks. But it found television viewing had the main impact on results. "Turn off the box, or at least don't view too much of it," the survey results said, adding those who watched less than one hour a day performed better at all memory tasks." Those who drank less than two alcoholic drinks a day performed better at all memory tasks. People who did crosswords were better at remembering shopping lists and recalling names, while eating fish once a week improved the ability to remember shopping lists.
However, it cautioned that while the test can give people an indication of their memory, the results have not been tested for statistical significance, and the internet survey meant it was possible that people could have cheated or lied.
Pachana said having an active mind was important for memory, and some television programs could be good for helping to improve the memory. "TV can be a really passive activity, while reading is active, and any active activity is better," she said, adding TV quiz shows and news programs could be good for the mind. "So TV is not all that bad. It just might be taking time away from doing something that is a bit more active for the mind." She said health issues such as depression, obesity, lack of sleep and being stressed or worried could have an impact on a person's performance in a memory test.
The test is available on-line at www.nationalmemorytest.net.au
Source: University of Queensland's School of
Psychology
8 August 2006
1 in 12 child injuries treated in Scottish hospitals result from playing football
One in 12 of all child injuries treated in hospital occur while playing football a new study reveals. Scientists from Edinburgh University are calling for regulations to make football safer, including the introduction of protective clothing and a ban on hard pitches. The Scottish Youth Football Association (SYFA) has already drawn up a series of health and safety rules aimed at cutting the number of injuries to young players. Measures include the compulsory wearing of shin guards, inspecting pitches for broken glass and pot holes and banning players from sitting behind the goals in case they get hit by a ball. SYFA rules also insist on strict mesh size on goal nets to stop children tripping over or getting their heads caught.
Barry Klaassen, an accident and emergency consultant at Ninewells Hospital in Dundee, said that because football is so widely played, it was not really surprising that so many children's injuries are caused by it. He said: "We probably see between 1,500 and 2,000 sports injuries in children a year and most of them will be from football. It is difficult to see how the game could be made safer without completely changing it."
But the researchers at Edinburgh University believe the majority of injuries suffered by young footballers can be prevented by making the game safer. They found that the game accounted for more than 1,545 injuries, mainly to arms and legs, in under-17s over a four-year period at the A&E ward of Monklands Hospital in Airdrie, Lanarkshire. Football was overwhelmingly the main cause of sporting injuries, accounting for about half of all hospital attendances caused by sport and 62% of injuries in boys aged between 12 and 17. The study also found that 28% of all fractures in adolescent boys were football related. Emergency room doctors claim the figures would be similar at other major hospitals around Scotland, meaning thousands of children go to hospital with football injuries each year.
Ruth McQuillan, a public health scientist at Edinburgh University, warned that teenagers suffering serious injuries could be forced to give up playing sport all together. She said: "Looking at the playing surfaces and using wrist guards could help as a lot of the injuries are caused by people falling and putting their wrist down, meaning broken wrists are a big problem. "But the worst thing that could come out of this would be children not playing football because it is dangerous. The damage caused by children stopping exercising altogether would be far worse." The research also showed that football was the main cause of injury among boys regardless of whether it was during organised games, such as in PE lessons and club matches, or informal kickabouts in the playground. Ms. McQuillan said that football caused 65% of injuries sustained in organised sport and 77% of those in informal sporting activities.
Football officials have now come round to the view that further steps are needed to improve the safety of young players during football matches. The SYFA insists on at least one trained first-aider being present at all youth games played in Scotland. They have also drawn up a list of health and safety measures for coaches to ensure players have a safe environment to play in. David Little, national secretary for the SYFA, said: "We have mandatory first-aid cover at all matches now and we have also set strict age groups to prevent younger players being injured by older, bigger children. We should make every effort to reduce the risk, but at the end of the day football is a contact sport and sometimes people do get injured."
The Edinburgh study found that the second-most prevalent cause of sports injuries in boys was rugby, accounting for 3.5% of the total, followed by ice skating which caused 3.1% of injuries. In girls, ice skating was the most common sport that resulted in injuries (8.8%), followed by football (8.6%) and netball, which accounted for 6.3% of injuries. In rugby, officials have introduced less physical forms of the game such as mini rugby and touch rugby for teenagers to play. But critics say this would be almost impossible to replicate in football.
Conrad Murray
27 August 2006
FDA allows easier access to "morning-after" pill
A "morning-after" contraceptive can be sold to adults in the United States without a prescription, health officials ruled on Thursday, ending a three-year fight over wider access and use by teenagers.
The Food and Drug Administration said Barr Pharmaceuticals Inc.'s Plan B pills must stay behind pharmacy counters to prevent girls under 18 from getting the drug without a doctor's order. Backers welcomed the decision but balked at the age limit, saying all females needed quick access in order for the pills to work. Two Plan B pills - sold by prescription since 1999 - can prevent pregnancy if taken soon after intercourse. The decision also angered conservatives, and some groups on both sides were girding to challenge the decision in court.
FDA officials said Plan B was safe and effective for women when taken as directed, but should not be used routinely. Women's groups said wider access could reduce unwanted pregnancies and abortions. Studies show Plan B cuts the chances of pregnancy by 89 percent if taken within 72 hours of sex. It works best when used within 24 hours. "There's no scientific or medical reason" for the age limit, said Amy Allina, program director for the National Women's Health Network.
Barr plans studies to back non-prescription use by a broader age group, said company spokeswoman Carol Cox. Conservative groups that fought wider availability said age enforcement was impossible. They worry it could increase promiscuity and sexually transmitted diseases, particularly among teenagers. The Family Research Council, a Christian lobbying group, said the FDA overreached and it would pursue legal and legislative options.
Women who have sued the FDA over repeated delays on Plan B said they would fight in court to have the age limit lifted. The FDA said women and men must show proof of age to buy the emergency contraceptive without a prescription, and younger girls still need a doctor's order.
Barr agreed to monitor age enforcement and limit Plan B distribution to health clinics and stores with pharmacies. Nonprescription packaging should be available by year's end. Barr has not set a price for non-prescription Plan B, Cox said. The prescription product now sells for about $25 to $40.
Aimee Hess, a health-care analyst at Rochdale Research, said Plan B was a modest-sized product for Barr with estimated annual sales of about $30 million. "Sales could double within the next year or two, and a major emotional issue has been dealt with," Hess said. Approval prompted Democratic Senators Patty Murray of Washington and Hillary Rodham Clinton of New York to end their objection to a Senate confirmation vote on President George W. Bush's pick to run the FDA, acting Commissioner Andrew von Eschenbach.
Murray, Clinton and other Plan B supporters argued that repeated delays since the initial application in April 2003 were triggered by politics rather than scientific concerns. FDA approval came three days after Bush said he supported the age limit on nonprescription sales. "The FDA made clear that it will insist on stringent conditions and restrictions on access to reduce both health risks and opportunities for abuse, especially to protect minors," White House spokeswoman Dana Perino said. Emergency contraceptives are available without a prescription in about 40 countries. Nine U.S. states already allow access by those of any age through pharmacists.
Plan B pills contain higher doses of progestin, a hormone used in prescription birth-control pills for 35 years. Women are supposed to take the two tablets 12 hours apart. Like prescription birth control pills, Plan B blocks the release or fertilization of an egg. Some research suggests the hormone also may keep a fertilized egg from attaching to the womb, and some opponents liken that mechanism to abortion. Plan B is different from RU-486, a pill that causes an abortion early in pregnancy by blocking the hormone that keeps a fertilized egg implanted in the uterus.
Lisa Richwine
24 August 2006
Pupils of either sex who had recently been worried about their sexual orientation had relatively higher rates of self-harm
Gay anxiety leading to self harm
Self harming is common amongst school pupils anxious about their sexual orientation, according to a study. Research carried out by the Samaritans, the Centre for Suicide Research at the University of Oxford and the University of Bath found that girls are four times more likely to have engaged in deliberate self-harm compared to boys, with worries about sexual orientation being one of the contributing factors.
The survey of 6000 pupils aged 15 and 16 found that 11 per cent of girls and 3 per cent of boys reported that they had self-harmed within the last year. For both sexes there was an incremental increase in deliberate self-harm with increased consumption of cigarettes or alcohol, and all categories of drug use. Self-harm was more common in pupils who had been bullied and was strongly associated with physical and sexual abuse in both sexes.
Approximately 3% of the children admitted having worries about their sexual orientation, the research said: "Females who were worried about their sexual orientation were four times more likely than females without such worries to report deliberate self-harm and males with such worries were more than twice as likely as other males to report deliberate self-harm. "In neither gender, however, was an independent association with deliberate self-harm found. This may well reflect the relatively low rate of reporting of these concerns."
Previous estimates for the amount self-harm in the country were based on the 25,000 “presentations” at hospitals in England and Wales each year that are the result of deliberate self-poisoning or self-injury amongst teenagers. However, this research found that only 13 per cent of self-harming incidents reported by the pupils had resulted in a hospital visit. Although self-poisoning is the most common form of self-harm reported in hospitals, the study revealed that self-cutting was the more prevalent (64.5 per cent), followed by self-poisoning through overdose (31 per cent).
Karen Rodham from the Department of Psychology at the University of Bath is co-author of the study, she said: “The study shows that deliberate self-harm is common amongst teenagers in England, especially in girls who are four times more likely to self-harm than boys. “Until now, most studies of deliberate self-harm in adolescents in the UK have been based on the cases that reach hospital. “We have found that the true extent of self-harm in England is significantly wider than that.”
Professor Keith Hawton from the Centre for Suicide Research at the University of Oxford, who directed the project, said: “This study provides more information about why young people engage in deliberate self-harm and helps us to recognise those at risk, to develop explanatory models and to design effective prevention programmes. “In many cases, self-harming behaviour represents a transient period of distress, but for others it is an important indicator of mental health problems and a risk of suicide. “It is important that we develop effective school-based initiatives that help tackle what has become a most pressing health issue for teenagers.”
The research has been published in a new book, By
Their Own Young Hand, which includes practical advice for teachers
on how to detect young people at risk – based on the evidence collected
by the academics. The book also suggests advice on coping with the
aftermath of self-harm or attempted suicide in schools, and advice on
designing training courses for teachers. The research took place in 41
schools in Oxfordshire, Northamptonshire and Birmingham in 2000 and
2001.
Pupils were asked to complete a 30 minute questionnaire which explored
issues surrounding self-harm and suicidal thinking – together with other
personal factors such as depression, anxiety, impulsivity and
self-esteem. Those who reported self-harm were asked to provide a
description of the act, its motivation and its consequences. “The
reasons why boys and girls decide to self-harm are varied but the most
frequent motive expressed by both males and females was as a means of
coping with distress,” said Dr Rodham.
The vast majority of pupils said that their friends were the people they felt that they could talk to about things that bothered them and those who had self-harmed most often turned to their friends. “This responsibility places a great burden on adolescents to support their peers, yet most adolescents have not in any way been coached in how best to do this,” said Professor Hawton. “Attention to this aspect of support for adolescents should be an essential part of mental health education in schools, and it is great to see the development of the wellness programmes currently being tried in some schools. “Whilst effort to encourage adolescents to seek help through friends, family, help lines and clinical services are very relevant, prevention should be focused on reducing the problems that lead to thoughts of self-harm. “This is where school-based initiatives can make the most important contribution to this important aspect of mental health.”
Marc Shoffman
23 August 2006
http://www.pinknews.co.uk/news/politics/2005-2307.html
Point-click-drink: It's that easy for teens
The Internet is providing a new avenue for underage drinking. Results of a new survey confirm that millions of teenagers either buy alcohol online or know an underage friend who does. A related audit of states shows that many state legislators are easing restrictions on online alcohol sales with little monitoring or oversight. "This is a dangerous situation," said Stan Hastings chairman of the Wine and Spirits Wholesales of America, Inc. (WSWA), the trade group that commissioned the survey.
"For the first time, we have hard evidence that millions of kids are buying alcohol online and that the Internet is fast becoming a high-tech, low-risk way for kids to get beer, wine and liquor delivered to their home with no ID check," Hastings said in a statement. The survey results are "alarming," he added, "because state legislators are rushing to allow wine and other online alcohol sales at a time we know regulatory agencies are telling us they are unable to monitor these types of sales because they lack manpower and resources."
Conducted in 2006 by Teenage Research Unlimited, the survey of a nationally representative sample of 1,001 young people between the ages of 14 and 20 years revealed that 2 percent (representing 551,000 nationally) reported having personally bought alcohol online. Moreover, 12 percent, equivalent to 3.1 million minors, report having a friend who has ordered alcohol online.
The survey also shows that alcohol purchased online is shared among friends. Roughly 3 percent of 14- to 20-year-olds (equivalent to 735,000 nationally) admit to drinking alcohol purchased by someone else online or by phone. And more than half of those with friends who have obtained alcohol illegally online or by phone say those friends share it (80 percent), drink it themselves (79 percent), or give to another underage person (53 percent).
Researchers warn that as awareness and exposure to online alcohol sales increases, even more minors can be expected to buy beer, wine, and liquor on the Internet unless steps are taken today to address the problem. This is consistent with a 2003 National Academy of Sciences report that concluded that minors are buying alcohol over the Internet and that increasing use of the Internet will make this problem worse in the future. Compounding the problem, at least 20 states passed laws expanding online sales of alcohol in the past year, according to WSWA.
22 August 2006
SOUTH AFRICA
Dealers eye children with affordable heroin 'fun packs'
Heroin in Cape Town has become cheaper, more widely available and better marketed, experts have said in the wake of a damning United Nations report naming South Africa as a growing player in international drug trafficking. Not only has the price of heroin dropped drastically in South Africa in the past few years - making it more accessible to teenagers and schoolchildren - it is also available in smaller and more affordable "fun-size" quantities.
A steady supply of the drug has been available in Cape Town for the first time, says Grant Jardine of the Cape Town Drug Counselling Centre. "Cape Town is particularly badly affected as it is part of a major international drug-trafficking route where heroin comes down from southeast Asia and central Asia, through Africa and exits to Europe and America," he said. With an estimated 15 000 heroin users in Cape Town, abuse of the drug has reached epidemic proportions. "With the emergence of tik (methamphetamine), as the drug of choice in Cape Town, the heroin problem has been overlooked," Jardine said. "But it has been growing steadily... and in the past two years the Drug Counselling Centre has seen it far outstrip Mandrax and dagga use."
In recent months drug syndicates seem to have been targeting Cape Town's youth, says Charles Parry, of the Medical Research Council. "There seems to be a deliberate move to bring the price of heroin down and sell it in smaller quantities. The dealers are also more subtly bringing high school children in by selling it as 'Unga', a smokeable format mixed with dagga."
In June it became necessary to open a detoxification clinic dedicated to heroin at Stikland Hospital, Cape Town, to cope with the number of addicts trying to quit. The numerous harmful effects are causing considerable unease among doctors, who have noted there is a growing numbers of users. "Heroin can do enormous damage when injected because the talcum or other substances it is mixed with can build up in kidneys or lungs," said Lize Weich, a doctor. It also slows the respiratory system and can stop breathing. "If an addict has been out of use for a while, say in prison or in rehab, their tolerance will have gone down and it is easy to take a lethal overdose."
Addicts with painful withdrawal symptoms often turn to crime or prostitution to fund their next fix. Intravenous users are also particularly vulnerable to infectious diseases such as hepatitis and HIV. Heroin addicts also miss out on social and psychological development. "An addict who begins at 14 will have the emotional tools of a 14-year-old at 25," says Jardine.
Hannah Roberts
22 August 2006
http://www.iol.co.za/index.php?set_id=1&click_id=15&art_id=vn20060822020037767C345217
New warnings on ADHD drugs
Several drugs to treat attention deficit hyperactivity disorder must include new warning information about the risk of heart problems and psychotic behavior, U.S. health officials said on Monday. The drugs, which include GlaxoSmithKline Plc's Dexedrine and Novartis AG's Ritalin, must include a warning about the possible risk of sudden death and serious heart problems, Food and Drug Administration spokeswoman Susan Bro told Reuters.
The drugs, stimulants that can raise blood pressure, must also include warnings about the risk of behavioral problems such as aggression and mania, she said. Bro could not confirm whether other ADHD drugs – Johnson & Johnson's Concerta and Eli Lilly and Co.'s Strattera – also were ordered to carry the warnings. Strattera already includes a caution about suicidal thoughts, while Shire Plc's Adderall already carries a warning that misuse can cause heart problems.
The FDA's decision comes months after two separate panels of outside experts offered conflicting opinions on whether the risks warranted the strongest warnings possible – a so-called black box. FDA's Bro could not confirm whether the heart warning was boxed. But a letter from Glaxo made public earlier on Monday advising doctors about the new warnings said the heart caution was a boxed warning. Other non-boxed warnings about psychotic behavior, stunted growth, seizures and vision problems also were included, Glaxo's letter said.
Holly Russell, spokeswoman for the British drugmaker, said Glaxo agreed with the FDA's request to add the warning language and complied with the agency's recommended wording. Other drugmakers did not immediately return calls seeking comment.
In March, FDA advisers said new information about the risks should be added to the labels for attention deficit drugs. The outside experts stopped short of supporting a boxed warning, saying they did not want to scare off patients or their parents. A different FDA panel in February recommended black box heart-related warnings but said it was unclear if the drugs caused heart-related complications.
Some doctors have expressed concern that new warnings could dampen use of the medicines, which the FDA has estimated see about 1 million prescriptions for adults and 2 million for children each month. Critics say many of the prescriptions are unnecessary and that the drugs are over used. FDA's Bro said the agency began contacting Glaxo and Novartis about the new warning requirements in May. That same month, Canadian health authorities publicly warned people with high blood pressure, heart disease and other medical problems to avoid taking medications for ADHD.
Susan Heavey
21 August 2006
All forms of tobacco harmful
All forms of tobacco consumption – smoking, chewing and second hand smoke – raise the risk of heart attack by up to three times, according to the results of a new study in Friday's edition of the Lancet medical journal. The study, covering a total of 27,000 people in 52 countries, found that tobacco use in any form – including sheesha, popular in the Middle East, and beedie, common in South Asia -- were bad for health. Compared to people who had never smoked, heavy smokers had a tripled risk of heart attack while even light smokers and people who chewed tobacco had a doubled risk.
The INTERHEART study was carried out by a team lead by Salim Yusuf and Koon Teo of McMaster University, Ontario, Canada. It also found that the risk of heart attack diminished over time after an individual had stopped smoking -- with the rate of diminution dependent on the heaviness of the habit.
In light smokers -- less than 10 a day -- there was no increased risk five years after quitting, but in people who had smoked more that 20 a day there was still a 22 percent increased risk of heart attack two decades later. "Since the risks of heart attack associated with smoking dissipate substantially after smoking cessation, public health efforts to prevent people from starting the habit and promote quitting ... will have a large impact in prevention of heart attack worldwide," Yusuf said.
18 August 2006
TV more effective than hugs for child pain: study
Television can act like a painkiller when it comes to children and is more effective than a mother's comforting, according to a small Italian study. The University of Siena study, published in Archives of Disease in Childhood, was based on 69 children aged seven to 12 who were divided into three groups to have blood taken.
One group was given no distraction while the blood was being taken while mothers of children in the second group attempted to distract the youngsters by talking to them, soothing, and/or caressing them. In the third group, the children were allowed to watch television cartoons while the procedure was being carried out. After the samples were taken, the children and their mothers rated their pain scores.
The children recording the highest pain scores were in the group getting no distraction. These scores were about three times as high as those recorded by children allowed to watch the cartoons. Children comforted by their mothers recorded middling scores. On average, the mothers rated pain scores higher than the children but they also recorded the lowest pain scores for children who had been allowed to watch television. "The higher pain level reported by children during mothers' efforts at distraction shows the difficulty mothers have in interacting positively at a difficult moment in their children's life," the researchers said in their report. They added that watching television also seemed to increase children's pain tolerance.
Source: Archives of Disease in Childhood
17 August 2006
Lack of outdoor play is health time bomb for children
Unless more suitable outdoor play opportunities are provided for children and young people, a physical and mental illness time bomb is likely to explode, an international conference in Bristol was told. “As councils cut their spending on outdoor spaces and society encourages physical idleness, obesity is becoming an epidemic. Young people now face heart problems, diabetes and other diseases because of their sedentary lifestyles. This puts them at risk of premature death and confronts the NHS with a rocketing bill,” said Professor Lamine Mahdjoubi, from the University of the West of England, who chaired the conference.
Children are denied the opportunities for playing out of doors that previous generations took for granted. Delegates heard moving testimony from four mothers from Glasgow who contrasted their experiences of playing in the street with the restrictions placed on children in the city today. “The streets are unrecognisable from our youth,” said Marie Forsyth, of the parents' group To play or not to play. “Now, they are full of traffic, and play spaces are desolate and scarred by drug-taking. We were poor but at least we had a childhood.”
Surveys of children and young people reveal they are increasingly dissatisfied with their outdoor environments and many of them would prefer to spend time in healthy activities, if only more were available. Fears about health, safety and litigation have resulted in councils trying to minimise the risks of public spaces, leading to unchallenging playgrounds that do not appeal to young people.
However, now is the time to act, with improving urban spaces and tackling childhood obesity increasingly on the government agenda. Delegates at the conference - which brought together parents' lobbying groups and experts on planning policy, safety, transport, health, food and physical activity, and the psychological impacts on children unable to socialise out of doors - shared views on overcoming barriers to outdoor play. They identified the need to assess the socio-cultural as well as physical benefits of outdoor play; the need to measure the way our environment encourages idleness; and found that design can be used to encourage a diversity of activities.
They found that open spaces were more cost-effective than indoor fitness centres, and were of benefit to a wider range of people. Fitness facilities tend to be exclusive, typically appealing to a segment of the population aged 18-45 who can afford membership and can travel there by car. In contrast, outdoor recreation areas appeal to a wider range of social and age groups and are usually accessed by foot. Investment on urban parks and open spaces dropped from 44% of local authority spending in 1976/7 to 31% by 1998/9. “Open urban spaces cost £600 million to run for 2.5 billion visits,” said Lamine. “In contrast, the fitness culture costs £400 million for 100 million visits and 80% of customers use their cars to get there.”
Keynote speaker Professor Dick Jackson, an adviser to President Bush and Californian Governor Arnold Schwarzenegger on the impact of the built environment on health, warned that the UK was fast catching up with American levels of childhood obesity and that mental illness can be directly attributed to poorly designed neighbourhoods. Highways planning still dominates urban design and new housing developments, and the biggest single impact on children's freedom has been the rise of the car and the subsequent lack of connection between home, street and neighbourhood. “This is a subject that affects us all,” continued Professor Mahdjoubi. “The cost of obesity will have to be met ultimately by society - it is a time bomb waiting to go off, like climate change.”
Source: University of the West of England
International Conference
Medical News
17 August 2006
http://www.medicalnewstoday.com/medicalnews.php?newsid=49824
Primary care docs can help depressed teens
Adolescents suffering from depression don't necessarily have to see a specialist; they can often be helped by their primary care doctor, according to a report in the medical journal Pediatrics. "All of us have some tools of the trade at our disposal, and we are familiar with applying them for other problems," Dr. Ruth E. K. Stein told Reuters Health. "We should not be afraid of using them for adolescent depression."
Stein, from the Albert Einstein College of Medicine in the Bronx, New York, and colleagues reviewed existing studies to assess the effects of various forms of depression treatment in primary care settings. Four studies provided some direct evidence for the effectiveness of primary care management of depression in adolescents. "Nonetheless," the authors say, "the evidence is still somewhat sparse, and more research is needed." More than a dozen additional studies not focused on adolescent depression suggest that primary care interventions can be beneficial, the report indicates.
The researchers also note that guidelines for managing adolescent depression will be available soon. "These guidelines," the investigators write, "should be an important first step in improving the ability of primary care clinicians to address these issues." For primary care doctors who haven't seen a lot of teen depression cases, educational interactive sessions on diagnosis and treatment are available, Stein said. The aim is "to provide an easy access on-call consultation system for primary care pediatricians who want help in handling these and other common issues."
SOURCE: Pediatrics, August 2006.
Will Boggs
16 August 2006
Many ADHD children not getting medication
While many people believe that too many children are being treated for attention deficit/hyperactivity disorder (ADHD) these days, a new study shows that many children with the condition are not being treated. "Rather than the popular belief that children are being overmedicated... in fact they're being undermedicated," study co-author Dr Wendy Reich, of Washington University School of Medicine, in St Louis, Missouri, said.
Various researchers have reported an increase in the rate of treatment for ADHD, but other reports suggest that medications are not prescribed for those who need them most. 'On the borderline' In the current study, Reich and her team assessed ADHD medication use among 1 610 Missouri twins, aged seven to 17 years, based on information that was collected between 1996 and 2001 via the Missouri Assessment of Genetics Interview for Children.
A total of 359 individual twins - 302 boys and 57 girls - met the criteria for a diagnosis of ADHD. Yet, only about 59 percent of boys and 46 percent of girls with ADHD were treated with medication, the researchers report in the Journal of the American Academy of Child and Adolescent Psychiatry. On the other hand, more than a third (35 percent) of study participants who did receive medication for ADHD did not meet the full criteria for an ADHD diagnosis, although they had about nine or ten symptoms of the condition. "These children were clearly on the borderline," Reich said.
Whether or not the child met the full criteria for an ADHD diagnosis, many of those treated with medication experienced an improvement in their symptoms, according to their parents' report. Children with ADHD were most likely to see a physician for treatment if they were diagnosed with the condition; if they had a fraternal, rather than identical twin; if their twin was also being treated; if they were male; and if they had conduct disorder.
They were more likely to actually receive treatment, however, if they had a twin who was also being treated. "There continues to be room for improvement in the treatment of ADHD in the general population," Reich and her co-authors conclude. "From a clinical point of view, this study affirms that for whatever reason, many children who could benefit from treatment are not receiving it," Reich added in a university statement.
For parents wondering, for example, if their son's hyperactivity or their daughter's inability to focus are signs of ADHD, the first step they should take is to contact their child's pediatrician, Reich said. "The pediatrician is the first line of defense," she said. The pediatrician may then recommend seeing a child psychologist.
Source: Journal of the American Academy of Child
and Adolescent Psychiatry, July 2006
Charnicia Huggins
15 August 2006
http://www.iol.co.za/index.php?click_id=31&art_id=qw1155663903754B243&set_id=
Kids with OCD bullied more than others, study shows
Children with obsessive-compulsive disorder are three times more likely to be bullied than other children, and the name-slinging could cause symptoms of OCD to worsen, University of Florida researchers have found. “One of the things we have noticed working with many kids with OCD is that peer relations are extremely impaired,” said Eric Storch, a UF assistant professor of psychiatry and pediatrics and lead author of the study. “Kids target kids who are different. Kids with OCD sometimes exhibit behaviors that peers simply don’t understand.”
More than one-quarter of the children with OCD who researchers studied reported chronic bullying as a problem, according to findings described in the September issue of the Journal of Clinical Child and Adolescent Psychology. By comparison, only 9 percent of kids in the two other groups researchers studied – healthy kids without medical or mental conditions and children with type 1 diabetes – reported serious problems with bullies.
Nearly all children are bullied at least once in their lives. But chronic bullying equates to about one taunt per day, ranging from kicking or hitting to name-calling or excluding children from activities in school. “The kids with OCD are really experiencing higher rates of peer problems than other kids,” Storch said. “We’re not saying one causes the other, but there is a positive relationship between (OCD and bullying).”
About one in 100 children struggle with OCD, an anxiety disorder that leads people to engage in rituals such as hand washing to drive away obsessive thoughts about germs or other worries. Rituals often become so involved that they interfere with a person’s ability to function, according to the National Institute of Mental Health. “Their day becomes filled with repeating behaviors,” Storch said. “For a lot of kids, peers don’t understand what is going on. They are isolated. They are ostracized because it doesn’t make sense why they are washing their hands. Why they keep repeating questions.”
The researchers also found links between bullying and other problems, namely loneliness and depression, in children with OCD, Storch said. Kids were also apt to internalize bullies’ negative comments, telling themselves, “No one will ever love me,” or “Maybe I am a loser,” Storch said. Having OCD and conditions such as depression is linked to worsening obsessive-compulsive symptoms, potentially explaining why researchers also found a link between bullying and more serious symptoms. “It could be that the peers are attacking because they are doing things that are so different,” he said. “Or it might be that bullying is in some way contributing to OCD.”
Compulsive behaviors such as repeating questions, recounting and rechecking information can draw attention to kids with OCD in school, as can vocal or physical tics, common among children with OCD, said Phoebe Moore, an assistant clinical professor of child psychiatry at Duke University. “That kind of behavior can draw fire,” Moore said. “I definitely see that clinically.”
Treating OCD either with approved drugs or behavior modification techniques will help patients control their obsessions and compulsions, Storch said. But he emphasizes that doctors need to examine the whole child and not just treat OCD symptoms. “When one focuses solely on the obsessions and compulsions you experience a resolution of those problems, but problems like depression or anxiety and loneliness may still exist,” he said. “If you address the OCD without addressing the peer problems, that depression and loneliness may not go away.”
Storch suggests parents help children learn how to handle aggressive peers, either at home or by finding a counselor who can help them develop social skills. Parents should also take their concerns to their child’s school if teachers or administrators are not stopping the bullying before it becomes a problem. “Bullying is one of the largest challenges kids, with OCD and in general, have to face,” he said. “One of the main clinical implications is considering the child as an entire person, one who has OCD but who also has other impairments.”
Source: University of Florida and the Journal of
Clinical Child and Adolescent Psychology, September 2006.
Press release: WebWire
14 August 2006
http://www.webwire.com/ViewPressRel.asp?aId=18474
Fewer high school students having sex
Fewer U.S. high school students are having sex, and the ones who do are less likely to have multiple partners, according to a report issued on Thursday by the Centers for Disease Control and Prevention. Some 46.8 percent of students said they engaged in sexual intercourse in a 2005 survey, down from 54.1 percent in 1991, according to the report. Some 14.3 percent of students in 2005 said they have had multiple partners, defined as sex with four different people during one's lifetime. That figure is down from 18.7 percent in 1991.
At the same time, the number of students who say they used a condom the last time they had intercourse rose to 62.8 percent in 2005 from 46.2 percent in 1991, the survey said. The report was based on student responses to anonymous, self-administered questionnaires in public and private schools in all 50 states and the District of Columbia by the CDC's Youth Risk Behavior Surveys.
One aim was to determine the extent to which U.S. students were at risk from HIV or other behavior-related illnesses. High school students are generally aged 15 to 18. Some 2.1 percent of students said they had injected illegal drugs at least once, the same as in 1995, the survey said.
"During 1995-2005, the percentage of U.S. high school students who ever injected drugs remained less than 4 percent. However, many students still engage in HIV-related risk behaviors," the report said. The report was published ahead of the 16th International AIDS conference, billed as the world's largest, which starts August 13 in Toronto, Canada.
Matthew Bigg
11 August 2006
Mother's dieting can send wrong message to children
Mom's dieting habits can have a bad influence on the children. Some research indicates youngsters learn attitudes about dieting through observation. For some youngsters, that might mean an unhealthy fixation on body image, experts warn. "It's like trying on Mom's high heels. They're trying on their diets, too," said Carolyn Costin, spokeswoman for the National Eating Disorder Association.
As obesity rates climb among children, health officials are warning parents about the dangers of junk food and lack of exercise. Yet few speak about parents who count every calorie that crosses their lips. That type of obsession can be just as destructive and eventually teaches children to weigh their self-worth on the scale, said Christine Gerbstadt, a spokeswoman for the American Dietetic Association. The research focused on women and their daughters, since females are more likely to diet and worry about body image.
One study published this year by researchers at Harvard Medical School found that frequent dieting by mothers was associated with frequent dieting by their adolescent daughters. The study also found that girls with mothers who had weight concerns were more likely to develop anxieties about their own bodies.
A study in the Journal of the American Dietetic Association found that 5-year-old girls whose mothers dieted were twice as likely to be aware of dieting and weight-loss strategies as girls whose mothers didn't diet. Walking the line between encouraging healthy habits and not making an issue of weight can be tough. The best strategy is to lead by example, Costin said.
9 August 2006
http://www.chron.com/disp/story.mpl/nation/4106871.html
HIV-Positive children, teens in Romania experiencing discrimination, lack access to medical care, education, report says
More than 7,000 HIV-positive children and teenagers in Romania do not receive medical care or education about their disease and do not attend school for fear of discrimination and abuse, according to a report released Wednesday by Human Rights Watch, the AP/San Jose Mercury News reports. The findings of the report, titled, "Life Doesn't Wait': Romania's Failure to Protect and Support Children and Youth Living with HIV," were based on research conducted in February and June of HIV-positive teenagers, non-governmental organizations and government officials, Claris Bencomo, children's rights researcher for HRW and report author, said.
Findings According to the report, more than 7,200 teenagers, ages 15 to 19, between 1986 and 1991 as part of a government program were exposed to HIV after undergoing unscreened blood transfusions with contaminated needles at hospitals and orphanages across Romania (Osborn, Independent, 8/3). Fewer than 60% of the 7,200 HIV-positive children living in Romania attend school, and those who do are at risk of being abused by teachers and expelled if their status is revealed, the report says (Marinas, Reuters/ Washington Post, 8/2).
According to the report, physicians often decline to treat HIV-positive young people or harass them to discourage them from seeking medical care. In addition, antiretroviral therapy delays frequently occur in some of Romania's counties, causing interruptions in antiretroviral treatment for the youth, the report says. "The Romanian government has known about these children for more than 15 years, but it still doesn't have a plan for what will happen when they turn 18," Bencomo said, adding, "Unless the authorities take urgent measures now, unchecked discrimination will push far too many of these children to the margins of society" (HRW release, 8/2). Adrian Streinu Cercel, who coordinates Romania's AIDS program, refuted the report, saying, "It is possible that there are dentists that don't treat HIV patients, and schools where there is discrimination, and local authorities that don't respect the right to privacy, but it [is] not a widespread phenomenon" (AP/San Jose Mercury News, 8/2).
Recommendations HRW called on the Romanian government to ensure the safety and rights of HIV-positive children and teenagers living in the country by increasing their access to education, including information on reproductive health and HIV/AIDS; providing reliable medical care and antiretroviral therapy; eliminating regulations that mandate HIV testing for employment; ending the criminalization of the knowing transmission of HIV; preparing HIV-positive children in foster care and orphanages to live independently; and providing adequate on-going services to youth (HRW release, 8/2).
Human Rights Watch
8 August 2006
http://www.medicalnewstoday.com/medicalnews.php?newsid=48957
Family's weight comments cause girls lasting harm
Girls whose families criticize their weight or eating habits may develop lasting problems with body image and self-esteem, a new study suggests.
Researchers found that of 455 college women with poor
body image, more than 80 percent said their parents or siblings had made
negative comments about their bodies during childhood. Many believed the
comments reflected a general lack of love and support or were even part
of a pattern of emotional abuse -- with some saying family members also
called them "ugly," "stupid" or "lazy." But in more cases than not, the
women said their parents or siblings had only occasionally made comments
about their weight and body shape.
"The data suggest that even a few comments may have a negative impact,"
the study authors report in the journal Pediatrics. "In fact, in
otherwise or generally supportive families, a few negative comments may
have a particularly detrimental impact, because they stand out against
patterns of little or no criticism," write the researchers, led by Dr.
C. Barr Taylor of Stanford Medical Center in California. Parents, they
say, need to be aware that their words can have lasting effects on how
their daughters feel about themselves.
All of the women in the study were part of a larger project looking at eating disorder prevention; they were considered to be at high risk based on their excessive worries about their weight, shape and eating habits. At the start of the study, they all completed a battery of surveys, including ones that asked about hurtful comments during childhood and current levels of self-esteem. Most of the women said that family members had made some negative remarks about their bodies. Based on their reports, more than half of mothers had made such comments, as had roughly 40 percent of fathers and 40 percent of brothers and sisters.
Women whose parents had said these things showed relatively lower self-esteem and felt a lack of support from their families.
According to Taylor and colleagues, parents who are worried about their daughter's weight and health need to find ways to give "constructive advice" about healthy eating and exercise without being critical. It's also important for parents to lead by example, following a balanced diet, getting regular exercise and refraining from criticizing their own bodies, according to the researchers. Stanford University has a pamphlet with advice for parents that can be downloaded from http://bml.stanford.edu/mcknight.
SOURCE: Pediatrics, August 2006.
8 August 2006
Study links youth suicide, antidepressants
Amid growing concern that antidepressants could lead some children to attempt suicide, scientists set out to test whether these fears are justified. They are, according to a new study.
Dr. Mark Olfson and colleagues at the College of Physicians and Surgeons at Columbia University Medical Center used a Medicaid database of patients hospitalized with severe depression. They used more than 5,000 in the study, separating out a group of children aged 6 to 18, and a group of adults — and those who attempted suicide or succeeded. Then, they found five times as many patients who met the same criteria, but had not committed suicide or attempted it. At that point, they went back and looked to see who had taken antidepressants. They discovered that young people who attempted suicide were 1.5 times more likely to have been on an antidepressant. And although only eight children actually took their own lives, they found that they were 15 times more likely to have been on antidepressants.
Children who took their own lives were far more likely to have been taking a selective serotonin reuptake inhibitor, SSRI, like Zoloft and Paxil. This study adds to mounting evidence of a link between the popular class of SSRIs and an increased risk for suicide in young people. In 2004, the Food and Drug Administration issued a health advisory that included a black box warning so that health care providers consult families before children are prescribed these drugs.
If suicidal thoughts do occur, it is generally in the first weeks or months on the drugs. Parents are advised to keep a close eye on the child and report any unusual symptoms or thoughts expressed by the child. The Columbia study found no added suicidal risk among the adults studied.
"Children are not little adults," said Dr. Gabrielle Carlson, director of child and adolescent psychiatry at Stony Brook School of Medicine. "This is not a big effect," she added, although she labeled the finding "sobering." "What do parents do with this information? They talk to their child's doctor and weigh the benefits of taking these medicines and the risks," she said. Sponsor Ad
Olfson said there is probably a link between the drugs' side effect and the chemistry of the younger brain.
Jamie Talan
7 August 2006
http://www.southcoasttoday.com/daily/08-06/08-08-06/02health.htm
Isolated kids at risk of heart disease as adults
Children who tend to work by themselves, are not very well liked by their peers, or are otherwise socially isolated may have a higher risk of cardiovascular disease in adulthood, new study findings show. "Longitudinal findings about children followed up to adulthood suggest that social isolation has persistent and cumulative detrimental effects on adult health," lead author Dr. Avshalom Caspi, of the University of Wisconsin, Madison, and colleagues write in the Archives of Adolescent Medicine.
Previous studies have shown that loneliness and social isolation can have a detrimental effect on a person's physical health as well as psychological health. Previous studies have found that a lack of social support and isolation during adulthood are associated with coronary artery disease. Research has also shown that early life experiences may have a role in adult disease.
In the current study, Caspi and colleagues followed 1,037 children from birth to 26 years old. Parents and teachers assessed the subjects' social characteristics, body mass index and intelligence on eight different occasions during childhood. At 26 years old, the subjects underwent physical evaluation, which included measuring blood pressure, total cholesterol and other factors associated with cardiovascular disease. The subjects were considered socially isolated if they had no social or emotional support or close relationships and had not dated at all or been involved with a partner in the past year. Eight percent of the group was considered socially isolated.
The researchers found that subjects with signs of social isolation in childhood had a 37 percent increased risk of poor health at age 26 years old. This remained true when the researchers' took into consideration adult social isolation, as well as known childhood risk factors for poor health, such as obesity, low social class, low IQ and aggression. The association also remained after the researchers factored in the effects of health-damaging behaviors, such as a lack of exercise, smoking, and too much alcohol.
The association between childhood social isolation and poor adult health may be due to the "cumulative wear and tear caused by repeated adaptations to psychosocial stressors," the researchers speculate. Such stress may lead to a variety of responses, including high blood pressure or insulin resistance, that contribute to the clustering of factors that increase a person's risk for coronary artery disease. On the other hand, the researchers add, social isolation may disrupt the "constructive and restorative processes that enhance physiological capacities." "The epidemiologic evidence cannot identify the mechanisms involved, but is consistent with emerging evidence that social isolation and social exclusion may have tangible neurobiological effects on lifelong development," Caspi and colleagues conclude.
SOURCE: Archives of Pediatrics and Adolescent
Medicine
August 2006.
Impact of adolescent overweight on adult mortality
Children and adolescents in the U.S. and around the world are becoming more overweight. A new study from the Harvard School of Public Health (HSPH) has found that there may be serious consequences to that trend. Researchers found that being overweight at age 18 is associated with an increased risk of premature death in younger and middle-aged women. The study appears in the Annals of Internal Medicine.
"Our findings add to studies on overweight in middle-aged and older populations by providing insight into the impact of adolescent overweight on adult mortality," said Rob van Dam, a research scientist in the Department of Nutrition at HSPH and lead author of the study. Some previous studies had looked at the relationship between being overweight in childhood and adolescence and premature death in adulthood, but those studies tended to look at older cohorts (people born before 1945), in which few participants were overweight during their youth and the majority had smoked.
Van Dam and his colleagues examined data from 102,400 female nurses in the Nurses' Health Study II, a prospective study launched in 1989. At that time, study participants, all aged 24 to 44, reported their current height and weight and their weight at age 18. Researchers calculated body mass index (BMI)--weight in kilograms divided by the square of height in meters. Participants also answered questions in a number of other areas, including disease history, alcohol consumption, smoking and exercise. Follow-up questionnaires were sent to participants until July 1, 2001, or to the date of death, whichever came first. The results showed that women with a higher BMI at 18 consumed more alcohol, smoked more and were less likely to engage in vigorous physical activity during adolescence.
During the 12-year follow-up period (1989-2001), in which 710 participants died, the HSPH researchers found that women with a higher BMI at age 18 had a higher risk of dying prematurely. That was true for even moderately overweight adolescents. Associations between overweight and premature mortality were similar for women who were younger and older than 40 during follow-up. Major causes of death included cancer (258 deaths) and cardiovascular disease (55 deaths); of the deaths due to external causes (144 deaths), suicide was the most common cause (61 deaths).
The researchers also found that women with a low BMI at age 18 did not have an increased risk of mortality. This finding contrasts with several recent studies, in which both a low and high BMI in middle-aged and older adults was associated with excess mortality. However, at older ages, a low BMI may reflect lifelong smoking habits or weight loss as a result of diseases, which may bias associations between BMI and mortality.
To adjust for smoking, van Dam and his colleagues looked at the results for women who never smoked. They found the same results--women with a higher BMI during adolescence who never smoked had a significantly increased risk of premature death than those with a low BMI. Another key finding was that BMI at age 18 was a strong predictor of BMI in 1989 when women were, on average, 34 years old. Still, BMI in 1989 only partly explained the association between BMI at age 18 and premature death. In other words, being overweight as an adult couldn't fully explain why women died prematurely. Health effects of overweight that are specific to younger ages, differences in location of fat deposition, or long-term exposure to metabolic effects of overweight may explain this finding.
Past studies have also shown that overweight children and adolescents have higher risks of cardiovascular problems and chronic diseases. The results of this study, which show a risk of premature death for younger and middle-aged women, are in line with these findings. "This paper underscores the importance of efforts to prevent excessive weight gain in children, not only to prevent obesity but also to prevent moderate overweight," said Frank Hu, associate professor of nutrition and epidemiology at HSPH and a co-author of the study. "Given the prevalence of overweight, large-scale preventive strategies aimed at increasing physical activity and stimulating healthy eating habits in U.S. children and adolescents are warranted."
News-Medical.Net
6 August 2006
http://www.news-medical.net/?id=19287
Exercise in youth has lasting bone benefits
Men who participate in athletics in their late teens experience bone-building benefits that last for years, even if they are no longer training intensively, a new study shows. Osteoporosis or brittle bone disease is most common among women, but also occurs in men, with the incidence expected to triple over the next fifty years, Dr. Anna Nordstrom and colleagues from Umea University in Sweden note in The Journal of Clinical Endocrinology & Metabolism.
Physical activity is known to help build bone mineral density (BMD), which reduces the likelihood of fractures in later life. While people achieve peak BMD after reaching puberty, they add, there is evidence that exercise has the greatest bone-building effect during childhood and early puberty. Questions also remain about whether the benefits of early-life exercise for bone strength persist if a person stops training.
To investigate, the researchers followed 63 athletes and 27 non-athlete 'controls', whose average age was 17 at the study's outset, for nearly 8 years. At the beginning of the study, all the athletes -- who were either ice hockey or badminton players -- were actively training for an average of about 9 hours a week, with workouts including soccer, long distance running, weight training and other activities. They had been training for an average of 10 years previously, and had a greater average BMD than the controls.
Twenty-seven months into the study, the athletes showed increases in BMD compared to the control group. At the second follow up, at 68 months after the study's outset, 27 of the athletes had stopped active training, and showed greater BMD loss than their counterparts who remained active. By the third follow up, at 94 months, an additional 13 athletes had stopped training. This group lost more BMD than either the controls or the athletes who were still active. However, at the last follow-up, the men who began the study as active athletes still had higher BMD measurements than the control group, even if they were no longer training.
Most importantly, these gains were retained in the hip area, where fractures in later life can be particularly crippling, the researchers write. The gains seen among even the athletes who stopped training would be enough to reduce future fracture risk by 50%, Nordstrom and her team estimate. "These results may suggest that a high peak BMD resulting from previous training may reduce the risk of osteoporotic fractures in men," they conclude.
SOURCE: The Journal of Clinical Endocrinology &
Metabolism, July 2006.
3 August 2006
Suicide risk high with body image obsession
People with "body dysmorphic disorder" are 45 times more likely to commit suicide than people in the general population, a new study shows. The findings underscore the importance of recognizing and treating this "often secretive" psychiatric disorder, Dr. Katherine A. Phillips, the study's co-author, told Reuters Health.
Individuals with body dysmorphic disorder, or BDD, have a distorted body image and think obsessively about their appearance, often for hours a day, explained Phillips, who is at Butler Hospital and Brown Medical School in Providence, Rhode Island.
The disorder frequently leads to self-loathing and social isolation, she added. It is not uncommon for people with BDD to tell no one about their condition, even a spouse or very close friends. "I've worked with these patients for about 15 years now," Phillips added. "In my clinical experience they're often thinking about suicide. They're an unusually distressed group of people." Philips and her colleague William Menard conducted the first investigation in which a group of patients with BDD were followed over a period of time, and report the findings in the American Journal of Psychiatry.
During each year of the study, 58 percent of the 185 study participants reported thinking about suicide, and 2.6 percent tried to kill themselves. Two people completed suicide attempts, making the suicide rate among the patients roughly 45-fold greater than for people in the general population. Studies have suggested that up to 2.4 percent of people have BDD, Phillips said. While most of us have concerns about appearance, she added, a person with BDD obsesses about these concerns and is virtually crippled by them. Phillips said. "It's easy to trivialize BDD, it's easy to confuse it with vanity," she added.
Most people with BDD can be helped by treatment with antidepressant drugs known as selective serotonin reuptake inhibitors, which include Prozac and Zoloft, or a type of counseling known as cognitive behavioral therapy, Phillips said. "The good news is that there are two forms of treatment that seem to be helpful for most people with this disorder," she added. "This just underscores the importance of recognizing this illness and recognizing that it's a severe illness that can potentially respond very well to mental health treatment."
SOURCE: American Journal of Psychiatry, July
2006.
Anne Harding
2 July 2006
Psychotic pot users 'in vicious circle'
Pot smokers suffering from the early stages of schizophrenia are stuck in a vicious cycle of drug abuse and psychotic attacks, an Australian study has found. Research by the University of Melbourne found that the more marijuana a psychotic person used, the worse their condition got. And once they suffered a relapse in delusions and hallucinations they were more likely to turn to marijuana to cope.
The work, published in the latest British Journal of Psychiatry, tracked 81 Queenslanders who had developed a psychotic mental illness in the past six months. The subjects were typically male, aged in their early 20s, single, unemployed and addicted to marijuana.
Researcher Dr Leanne Hides monitored their drug use and mental condition weekly over six months, discovering that almost all were caught up in a vicious cycle that was impossible to escape. "We found that cannabis use contributes to a relapse in psychotic episodes and then as a result of that they are more likely to use cannabis," Dr Hides said. "Basically, they're going around in circles and they can't really win."
Statistically, the study found that for each day a psychotic person used cannabis during a week, the chance of a relapse increased by seven per cent. And for each new low in their condition, the chance of self medicating with marijuana also rose. "So the message is: if you smoke cannabis and have psychosis you're going to stay very unwell," she said.
Dr Hides said the problem stemmed from the fact that many relied on cannabis to lift them out of depression and anxiety caused by their condition. "The trade off for them is they're more likely to have a serious relapse in their illness," she said. "As far as they're concerned it's worth it, but it comes at a serious cost." The researchers have called for early intervention for substance abuse in young people to break the cycle before it becomes ingrained.
Tamara McLean
2 August 2006
http://www.theaustralian.news.com.au/story/0,20867,19993700-1702,00.html
Uganda: diabetes rising among children
A lifestyle characterised by inactivity, comfort and overeating among Uganda's urban school-going youth from well-to-do families has made them and their parents prone to diabetes, exposing them to impotence, research has revealed. Opening the 4th scientific conference of the Uganda Diabetes Association (UDA) at Hotel Africana yesterday, Premier Prof. Apolo Nsibambi regretted the findings of UDA, saying they cast a gloomy picture on Uganda's health image. "Here in Uganda, diabetes mellitus and hypertension were considered to be rare diseases among Africans at the time of our independence up to the seventies.
However, by 1972, only 254 African diabetic subjects were registered in the new Mulago Hospital diabetic clinic. "Most of the current upsurge of new diabetics is in the third world countries, particularly in the subtropical regions. This is mainly because of the changing lifestyle, tending towards those characterised by inactivity, comfort and overeating," he said.
He said appropriately one million Ugandans suffer from diabetes mellitus. "This is a huge number for a poor country like Uganda to cope with, bearing in mind that we are already over-burdened with the communicable diseases like tuberculosis, AIDS and malaria," he said.
UDA chairman Prof. Andrew Otim said the prevalence of diabetes among school-going children began to shoot up in 1976, for ages as young as 6-11 and 12-17. Otim, also a diabetic, formed UDA in 1982 to train diabetic trainers and create public awareness of it.
Cyprian Musoke
31 July 2006
http://allafrica.com/stories/200607310338.html
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