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August 2007 Adult responsibility Let's get off our rears. We know what causes obesity in kids, but can we act? Here's one ranking the Carolinas do not want to brag about: A nationwide study of obesity by a health advocacy group ranked the two states among the worst in overweight kids. According to the fourth annual report called "F as in Fat: How Obesity Policies are Failing in America," North Carolina ranks fifth and South Carolina ranks seventh in the highest percentages of overweight children ages 10-17. That's serious. Here's why: Being overweight translates into an increased risk of serious diseases such as diabetes, heart disease and stroke. That means more than poor health. It also comes with a cost to all of us for lost productivity and the societal costs of health care. What ought to be done? For starters, grown-ups should set better examples. The study showed adults in the two states don't fare much better. The reasons are simple: Choices about diet and exercise are poor. We eat too much, eat the wrong things and sit too much -- and apparently are passing those habits on to our kids. Yet it's not just a matter of poor personal choices. Obesity in kids presents a major policy challenge for communities. Some things are already being done. North Carolina requires that young children get at least 30 minutes of physical activity at school each day and that school cafeterias offer healthier choices. South Carolina requires that elementary schools offer a low-fat choice at each meal. Yet fixing the problem will require a major societal shift in public attitudes toward eating and activity. Implications are far-reaching. Communities need sidewalks, parks and sufficient open space to encourage activity. Recreation programs and facilities must go beyond competitive sports and offer something everyone can do. Teaching healthy habits through public outreach must be done continuously. U.S. Surgeon General David Satcher is straightforward about what will happen if we do not get off our rears. "... Our current generation of youth may indeed be the first to have a shorter life expectancy than their parents," he wrote in the Observer earlier this year. That's unacceptable. And it's avoidable -- if only we will act. 30 August 2007 http://www.charlotte.com/opinion/story/256463.html ___ Private issues may be root of Internet 'addiction' Parents who used to worry about their children watching too much television or spending too much time on the phone now have different concerns: their 12 year-olds making "friends" in chat rooms and on MySpace; their teens battling demons through the night with other cybergamers in World of Warcraft; their university students playing on Internet casino sites. The question parents often ask me is: "How do I know if it's healthy or not?" Many young people are going to experiment with social norms. Part of adolescence involves staking out one's individual territory from the family. The Internet provides a way to do so. Online activities become a problem when a youth is no longer maintaining the expected healthy adolescent achievements, such as grades, steady school attendance, and participating in family life and friendships outside of cyberspace. Healthy teenagers don't usually get into trouble with the law or sneak out for secretive encounters with people they have met through Internet chats. They don't post inappropriate pictures of themselves online or lose sleep from spending hours glued to their computers. Basically, it isn't a problem unless it's a problem. Although there are many parent groups and health-care professionals lobbying to have gaming and Internet "addiction" recognized as a unique condition, it's important to realize that individuals can have many reasons for developing difficulties in this area. In my experience, problem behaviours centred on the Internet, gaming and online gambling often arise out of a failure to find a coping strategy for underlying mental-health issues. These issues include Asperger's syndrome (the problem Internet behaviour would be trying to find out everything about a topic by constantly researching it); pathological gambling (getting stuck on the casino sites); social anxiety disorder (chats, role-play gaming worlds); obsessive-compulsive disorder (obsessed with something that keeps them tied to the Internet); substance use disorders (ordering and researching ways to use drugs), and sexual "addiction" (seeking and downloading pornography). Tumultuous events in a teen's life - loneliness, being bullied or parental divorce - can also be at the root of a problem. In short, technology is not the sole issue - it's really how Internet use and online habits interact with a person's unique makeup that determine whether there are the seeds of a problem. Dr Bruce Ballon http://www.theglobeandmail.com/servlet/story/RTGAM.20070828.wlseriously28/BNStory/PersonalTech/home ___ Alcoholism Blunts Brain's Interpretation of Negative Emotions Alcoholism diminishes brain activity related to interpretation of negative emotions, in addition to its adverse effects on cognition, results of a brain imaging study suggest. MRI evaluation revealed significantly less brain activation during interpretation of facial expressions of fear and disgust by alcoholics versus nonalcoholics, investigators here reported online and in the September issue of Alcoholism: Clinical and Experimental Research. Alcoholics' brains also had diminished activation during viewing of sad faces, said Jasmin B. Salloum, Ph.D., of the National Institute on Alcohol Abuse and Alcoholism, and colleagues. The findings may offer a clue to some alcoholics' relapse, they said. "Patients often relapse when entering previous drinking situations, that is, entering a bar or a shop in which you can buy alcoholic drinks," commented Andreas Heinz, M.D., of Charite-University Medical Center in Berlin, a co-investigator. "One reason may be that they fail to perceive dangerous situations. This study suggests that there is a neurobiological correlate of this often-reduced ability to perceive dangerous situations," he said Most studies of the brain effects of alcoholism have focused on cognitive function. However, alcoholics also have been shown to be deficient in emotional processes, but that aspect of brain impairment has not been studied extensively, the authors noted. In the current study, the investigators used functional MRI to examine brain blood oxygenation level dependent (BOLD) response to emotional stimuli. Previous functional imaging studies had demonstrated increased BOLD activation to negative facial expressions in anxious versus non-anxious individuals. Other research has shown that alcoholics have blunted response to negative but not positive emotional stimuli, suggesting insensitivity to aversive stimuli. The study involved 11 male alcoholic patients (mean age 35) and 11 healthy age-matched nonalcoholic males. Both groups underwent functional MRI assessment while performing a task involving emotional processing. The study participants were asked to determine the intensity level of 240 standardized facial expressions-sad, happy, anger, fear, disgust, and non-emotional control stimuli. Overall, alcoholic patients demonstrated less brain activation during decoding of all emotions compared with controls. Processing of negative emotions resulted in the largest differences between the groups. The groups differed significantly with respect to brain activation during interpretation of images reflecting fear, disgust, and sadness. The groups did not differ significantly in the degree of brain activation in response to anger. The two groups demonstrated similar speed and accuracy in their judgments of emotional intensity, suggesting the differences in performance "reflect different functional approaches to decoding the emotional intensity of human facial expressions taken by alcoholics and controls," the authors stated. The brain region that showed the greatest blunting of response in the alcoholic patients was the rostral affective division of the anterior cingulate cortex. Some evidence suggests this brain region might be specialized for higher-order cognitive evaluation and decision making related to affective stimuli, the authors noted. Available evidence also suggests that alcoholics' chronic deficit in social interaction and communication might be caused in part by a diminished ability to interpret the emotional state of others. "We knew that alcoholics show a deficit in accurate recognition of facial emotions," said Dr. Salloum. "This can lead to insensitivity to, and overestimation and/or misattribution of, certain facial expressions." The authors pointed out several limitations of the study. "It is a relatively small study involving only 11 subjects in each group. Also, the alcoholic subjects in this study had significant amounts of psychopathology and other substance abuse, they said. "Thus, it is uncertain if the blunted responses we found in the affective division of the ACC characterize relatively ''pure'' alcoholics as well as they do the more pathological sample we report on here," they wrote. "In addition, it is unknown whether the deficits we observe in rostral ACC function are secondary to prolonged and heavy alcohol use or precede heavy alcohol use. Studies in young adolescent children of alcoholics may be useful in this regard," they concluded. Charles Bankhead ___ Study finds emotional trauma can alter size of a child's brain Hoping to unlock some of the mysteries of post-traumatic stress disorder in children, a Stanford University researcher looked inside their heads. What Dr. Victor Carrion found was startling: Children with PTSD and exposure to severe trauma had smaller brains. Carrion found a nearly 9 percent reduction in the size of the hippocampus, a horseshoe-shaped sheet of neurons that deals with memory and emotions. The study, released earlier this year, was just a first step toward understanding the physical effects of trauma and why some children have a greater ability to ward off physical and mental reactions. The disorder is relatively new to the psychiatric community. PTSD was officially included in the list of mental disorders in 1980, but only for adults. Children were added in 1987. Early PTSD studies focused on Vietnam War vets and rape victims. More recent research shows the rates in children depend on the type of trauma:
In Los Angeles, school officials and researchers wanted to know if the rate of PTSD quoted by experts and the federal government held true in their hallways. They wondered if it were possible that up to 35 percent of "urban youth exposed to community violence" had PTSD, a statistic cited by the National Center for Posttraumatic Stress Disorder, part of the U.S. Department of Veteran Affairs. In 2000, they joined UCLA researchers in screening students from 20 schools in violence-prone parts of the city. Of the 1,000 students randomly selected, 90 percent were a victim of or a witness to community violence, and 27 to 34 percent had PTSD, said Marleen Wong, director of the district's Crisis Counseling and Intervention Services. "PTSD is a hidden disorder," she said. "But it's hidden in plain sight." Few districts in the country address PTSD and similar conditions related to ongoing community violence, said Alan Steinberg, associate director of the National Center for Child Traumatic Stress in Los Angeles. However, Los Angeles school officials did recognize the problem, identified children with PTSD, developed and tested a treatment, and created a step-by-step process for schools to use. Yet implementation has come in fits and starts, with a school here and there embracing the group-counseling program only to see it die for lack of staff or monetary support, Wong said. "To take it to scale, it means funding," she said. This year, the California Department of Education's Safe and Healthy Kids Program Office will try to identify mental health needs in the schools with $633,000 from the state bond measure. But it's not enough, school officials and researchers say. "Part of a real public investment in enhancing public education is the need for school-based programs to help these kids recover from the experiences," Steinberg said. Jill Tucker
http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2007/08/26/MN7PRKTK5.DTL SOUTH AFRICA Manual Gives Teachers Alternative to Hitting Pupils A new manual is set to help teachers find alternative methods to deal with disruptive and unruly children, as opposed to corporal punishment. The document is produced by the Education Management and Development Centre (EMDC) and its main objective is to provide for the effective management of healthy and positive discipline. Western Cape Education MEC Cameron Dugmore, has lauded its production and said officials in his department will work with the district office to find a way of further developing the manual to make it available as a resource and tool for all schools in the province. "Each school will receive a copy and a CD with the information in all three languages," he said. Key features include ways to develop, implement and maintain a supportive and restorative Code of Conduct for learners. It explains the duties and responsibilities of role payers such as principals, learners and parents and looks at the establishment of support systems to deal with learner offences. These include bullying, anger management, conflicts and other behaviour problems. The manual contains pamphlets on 15 different topics and is developed so that important additional information can be added to build up a school portfolio on school discipline. Principals, deputies and teachers will be introduced to the manual, while training and support of teachers will take place over three years. The producers of the manual highlighted the plight of teachers when dealing with learners' as the critical problem. EMDC North Director Barry Volschenk said that learner behaviour problems had, for years been a major concern for teachers, administrators and parents. "More than ever before, teachers are faced with critical problems in their classrooms, and are confronted on a daily basis with unacceptable learner behaviour and threatening situations. After the abolishment of the old system of corporal punishment and control, an urgent need arose to deal with behavioural issues in innovative ways," Mr Volschenk said. In June 1995 corporal punishment was ruled as unconstitutional on the grounds that it violates the right not to be treated or punished in a cruel, inhuman or degrading way. Mr Volschenk described the new approach to behavioural support as one representing a shift from a focus on deficit and control, towards a developmental and restorative approach. MEC Dugmore noted the importance of involving parents on disciplinary issues. "In situations involving learner disciplinary issues we often tend to focus our solution-seeking efforts on the child and we neglect the needs of the parents and educators," he said. The MEC said as a result of the abolishment of corporal punishment, many teachers suddenly felt confused, frustrated, and resigned themselves to be without power as they had only known one method of discipline. "Children have become aware of their rights and they have started to test the boundaries of discipline to the extreme," said the MEC. He suggested that perhaps the behaviour of learners had worsened because force and physical coercion were seen as a form of "authority" and the only way of asserting oneself for centuries. "A lot of it has to do with the history of our country and how it has shaped the daily lives of men, women and families," the MEC said "I think this document provides an excellent framework for the establishment of structures in schools for the effective management of healthy, positive discipline. I'm happy that it is in all three languages (Xhosa, Afrikaans and English)." Themba Gadebe http://allafrica.com/stories/200708220771.html ___ Psychiatric drug OK'd for youths The Food and Drug Administration yesterday approved a drug for the treatment of two psychiatric conditions in teenagers and for the short-term treatment of manic-depression in children. The FDA approved Risperdal, manufactured by Janssen LP of Titusville, N.J., for the treatment of schizophrenia in adolescents ages 13 to 17 and for the short-term treatment of bipolar (affective) disorder in ages 10 to 17. Until now, there has been no FDA-approved drug for the treatment of schizophrenia for pediatric use, and only lithium is approved for the treatment of bipolar disorder in adolescents ages 12 and up. Approximately 2.4 million American adults, or about 1.1 percent of the population age 18 and older in a given year, have schizophrenia, according to the National Institutes of Health. NIH does not keep data on the number of children 18 year old and younger who have schizophrenia or bipolar disorder. It is difficult to diagnose a child with a mental disorder because in most cases mental illnesses start in adulthood. However, the American Psychiatric Association estimates that 60 percent of the population's first schizophrenic episode occurs in adolescence and 20 percent of the population with manic-depression experience the first episode in childhood. Safety concerns about the drug include significant weight gain in children taking Risperdal. The dose approved for youths by the FDA, between 1 milligram and 3 milligrams, is slightly lower than the adult dosage level. "There are some risks in taking these medications, there's no question about that, but schizophrenia is a very serious disorder, and it has to be treated," said Dr. Thomas Laughren, director for the Division of Psychiatry Products at the FDA. Symptoms of schizophrenia may include hallucinations, delusions and disorganized thinking. Bipolar disorder, also known as manic-depressive illness, is a serious psychiatric disorder that causes wide shifts in a person's mood, energy and ability to function. The FDA approved Risperdal in 1993 for the treatment of schizophrenia in adults. The drug later was approved for short-term treatment of manic-depression in adults and the treatment of irritability associated with autistic disorder in children and teens 5 to 16 years old. Doctors have been prescribing Risperdal to children on an off-label basis for years, meaning the medication was not federally approved for children but physicians felt it was the best available treatment option. To this point, physicians have not had much guidance in prescribing the drug to these younger populations. "For any medication, there are benefits and potential risks," said Dr. Darrel Regier, executive director of the American Psychiatric Institute for Research and Education. "For many children with these disorders, the FDA's action today provides additional information to guide treatment options in these special populations. We anticipate that approval of this medication will encourage federal research agencies to accelerate urgently needed studies of mental disorders in children." Gregory Lopes http://www.washingtontimes.com/apps/pbcs.dll/article?AID=/20070823/BUSINESS/108230033/1006 ___ High blood pressure in children is a hidden epidemic, warn doctors Many children and adolescents now have high blood pressure that is going undetected, a study has shown. Doctors described an epidemic of high blood pressure, going hand in hand with the obesity epidemic. They blamed poor diets, salty foods and lack of exercise for the changes. Professor Bryan Williams, of the University of Leicester, a past president of the British Hypertension Society, said: “We have probably seen a doubling of high blood pressure in the young over the past 20 years.” He said that lifestyle changes were building up serious health problems that could undermine recent advances in the control of disease. The US study estimates that as many as one in 20 American teenagers may suffer from high blood pressure. The long-term effects can include heart attack, heart failure, stroke and kidney disease in later life. Blood pressure is seldom measured in children in the UK, and judging what is a risky level has always been contentious. But a recent study showed that nearly a quarter of young men in Britain have a systolic blood pressure above 140mm of mercury, the cut-off point for adult hypertension. This finding prompted Professor Francesco Cappuccio, of the University of Warwick, to speak of “an evolving epidemic of hypertension in youth, which is closely associated with a parallel epidemic of obesity”. This meant, he said yesterday, that by the age of 40 many of today’s teenagers could need multi-drug treatment, as the effects of high blood pressure hit home. “Twenty years ago 50 was the age of risk for the effects to begin to show,” he said. “Now it’s 25 to 30. We are moving down the age band in seeing the health effects.” In the new study, published in Journal of the American Medical Association, Matthew Hansen, of Case Western Reserve University, in Cleveland, and colleagues attempted to discover how much undiagnosed high blood pressure there was by looking at the health check records of more than 14,000 children, aged between three and 18, living in northern Ohio. The results show that of 507 children who had high blood pressure, only 136, just over a quarter, had had such a diagnosis noted on their record. The team concludes that even where blood pressure is measured, doctors are not drawing the appropriate conclusions. The team said: “Identification of elevated blood pressure in children is important because of the increasing prevalence of paediatric weight problems and because secondary hypertension is more common in children than adults, requiring identification and appropriate work-up. “If abnormal blood pressure is not identified by a patient’s paediatric clini-cian, it may be years before the abnormal blood pressure is detected, leading to end-organ damage.” Joe Korner, of the Stroke Association, said high blood pressure in teenagers was unlikely to cause strokes, but it was a very good indicator of the risk of high blood pressure as an adult. “Diagnosing high blood pressure is very important” he said. “It’s not very surprising that it isn’t being diagnosed, but it is of concern.” He blamed the marketing of junk foods, particularly salty ones, for the changes. Professor Cappuccio agreed: “We have got to stop kids putting on weight, give them a proper diet with lower salt levels, ands stop them starting to smoke” he said. “That should be the message.” Nigel Hawkes http://www.timesonline.co.uk/tol/life_and_style/health/article2303153.ece ___ Parents can influence food likes of children ___ Drug fight targets ADHD The Western Australia Government aims to cut reliance on amphetamines in treating Attention Deficit Hyperactivity Disorder (ADHD) under a multi-million-dollar program. Studies show dexamphetamines account for a substantial amount of amphetamine use by young people in WA. The state has the nation's highest rate of amphetamine usage overall, and the highest rate of prescriptions of amphetamines for children diagnosed with ADHD. Premier Alan Carpenter announced $9 million would be pumped into treatment of ADHD and the associated use of dexamphetamine. “The teams will include professionals from a range of disciplines including psychiatrists, paediatricians, clinical psychologists, clinical nurses, speech pathologists, occupational therapists and social workers,” Mr Carpenter said. “While medication may still be required for severe cases of ADHD, this new approach will ensure that stimulant medication is not the first line of treatment.” The move is one of 49 recommendations adopted after a summit meeting held last month to tackle the illicit amphetamine scourge in WA. Mr Carpenter said there was evidence to link the use of dexamphetamines during childhood to the broader use and abuse of amphetamines in adulthood. “There is some evidence and a strongly held view amphetamines for the treatment of ADHD leads and encourages the use of amphetamines more broadly and clearly, obviously, the abuse,” Mr Carpenter said. Drug and Alcohol Office executive director Terry Murphy said the use of medication for ADHD patients was not wrong, but reliance on amphetamines in ADHD treatment was too heavy. “Medication is not wrong per se. There will be some people for whom that is the optimum treatment, but here in Western Australia with the highest (rate) in the country, we think there is too heavy a reliance on that,” Mr Murphy said. Mr Murphy said 6.5 per cent of WA high school students reported using amphetamines and 5.5 per cent reported using diverted dexamphetamines. “There's a big overlap between those two figures,” Mr Murphy said. A $16 million package has been earmarked to carry out recommendations to curb amphetamine use in WA, including tougher penalties for dealers who sell drugs around children or near licensed premises. Under the changes, the sale of drugs to a child at or near a school or a public place where children are often present, will be considered an aggravated offence. Andrea Hayward http://www.news.com.au/perthnow/story/0,21598,22274034-2761,00.html ___ Study looks at father's role in a household with a depressed mother Children whose mothers are depressed are less likely to develop problem behaviors if their fathers are actively engaged in family life, a Saint Louis University researcher finds. It is well documented that children living in homes with depressed mothers are at increased risk of developing problems such as aggression, hyperactivity, depression and anxiety. However, an involved father - one who has a positive relationship with his children - may reduce the risk of those behaviors. The 10-year, population-based study published in the July issue of the Archives of Pediatric and Adolescent Medicine, is the first to examine a father's role in a household with a depressed mother. "My study corroborates findings from previous research that a child is at increased risk of problem behaviors when the mother is depressed," said Jen Jen Chang, Ph.D., assistant professor of community health in epidemiology at the Saint Louis University School of Public Health and principal investigator. "But once we factored in a father's positive involvement, I observed that the adverse impact of the mother's depression was attenuated. The father served as a buffer. He may have engaged with the children when the mother wasn't available due to her illness." The level of a father's involvement was based on questions given to children age 10 and older. Investigators asked the children how often their father talked over important decisions with them; whether he listened to their side of an argument; whether he knew where they were when not at home; whether their father missed events or activities that were important to them; and how close they felt to their father. Chang's study is unprecedented not only because it examined a father's role in a household with a depressed mother but because it followed the children with multiple assessments throughout childhood and adolescence in a continuous context. Her results drew on data from the National Longitudinal Survey of Youth (NLSY), an ongoing government-funded study of ethnically and economically diverse men and women and their labor market experiences. The NLSY contains detailed information about the biological children of these men and women, including each child's behavioral and social functioning. Chang's sample included 6,552 mother/child pairs. Child behavior problems were assessed every two years. Chang said results of her study have important implications for intervention. "I would advocate for health professionals to educate parents, specifically fathers, to be more involved with their children when their wives are diagnosed with depression. Mothers play an important role in a child's life. When she's mentally ill, the child is going to have difficulty, the whole family suffers. Fathers are in a position to negate that but may need a health professional's guidance." Chang said her study was inspired by her family experience. Her sister suffered from mental illness and Chang witnessed how difficult the illness was on her sister, her family and her sister's family. "My research has become a personal quest and I hope it will bring more focus to the issue of maternal depression," she said. "Health care professionals must do a better job of screening for this debilitating and under-diagnosed illness." Chang next plans to study the effect of a mother's depression on a child's risk of substance abuse and whether a father's positive involvement in a child's life may reduce this risk. News-Medical.net http://www.news-medical.net/?id=28804 ___ Study: Children with quality child care have more behavior problems There is a study out on child care and its effect on children as they age, and it is being questioned by the Executive Director of Head Start in Kennewick. The research, done by the National Institute of Child Health, was compiled after long-term studies of children beginning at birth. It indicates that kids who get quality child care before entering kindergarten have higher vocabularies in fifth grade. But it also shows that the more time kids spent in child care, the more often teachers report problem behavior. Local Head Start experts say their studies differ from the NICH research. Jim Skucy, the Executive Director of Benton Franklin Head Start said studies show no deterioration in a child's behavior over time. Skucy said Monday that children in Head Start programs continue to thrive in spite of the pressures on the family as a whole. "Not only are they bogged down, working, school, getting the kids to little league, but they're struggling with making it economically too." Skucy said Head Start studies indicate no increase in behavioral problems as kids in their program get older. The program, he said, is required to meet Federal and State standards on training and requirements, materials, and staffing. Stucy is quick to point out that not all Head Start programs across the nation are equivalent. Meanwhile, the National Institute of Child Health researchers say the link in their study between behavior problems and child care could be that high quality teachers are in short supply, and that teachers have little time to address behavior problems. 14 August 2007 http://www.msnbc.msn.com/id/20255921/ ___ Northern Ireland: Big rise in child drug treatments The number of children being treated for drug or alcohol abuse in Northern Ireland has more than trebled in the past two years. Figures from the Department of Health show that in March 2005, 271 under-18s were receiving treatment for substance abuse. In March this year, some 847 young people were on treatment programmes. The statistics show that, in total, 5,583 people were either being treated for drug or alcohol misuse in March. This represents a rise of 10% on the 2005 figure of 5,064. The figures have been compiled by the Drug and Alcohol Information and Research Unit, within the Department of Health, Social Services and Public Safety. They also revealed that 62% of those in programmes on 1 March were being treated for drink-related problems, 20% for drug abuse and the remainder were being treated for both drink and drug problems. Two thirds of those people were male. Some 15% of those being treated were children. It was the second census of Drug and Alcohol Treatment Services in Northern Ireland to be carried out by the department. 14 August 2007 http://news.bbc.co.uk/2/hi/uk_news/northern_ireland/6945809.stm ___ Canada looks to ban "light" label on cigarettes Cigarettes in Canada would no longer be allowed to be labeled as "light" or "mild" under proposed government regulations announced on Friday. Already last November, three of Canada's largest tobacco companies agreed to change their labeling in anticipation of the federal regulations, saying they would stop using such terms by the middle of this year. Use of the terms has also been eliminated from marketing in the European Union and Australia, but not in the United States despite recommendations in May by an expert panel. Canadian Health Minister Tony Clement announced the proposed regulations, which will carry a 75-day comment period. "Research has shown that many smokers incorrectly believe that smoking 'light and mild' cigarettes is less harmful to their health," Clement said in a statement. "These proposed regulations would put in place a mandatory -- and permanent -- ban on these deceptive terms." More than half of all smokers in Canada report smoking "light," "mild," "ultra light" or other similarly labeled products. 10 August 2007 ___ Stunning dividends from early learning The question isn’t whether we can afford to do early childhood intervention. It’s whether we can afford not to. Yet another study has produced the same answer: no. The study – led by Arthur J. Reynolds, a University of Minnesota child development expert – followed youth who’d been enrolled in Chicago’s Child-Parent Centers. They were mostly disadvantaged inner-city children: The centers were first established by the Chicago school system in 1967 to give preschoolers from poor families a better chance of success. These preschools offered much more than even Head Start and other high-end conventional preschool programs. They enrolled 3- and 4-year-olds and assisted them through the second or third grades. Their teachers had college degrees with special training in early childhood education. The staff expected parents to be involved in the classroom; they also supported those parents by helping them find jobs and connect with social services. The results are in, published this month in the Archive of Pediatrics and Adolescent Medicine. The Chicago Longitudinal Study examined the subsequent histories of more than 1,000 children who’d attended a Child-Parent Center kindergarten in 1985 and 1986. Born in 1980, they are now in their late 20s. By almost every measure, they’ve outdone children of similar backgrounds who hadn’t been in the program. More graduated from high school; more are employed full-time; fewer are depressed; fewer have been arrested on felony charges; fewer have landed in prison. All this not only helps them; it helps the rest of society. Children who are well-prepared for school are more likely to graduate from high school, get full-time jobs and pay taxes; they’re less likely to need remedial education, drop out of high school, get pregnant too young, commit crimes and run up criminal justice costs. Reynolds says the reduction of social welfare costs have already far outstripped the $5,000 a year needed to keep these children in the Child-Parent Centers. “By the time they’re 65, a conservative estimate would be a 10-to-1 gain,” he said. The Chicago Longitudinal Study tracks earlier, more limited studies that also showed demonstrated big gains among poor children who got first-rate early childhood education. Hard-headed economists have estimated that society’s investment in this kind of program produces an annual rate of return of about 16 percent. Washington doesn’t have much to compare with the Child-Parent Centers, but it is moving to jump-start their creation here. Thrive by Five, a public-private initiative, is creating similar centers in White Center and Yakima as demonstration projects to show other communities how to give disadvantaged children the best possible start in life. In Pierce County, United Way is already working to improve and coordinate existing early learning efforts. The Chicago study has shown, once again, that this can’t happen soon enough. 12 August 2007 http://www.thenewstribune.com/opinion/story/131120.html ___ Teen smoking rates drop; some young
people who smoke The number of teenage smokers in Canada is decreasing, but local teens say the city's cloud of cigarette smoke hasn't cleared enough for them to notice a difference. According to a recently released Statistics Canada report, 15 per cent of youth aged 15 to 19 smoked daily or occasionally last year, down from 18 per cent in 2005. Roughly five million Canadians - or 19 per cent - are smokers, and the report says that all provincial smoking rates are within four percentage points of the national rate. But a local Heart and Stroke Foundation representative says city residents often don't see evidence of the decline. "Because you see those people standing in front of schools smoking, the perception is that everybody smokes," says Susan David. Eighteen-year-old smoker Vanessa Prevost agrees. "You look around and everyone's smoking so to know that it's gone down is a shock," she says. "Maybe it will be easier (for me) to quit if other people are quitting." The Long Sault resident says smoking bans in the area discourage teens from picking up the habit, particularly bylaws that prohibit smoking on school property. "You can get a pretty big fine for that and I think that's what scares a lot of kids," Prevost says. While most city high schools strictly enforce the bylaw on their properties, most schools still allow students to carry cigarettes. Ecole Secondaire la Citadelle students Martine Wilson, 16, and Emilie Collins, 15, say their school's complete ban on tobacco products helps teens remain smoke-free. "A lot of people don't see the point of starting (to smoke)," says Collins. Wilson says many non-smoking teens avoid hanging out with smokers so they're not tempted to light up themselves. "It's a bad influence just being around them," she says. Social smoking is still a major reason why teens become addicted to cigarettes. Thirteen-year-old Amber Helmer says she's surprised the number of smoking teens in the country is decreasing because she and nearly all of her friends smoke. Usually teens are forced to smoke," she says. "People peer pressure them into smoking." Though young people will find ways to get cigarettes if they really want them, a lot of teens simply can't afford to pay hefty tobacco taxes, says former smoker Andrew Bissonnette. "With all the imported cigarettes, I figured (the number of teen smokers) would go up," he says. "It's surprising, but it's good." The 21-year-old started smoking as a teen out of boredom and got hooked for two years before quitting. But he says kids are now more educated about the negative effects of smoking. "Me and my buddies after school, we wouldn't have anything to do (so) we'd go and have a smoke," Bissonnette says. "Definitely (younger teens are) more aware than somebody older." Kayla Ouimet, 17, agrees teens steer clear of cigarettes because they're concerned about the health risks. "I used to smoke," she says. "But I realized it wasn't a good idea and I didn't want to die early." Cigarettes shouldn't be normal within the community, says Dr. Paul Roumeliotis, and teens are getting the message. "We're very happy that it's decreasing," he says. "There's room to go because I don't want any teenagers smoking." The medical officer of the Eastern Ontario Health Unit says the organization focuses on peer-led anti-smoking programs, such as the provincewide Veritas (the truth) campaign, to teach students about the dangers of smoking. Katie May ___ Children of single dads get less health care Single fathers are less likely than other parents to take their children for routine doctor visits, and more likely to go without health insurance, a new study suggests. Using data from a national survey of US families, researchers found that fewer children in single-father homes made routine, "well-child" doctor visits compared with children in either two-parent or single-mother homes. The children with single fathers were also 20 percent more likely to go a full year without health insurance, according to findings published online by the journal Health Services Research. In contrast, children of single mothers had "comparable if not better access to care" than children living with both parents, the study authors report. "The bottom line is that children in single-father families may be more vulnerable to health problems because they're not getting well-child visits or they don't have easy access to care when they need it," study co-author Dr Kathleen Ziol-Guest said in a statement. Men are generally less likely than women to make routine doctor visits for their own health, and this may partially explain the findings, according to Ziol-Guest, a researcher at the Harvard School of Public Health in Boston. "We should be looking for ways to make single fathers more aware of the importance of health care coverage and routine doctor visits," she said. The findings are based on a national survey that included parents of 62 193 children younger than 18. Just 3 percent of the children lived in a single-father home, while 22 percent lived in a single-mother home. Families headed by single women were far more likely to live under the poverty line and have government health insurance than either single-father or two-parent families. Nonetheless, children of single mothers were most likely to make well-child visits to the doctor for preventive care. Children of single fathers had the lowest rate of well-child visits in the past year - 57 percent - compared to 69 percent and 67 percent of children in single-mother and two-parent homes, respectively. "Like single mothers, most single fathers are undoubtedly doing the best they can under difficult circumstances," Ziol-Guest said. "But they may need more education and support when it comes to getting proper health care for their children." Source: Health Services Research http://www.iol.co.za/index.php?set_id=1&click_id=117&art_id=nw20070808185550425C592085 ___ Kids: Food in McDonald's wrappers taste better McDonald's Corp.'s packaging makes preschoolers think its Chicken McNuggets, hamburgers and french fries taste better, according to a Stanford University study aimed at reducing childhood obesity. "Specific branding can alter young children's taste preferences," according to an article in the August issue of the Archives of Pediatrics & Adolescent Medicine. Thomas Robinson, the author and a pediatrician at Stanford's Lucile Packard Children's Hospital, said food companies should serve healthier items to help stem rising childhood obesity rates. Sixty-three children who took part in the research tasted foods and beverages from McDonald's, some of them served in regular McDonald's packaging and some in plain paper. The kids, who ranged in age from 3 to 5 years old, preferred the taste of the items in the McDonald's wrappers. The Journal of American Medical Association publication appeared three weeks after General Mills Inc., Kraft Foods Inc., PepsiCo Inc. and other companies said they will change how they market food to children to promote healthier eating. The companies announced the steps at a U.S. Federal Trade Commission hearing amid growing criticism of advertising to kids by packaged food and restaurant companies. McDonald's, the world's largest restaurant company, said the only Happy Meals it advertises contain white-meat McNuggets, fresh apple slices and low-fat milk, which total 375 calories. Its "Shrek the Third" film promotion in May marked the company's biggest effort to advertise fruit, vegetables and milk, spokesman Walt Riker said. Two a Month "The fact is, parents make the decisions for their children," Riker said. "To put this topic in the proper context, McDonald's Happy Meal customers on average purchase two a month." Shares of McDonald's rose 94 cents, or 1.9 percent, to $49.46 at 4:26 p.m. in New York Stock Exchange composite trading. Robinson said in an interview that U.S. food companies should eliminate advertising to kids in "a move of responsibility" to stem obesity rates approaching 20 percent for U.S. children ages 6 years to 11 years. The percentage of overweight youngsters in the U.S. has more than tripled since 1980, according to the U.S. Centers for Disease Control in Atlanta, making companies targeting children vulnerable to criticism. "Advertising or marketing to children at all is something that should be reconsidered," Robinson said. McDonald's has added meal-sized salads, chicken sandwiches and carrot sticks while developing french fries without trans fatty acids linked to high-cholesterol and other health problems. "I applaud the changes they've made, but I'd like them to make them more quickly," Robinson said. "I would like McDonald's to do more to change their menu to one dominated by more healthful fruits and vegetables and less junk food." 6 August 2007 http://www.azcentral.com/community/chandler/articles/0806biz-mcdonaldsstudy06-ON.html ___ Rate of anorexia may be underestimated The occurrence rate of anorexia among young women seems to be substantially underestimated, study findings suggest, and at the same time many affected women recover without treatment. An assessment of data from a study of Finnish female twins indicates that anorexia nervosa occurs at a rate equivalent to 270 cases per 100,000 people per year among women aged 15 to 19 years, report Dr. Anna Keski-Rahkonen, at the University of Helsinki, and colleagues. Previous reports pegged incidence rates at 136 and 109 per 100,000 person-years in the United States and the Netherlands, respectively. However, these estimates were based on cases that were identified and treated. Up to half of cases go unrecognized and untreated, Keski-Rahkonen told Reuters Health. "The number of unrecognized and untreated women with anorexia is very similar in any industrialized western country," she added. To better understand the long-term impact of the eating disorder, the researchers conducted telephone interviews with 292 Finnish twins with symptoms of anorexia as well as with 134 of their symptom-free co-twins and 210 randomly selected "controls" who screened negative for the disorder. These interviews showed that two-thirds of those with anorexia recovered within 5 years, to the point of being as physically healthy as their unaffected co-twins and the control group, Keski-Rahkonen and colleagues report in American Journal of Psychiatry. The psychological impact of the illness also receded steadily on all measures except body dissatisfaction and psychosomatic symptoms, the researchers found. Factors that helped undiagnosed women regain control of their lives and recover from anorexia, Keski-Rahkonen said, included not wanting to see a psychiatrist, an aversion to lengthy hospital stays or long treatments, new interests or friends, or moves to a new school or city. Still, early detection and effective treatments are important. Even though "seven out of ten women will eventually recover," Keski-Rahkonen said, "we can't currently predict the course of the illness ... who will recover spontaneously, who will need lots of intensive treatment, and who will die from anorexia." SOURCE: American Journal of Psychiatry, August 2007. Joene Hendry ___ Smokeless tobacco product still has risks Despite the spin it's been given by marketers, the tobacco industry's new smokeless tobacco product, called snus, is not a healthy alternative to smoking, health officials say. Dearbhla Lynch, a health promoter with the Haliburton, Kawartha, Pine Ridge District Health Unit, says snus (rhymes with loose) is a smokeless product, like snuff or chewing tobacco. It undergoes a different manufacturing process that tobacco companies claim is safer than cigarettes. Snus is very common in Europe, particularly in Sweden and Norway. Three months ago, Imperial Tobacco announced plans to begin market testing snus in Canada, with a goal of introducing the product to Canadians over the next year. Producers' take on snus is that it is a safer way of consuming tobacco. "The problem is, the evidence isn't all in," says Ms Lynch. She compares the marketing to the industry's claims that light cigarettes are less harmful. Snus users have lower lung cancer occurrence, says Ms Lynch, but higher pancreatic cancer rates. "It still has cancerous properties," she says. "It's a matter of which cancer would you want?" Smokeless tobacco can result in oral cancer, periodontal disease, throat cancer, stomach cancer, cardiovascular disease and addiction. They can also suffer fatigue, muscle weakness, depression, mood swings, bad breath and upset stomach. Ms Lynch says snus should not be considered an alternative to smoking. It's only plus is that it does not produce second-hand smoke. For people addicted to nicotine, there are patches, gum and inhalers that are "safe alternatives to smoking," says Ms Lynch. Because snus is a tobacco product, it will be regulated and sold the same as cigarettes. She is concerned that the claims about its safety will hook new customers, especially young people. She says public health staff across Ontario are alarmed that smokeless tobacco products are marketed to youth and are available in flavours like cherry, vanilla, peach and mint. A study by the National Cancer Institute in 1999 showed that one pinch of smokeless tobacco held in the mouth for 30 minutes released as much nicotine as smoking three to four cigarettes Deb Bartlett http://www.mykawartha.com/article/14935 ___ Abstinence-only programs do not reduce HIV risk In high income countries, programs that encourage abstinence from sex as the only method of preventing HIV infection are not effective in achieving this goal, findings from a review of trial data suggest. As reported in this week's issue of the British Medical Journal, Dr. Kristen Underhill and colleagues, from the University of Oxford in the UK, searched 30 electronic databases to identify studies that examined the effectiveness of abstinence-only programs as a means of preventing HIV infection. Data from 13 trials, containing nearly 16,000 U.S. youth, were included in their analysis. Compared with no program, safer sex programs, and various other control programs, the abstinence-only programs did not seem to reduce HIV risk. Specifically, abstinence-only programs did not influence the rate of unprotected vaginal sex, the number of sexual partners, condom use, or initiation of sexual activity. In one trial, there was evidence that abstinence-only programs may have had an adverse effect. Compared with a comparison group of young people who did not participate in an HIV prevention program, abstinence-only programs were associated with a rise in sexually transmitted infections and pregnancy. Still, the authors note that other trials did not show a significant link between abstinence-only programs and these outcomes. In another trial, there was a suggestion that abstinence-only programs may reduce levels of vaginal sex, but the follow-up period was relatively short. "In contrast to abstinence only programs, programs that promote the use of condoms greatly reduce the risk of acquiring HIV, especially when such programs are culturally tailored behavioral interventions targeting people at highest risk of HIV infection," Dr. Stephen E. Hawes, from the University of Washington in Seattle, and colleagues note in a relate editorial. SOURCE: British Medical Journal ___ NEW ZEALAND Suicide rate soars among teenagers from abusive families Teenagers who see adults fighting at home are more likely to lash out violently against others - and a quarter of them try to kill themselves each year. Latest results from a national survey of 9700 high school students in the year 2000, released at Parliament yesterday, show that New Zealand's teenagers live in a culture where violence is common. Half of all high school boys were hit or harmed by others at least once in the previous year, a quarter were involved in serious fights, 5 per cent had to get medical treatment after a fight and 3 per cent attacked someone else with a weapon. Only 5 per cent came from homes where they saw adults hitting or physically hurting each other in the previous year, and only 1 per cent saw adults hitting each other more than once or twice a year. But boys from that 1 per cent of most violent homes were far more likely than other boys to be violent themselves. Some 26 per cent of them hit others at least three times during the previous year, compared with 12 per cent of boys from other homes. Eighteen per cent of them, compared with only 2.5 per cent of other boys, attacked someone with a weapon. Children from the 5 per cent of homes where adults hit each other were also three times as likely as other children to be depressed, and 28 per cent tried to kill themselves. The attempted suicide rate in the whole high school population was only about a quarter of this. Lead researcher Peter Watson, a paediatrician at Auckland University, said the survey could not tell whether seeing violence at home actually made teenagers more violent or suicidal, or simply reflected other factors that made the whole family "dysfunctional". "My sense, as a clinician in child and youth mental health, is that it's both," he said. "There are some young people exposed to violence in the home where that has a direct impact. "They have post-traumatic stress disorder and anxiety problems as a direct result of witnessing violence in the home. Also, there is very strong evidence that violence is a marker of disturbed family functioning, disturbed relationships and attachment problems between kids and their parents. So it's not either/or." The 2000 survey, funded by the Ministry of Health, was the first of its kind so there are no easy comparisons with any previous data in New Zealand or elsewhere. The survey team has already reported on other aspects of the survey, but was asked to extract details on violence for yesterday's official announcement of a national initiative to question all women and caregivers of children arriving at public hospitals about whether there is any violence at home. An $11 million advertising campaign to change New Zealanders' attitudes and behaviour around family violence will begin on September 4. At the same time, the Auckland University team behind the 2000 survey is now repeating the survey in high schools to see whether anything has changed in seven years. Its results are due late next year. Dr Watson said violence had always been "part of the human condition", but the survey showed that about half of all teenagers still managed to avoid it, and that it had negative effects on the health and wellbeing of many of its victims. Apart from depression and attempted suicide, teenagers who saw violence at home were roughly twice as likely as others to smoke, drink alcohol and take cannabis. Girls were twice as likely as other girls to have unwanted sexual contact and boys were more than four times as likely as other boys to be sexually abusive. The survey found that 33 per cent of both boys and girls at age 15 claimed to have had sexual intercourse, even though sex with anyone under 16 is illegal. Twelve per cent of the girls and 3 per cent of the boys who had had sexual intercourse said they did not want to have it the first time it happened. Simon Collins http://www.nzherald.co.nz/section/1/story.cfm?c_id=1&objectid=10455306 ___ Nicotine addiction is quick in youths, research finds A young cigarette smoker can begin to feel powerful desires for nicotine within two days of first inhaling, a new study has found, and about half of children who become addicted report symptoms of dependence by the time they are smoking only seven cigarettes a month. "The importance of this study is that it contradicts what has been the accepted wisdom for many decades," said Dr. Joseph DiFranza, the lead author, "which is that people had to smoke at least five cigarettes a day over a long period of time to risk becoming addicted to nicotine. Now, we know that children can be addicted very quickly." DiFranza is a professor of family medicine at the University of Massachusetts. The researchers recruited 1,246 sixth-grade volunteers in public schools in Massachusetts, interviewing them 11 times over a four-year period. They also took saliva samples to determine blood levels of nicotine and link them to addictive behavior. At some time during the four years almost a third of the children puffed on a cigarette, more than 17 percent inhaled, and about 7.5 percent used tobacco daily. Since inhaling is required for sufficient drug delivery to cause dependence, the researchers limited their analysis, published in the July issue of The Archives of Pediatrics and Adolescent Medicine, to the 217 inhalers in the group. Their average age when they first inhaled was 12.8 years. Of these, almost 60 percent had lost some control over their smoking, and 38 percent developed tobacco dependence as defined by the widely used diagnostic manual published by the World Health Organization. In the 10 percent of children who were most susceptible, cravings began within two days of the first inhalation, and saliva analysis showed that being dependent did not require high blood levels of nicotine throughout the day. In some cases dependence could be diagnosed as early as 13 days after the first smoking episode. For most inhalers, daily smoking was not required to cause withdrawal symptoms. More than 70 percent had cravings that were difficult to control before they were smoking every day. The biochemical analyses confirmed this: the symptoms of dependence began mostly at the lowest levels of nicotine intake. "We know very little about the natural history of dependence," said Denise Kandel, a professor of sociomedical sciences at Columbia and a widely published addiction researcher who was not involved in the study. "This is really the first study that addresses the issue. Its strength is that DiFranza has followed a community sample of adolescents and interviewed them every three months, which is very difficult to do. "On the other hand," she continued, "his definition of dependence is based on single symptoms, which may be open to question." The definition of tobacco addiction is controversial, but the scientists used widely accepted criteria to diagnose dependence and a well-validated questionnaire to determine the extent to which smokers had allowed the habit to dictate their behavior. The researchers write that it may seem implausible that intermittent smoking could provide relief from withdrawal symptoms. But in fact a single dose of nicotine has effects on the brain that can last as long as a month, and the nicotine obtained from just one or two puffs on a cigarette will occupy half of the brain's nicotinic receptors, the molecules specifically sought by nicotine in tobacco addiction. The authors acknowledge that some of their data are retrospective and comes from self-reports, which can be unreliable, and that it is not possible to draw conclusions about other populations from their sample. In addition, they did not consider the roles of puberty, alcohol and other drug use. But the study has considerable strengths in measuring frequency and duration of smoking and in collecting exposure data by biochemical analysis as well as by repeated interviews. "People used to think that long-term heavy use caused addiction," DiFranza said. "Now, we know it's the other way around: addiction is what causes long-term heavy use." Nicholas Bakalar http://www.iht.com/articles/2007/07/31/healthscience/snnic.php ___ |
