Extracts from the "Other" Journals relating to Children, Youth and
Families
in the fields of health, substance abuse, education, psychology, science
...
August 2008
HIV spreads in NY at
three times the U.S. average
New Yorkers are contracting HIV at
three times the national rate, the city health department said on
Wednesday, attributing the difference to New York's large population of
high-risk groups such as gay men and blacks.
In 2006, 72 in every 100,000 New Yorkers became infected with HIV, the
virus that causes AIDS, compared with the national average of 23
infections, the health department said.
Some 4,800 people contracted HIV in 2006 in New York, long considered
the epicenter of the U.S. HIV/AIDS epidemic. About 100,000 New Yorkers
are believed to be infected with the virus, officials said.
Blacks and men who have sex with men have the highest rates of new
infections and are represented in large numbers in New York City.
Half of the city's 2006 infections occurred among men who have sex with
men, the city's health report said.
Black men and women were infected at three times the rate of whites.
Some 17 percent of the total number of new infections were among black
men who have sex with men and blacks in general accounted for nearly
half of the city's new infections.
The data was gathered using a new formula developed by the U.S. Centers
for Disease Control and Prevention, which involves testing blood samples
found to be HIV-positive to determine when the infection occurred.
Previous data did not distinguish recent infections from those that
occurred years earlier, the department said.
Monica Sweeney, the city health department's assistant commissioner for
HIV prevention and control, said the numbers will help New York better
allocate resources to fight the epidemic.
Edith Honan; Editing by Michelle Nichols and Xavier Briand
27 August 2008
http://today.reuters.com/news/articlenews.aspx?type=healthNews&storyID=2008-08-27T235821Z_01_N27485775_RTRUKOC_0_US-AIDS-NEWYORK.xml
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STDs common among
arrested teenagers
Teenagers arrested for juvenile offenses have a high rate of sexually
transmitted diseases, so screening these teens soon after arrest may
help catch many cases, a new study suggests.
Past research has found relatively high rates of STDs among incarcerated
adolescents, but little is known about the STD risk among teens who are
arrested and then released.
The new study assessed a pilot program set up in Hillsborough Country,
Florida, to offer STD testing to teenagers soon after their arrest,
before a decision is made to release or detain them. All arrested teens
who were submitting a urine sample for drug testing were asked whether
they also wanted the sample tested for gonorrhea and chlamydia.
Researchers found that among more than 900 juvenile offenders who agreed
to be tested, 13 percent had gonorrhea, chlamydia or both -- similar to
rates that have been found among incarcerated adolescents.
The findings suggest that "a voluntary STD screening protocol is
feasible for arrested youth entering the juvenile justice system, and
these offenders are at high risk for STDs," the researchers report in
the journal Sexually Transmitted Diseases.
Routine testing and treating adolescences for STDs soon after arrest
could have "enormous potential public health benefits," write the
researchers, led by Dr. Steven Belenko of Temple University in
Philadelphia.
The study included 948 boys and girls between the ages of 12 and 17 who
were arrested for juvenile offenses. They gave urine samples while at a
central processing center where officials decide whether to release them
or to send them to a detention center.
Overall, 10.5 percent of males tested positive for chlamydia or
gonorrhea, as did 19 percent of females.
The investigators identified three other statistically significant risk
factors for having an STD. These included being female, being black;
being sent to a detection center; and having more than three lifetime
sex partners, which increased the risk by 4.67-fold, 3.62-fold,
2.32-fold and 2.06-fold, respectively.
Both gonorrhea and chlamydia often have no obvious symptoms, which means
that screening can catch many cases that would otherwise go undetected,
the researchers point out.
"The asymptomatic nature of most bacterial STDs," they write, "increases
the urgency to expand routine STD testing, and prevention programs, at
all stages of the juvenile justice system, but especially right after
arrest and as youths enter detention."
Right now, the researchers note, "few, if any," processing centers for
juvenile offenders have STD screening programs.
SOURCE: Sexually Transmitted Diseases, August 2008.
25 August 20087
http://uk.reuters.com/article/healthNews/idUKCOL56563620080825
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Underage drinking tough to control
He says he drank his first alcohol at 14, and it made him feel "good and kind of dizzy." He's 16 now and lives in a Wichita suburb. Until recently, he said, he drank at teen parties nearly every weekend -- six to seven beers each time. His mother put him in treatment after she found marijuana in his car. "I'm the dumbest person, I guess," she said, for not detecting his problem earlier. "I'm not dumb anymore."
Their experience is part of a continuing problem of underage drinking. About 48 percent of Kansas high school students say they have had a drink in the past 30 days, compared with 40 percent nationally, according to a report by the state Department of Social and Rehabilitation Services. The numbers are based on a statewide survey of students.
There has been some good news: Surveys also indicated slightly declining rates of drinking by the state's high school students from 2001 to 2005, although officials note the decline has been small. Some treatment experts said they suspect that part of the decline in alcohol use is due to use of illegal drugs instead. In 2005, about 55 percent of the state's high school seniors reported drinking alcohol in the past 30 days, according to SRS. About 35 percent of seniors reported binge drinking -- having five or more drinks in a row at least once within the previous two weeks. "Perhaps of even more concern is the fact that nearly one in 10 youth in sixth grade report drinking alcohol in the past 30 days," said the report, based on a survey.
SRS has started a program to combat underage drinking in 14 counties, including Sumner, Reno, Harper and Kingman counties in south-central Kansas. "I think we get complacent until something really bad happens," said Tom Buell, addiction services director for DCCCA Inc., one the largest nonprofit social-service agencies in the state.
Early on the morning of Aug. 16, a 15-year-old Derby girl suffered critical injuries when a car struck her as a drinking party broke up following a fight, Sedgwick County sheriff's officials say. About 50 people, ages 15 to 20, were at the party on South 116th Street East, in southeastern Sedgwick County. Detectives are continuing to investigate.
National and local issue
Underage drinking has become a national issue as well, with a
debate over whether the legal drinking age should be lowered to 18. Some
university presidents contend that lowering the age would reduce binge
drinking. And with school starting, teens are holding more parties,
police say. Parents are a big part of the problem because they often
support drinking parties, under a misguided belief that teens are safer
if they drink at someone's home, Wichita police and treatment officials
say.
Meanwhile, two state-supported Wichita residential treatment facilities for adolescents -- which had a total of 31 beds -- have closed in the past year. So now the closest residential treatment facility is in the Kansas City area. The situation moves adolescents away from their families and makes it difficult for parents to be involved in their children's treatment, officials say. Teens "should be considered a priority for treatment access in Kansas, and they are not treated as a priority," said Harold Casey, head of the Substance Abuse Center of Kansas, a nonprofit treatment, assessment and referral agency in Wichita. The federal government sets the priorities for the states, Casey said.
'A challenge for me'
Until he was caught with cocaine and began attending outpatient
treatment, a Wichita 16-year-old says he drank six to nine beers every
weekend at parties. At the time, he said, he approached drinking as
"something you had to do" at a party. "You just can't be the only sober
one," said the teen, after a recent treatment session attended by his
mother.
To protect their anonymity as they recover, The Eagle is not naming teens interviewed for this article.
When the 16-year-old drank, he lost his inhibitions. It was the only way he would dance. "If I didn't drink," he said, "I'd be embarrassed." But he never drank and drove, he said. "It was just something I knew I couldn't do." His sober sister was his driver. Nationwide, alcohol-related traffic accidents are the leading cause of death among teens and young adults, the SRS report said.
The 16-year-old said he used cocaine so he could drink more and stay awake longer. Still, he said he doesn't consider himself an alcoholic. He said he has been to two parties and stayed sober. "And it's not bad. I just tell them I don't want to drink. I tell them I'm in treatment, and they understand." He's getting more sleep and trying to improve his grades so he can graduate "because people in my family think I can't do it. So it's a challenge for me."
The 16-year-old is Hispanic. That is relevant, the SRS report said, noting that Hispanic students and white students reported a higher prevalence of alcohol consumption.
'It's still not safe'
It seems that more parents are allowing teens and their friends
to drink at home as long as they don't drive, says Buell, addiction
services director with DCCCA. But it's still harmful and irresponsible,
he said. "The bottom line is you never know which one of those kids will
take that first drink and immediately" be at risk of alcoholism because
they are genetically predisposed, he said.
Pam McLucas, a drug and alcohol counselor at Wichita Children's Home, said, "I've heard a lot kids say that, 'My parents don't care if I drink at home. They'd rather me drink at home, in front of them.' " But it ends up encouraging teens to drink elsewhere as well, she said.
Officer Michael Lloyd, who coordinates the Wichita Police Department's efforts against underage drinking, said if police break up a party, "if there's 20 kids, at least four of those parents will say, 'Well, at least they're not out running around.' "I just tell them honestly, 'It still doesn't make it right; it's still not safe.' "We've even had them at hotels where parents are renting the rooms for them," Lloyd said. Part of problem, he said, is "the parent, they want to be their best friend."
But it can get the parent prosecuted. A law that many parents don't know about makes it a misdemeanor to host an underage party where alcohol is consumed, he said.
'Here, have a drink'
About 85 percent of the children coming to the Children's Home
are from families with a substance abuse history, said McLucas, the
counselor. "I say this over and over again: 'Be what you want your kids
to be,' " she said. "That may be giving up drinking, even socially.
People who go to a party, and they have a few drinks, and then they get
in a car and go home. But they're telling their kids not to do that."
Most of the time, she said, "kids will follow their parents' lead."
A 21-year-old Wichita man, now in treatment, says he got his first drink when he was 15, in another state. He says his mother said, "Here, have a drink," and handed him a bottle with a mixture of vodka and Sprite. "She was partying, her and my dad." Growing up, he said, "everybody around me drank." By 16, he was sneaking into his parents' room to get their alcohol. "I was drinking like a 30- pack a day when I was 17," he said, although he considered marijuana his main problem because he spent most of his money on it.
After a few years in Wichita, his problems mounted. "I got drunk and did something stupid" -- breaking into a home. He said he has been convicted of weapon possession and burglary. "I wouldn't do that if I wasn't drunk," he said. He said he has been sober about four months. "I found God, so all I do is pray," he said.
He knows he will go to prison for 34 months if gets in trouble again. All it would take is testing positive for alcohol. People on his street still ask if he wants a beer or some weed. "No, I'm good," he said he tells them. "And I just keep walking."
Tim Potter
24 August 2008
http://www.kansas.com/news/local/story/504453.html
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Poor sleep equals high blood pressure for teens
Poor sleep habits can do more than annoy parents and make teenagers drowsy in school -- they can lead to high blood pressure, U.S. researchers reported on Monday. Teens who slept fewer than 6 1/2 hours a night had more than twice the risk of high blood pressure and those with troubled sleep had more than triple the risk, the team at Case Western Reserve University in Cleveland, Ohio found.
Writing in the American Heart Association journal Circulation, the researchers found the pattern held even when adjusted for sex, weight and socioeconomic status. "Our study underscores the high rate of poor quality and inadequate sleep in adolescence coupled with the risk of developing high blood pressure and other health problems," said Dr. Susan Redline, the pediatrician who led the study. "We also found that a low sleep efficiency may be more consistently associated with pre-hypertension than a shorter sleep period."
High blood pressure can damage arteries and kidneys, causing stroke, kidney disease and other illnesses.
Redline's team studied 238 13-to-16-year-olds and found 14 percent of the adolescents had high blood pressure or readings at the borderline, called pre-hypertension. For adults, high blood pressure is defined as a reading of 140/90 or above, but for children it is defined as being in the 90th percentile for their age
They had the volunteers fill out sleep diaries but also measured their movements while in bed to gauge whether they were really asleep. On average, the teens got just 7.7 hours of sleep a night, while they need nine hours at that age. And 16 percent of the teens had low sleep efficiency, meaning they had trouble falling asleep much of the time or woke up too early. Another 11 percent slept less than 6 1/2 hours a night. "These associations may have a large public health impact," Redline said in a statement.
"Part of the problem is the technological invasion of the bedroom with computers, cell phones and music," Redline said. "There are teens who text message or listen to music all night, compounded by early school hours. Adolescents need nine hours of sleep. Parents should optimize sleep quality for their family with regular sleep and wake times and bedrooms should be kept quiet, dark and conducive to sleep."
The National Heart, Lung and Blood Institute said caffeine and too-warm temperatures also keep people awake. "Signs of not getting enough sleep or sleeping poorly include consistently taking more than 30 minutes to fall asleep, awakening more than a few times or for long periods each night, feeling sleepy during the day, or having trouble concentrating at school or at work," the NHLBI, part of the National Institutes of Health, said in a statement.
Redline said the study may underestimate the problem because it excluded children with known sleep disorders and other illnesses.
Maggie Fox; editing by Todd Eastham
18 August 2008
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Number of people accessing HIV/AIDS treatment increasing in northwest England, study finds
The number of people accessing HIV/AIDS treatment in the northwest region of England increased by 9% in 2007 compared with data from 2006, according to a report released recently by the Centre for Public Health at Liverpool John Moores University and the North West Protection Agency, the Press Association reports. The report said that in 2007, the total number of HIV-positive people receiving treatment was 5,212, compared with 4,761 people in 2006. The report also showed a 10% decrease in the number of newly reported cases. There were 907 newly recorded cases in 2006, compared with 817 newly recorded cases in 2007. Report co-author Penny Cook said the decrease in newly recorded cases should not lead to complacency among researchers and health officials about HIV/AIDS, adding, "We must ensure that prevention and treatment services continue to help those most in need."
The 2007 data in the report also showed that 42% of all newly recorded cases, or 345 cases, involved men who have sex with men. Heterosexual sex was associated with 49% of newly recorded cases, or 401 cases. According to the report, advances in antiretroviral therapy have led to a reduction in the number of recorded AIDS-related deaths from 87 in 1996 to 33 in 2007. Mark Bellis, director of the Centre for Public Health and co-author of the report, said regulations on advertising for condoms need to be changed so that they can be "marketed as sexy and appealing products" to young people before they become sexually active
The report is available online. http://www.cph.org.uk/publications.aspx
19 August 2008
http://www.medicalnewstoday.com/articles/118636.php
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UK
Dangerously overweight children could be taken from their parents and put into care if the obesity epidemic continues, council leaders warned yesterday.
Fat children 'should be put in care'
The Local Government Association said seriously fat children should be classed as examples of "parental neglect". It said that parents who allow their children to eat too much are just as guilty of ill treatment as parents who do not feed them at all.
Some forecasts predict that by 2012 one million children in England will be obese and by 2025 almost a quarter of boys will be classed as dangerously overweight. There have been some reported cases where children under 10 have weighed up to 14st (89kg) and a three-year-old has weighed 10st – putting them at a high risk of diabetes and heart disease.
The LGA, which represents over 400 councils in England and Wales, said it wanted a national debate about the extent to which dangerous childhood obesity could be considered as a factor contributing to parental neglect. David Rogers, LGA spokesman on public health, said: "We need to eat better, exercise more and lead healthier lives in general and councils play a huge part in that. From providing children with free fruit and vegetables and planning towns and cities that encourage walking, to encouraging people to get into the gym and into sports, town halls are on the front line of tackling obesity."
Jessica Salter
16 August 2008
http://www.telegraph.co.uk/news/2567603/Fat-children-should-be-put-in-care.html
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Boys more likely than girls to outgrow asthma
Boys may be more likely than girls to have childhood asthma, but they are also more likely to grow out of it during adolescence, a new study shows. Results of the study released Friday help solve the mystery of age and sex differences in the natural history of childhood asthma, the lead researcher told Reuters Health. "Persistence of airway responsiveness -- commonly referred to as twitchy airways -- is a major reason why asthma in girls may persist (or develop) past the onset of puberty," Dr. Kelan G. Tantisira, of Brigham and Women's Hospital and Harvard Medical School in Boston, told Reuters Health.
It's known that the incidence of asthma around early school age is higher in boys than girls, whereas the incidence in adolescence and adulthood is higher in females than males, the researcher explained.
In addition to symptoms, twitchy or over-reactive airways are one useful marker for the development of asthma. Upon exposure to certain asthma triggers like pollen, dog or cat dander, cold air or histamine, an asthmatic's airways are much more likely to constrict than those of a person without asthma. Tantisira's team studied the natural history of airway responsiveness in 1,041 children with mild to moderate asthma who were between 5 and 12 years old at the outset. They conducted standard "methacholine challenge" tests for twitchy airways annually over a period of nearly nine years.
Results showed that up until the age of about 11, airway "hyper-reactivity" decreased in both boys and girls and the average twitchiness was about the same in both sexes. However, starting around puberty, the level of airway hyper-reactivity remained fairly constant in girls and was more severe relative to that seen in boys.
This is a "fascinating finding," Dr. Jorrit Gerritsen, of Beatrix Children's Hospital in Groningen, the Netherlands, writes in a commentary published with the study in the American Journal of Respiratory and Critical Care Medicine.
According to Tantisira, it had been unclear why pre- and post-puberty asthma incidence shows different patterns in girls and boys -- and why the disease seems more likely to remit in boys than girls. Now it appears that the difference is related to the persistence of, or increased susceptibility to, airway responsiveness in girls, Tantisira explained. Boys, in contrast, show an improvement as they get older.
Why twitchy airways persist in girls is not known, but may be related to hormonal factors, the researcher said, noting that progesterone, which increases in girls during puberty, has been shown to make airways less likely to "bronchodilate," or open up. Similarly, hormonal supplementation in postmenopausal women has been shown to increase the incidence of asthma. On the other hand, testosterone, which is increased in boys during puberty, has been associated with smooth muscle relaxation in animal research.
"It is possible in the future," Tantisira said, "that therapy may be developed that would be directed toward the mechanistic basis for persistence of airway responsiveness. This may include airway specific hormonal modulation or therapy directed at sex-specific genetic determinants of asthma (and) airway responsiveness. Obviously," the researcher added, "much work still needs to be done."
SOURCE: American Journal of Respiratory and Critical Care Medicine, August 2008.
15 August 2008
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Drug court makes difference in lives of youth
You've got to hand it to Ontario court Justice Kofi Barnes. He was a man who saw a problem, didn't like the current solutions and sought a new way to deal with those charged with drug offences. The Durham-based judge, who had experience working as a prosecutor in Toronto with people charged with drug offences, had seen the same old depressing pattern of revolving door offences. Young people would be charged, appear in court, receive sentencing and show right back up in the same place time after time.
Whatever was being done in the name of justice with these offenders, it wasn't working. It was a short-term answer to a long-term problem and no discernible difference was being made. So Justice Barnes decided to change the way the system worked. His goal was to make a meaningful difference in young lives gone off track, with the hope of getting them back on the rails.
The answer is Durham Region's Drug Treatment Court. The goal of the court is to help drug addicts facing non-violent criminal charges get to the root cause of their problem. They have to be willing to make an effort to change. And if they do their part, Justice Barnes, part judge, part parent, part brother, part friend, will be there to congratulate them for success.
The judge gave kudos recently to a young man after receiving reports from the Crown attorney and the defendant that suggested he was making good progress in life. He dealt with several others who are experiencing varying degrees of success and failure but are under the watchful eye of the judge and the system. The message seems clear: If you really want to change, we'll help you along the way. We won't forget about you or neglect you.
The long-term goal is to help save young lives and provide a way for people to realize their potential before they end up going down a black hole into a life of crime and addiction. Justice Barnes is leading the fight and deserves credit. But it's clear the winners in this story are those who take advantage of what's offered and turn their lives around. We're all better for it.
Metroland Durham Region Media Group
13 August 2008
http://www.newsdurhamregion.com/news/opinion/editorials/article/105079
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Spending time outdoors good for kids' eyes
Parents now have another reason to shoo their kids outdoors to play, along with making sure they get enough fresh air and exercise. In a study, Australian researchers found evidence that children who spent the most time outdoors were the least likely to suffer from myopia, also called nearsightedness or shortsightedness. "Our evidence suggests that the key factor is being outdoors, and that it does not matter if that time is spent in having a picnic or in playing sport," Dr. Kathryn A. Rose told Reuters Health. "Both will protect a child's eyes from growing excessively, which is the major cause of myopia."
Myopia has become increasingly common in recent decades, with more than 80 percent of people in some highly-educated groups being nearsighted, Rose of the University of Sydney and her colleagues point out in the journal Ophthalmology. Work that requires a person to focus on something close up -- for example reading -- has been proposed to cause nearsightedness, they add.
To investigate how viewing activities at various distances might influence myopia risk, the researchers looked at 1,765 six-year-olds and 2,367 12-year-olds participating in the Sydney Myopia Study. Just 1.5 percent of the six-year-olds were myopic, but 12.8 percent of the older children were. Both age groups spent about 2.3 hours outside each day, on average. Time spent outside had no significant relationship to myopia prevalence among the younger children, nor did the amount of close work they did.
But among the 12-year-olds, those who spent more than 2.8 hours outside every day were less likely to be myopic than their peers who spent more of their time indoors. Children who spent less than 1.6 hours outdoors every day and more than 3.1 hours in near-work activity had double to triple the likelihood of being nearsighted compared to kids who spent the most time outside and the least time in close-up work.
"We have not yet established why being outside is protective," Rose said. "But a likely candidate is the high levels of light experienced outside compared to inside. Studies in animals suggest that retinal dopamine is released in response to light, and dopamine is known to be able to block eye growth." Myopia is caused when the eyeball grows too long.
The researcher offers the following advice to parents: "Try to ensure that your children spend time outside because we have evidence that the more time they spend outdoors, the less likely they are to develop myopia. This is true, even if they are also doing a lot of close work such as reading and studying." But also, she adds, parents should be sure their kids are wearing hats and sunscreen.
SOURCE: Ophthalmology, August 2008.
Anne Harding
11 August 2008
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Bad childhood experiences tied to early drinking
Children who deal with divorce, abuse or certain other hardships may be more likely than their peers to start drinking at a young age, a U.S. study suggests. The study, of nearly 3,600 Americans ages 18 to 39, found that those who'd gone through certain negative experiences as a child were more likely to have started drinking before age 15.
The experiences specifically linked to early drinking were physical abuse, sexual abuse, living with a mentally ill family member, substance abuse in the home, and parents' divorce or separation. The findings, reported in the journal Pediatrics, add to evidence that negative childhood experiences are related to early drinking.
What's new is that they point to specific circumstances that may be especially problematic, according to the researchers, led by Dr. Emily F. Rothman of the Boston University School of Public Health.
They found that adults who reported any of those five childhood experiences were more likely not only to drink early, but to drink specifically to cope with their problems. Drinking early, especially as a way to manage stress, could shape a person's drinking patterns for a lifetime, the researchers note -- possibly raising the risk of alcohol dependence in adulthood.
The study involved a nationally representative sample of U.S. adults who were either current or former drinkers. They were surveyed about various adverse childhood experiences, the age at which they started drinking and the reasons that they typically drank during that first year. Overall, two-thirds of the respondents said they had gone through at least one negative childhood experience. However, only five types of experiences stood out as being linked to early drinking.
Childhood abuse was most strongly associated with early drinking, conferring a two- to three-fold higher risk. Similarly, having a family member who was mentally ill or a substance abuser doubled the odds of early drinking. Adults whose parents had divorced or separated when they were children were 70 percent more likely to report early drinking than those whose parents stayed together.
However, the researchers say the findings do not imply that all children who go through these experiences are necessarily at risk of early drinking, or of turning to alcohol to cope with their problems. One reason these children may start drinking is a lack of adult supervision, Rothman and her colleagues point out; parents dealing with mental illness, for example, may not be able to monitor their children closely. And this, the researchers write, would mean that having at least one "engaged" parent could help protect children from the effects of whatever stressful circumstance they are facing.
SOURCE: Pediatrics, August 2008.
11 August 2008
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SWEDEN
Study: Young convicts worse off mentally
Young criminals often feel worse mentally compared to other young people, new statistics show. Despite this there is no specialized forensic care for young people in Sweden. Young people that commit serious crimes have a ten-fold greater risk of psychosis than average, new statistics compiled by the Karolinska Institute in Solna show.
The incidence of ADHD and depression is two-five times more common in the group, writes Svenska Dagbladet online. The new statistics have been compiled by researchers at Karolinska Institute based on 25 surveys undertaken in the USA, Britain, Russia and Spain. That young criminals feel worse psychologically is not a new theory in itself, but this is the first time that the phenomenon has been researched from actual diagnoses.
Niklas Långström is a child and youth psychiatrist at Karolinska Institute and a co-author of the study. "Those with criminal tendencies when young tend to do very badly later in life. They get stuck in criminality, they suffer accidents, they are substance abusers, they don't get any jobs, they beat their families. To catch them in time would be of great benefit," he said to Svenska Dagbladet.
In Sweden today there is no forensic psychiatric care specifically for young people. Young people sentenced to psychiatric care are instead placed in a clinic for adults.
Peter Simpson
10 August 2008
http://www.thelocal.se/13600/20080810/
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NEW ZEALAND
Melanoma warning aimed at young people
Young people are the focus of the latest warning about melanoma rates. The figures show that despite public campaigns to raise awareness of the risks, the number of New Zealanders being diagnosed has stayed much the same over the past 15 years. The Otago University researchers have analysed 10 years of data fomr the New Zealand cancer registry and are disappointed but not surprised, as the same trend has been found in other countries.
New Zealand has a 40 percent higher level of ultraviolet radiation than similar latitudes in the northern hemisphere and that is the link to skin cancer. NZ Dermatology Society president Kevin McKerrow said: “I think there's a great denial among young people in this country with regard to melanoma”.
A Cancer Society survey of sun awareness shows that young people in particular continue to expose themselves to UV radiation - intentionally or not. 20 percent of New Zealanders in the sample reported getting sunburnt in the previous weekend in Summer and 40 percent said they had been sunburnt in the past. Young people were also at risk because of the perception that artificial light used for tanning at beauty clinics was not harmful, but there was evidence to show it was harmful.
Despite the figures, the Cancer Society is clear about its focus and will keep putting the prevention and early detection messages out there. But translating the prevention message into changing behaviour is more difficult. The public are well aware of campaigns like ‘slip slop slap’ but their impact on preventing and early detection of melanomas may not be known until several decades from now.
10 August 2008
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All U.S. adults could be overweight in 40 years
If the trends of the past three decades continue, it's possible that every American adult could be overweight 40 years from now, a government-funded study projects.
The figure might sound alarming, or impossible, but researchers say that even if the actual rate never reaches the 100-percent mark, any upward movement is worrying; two-thirds of the population is already overweight. "Genetically and physiologically, it should be impossible" for all U.S. adults to become overweight, said Dr. Lan Liang of the federal government's Agency for Healthcare Research and Quality, one of the researchers on the study. However, she told Reuters Health, the data suggest that if the trends of the past 30 years persist, "that is the direction we're going."
Already, she and her colleagues point out, some groups of U.S. adults have extremely high rates of overweight and obesity; among African- American women, for instance, 78 percent are currently overweight or obese.
The new projections, published in the journal Obesity, are based on government survey data collected between the 1970s and 2004.
If the trends of those years continue, the researchers estimate that 86 percent of American adults will be overweight by 2030, with an obesity rate of 51 percent. By 2048, all U.S. adults could be at least mildly overweight. Weight problems will be most acute among African-Americans and Mexican- Americans, the study projects. All black women could be overweight by 2034, according to the researchers, as could more than 90 percent of Mexican-American men.
All of this rests on the "big assumption" that the trends of recent decades will march on unabated, Liang acknowledged. "This is really intended as a wake-up call to show what could happen if nothing changes," she said.
Waistlines aren't the only thing poised to balloon in the future, according to Liang and her colleagues. They estimate that the healthcare costs directly related to excess pounds will double each decade, reaching $957 billion in 2030 -- accounting for one of every six healthcare dollars spent in the U.S. Those financial projections are based on Census data and published estimates of the current healthcare costs attributed to excess weight -- and they are probably a "huge underestimate" of what the actual costs will be, Liang said.
The findings highlight a need for widespread efforts to improve Americans' lifestyles and keep their weight in check, according to the researchers. Simply telling people to eat less and exercise more is not enough, Liang noted. Broader social changes are needed as well, she said -- such as making communities more pedestrian-friendly so that people can walk regularly, or getting the food industry to offer healthier, calorie-conscious choices. "It really needs to be more than an individual effort," Liang said. "It needs to be a societal effort."
Amy Norton
6 August 2008
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Psychotropic medications overused among foster children
New research finds that psychotropic medications are frequently used to treat youth in foster care. The pattern is disturbing because effectiveness and safety of the pharmaceuticals has not been established. Psychotropic medications act on the central nervous system to alter emotion or behavior temporarily.
In a study of Texas children with Medicaid coverage, the latest in a series of analyses of state Medicaid records, foster care youth received at least three times more psychotropic drugs than comparable children in poor families. But there is no clear treatment advantage to the foster children, according to Baltimore researcher, Julie Zito PhD, professor of pharmacy and psychiatry at the University of Maryland.
Of 32,135 Texas foster care children enrolled in Medicaid from September 2003 to August 2004, 12,189 (38 percent) were dispensed one or more psychotropic medications. Among those receiving psychotropic medications, 41.3 percent of a random sample of 472 youths received three or more psychotropic drugs daily. The medicated children were most likely to be Caucasian males, and 10 to 14 years of age. This sizable proportion of youth receiving drug combinations poses questions about appropriateness, benefits and risks, says Zito.
The Texas study also indicated that decisions to give some children three or more psychotropic drugs may be largely based on behavioral and emotional symptoms rather than conclusive diagnosis of a specific mental condition. “These data do not provide sufficient information to address questions of severity and impairment that might explain such complex drug regimens,” Zito suggests.
Emphasizing symptoms can lead to the diagnosis of more than one mental disorder in a patient, leading to greater use of combinations of drugs, said the study, which was published earlier this year in the journal Pediatrics. Zito says, “There are serious behavioral and emotional problems with many foster children and we want to make sure they are medicated appropriately. These are our troubled children.” Many foster children experience multiple family placements and such disruption poses real challenges for the developing child, caregivers, and treating clinicians.
She says the extensive use of such drugs in foster care youth is an indication of a trend of expanding use “in U.S. youth across the country. This [increase in psychotropic drug use] represents a sea change in the practice of child mental health treatment since 1990. Such trends in community treatment deserve further investigation. Let’s learn more about the medications being taken by children, the reasons for use, who benefits and who doesn’t.”
More than 75 percent of the psychotropic medication use for children is off-label, a practice of prescribing drugs for a purpose other than the approved use on its label. “So we are generalizing our [knowledge] from adults to children without knowing enough about pharmacokinetics, dosing, or long-term safety in the pediatric population,” said Zito.
Zito has been leading studies of children’s use of medication in the Medicaid population for more than a decade, with funding for the past five years from the National Institutes of Health’s National Institute of Child Health and Human Development. To enhance the work, the Maryland School of Pharmacy’s Pharmaceutical Research Computing (PRC) center has established state-of-the-science computing resources to analyze very large data sets.
As one of a new breed researchers called pharmacoepidemiologists, Zito studies community populations for the use and safety of medications already on the market. She says her work may be thought of as phase IV drug analysis, a logical continuation of the common three-phase clinical trials that a drug maker needs to complete before seeking federal approval to market the drug.
“This is a ‘post-marketing’ view of how a drug is doing,” she says.
Rick Nauert
4 August 2008
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LETTER
A better chance for children in care
You describe the state as a "miserable parent" because of the well-rehearsed evidence of poor outcomes for adults who have experience of being a child in care (Leaders, July 28). No one would dispute that we must do more to improve those outcomes. But research also shows that generally the longer a child has spent in care, the less likely they are to experience those poor outcomes.
The sad fact is that the longer it takes for a child to come into care, if that's where they need to be, then the more ingrained the damage will be - often the result of generations of poor parenting and poverty. This is surely a case for earlier and more responsive intervention.
Second, there is no substantive evidence that local authorities put financial considerations before decisions to initiate care proceedings. There is plenty to show that when there is, as now, a significant change to the law, there is a temporary dip in activity as the system comes to terms with the change - in this case it's the introduction of the Public Law Outline to improve pre-court planning, and the shift of resources to pay court fees. The PLO is generally welcomed because it should help to reduce delay. At present it rarely takes less than a year to navigate this process and secure a child's future. The full financial costs of this delay far outweigh the court fees element. The government did well by introducing PLO, less so in handling the fees transfer, but they have listened and responded to our complaints. Of course, if there are fewer proceedings and they are dealt with more quickly, that will mean more resources can go where they are needed, directly to the care of the child.
John Coughlan
Association of Directors of Children's Services
1 August 2008
http://www.guardian.co.uk/society/2008/aug/01/childprotection.children
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