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EXTRACTS FROM OTHER JOURNALS RELATING TO CHILDREN, YOUTH AND FAMILIES — IN THE FIELDS OF HEALTH, SUBSTANCE ABUSE, EDUCATION, PSYCHOLOGY, SCIENCE

June 2002

Pets can help to strengthen children's immune systems
Children from pet-owning families have stronger immune systems and are ill less frequently than other youngsters, research has shown.
Doctors who tested the saliva of 138 children found that those exposed to animals had more stable immune systems than those that were not, which meant they were better at fending off infection. They were also less likely to take days off school than other children.
Dr June McNicholas, a health psychologist from the University of Warwick who led the study, said: "Pet ownership was significantly associated with better school attendance rates. This was apparent across all classes, but was most pronounced in the lower school [classes one to three for age groups five to eight].
"Here, the pet owners benefited from up to 18 extra half-days' schooling per annum than their non-pet owning counterparts."
The researchers tested the children's saliva for the antibody immunoglobulin A (IgA), which is used as an indicator of immune system strength. The study showed antibody levels in pet-owning children were considerably more stable than in other children, indicating that they had robust immune systems.
The results appear to support the "dirty hypothesis", which argues that too much cleanliness early in life can weaken the immune system, a possible reason for the soaring rates of childhood asthma.
Dr McNicholas warned, though, that being too close to a pet could cause health problems. One of the biggest risks was a dog roundworm, which could cause stomach ache and eye damage.

Cigarette Campaigns Hook Youth with Lifestyle Ads
(Reuters Health) - When it comes to creating anti-smoking campaigns, public health officials should take a page from cigarette advertisers' book, researchers suggest.
Their analysis of roughly 100 previously secret marketing reports, memos and strategic planning documents from tobacco companies revealed that cigarette advertising is largely focused on the consumer attitudes and lifestyles of young adults, who are on the brink of becoming fully addicted smokers or deciding not to smoke.
This group of 18- to 24-year-olds also serves as a role model for teenagers, who may try smoking for the first time, researchers point out in the June 12th issue of The Journal of the American Medical Association.
"Market segmentation strategies based on the attitudes, lifestyle, aspirations and activities of young adults may be more useful than demographic data alone," conclude Drs. Pamela M. Ling and Stanton A. Glantz from the University of California, San Francisco.
"Physician counseling and public health campaigns that identify with the psychological needs and values of smokers and nonsmokers may improve smoking prevention and cessation efforts," they add.
According to their analysis, cost emerged as an important issue among young smokers during the 1980s. To attract potential consumers in this group, R. J. Reynolds began offering savings opportunities such as "buy one, get one free," coupons and free promotional items.
Philip Morris also discussed targeting smokers based on their leisure activities, political opinions, media use, attitudes and goals in its internal memos.
Over the next decade, smoking became less socially acceptable, which threatened to cut profits in the tobacco industry. Many smokers felt guilty about the effect of secondhand smoke on others. Based on this, R. J. Reynolds defined a new market segment, which it dubbed "Social Guilt." This segment accounted for roughly one quarter of the market.
In an interview with Reuters Health, Glantz suggested that clean indoor air and price increases might be effective targets of anti-smoking campaigns, based on the findings.
"We need to be concentrating more on young adults than teens and use the same marketing approaches that the tobacco industry does," he said.
For instance, anti-smoking campaigns that used a rebellious tone and encouraged young people to fight tobacco-industry manipulation were successful in the 1990s because they provided an alternative way to rebel.
"Exposing specific manipulative targeting in tobacco-industry campaigns, such as Philip Morris' program to reach black smokers with so-called inner-city bar nights...may be useful in reaching other rebellious smokers," the authors suggest.
SOURCE: The Journal of the American Medical Association 2002;287:2983-

Persistent Crying in Infancy Tied to Later Problems
(Reuters Health) - Children who cry for abnormal periods of time during much of their infancy are more likely than their peers to exhibit hyperactivity and academic problems during their middle childhood, researchers report.
Although most children termed persistent criers during their infancy did not develop behavior problems later in life, they did exhibit an increased risk relative to their peers, the lead investigator told Reuters Health.
"Our findings indicate that in those infants who persist in their crying beyond 4 months of age, and where this is associated with persistent feeding or sleeping problems, there is an increased risk for attention/hyperactivity problems," said Dr. Dieter Wolke of the University of Hertfordshire, UK.
Infants were considered persistent criers if they regularly cried for many hours a day, and the period of unexplained crying lasted longer than the normal colic period for babies, which occurs in the first 3 months of life. Colicky babies--who can also be fussy and seemingly inconsolable-- have not been found to exhibit any long-term consequences from their early crying.
All 64 participants who were persistent criers as infants were diagnosed at an average of 4 months of age, when their parents sought medical advice for the crying. Wolke and his team then later assessed the persistent criers for behavior problems when they were between the ages of 8 and 10, and compared them with 64 of their peers.
The investigators surveyed parents, children and teachers to determine whether the children exhibited hyperactivity disorders or antisocial behaviors, such as bullying, stealing, and cruelty to animals.
As Wolke and his colleagues report in the June 6th issue of Pediatrics, 19% of the early criers were hyperactive during their middle childhood years, relative to only 2% of their peers. In addition, persistent criers tended to perform worse than their peers in certain academic subjects, such as English and geography.
Parents of early criers and the children themselves reported that they exhibited more antisocial behaviors than their peers, but teachers did not note a difference between the two groups.
In an interview with Reuters Health, Wolke said that the link between early, persistent crying and later behavior problems is likely due to a combination of both neurodevelopmental problems and the attitude of caretakers towards the child.
For example, Wolke explained that infants could possess certain genetic factors that predispose them to having problems with behavior control, which could explain both persistent crying and behavior problems.
Persistent crying occurs when the infant is unable to control herself, Wolke explained, and therefore cannot stop crying or fall asleep unaided. The baby is also less able to concentrate on stimuli and cannot maintain a happy state. Similarly, hyperactivity disorders can be linked to a lack of control, in which a child cannot shut out stimuli and concentrate on individual tasks, he added.
In addition, Wolke noted that being the parent of a persistent crier can be quite difficult, and infants can need a lot of extra attention. If the infant cries for much of its early months, parents may begin to treat the baby differently, perhaps inducing the infant to eventually adopt difficult behaviors.
"Families with infants who persist in their excessive crying beyond 3 months of age may require additional support in the form of individually structured behavioral programs that include very strict routines for the infant to provide behavioral control the infants find difficult to find within themselves," Wolke recommended.
SOURCE: Pediatrics 2002;109:1054-1060.

Mental Illness a Growing Burden for Young Germans
(Reuters Health) - A leading German health insurer has called for mental health issues to be given greater priority after recording a 51% increase in sick days due to such problems over 4 years. Eckard Schupeta, deputy chairman of the German Employees' Health Insurer (DAK) board, said that the rise in mental health problems experienced by young people is of particular concern.
At a press conference in Hamburg on Tuesday 4 June to release the company's annual health report, Schupeta said that there was a huge increase in mental illness among people between 15 and 29 years old.
"The analyses show that the cases of illness, as well as the days taken off sick, have continually risen since 1997. The frequency of cases in young people has experienced an over-proportional and alarming growth of between 70% and 90%," he said.
"More and more young people are obviously reacting to the demands in their professional and private lives by developing psychological problems," Chupeta said. "Improvements in the care for people with psychological illnesses must be given higher priority in future health policies."
The report notes that depression is the most common form of mental illness to cause workers to take sick days, accounting for about 75% of all psychological-related time off work, with women taking nearly twice as much time off for depression as men.
To compare the impact of various mental illnesses on different sectors of the population, the insurer calculated the number of days taken off sick per 100 people in each year.
Each year, 42.3 workdays per 100 women were taken off sick due to depression, compared with 23.5 sick days per 100 men per year, the report found.
So-called neurotic illnesses also play a big role, according to the report. These include panic attacks, compulsive behaviours, reactions to stress and psychosomatic problems.
The most common of the neurotic illnesses were stress reactions, accounting for 21.3 sick days per 100 women and 11.7 per 100 men each year. Psychosomatic problems accounted for 12.9 days for women and 7.1 days for men, followed by panic-related disorders at 8.4 days for women and 4.5 days for men.
A sharp increase can be seen in the sick days due to eating disorders, with the average combined time taken off by 100 women reaching 2.6 days in 2001 compared with 1.6 days the year before. Although the figures for men's eating disorders were negligible, a slight increase was also observed, the report states.
The DAK is Germany's second-largest health insurer, covering 7.3 million people, 3.1 million of whom are of working age.

Opportunity May Be Key to 'Gateway Drug' Effect
(Reuters Health) - Researchers have long speculated about whether using so-called "soft" drugs like marijuana will lead to the use of "harder," more physically addictive drugs, such as cocaine and heroin. Now, new research suggests a reason why this progression in drug use might occur: opportunity.
Based on a survey of US households, Dr. James C. Anthony and a colleague from Johns Hopkins University in Baltimore, Maryland, determined that tobacco and alcohol users are more likely to encounter opportunities to try illegal drugs like marijuana. Furthermore, once faced with the opportunity, users of tobacco and alcohol are more likely to accept marijuana.
And, the investigators found, people who had used marijuana were more likely to have opportunities to use cocaine. Among those given the opportunity to use cocaine, those who had used marijuana in the past were more likely to accept the drug than those who had never smoked pot.
In an interview with Reuters Health, Anthony recommended that programs aimed at drug prevention take the factor of opportunity into account. Classroom-based initiatives tend to focus on resisting opportunities when they arise, a technique that doesn't target the entire problem, Anthony said.
"These resistance skills do not come into play until kids have the drug exposure opportunities," he noted. "No one 'just says no' unless the drug is offered to them."
Anthony and his co-author, Fernando A. Wagner, developed their findings based on surveys of 44,624 residents of US households between the ages of 12 and 25. The surveys were conducted annually from 1991 to 1994, and include questions about the first use of drugs, and what types of drug-taking opportunities were encountered.
The investigators determined that a crucial factor that enables tobacco or alcohol users to progress to marijuana, and pot smokers to take up cocaine, is "exposure opportunity."
"This exposure opportunity can occur because kids seek it out, or it can occur simply because kids are exposed without any effort at all--e.g., when they are walking down the street, or going to parties where others are using drugs, or sometimes their parents or caregivers offer the drugs," Anthony said.
Anthony emphasized that exposure is not solely due to alcohol or tobacco users seeking out other drugs, for even when the influence of drug-seeking is removed, users still progressed to more serious drugs.
This indicates that a certain amount of "active sharing" of drugs within peer groups is also promoting the stepping-stone progression of use, Anthony said.
He compared offering a peer cocaine to handing over a gun loaded with one bullet, and playing Russian roulette; the teen may get shot, or may develop a life-threatening dependency on cocaine. "The odds of getting badly hurt with cocaine are at least as bad as the odds of getting hit by the bullet," the researcher said.
"We don't stress the sharing of drugs in our prevention programs. We need to do so," he added.
To combat the problem, parents could try to steer children in early adolescence towards peer groups--such as church-related groups--in which they are less likely to encounter drug use later on, Anthony said. Also, programs aimed at drug prevention could encourage teens to not share their drug-taking habits with kids who have never become involved in drugs.
SOURCE: American Journal of Epidemiology 2002;155:918-925.

US Teen Birth Rate Drops for 10th Straight Year: CDC
(Reuters Health) - The birth rate among US teens has dropped to a new record low, according to a report from the Centers for Disease Control and Prevention (news - web sites) (CDC) released Thursday 6 June.
There has been a 26% drop in the teen birthrate since the early 1990s, including a 5% decline from 2000 to 2001.
"This is an important milestone in our fight against teen pregnancy," HHS Secretary Tommy G. Thompson said in a statement announcing the findings.
"The research shows us that when teens postpone parenthood, they improve their lives and the lives of their children," he added. "While we've seen remarkable progress, we must continue our efforts in local communities to reach teens with the message that everyone benefits when they wait until they are truly ready to start a family."
Overall, in 2000 there were roughly 49 births for every 1,000 women aged 15 to 19. One year later, the birthrate dropped to about 46 births per 1,000 teen females.
This decline was particularly sharp among 15- to 17-year olds, who reportedly experienced a 35% decrease in birth rate since 1991 and an 8% decrease between 2000 and 2001. In comparison, there was a 20% drop in births among 18- to 19-year-old women since the early 1990s and a 4% drop since 2000.
The decline in teen births was observed for women of all races, but especially among black women, who saw a 37% decrease in teen births since 1991 and an 8% decrease from 2000 to 2001. White teens experienced a 7% decrease since 2000 and Asian/Pacific Islander women showed a 5% decrease.
In other findings, there was a 2% drop between 2000 and 2001 in the percentage of births among women aged 20 to 24, and a slightly less than 1% increase in the percentage of women who reported receiving prenatal care during the early stages of their pregnancy.
"While we've made excellent progress in reducing teen births and in improving the number of expectant women who receive timely prenatal care, much work remains," CDC Acting Director Dr. David Fleming said in a statement. "Last year almost a half-million teens gave birth, and one of every four black and Hispanic mothers did not receive timely prenatal care."

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