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May 2006
Anti-AIDS drive still falling short
Twenty-five years after AIDS was first recognized, the world is still falling short in its battle against the disease with severe gaps in prevention and treatment, the United Nations said on Tuesday. "Despite some notable achievements, the response to the AIDS epidemic to date has been nowhere near adequate," said UNAIDS, the U.N. agency that coordinates the global campaign against the pandemic. Since U.S. doctors first described the disease in June 1981, AIDS and the HIV virus that causes it have spread relentlessly from a few widely scattered hot spots to virtually every country in the world, infecting 65 million people and killing 25 million, UNAIDS said in a 630-page report.
Researchers have produced "mountains of evidence" about how to prevent and treat this disease, said the report, based on data gathered from 126 countries since December 2005. But anti-AIDS initiatives and their results vary widely from country to country, and many are falling short of the benchmarks set in a landmark high-level U.N. General Assembly session in 2001, UNAIDS said. "Because this pandemic and its toll cannot be reversed in the short term, we need to sustain a full-scale response for the next decades," it said on the eve of a follow-up session opening on Wednesday in New York.
Dr. Peter Piot, executive director of UNAIDS, told a news conference he expected long-term commitments at this week's meeting, noting that spending on AIDS had reached its target for 2005 with expenditures of $8.3 billion compared to $1.6 billion in 2001. He said it was time to move beyond short-term crisis management and hoped for $20 billion annually by 2010. Among successes since the last special session, the report cited evidence that more people are using condoms, having fewer sex partners and starting sexual activity later in life.
PEAKED IN LATE 1990S
The global AIDS incidence rate is believed to have peaked in the late 1990s. About 1.3 million people in the developing world are now on life-extending antiretroviral medicines, which saved about 300,000 lives last year alone. Still, some 4.1 million people were newly infected and 2.8 million died in 2005. There were 4.9 million new infections and 3.1 million deaths in 2004.
Fewer than half of young people were knowledgeable about AIDS. Among those injecting illegal drugs or having homosexual sex, few received preventive services last year.
The global supply of condoms was less than 50 percent of what was needed, and antiretroviral drugs, while more widely available, remained costly and hard to get. Ignored in many countries are prostitutes, said Thoraya Obeid, the Saudi Arabian executive director of the U.N. Population Fund. She said they also had the right to prevention and treatment, especially since many were poor women or girls, sold into prostitution and victims of violence.
However, a final statement by governments at the conference this week is not expected to refer to prostitutes, drug users or homosexuals, due to objections from Islamic nations, some Catholic countries and the United States which fear that merely mentioning these groups would endorse their behavior. Infected individuals still suffer from ostracism and discrimination, while the vast majority of the world's 40 million infected people have never been tested for HIV and are unaware of their status, the report said.
While $8.9 billion is expected to be available in 2006 to combat AIDS in developing countries, $14.9 billion will be needed, UNAIDS said. By 2008, it predicted, $22.1 billion would be needed, including $11.4 billion for prevention plans alone.
The report called for more and better-targeted education and prevention strategies, more treatment opportunities, and more drug research, particularly on drugs for children, whose needs "have been largely left out of the research agenda."
Irwin Arieff
30 May 2006
Early deprivation has long-lasting effects: study
Severe malnourishment and other forms of deprivation for sustained periods during a child's early years may have lasting consequences on his or her intellectual development in later childhood, results of a new study show.
Children who experienced such deprivation for more than 6 months after birth had lower IQ scores at age 11 years, despite their having been removed from the deprived environment for seven years or longer, reports a team of researchers from the UK and the USA. "There are long lasting effects from early deprivation on children's ability even though children have been adopted into caring, nurturing families," study co-author Dr. Celia M. Beckett, of King's College, in London, UK, told Reuters Health.
The findings are based on assessments of 131 Romanian children who lived in extremely deprived conditions in state institutions until the fall of the Ceausescu regime during the late 1980's, after which they were adopted into families living in the United Kingdom and Canada. These children, who were adopted before 6 months of age, between 6 and 24 months of age, or between 24 and 43 months, were compared with 50 children who were born in the UK and adopted there by 6 months of age.
Previously published studies on the Romanian children, who usually entered the institutions as young babies, showed that those adopted before 6 months old were cognitively similar to the UK children, while those adopted at later ages had lower IQ scores. Yet, most children adopted at later ages reportedly experienced intellectual "catch-up" by age 4 or 6. Beckett and her team investigated whether this catch-up was maintained at age 11. They found that children with the lowest IQ scores at age 6, those adopted at the oldest ages, exhibited even further "catch-up" between the ages of 6 and 11. "The children who have been affected the worse continue to make progress over time, catching up a little with those who had not been so badly affected," Beckett explained.
Still, they, as well as other children adopted at later ages, continued to exhibit significant intellectual impairment at 11 years old, Beckett and her co-authors report in the journal Child Development. "The window of opportunity for intellectual gains post-adoptions between 6 and 11 seems wider than appeared likely at 6, but there are clear limits, as shown by the relative persistence in cognitive impairment," they write. Such detrimental effects of institutional deprivation were evident only for children who lived in the institutions beyond 6 months of age, however. There was "no measurable effect" or consequences of institutional deprivation among those who lived in the institutions for shorter periods, the researchers note. In particular, those over 6 months old by the time they were adopted had IQ scores that were 15 points lower than children adopted at earlier ages. IQ scores were similar among children adopted at older ages, however, regardless of their age at adoption, up to 42 months.
According to Beckett, "more than six months in a very depriving environment is a risk factor for later development, but the risks are not increased when the deprivation lasts for more than 2 years."
In other findings, differences in the children's mental abilities at 11 years old, or changes in their cognitive abilities between 6 and 11 years old, were not associated with differences in their respective adoptive families, the researchers note. However, the adoptive families did appear to have an early effect on the children's cognition, as evidenced by the "massive catch-up" the children experienced within two years after their adoption, the report indicates.
"The implications are that adopting families need to be aware that the effects of early deprivation on later outcomes are persistent and this is especially so if the child has lived in an institution for more than six months," Beckett told Reuters Health. "Secondly, the adopted children will continue to benefit from a nurturing environment and continue to make progress and modest catch-up long after placement."
Further, she added, "teachers need to be aware of the long term effect of early deprivation and the implications for children's educational needs.
Source: Child Development
Charnicia E. Huggins
29 May 2006
Certain foster children at greatest health risk
Foster children are known to have a much higher-than-average rate of chronic health problems, but new research suggests that the youngest children are among those at greatest risk. Using data from a national study of 727 U.S. foster children, researchers found that children younger than 2 and those placed in relatively small households were particularly likely to have chronic medical conditions such as asthma, allergies or repeat ear infections.
On the other hand, Hispanic caregivers reported fewer child health problems compared with foster parents of other ethnicities. The reasons for these associations are not completely clear, but the findings offer some direction as to which foster children have the greatest healthcare needs, according to Dr. Sandra H. Jee of the University of Rochester School of Medicine and Dentistry in Rochester, New York. In an interview, Jee explained that foster children younger than 2 may have more health problems due to factors such as preterm birth and prenatal exposure to drugs or alcohol. The finding on small family size, according to Jee, likely reflects the fact that children with greater health needs may be intentionally placed in smaller households. In general, Jee said, most foster children are probably coming into the system already suffering from various physical and mental health problems. She and her colleagues report their findings in the Journal of Health Care for the Poor and Underserved.
Studies on the state and local level have estimated that anywhere from 44 percent to 82 percent of U.S. children in foster care have a chronic health problem. Along with physical illnesses like asthma and allergies, many children also have mental health conditions such as depression, anxiety and behavioral disorders. "Ideally," Jee said, "we would like all primary care providers to understand that all kids in foster care should get special attention." But, she added, her team's findings point to certain children who may be especially vulnerable to health problems. Overall, 30 percent of the children in the study had at least one chronic medical condition, according to caregivers' reports. But among children younger than 2, the rate was 40 percent. Similarly, one-third of children in households with fewer than four people had a chronic health condition, versus 20 percent in larger families. On the other hand, Hispanic children were less likely to have a health problem than either white or black children, and Hispanic caregivers were least likely to say their foster child had a medical condition. Jee said this is an "interesting" finding that deserves further study. It's possible, she speculated, that Hispanic families have strong social support that translates into better health for their foster children.
SOURCE: Journal of Health Care for the Poor and
Underserved, May 2006.
Amy Norton
26 May 2006
ADHD drugs take toll on minors
Accidental overdoses and side effects from attention-deficit (hyperactivity) disorder drugs send about 3,100 Americans -- 80 percent of them children -- to hospital emergency rooms annually, a federal survey has found. The U.S. Centers for Disease Control and Prevention said 60 percent of the overdoses were accidental and were preventable if parents had kept the stimulant drugs locked in cabinets and in child-resistant containers. Fourteen percent of patients had side effects including chest pain, high blood pressure and irregular heartbeats -- indicators of potentially serious cardiac problems. Dr. Adam L. Cohen, a CDC epidemiologist, said the study was done to gauge "adverse events" linked to the widely prescribed drugs, especially serious heart problems that have led to calls for the Food and Drug Administration to require its most serious "black-box" warnings on the stimulants.
The CDC's survey was reported in a letter from Dr. Cohen in today's New England Journal of Medicine, which included responses from doctors worried about the dangers of not treating attention-deficit (hyperactivity) disorder. "The numbers [of side effects] are puny compared to the numbers of stimulant prescriptions per year," said Dr. Tolga Taneli, a child and adolescent psychiatrist at University of Medicine and Dentistry of New Jersey in Newark. "I'm not alarmed." An estimated 3.3 million Americans who are 19 or younger and nearly 1.5 million ages 20 and older are taking ADHD medicines, making the incidence of emergency-room visits at less than 1 percent. The mostly male victims range in age from a one-month old infant to an octogenarian.
Popular ADHD therapies include Ritalin, Concerta and Adderall. Twenty-five deaths linked to ADHD drugs, 19 involving children, were reported to the FDA from 1999 through 2003. Fifty-four other cases of serious heart problems, including heart attacks and strokes, were also reported. Some of the patients had prior heart problems. In February, an FDA drug safety advisory panel voted 8-7 for a black-box warning. The next month, another FDA panel instead recommended data on cardiac and other risks go in a new "highlights" section the agency plans to add to the top of drug inserts. CDC researchers used data from the National Electronic Injury Surveillance System?Cooperative Adverse Drug Event Surveillance (NEISS?CADES) project for its analysis. NEISS-CADES is a public health surveillance system based on a review of clinical records from hospital emergency departments.
Nearly 1 in 5 patients was admitted to the hospital, 1 in 5 needed stomach pumping or treatment with medicines, and 1 in 7 had cardiac symptoms. Sixteen percent of the side effects involved interaction with another drug. Besides cardiac problems, common symptoms included abdominal pain, rashes and spasms, and pain or weakness in muscles, Dr. Cohen said. No patients died. In another letter in the journal, the heads of the American Psychiatric Association and the American Academy of Child and Adolescent Psychiatry wrote they are concerned a black-box warning would discourage use of ADHD drugs, raising patients' risks of academic failure, substance abuse and other problems.
Dr. Marsha Rappley, pediatrics professor at Michigan State University, and two other doctors on the advisory panels think the vote for a black box was premature. She said studies show the drugs raise blood pressure and pulse rates a bit, but that it's unknown whether that would harm children taking them for years and that cardiac risks may be higher for adults. Dr. Steven Nissen, cardiology chief at the Cleveland Clinic, who had pressed for a black-box warning at the FDA panel meeting, said ADHD drugs are powerful stimulants and inherently risky. Dr. Cohen said the CDC turned over the data to the FDA for use in its consideration of whether to change warning labels for ADHD therapies.
Joyce Howard Price
May 25, 2006
http://washingtontimes.com/national/20060525-123310-5356r.htm
New drug may hold promise for stutterers: trial
When Dr. Gerald Maguire was a child, he resolved every New Year's Eve to stop stuttering. The resolution usually lasted less than two hours. Now Maguire is helping investigate an experimental new drug that he believes could offer hope to the more than 3 million Americans who suffer from the speech disorder. The drug, pagoclone, is being developed by Indevus Pharmaceuticals Inc. Results of a 132-patient trial released on Wednesday showed that 55 percent of patients taking pagoclone showed a significant improvement in symptoms compared to 36 percent who took a placebo.
Shares of Lexington, Massachusetts-based Indevus rose as much as 10 percent on Wednesday on the news. Maguire, who is an associate professor of psychiatry at the University of California Irvine School of Medicine, said pagoclone, if approved, would be the first drug specifically designed to treat stuttering. Today, patients are either not treated, or are treated with drugs that are not approved for the disorder such as the benzodiazepine class of anti-anxiety drugs or antipsychotics such as Zyprexa and Risperdal. Maguire believes pagoclone may help stutterers without causing the kind of dependence linked to benzodiazepines or the weight gain often associated with the newer antipsychotics. Pagoclone is designed to heighten activity of the brain chemical GABA, which is thought in turn to block the chemical dopamine. Dopamine, which is responsible for motion and movement, is often too high in people who stutter, Maguire said. "Stuttering is a neurological disorder that has psychological consequences," he said.
For four years, Maguire did not talk on the phone, as his anxiety overwhelmed his ability to speak. He said the antipsychotic Zyprexa helps. The disorder, which affects about 1 percent of the adult population, normally begins in childhood. About half of children who develop it grow out of it. That could be because an area of the brain called the striatum, which acts as the timer and initiator of speech, does not fully develop until later in life. Pagoclone is designed to enhance the functioning of the striatum, Maguire said. The drug, which was tested in patients for eight weeks, was not associated with any serious complications, Indevus said. Indevus said it will meet with the U.S. Food and Drug Administration to discuss the findings and plans for further development. By mid-afternoon trading, the company's shares were up 3.8 percent at $4.61 on Nasdaq.
Toni Clarke
24 May 2006
"Sleeper effect" of cigarettes can last for years
Trying just one cigarette may not be so harmless for non-smokers after all. Scientists have discovered that a single cigarette has a "sleeper effect" that can increase a person's vulnerability for three years or more to becoming a regular smoker. "We know that progression from experimenting with one cigarette to being a smoker can take several years," said Jennifer Fidler of University College London. "But for the first time we've shown that there may be a period of dormancy between trying cigarettes and becoming a regular smoker -- a 'sleeper effect' or vulnerability to nicotine addition," she added.
Fidler and her team analyzed the impact of smoking a single cigarette on more than 2,000 children aged between 11 and 16 over five years. Of the 260 children who by age 11 had tried one cigarette, 18 percent were regular smokers by the time they reached 14. But only seven percent of 11-year-olds who had never smoked had taken up the habit three years later. "The results also indicate that prior experimentation is a strong predictor of taking up smoking later," said Fidler, who reported the findings in the journal Tobacco Control on Thursday. The scientists are not sure why a single cigarette has such an impact but they said the exposure to nicotine could change pathways in the brain which could make children more vulnerable to stress or depression, which can make them more likely to try it again. The first cigarette could also remove fears about getting caught or how to smoke, which would have prevented them from taking up the habit. Jean King, of the charity Cancer Research UK, said the findings have important implications for anti-smoking campaigns. "Any research that helps unravel the processes involved in young people becoming addicted to nicotine is key to developing effective and targeted ways to prevent them from starting smoking in the first place," she said.
25 May 2006
Study: obesity rises faster in poor teens
Older American teenagers living in poverty have grown fatter at a higher rate than their peers, according to research that seems to underscore the unequal burden of obesity on the nation's poor. "Today the percentage of adolescents age 15-17 who are overweight is about 50 percent higher in poor as compared to non-poor families, a difference that has emerged recently," said Johns Hopkins' sociologist Richard Miech, the study's lead author. Obesity rates among all teens climbed substantially during the study, which covered 30 years. But the great divide according to income occurred most notably among the 15- to 17-year-old age group. That led one outside expert to challenge the findings. Rand Corp. economist Roland Sturm said it seems implausible that younger teens would differ so much from older teens. Even if they do, he said, "It seems a rather secondary issue compared to the general trend in weight gain across all youth." Miech argued that older teens generally have more autonomy to buy what they want and to determine their own activity levels, which he said might explain the results. And Sturm and other experts said the study's underlying message about obesity and poverty is sound.
The study appears in Wednesday's Journal of the American Medical Association. It is based on data from 10,800 youngsters ages 12 to 17 who participated in four nationally representative health surveys conducted from 1971 to 2004. The researchers determined poverty levels using family income and the U.S. Census Bureau's poverty threshold. In the early 1970s, about 4 percent of poor youngsters ages 15 to 17 were severely overweight, compared with about 5 percent of teens who weren't poor. By the early 2000s, those rates jumped to 23 percent of the poor and 14 percent of other kids, the researchers said. The results contrast with recent research suggesting that while the poor are most likely to be overweight, obesity rates among U.S. adults have climbed fastest in recent decades among those with annual salaries over $60,000.
Miech said both could be right because eating and exercise habits are different for adults and adolescents. Over the past decade, the percentage of calories from sweetened drinks has grown by more than 20 percent among kids in the 15-17 age group - an increase concentrated among the poor, he said. "We also find that physical inactivity increases with age in adolescence, as well as the probability of skipping breakfast," said Miech. "Both these factors are more likely to be found among the poor and are also associated with overweight."
Economic differences have been linked to other health problems too, including AIDS, cardiovascular disease and some cancers. The disproportionate rates emerge as wealthier people seek medical care and make lifestyle changes, while the poor do not, said Barry Popkin, a nutrition scientist at the University of North Carolina at Chapel Hill. The study shows that this trend "is emerging in late adolescence and just building into adulthood," Popkin said. The results also show the need for healthful resources in low-income neighborhoods, said Dr. Rebecca Unger, a Chicago pediatrician who works with a group seeking to lower obesity rates among Chicago children. Adam Drewnowski, a University of Washington researcher, said the disparity will persist unless the underlying problem, poverty, is also addressed. "The campaign against obesity and the struggle against poverty are, in fact, one and the same," he said. "...Healthier diets cost more," he said, and access to physical activity "depends on how much money you've got."
23 May 2006
http://www.azcentral.com/health/news/articles/0524obesity-CR.html
U.S. still has highest teen pregnancy rate despite a drop of 28% from 1990 to 2000
We can celebrate more than a decade of declining teen pregnancy rates right here in Cabarrus County as well as across North Carolina and the nation. May is Teen Pregnancy Prevention Month. In 1991, the Cabarrus County teen pregnancy rate was 100 pregnancies for every 1,000 females ages 15 to 19. By 2004, that rate had dropped to 60. During the same period, North Carolina's rate dropped from 101 in 1991 to 62.4 in 2004. Across the United States between 1990 and 2000, the teen pregnancy rate dropped by 28 percent. Despite the improvement, however, the United States continues to have the highest rates of adolescent pregnancy and birth in the industrialized world.
Building on the reduction in teen pregnancies the nation has already achieved, the National Campaign to Prevent Teen Pregnancy now challenges the United States to reduce the teen pregnancy rate by another one-third by 2015. What will it take to meet that new goal?
The national campaign has developed the following "must do's" to further reduce teen pregnancies:
1. Recognize the problem isn't solved. Community efforts must continue. Success in further reducing in teen pregnancy rates will require work and support from across the community, including schools, churches, health professionals and parents.
2. Parents must do more to help. Teens consistently say parents have the most influence on their decisions about sex, but parents don't believe it and don't use that power. Parents also need help. Nine in 10 parents believe they should talk to their kids about sex but don't know what to say, how to say it or when to start.
Here are 10 tips for parents:
- Be clear about your own sexual values and attitudes.
- Talk with your children early and often about sex, and be specific.
- Supervise and monitor your children and adolescents.
- Know your children's friends and their families.
- Discourage early, frequent and steady dating.
- Take a strong stand against your daughter dating a boy significantly older than she is or your son dating a much younger girl.
- Help your teenagers to have options for the future that are more attractive than early pregnancy and parenthood.
- Let your kids know that you highly value education.
- Know what your kids are listening to, watching and reading.
- Strive for a relationship that is warm in tone, firm in discipline and rich in communication and that emphasizes mutual trust and respect.
3. Stop fighting about abstinence versus contraception. The best choice for school-age children and teens is to delay sexual activity. Because it is the best choice, it deserves the most attention and emphasis. But sexually active teens also need good health care to avoid pregnancy and sexually transmitted diseases. All teens need accurate information.
4. Intensify efforts in communities with especially high rates of teen pregnancy. For example, despite significant progress, Latinas have the highest teen birth rate in the United States, and teen pregnancies among Latinas have not declined as rapidly as other groups.
5. Make the connection between teen pregnancy and poverty. Declining teen pregnancy and birth rates have significantly improved overall child well-being across the U.S., including nearly half a million fewer children living in poverty (in 2002).
6. Teen pregnancy is not just a "girl" thing. The relatively recent focus on boys in teen pregnancy prevention is spotty and not supported by adequate research. We must do more; for example, efforts to make dads better fathers should focus more on their role in prevention.
7. Start early. A sharper focus on young teens is appropriate because a significant minority of teens is sexually active at a very early age, young teens are easier to "reach," and prevention tends to work better with this group.
8. Involve the powerful. Major, sustained change often requires that powerful people be engaged. Elected officials, corporate CEOs, press leaders, foundation heads, faith leaders, education officials and others need to get involved in preventing teen pregnancy -- or, if they are already engaged, to redouble their efforts.
9. Set a goal for progress. States and communities should set a specific numerical goal for reducing teen pregnancy within a specified time frame.
10. Stay on the cutting edge. On average, young people age 8 to 18 spend nearly four hours a day watching TV and videos, listening to music, using computers, playing video games, text-messaging and reading. Any effort to reach teens needs to recognize the challenge and opportunity presented by ever-changing technology.
Gina Goff
21 May 2006
Chips only twice a week for English school kids
Children will be served at least two portions of fruit or vegetables in school lunches and get deep-fried items such as chips no more than twice a week under nutrition standards published by the government on Friday. From September school meals in England must be free from low quality meat products, fizzy drinks, crisps, and chocolates. Also banned is the sale of junk food in school tuck shops and vending machines. Instead, high quality meat, chicken or oily fish must be offered on a regular basis. "This is a really ambitious program," Schools Minister Jim Knight told BBC radio. "It will take a long time to transform a whole culture around food and transform the health content of school meals, undoing decades of neglect."
The minimum nutrition standards come as part of a 220 million pound program announced March last year by then Education Secretary Ruth Kelly to improve school meals. Her pledge followed a public outcry over the quality of food served to schoolchildren led by television chef Jamie Oliver. The extra money is to cover the cost of better ingredients as well as training for school kitchen staff. But some fear too strict a ban on junk food may backfire. "If you start imposing something like this, children will either vote with their feet, go home or visit the local chip shop," Mick Brookes, general secretary of the National Association of Head Teachers told the BBC.
19 May 2006
Safe sex messages in schools failing: study
Better strategies are needed to prevent unwanted pregnancies, HIV and other sexually transmitted diseases because safe sex messages in schools are not changing risky behavior, researchers in Mexico said on Friday. They found that programs promoting the importance of using condoms or the benefits of abstinence improved students' knowledge but had little impact on the measures they took to protect themselves. "Our study adds to the growing body of evidence that current HIV prevention efforts based in schools do not alter sexual risk behavior," said Dilys Walker, of the National Institute of Public Health in Morelos, Mexico.
The researchers analyzed the effect of different HIV prevention programs on nearly 11,000 students in 40 public high schools in Mexico. In 15 schools the program promoted the use of a condom. Students in 15 other schools were told about condoms and emergency contraception and 10 schools, which acted as a control group, had the standard sex education course. All the pupils were questioned at the beginning of the program and four and 16 months later, to determine changes in their behavior.
The researchers found no long-term influence on the use of condoms or sexual behavior but students who received information about emergency contraception -- the morning-after pill -- reported increased use. They suggested combining the promotion of condoms and emergency contraception in the same program because it did not increase risky sexual behavior in the students. "Innovative approaches designed to decrease adolescent risk behavior are urgently needed," Walker said in the report in the British Medical Journal.
18 May 2006
Hurt teens often test positive for alcohol, drugs
Nearly 40 percent of teenagers treated for injuries at one hospital had traces of alcohol or illegal drugs in their blood, U.S. researchers reported on Wednesday. They said their finding, published in the Journal of Pediatric Surgery, suggested that it may be useful to screen young people treated for traumatic injuries for illegal substances. The team at the University of Michigan Health System studied 443 patients aged 14 to 17 who were admitted to the University of Michigan's hospital for treatment of a severe injury between 1999 and 2003. They found nearly 40 percent tested positive for something they should not have been using -- 29 percent of them for opiates such as opium or heroin, 11.2 percent for alcohol, and 20 percent for marijuana. "The two major preventable health issues facing adolescents are injuries that result in death or disability, and lifestyle choices that have long-term, adverse health consequences," said Dr. Peter Ehrlich, who led the study. "To help alter this risk-taking behavior, it is essential that drug testing and brief substance abuse intervention programs be included in the treatment of all injured adolescents," Ehrlich said in a statement.
Not every teen who was seen at the hospital was screened, so the researchers are not sure how representative their sample is. "To really make an impact on the care of these adolescents, drug screening cannot be performed selectively and irregularly," Ehrlich said. "Those who drink under the age of 19 are significantly more likely to report driving after drinking or getting into a car with someone who's been drinking -- and their odds of them being injured are two to three times greater than adults of legal drinking age," he said.
17 May 2006
Low fruit, vitamin C intake tied to asthma risk
People with symptomatic asthma eat less fruit and consume less vitamin C and manganese than people who don't have the disease, a new study shows. The findings suggest that "diet may be a potentially modifiable risk factor for the development of asthma," Dr. N.J. Wareham of the Medical Research Council in Cambridge, UK and colleagues write in the medical journal Thorax. Several antioxidant nutrients have been linked to reduced asthma risk, Wareham and his team note, but it is not clear whether each of these nutrients plays a role in reducing risk or if they instead represent an overall healthier lifestyle. To investigate, they compared the diets of 515 adults who had been diagnosed with asthma and 515 "controls" -- similar adults without the disease. All reported their food intake over a one-week period. One-third of the asthma patients reported having had no symptoms in the past 12 months.
Asthma patients ate an average of 132.1 grams of fruit daily, compared to 149.1 grams for healthy controls. Those who ate at least 46.3 grams of citrus daily had about half the risk of having asthma with symptoms compared to those who ate no citrus fruit at all. Lower intake of both vitamin C and manganese were tied to an increased risk of symptomatic asthma, while symptomatic asthma patients had significantly lower levels of plasma vitamin C than healthy controls.
The findings don't support the idea that overall healthy lifestyle plays a role in asthma risk, the researchers note, because both asthma patients and healthy controls consumed the same amounts of calories and fat and showed similar levels of physical activity, education, and likelihood of having smoked in the past.
what dietary factors contribute to reduced manganese consumption, they add. Controls did not eat more cereals and grains -- both of which are rich in manganese -- than asthma patients, although they did drink more tea, which is another key source of the antioxidant nutrient. The researchers conclude: "These findings may be of public health importance in understanding the apparent increase in the prevalence of asthma."
SOURCE: Thorax, May 2006.
16 May 2006
Work, motherhood a healthy combo for women – study
Juggling a career along with being a wife or partner and parent may help to keep women healthy, scientists said on Monday. After analyzing data from a study that tracked the health of Britons born in 1946, they found that women who had multiple roles were less likely than homemakers, single mothers or childless females to report poor health or to be obese in middle age. "Women who occupied multiple roles over the long term reported relatively good health at age 54," said Dr Anne McMunn, of University College London. "It looks like women are relatively healthy as a result of combining work and family life."
In the study published in the Journal of Epidemiology and Community Health, McMunn and her team analyzed self-reported health records of more than 2,000 women at the ages of 26 and 54 and their body mass index, a method of measuring obesity. Information on their marital status, work history and whether they had children was also included. The researchers found that women who had been homemakers most of their lives were most likely to report poor health, followed by single mothers and childless women.
Homemakers tended to gain weight more quickly and had the highest rate of obesity at 38 percent while women who were employees, wives and mothers had the lowest. McMunn said it has been known for some time that women who combine employment with motherhood and partnership have better health. But it was not clear whether they were working and having children because they were healthy, or whether they were healthy because they were combining the two. "This study is the first to show which way that direction runs," she added. "There may be potential long-term health benefits of being able to participate in all areas of society."
Source: Journal of Epidemiology and Community Health
The autistic brain never “rests”
The typical brain activity that occurs when most people are resting or daydreaming is impaired or absent in individuals with autism, new research suggests. The activity in this so-called "resting network" normally aids in the processing of emotional and social cues, "the very things that are abnormal in autism," lead investigator Daniel P. Kennedy noted in comments to Reuters Health. The resting network is known to be highly active when an individual is at rest.
When someone is asked to perform a mentally demanding task that is not of a social or emotional nature -- like a math problem -- the resting network shuts down or is deactivated, "most likely reflecting a reduction in these unconstrained resting thoughts," explained Kennedy, a graduate student in the neuroscience PhD program at the University of California at San Diego in La Jolla.
Kennedy, along with Elizabeth Redcay, a UCSD graduate student in psychology, and Eric Courchesne, also at UCSD, report their findings in the Proceedings of the National Academy of Sciences, Early Edition. Through brain imaging, Kennedy and his colleagues saw that the resting network of the autistic brain does not deactivate, likely because this high resting activity is not there during rest. "We think that this finding makes sense in terms of understanding the social and emotional aspects of the disorder," Kennedy said. "We found that a network of brain regions important for social and emotional processing is abnormal in a disorder of social and emotional processing," he said. The scientists also observed that the more abnormal the resting brain activity in the medial prefrontal cortex appeared, the more socially impaired the autistic subject was. Therefore, "it does seem that there is a clear relationship between this resting network and social impairment in autism," Kennedy said.
SOURCE: PNAS Early Edition, May 2006.
Megan Rauscher
12 May 2006
Drugs a factor in many sexual assaults, study says
Drug use, willful or unwitting, is a factor in many sexual assaults and significantly increases a woman's risk of unwanted sexual contact, according to a study released on Thursday. The study by researchers at the University of Illinois at Chicago found that drugs were involved in 62 percent of reported sexual assaults included in the study, and that in most cases the victims had taken the drugs voluntarily. Five percent of the victims were given so-called "date-rape" drugs such as Rohypnol, a tranquilizer 10 times more potent than Valium, the study said.
Adam Negrusz, lead author of the study, said drug use raises the risk of sexual assault, whether or not alcohol has been used. "In some cases the substances are taken voluntarily by the victims, impairing their ability to make decisions," Negrusz said. "In other cases the substances are given to the victims without their knowledge, which may decrease their ability to identify a dangerous situation or to resist the perpetrator," he said in a statement. In about 80 percent of sexual assault cases, the victim knows the assailant, he said. Negrusz said that in the study drug-facilitated sexual assault was more often due to the subject's own drug use, rather than surreptitious drugging by the perpetrator.
The study, funded by the U.S. National Institute of Justice, an agency of the Justice Department, was based on information collected from 144 victims of sexual assault who sought help in clinics in California, Minnesota, Texas and Washington state. Each clinic collected urine and hair samples from the women ranging in age from 18 to 56 who were also asked to describe the assault and any drugs they were using. They represented black, white and Hispanic ethnic backgrounds. "The urine and hair specimens were analyzed for about 45 drugs that have either been detected in sexual assault victims or whose pharmacology could be exploited for drug-facilitated sexual assaults," Negrusz said. Nearly 62 percent of the women had at least one of the 45 drugs in their system, the study said. Among those who voluntarily used a drug, 35 percent were likely to have been impaired at the time of the sexual assault, according to the research. "It also demonstrated that sexual assault complainants severely underreport their illegal drug usage," he said. "This could be corrected if the administering nursing staff was better educated on taking a truthful drug history."
JoAnne Allen
12 May 2006
Affairs of the heart matter to boys, too, sociologists find
Teenage boys have feelings, too, and when it comes to matters of the heart, they may not be so fleeting after all. Not far beneath the bravado often on display is an unsure adolescent who finds it hard to express emotions that, while new, are nonetheless often sincerely felt. Boys are more vulnerable and emotionally engaged in romantic relationships than previously thought, according to the Toledo Adolescent Relationships Study led by Drs. Peggy Giordano, Monica Longmore and Wendy Manning of Bowling Green State University (BGSU).
Also contrary to traditional belief, girls in the study, on average, scored higher than their male romantic partners in terms of decision-making power. The sociologists' findings appear in the April issue of American Sociological Review, the flagship journal of the American Sociological Association. "These early relationships matter for boys, as well as for girls, and even though they may not last forever, the young people are taking important lessons from them about how to conduct social relationships, and about themselves and their emerging identities," said Giordano, a Distinguished Research Professor of sociology at BGSU. "They (teen romantic relationships) really have important socializing influences," added Longmore, a professor of sociology.
Early dating experiences have been a relatively neglected subject of study, according to the BGSU researchers. That's due to assumptions that such relationships are short-lived and shallow, and therefore not very influential, Giordano explained. The focus has been almost exclusively on sexual behavior rather than on the relationship itself, she said. More is known about adolescent influences from parents and peers, with whom romantic partners are often lumped, Longmore noted. But the study, supported by funding from the National Institute of Child Health and Human Development, has sought to change that. Considering that about 80 percent of teenagers have had a romantic relationship by age 18, what it means to them should be of interest, Giordano said.
For the study, 1,316 junior high and high school students from seven Lucas County, Ohio, school districts were interviewed, primarily in their homes. The students recorded their responses on laptop computers. In-depth "relationship history" narratives were also elicited from 100 of the teens (51 girls and 49 boys). Giordano said that in general, the boys revealed a self-portrait far removed from the confident, dominant image seen in the existing research literature. They reported significantly lower levels of confidence, as well as greater "communication awkwardness," in their romantic relationships. Girls may be better prepared for those relationships because of more experience with intimate communication with friends. However, boys as well as girls reported feelings of heightened emotions toward their current or most recent romantic partner--contrary to the notion that boys are only looking to "score" and are not emotionally invested in the relationship.
Boys in the Toledo sample also perceived being influenced more by girls than vice versa and, while most participants from both sexes indicated they shared equal decision-making power in their relationships, the tilt was toward the girls when power was thought to be unequal. These findings go against not only prior research but also against the common belief that men routinely exert more power and influence than women, the BGSU sociologists pointed out. "If, in marriages, men are more powerful, there must be some point where there's a switch," said Manning, a professor of sociology and director of the University's Center for Family and Demographic Research, with which Giordano and Longmore are also affiliated.
It is interesting to consider how aspects of adolescent relationships might influence boys' and girls' relationships as adults, Manning said. Intriguing new research possibilities present themselves as adolescents enter the workforce and get married, Giordano added, calling her colleagues' and her data "a rich reservoir of information about their early histories." "What we're trying to argue in our research is that romantic relationships do play a role in development," she said. "While parents and friends continue to be critically important, the romantic partner also matters in multiple respects," she noted, saying the relationship "can be a life-affirming, identity-enhancing element of one's development."
American Sociological Association
May 11 2006
http://www.emaxhealth.com/22/5840.html
Young adults happier than adolescents
Although young adults are faced with a diversity of life choices, they seem to be coming to terms with themselves and their lives in their 20s, says new University of Alberta research that shows psychological well-being improves after adolescence and girls improve faster than boys. Dr. Nancy Galambos from the Department of Psychology followed a sample of the same cohort of people over a seven-year period and looked specifically at how 18-25 year olds make the transition from adolescence to adulthood. Few studies have tracked changes in psychological well-being in this age group. "I see these results as good news," said Galambos. "We can expect the average 18-year-old to show improved mental health over the course of the next seven years. I think it is important to note, though, that these are average trends, and we cannot ignore the fact that some mental health problems first appear in the early 20s and rates of clinical depression are quite high in this age group. So a certain proportion of young people will not do well during this period."
Another interesting finding was that improved psychological well-being reduced the gender differences first appearing in adolescence. As expected, women showed significantly higher levels of depressive symptoms and lower levels of self-esteem at age 18 than men, but on both indicators women improved at a faster rate than did men by age 25, bringing the two genders closer together. "The fact that girls improved faster than boys--or young women improved faster than young men--was a complete surprise," said Galambos. "I really did not know that this would happen."
The research team, also made up of the U of A's Dr. Harvey Krahn and Erin Barker, a PhD student at the time, looked at the effect that different backgrounds had on psychological well-being. They found that although parent education was unrelated to depressive symptoms and expressed anger at age 18, depression and anger decreased fastest among emerging adults with two university-educated parents. "Emerging adulthood is a period during which many young people are learning to do what they are supposed to do to reach maturity--they are learning to cope with challenges in an effective manner and to handle their emotions in a healthy way," said Galambos. "Of course, they can get thrown off by life's losses, such as unemployment or loss of friendships, but their development can also be enhanced by life's gains, such as getting married or establishing new friendships."
This research appears in the current issue of the journal, Developmental Psychology.
http://www.eurekalert.org/pub_releases/2006-05/uoa-yah051006.php
Women attracted to men who like children: study
Women can pick up cues about how men feel about children from their faces and use the subtle signs to rate them as potential partners, scientists said on Wednesday. The team of researchers from the United States showed that an affinity for children and male hormone levels play a role in determining how attractive men are to women. "Our data suggest that men's interest in children predicts their long-term mate attractiveness even after we account for how physically attractive the women rated the men," said James Roney of the University of California, Santa Barbara.
In the study of nearly 70 men and women, an interest in children was linked to long-term partnership potential while women were attracted to men with higher testosterone levels as short-term romantic mates. "The study provides the first direct evidence that women's attractiveness judgments specifically track both men's affinity for children and men's hormone concentrations," said Dario Maestripieri of the University of Chicago, and a co-author of the study. The scientists tested the testosterone levels of 39 male undergraduate students from saliva samples. They also determined their affinity for children by asking them to choose between photos of an adult or a baby and to rate their interest. The researchers photographed the men and showed the photos to 29 female students who were asked to rate the men on whether they thought they liked children, their masculinity, physical attractiveness and potential as short and long-term partners. The findings, published online by the journal Proceedings of the Royal Society B: Biological Sciences, showed the women were able to choose the men who had expressed an interest in children during the photo test. They also described men who had high testosterone levels as being masculine.
10 May 2006
Pediatricians fail to screen for autism, Hopkins study finds
Few Maryland and Delaware primary care pediatricians screen patients regularly for autism and autism-spectrum disorders (ASD) as part of their overall look at possible developmental delays, according to results of a joint study from Johns Hopkins Children's Center and the Johns Hopkins Bloomberg School of Public Health. Of the 255 pediatricians who participated in the study, 209 (82 percent) said they regularly screen their patients for general developmental delays, but only 20 of the 255 (8 percent) said they do so for ASD. Of those who do not screen routinely for ASD, almost two-thirds (62 percent) said they failed to do so because they weren't familiar with the screening tools. "Lack of familiarity with ASD screening tools appears to be the single greatest barrier to routine screening," said Susan dosReis, Ph.D., of the Children's Center Division of Child and Adolescent Psychiatry and lead author of the paper, which appears in a May 11 supplement of the April issue of the Journal of Developmental and Behavioral Pediatrics.
The findings suggest that screening for ASD remains largely opportunistic rather than systematic, researchers say. Screening is essential, as delay in diagnosis and treatment generally leads to poorer outcomes in children with developmental disorders. "This study suggests that current national efforts may not be sufficient to actively promote the use of ASD screening tools in the general pediatric practice," dosReis added. "So it is important to learn what some obstacles might be and what needs to be done to overcome those barriers." Previous research suggests that another factor might be that many pediatricians do not feel well-trained in general developmental and behavioral issues, researchers say. Enhancement of residency training, complemented by introduction and training in ASD screening tools, might boost ASD screening in the general pediatric practice, dosReis added.
Almost half (47 percent) of the physicians who did not screen routinely said they preferred to send the child to a clinical specialist, whereas nearly one-third (32 percent) cited lack of time as a major reason for not screening. Of those who reported screening regularly for ASD, 90 percent said they were usually prompted to do so by parental concern and/or suspicion of ASD during routine examination. Of the 18 percent who reported not screening routinely for any developmental delays, 73 percent cited lack of time as their top reason.
The prevalence of autism, estimated to be between 12 and 40 cases per 10,000 children, has grown over the last decade. The reasons behind the higher prevalence have flamed an ongoing debate. Some researchers attribute the increase to an actual jump in the incidence of the disorder, while others claim it is because of more aggressive screening and new diagnostic criteria, which leads to a higher number of new diagnoses. In the Hopkins study, 99 percent of the pediatricians who believed there is an increase in ASD prevalence attributed it, at least in part, to new diagnostic criteria. At the same time, 38 percent said that underlying risk factors, other than new diagnostic guidelines, have played a role. Of these, one-third believed that environmental factors played a role, while only 7 percent attributed the increase to genetic factors, and 1 percent attributed it to vaccinations. Researchers caution that the findings cannot be generalized beyond Maryland and Delaware because screening practices might vary by geographic area.
Oral and anal sex increasing among teens
During the past decade, there has been a significant increase in the proportion of teenagers and young adults engaging in oral sex and, less commonly, having anal intercourse, according to data from STD clinics in Baltimore, Maryland. The finding is not all that surprising, Dr. Emily Erbelding from Johns Hopkins Bayview Medical Center in Baltimore told Reuters Health. She explained that "a few national surveys conducted recently have suggested that oral sex may be a behavior that teenagers are increasingly participating in. For example, in the 2002 National Survey of Family Growth, most teenagers reported having oral sex and many had not had intercourse."
She presented the current study findings Tuesday in Jacksonville, Florida at the 2006 National STD Prevention Conference sponsored by the Centers for Disease Control and Prevention. In examining the 1994 medical records of 2,598 12- to 25-year olds, and the 2004 medical records of 6,438 subjects of the same age, attending STD clinics in Baltimore, Erbelding and colleagues found that over the 10-year period the prevalence of self-reported oral sex in the previous 90 days doubled among males (from 16 percent to 32 percent) and more than doubled among females (from 14 percent to 38 percent). There was also an increase in rectal sex among young women, "but it was a lot less common than oral sex," Erbelding said. Among young women, the prevalence of self-reported anal sex over the period rose from 3 percent to 5.5 percent.
There may be a general feeling out there that oral sex is safer than intercourse, Erbelding said, and it probably is for some diseases. However, Erbelding emphasized that oral and anal sex may result in the transmission of STDs that will not be detected in urine tests. "A urine test is not going to pick up gonorrhea or Chlamydia that might have been acquired through rectal or oral sex, with gonorrhea being the more significant infection for oral sex." Therefore, "clinicians need to routinely ask their adolescent and young adult patients about the full range of sexual behaviors and educate young people in general about what the relative risks are for different types of STDs for various sexual behaviors," Erbelding said.
Megan Rauscher
9 May 2006
Kids' incontinence may affect psyche, behavior
Children who have soiling problems are more likely than their peers to have a range of behavioral and emotional difficulties, new research shows. In a study of more than 8,200 British children ages 7 and 8, researchers found that those with fecal incontinence were more likely to have attention-deficit hyperactivity disorder, anxiety, obsessive-compulsive behavior and conduct problems like oppositional-defiant disorder. They were also more likely than their peers to either be victims of bullying or be bullies themselves.
The findings, published in the journal Pediatrics, show that children with soiling problems often have psychological difficulties. It's not clear, though, which problems come first, according to the study authors, led by Dr. Carol Joinson of the University of Bristol. In general, fecal incontinence in older children is often related to constipation. Still, Joinson and her colleagues write, it's likely that a complex mix of dietary, genetic, biological and psychological factors also come into play. The bottom line for parents, Joinson told Reuters Health, is that they should seek help for their children's incontinence early on. "Although soiling is a common childhood problem causing a great deal of distress to children and their families, little publicity is given to the problem," she said. As a result, Joinson added, many parents are unaware that soiling is a problem they should bring to their pediatrician's attention.
The study included 8,242 7- and 8-year-olds who were part of a larger project on child health and development. The children were interviewed about their behavior, friends, self-esteem and bullying, and their parents completed questionnaires on a range of childhood behavioral and emotional problems. Based on parents' reports, about 1 percent of the children soiled themselves once a week or more, while another 5 percent did so less frequently. Children in both of these groups also had more behavioral and emotional symptoms, but those who soiled frequently were particularly at risk. About 20 percent of the children with frequent incontinence had some developmental delay, compared with only 7 percent of kids with milder soiling problems and 3 percent of those without incontinence. But even with this difference taken into account, soiling problems themselves were still associated with behavioral and emotional difficulties, the researchers report. Because constipation commonly underlies children's soiling, Joinson said, treating that problem can often ease any psychological difficulties a child has. The current findings, she noted, underscore the importance of tackling soiling problems sooner rather than later.
SOURCE: Pediatrics, May 2006.
Amy Norton
8 May 2006
Listeners are risking permanent damage by cranking up their favourite tunes
Pump down the volume
Children as young as six are complaining about hearing problems to the Australian Tinnitus Association, which says young people are listening to music at damaging volumes. One of the biggest risk factors for hearing loss is using ear buds to listen to music on portable digital music players. These deliver loud sound straight into the ear, says the manager of the association, Radha Naidoo. The association (www.tinnitus.asn.au) assists people who suffer ringing in the ears. Naidoo says there's been an increase in the number of calls to the association's helpline as a direct result of loud music habits. Up to 30 per cent of the Australian population experience tinnitus. "People as young as 18 have hearing loss you'd expect to find in 80-year-olds," she says. "Exposure to very loud noise is not the only cause of tinnitus, but it's the most common and it's one we can control."
The World Health Organisation recommends any prolonged noise exposure - at work, play or straight in the ears - not exceed 85 decibels. At 75 decibels hearing damage is negligible. Apple's iPod, the most popular portable digital music player, has a maximum volume between 115 and 130 decibels, according to reports, higher than any other MP3 player. Naidoo says noise of 115 decibels compares to a gun shot (120) and a jet plane taking off (130) and is louder than a noisy disco (105).
Tinnitus is a symptom of hearing problems and often coincides with hearing loss later in life, according to Sarah Platt-Hepworth, audiologist and co-founder of the Hearing and Balance Centre at St Vincent's Hospital, Sydney (www.hearingbalance.com.au). It may begin as an occasional muffled or swishing sound heard straight after a loud noise or after taking earphones off and may become constant with regular exposure.
British guitar legend Pete Townshend of the Who recently appealed to fans to turn down their earphones. He's lost some hearing as a result of loud music and is forced to take 36-hour rests between sound recordings to avoid further damage. "Hearing loss is a terrible thing because it cannot be repaired. If you use an iPod or anything like it, or your child uses one, you may be OK, but my intuition tells me there is terrible trouble ahead," Towshend says on his website.
Platt-Hepworth says people should have their hearing tested if they suspect problems. "As a society we don't encourage people to have a hearing test. Parents probably just say [to kids] to turn it down," she says. It takes only one minute of exposure to any noise at 115 decibels to cause damage to the ears.
| Infofile
At the web site www.tinnitus.asn.au you can
see how noise travels through the ear to reach the brain as well
as listen to the "ringing sounds" heard by people with tinnitus.
|
A study conducted in Australia by the National Acoustics Laboratory (www.nal.gov.au) last year recommended users lower their player volume, saying every three-decibel decrease halves the risk of hearing damage.
In March, Apple released a software patch (www.apple.com.au/sound) for the iPod nano and video models. It allows users to set a limit on the device's volume control, so they won't be tempted to turn up their favourite tunes past this self-imposed restraint. The move followed a lawsuit filed by an iPod owner against Apple in California in January that claims the device causes hearing loss in users. Apple Australia spokesman John Marx denies the software release is a defensive move by the company. It recommends safe listening and provides tips on how to do so on the same web page it offers the sound-limit patch. Marx would not confirm the iPods' maximum volume level.
The market research firm GfK estimates Australians bought 1.9 million digital music players last year, making a total of 2.7 million since 2003. iPods account for the bulk of sales, but the patch only applies to Apple's nano and latest video models. A spokeswoman for Creative Labs (www.au.creative.com) says its Zen MP3 players do not exceed safe volume levels. The new Zen Vision:M plays music at a maximum 97 decibels. "We have not had any problems or complaints," she says.
Lia Timson
6 May 2006
http://www.theage.com.au/news/technology/pump-down-the-volume/2006/05/03/1146335804706.html
Eleven seen as a key age for obese children
Children who are overweight or obese by the age of 11 are likely to carry their excess weight into adulthood and to suffer from related health problems, researchers said on Friday. A study by scientists at University College London who tracked nearly 6,000 children in Britain over five years showed about a quarter had a weight problem when they entered secondary school. "Children who joined the study at age 11 and were already plump did not slim down at all over the five years of follow-up," said team head Professor Jane Wardle. The research, published online by the British Medical Journal, suggests that by the age of 11 a tendency to be overweight or obese is already set. "It looked like obesity at 11 is already persistent obesity, so these things are being set earlier than we had previously thought," she told Reuters.
Although the findings related to British children, Wardle said there is no reason to suspect that the same phenomenon would not been seen in other countries. "I think of it as being part of the whole obesity epidemic. What is happening is that persistent obesity is starting earlier and earlier," she added. Health experts expect child obesity rates to soar in most parts of the world by the end of the decade. In Europe the number could reach 26 million, according to the International Obesity TaskForce (IOTF). Overweight children face an increased risk of type 2 diabetes, high blood pressure, raised cholesterol levels and cancer as they grow older.
Wardle and her team said 29 percent of girls were overweight or obese, which was more than in boys. It rose to 38 percent among black girls but fell to 20 percent for Asian females. There was little difference in weight in boys of different ethnic origins but 31 percent of students from a deprived socio-economic background had a weight problem, according to the research. Wardle said the gender and ethnic association with excess weight was significant and requires further research. Changes in diet, less exercise and too much time spent in front of television and computer screens have been blamed for the obesity rise. North America, Europe and parts of the Western Pacific have the highest prevalence of overweight children. Wardle said the findings of the study, which was funded by the charity Cancer Research UK, highlight the need for early intervention to prevent childhood and adult obesity. "I think society as a whole needs to take childhood obesity much more seriously," she added.
Patricia Reaney
4 May 2006
One of two available alcoholism drugs works: study
One of two drugs approved for use to curb alcoholics' cravings worked slightly better than specialized counseling, but a second drug on the market was no better than a placebo, according to a study of alcoholics released on Tuesday. Naltrexone, sold generically in daily pill form under the brand name ReVia by Barr Pharmaceuticals Inc., was effective, while acamprosate, marketed under the brand name Campral by Forest Laboratories Inc., was not. "We were surprised by two findings from our study. One was that acamprosate was no more effective than placebo alone and two, that while naltrexone was effective in its own right, combining it with the specialized counseling added no more effectiveness than naltrexone by itself," said study author Dr. Raymond Anton, of the Medical University of South Carolina in Charleston. "People have a choice ... to either take naltrexone ... or to see a specialized counselor who can counsel them around relapse prevention, reduction of cravings, (and) dealing with their alcohol addiction," he said.
Naltrexone works on opiate receptors while acamprosate effects a neurotransmitter. Both have Food and Drug Administration approval, and an injectable form of naltrexone made by Alkermes Inc. to be taken monthly will be marketed by Cephalon Inc.. The report, published in the Journal of the American Medical Association, estimated there are 8 million alcoholics in the United States. The 1,400 alcohol-dependent patients in the study who wanted to stop drinking were divided into groups and treated for 16 weeks. Some received drugs, some a placebo, and some no pills at all. In addition, most subjects were medically managed -- meaning they were encouraged to abstain from alcohol and take their medication. And some subjects underwent specialized behavioral therapy.
Relapses, involving the consumption of several drinks in a day, were evaluated for up to a year. Subjects who took naltrexone and received management had the highest percentage of days of abstinence. Those who underwent behavioral treatment accompanied by a placebo did almost as well. "This study and others have shown that people should be optimistic about treatment for their alcohol problems, that treatment does work," Anton said. An accompanying editorial questioned the study's finding that acamprosate was ineffective, noting previous European studies have shown the drug helps alcoholics abstain.
3 May 2006
Puppy fat a myth: pediatrician
PUPPY fat in children was a myth, a leading pediatrician said today. Overweight children were likely to face several social and medical problems later in life, Louise Bauer, professor of pediatrics and child health at the University of Sydney said. "I want to put to rest the myth of puppy fat," Prof Bauer told delegates in an opening address at the Queensland Obesity Summit. "The child will not necessarily grow out of it, in fact they are highly likely not to. "Overweight and obesity in children and young people is associated with very significant complications." Obesity was shaping up as the epidemic of the 21st century, she said.
Queensland Premier Peter Beattie today announced a survey of up to 7000 students at 90 public and private schools to provide a statewide picture of the health of children. Mr Beattie said students from years one, five and 10 would be asked to take part. He said clear, reliable evidence was required about what children did during a normal week, and the results of the survey would help the Government make decisions about the health of children. Mr Beattie, who recently shed 20kg, said his own weight loss was the hardest thing he had done, with keeping off the weight coming second. "Forget about winning elections, they are easy," he said. The Premier said his wife, Dr Heather Beattie, made sure his family ate healthily and their fridge at home was stacked with vegetables resembling a "rabbit convention".
Rosemary Desmond
May 3, 2006
http://www.theaustralian.news.com.au/story/0,20867,19011864-1702,00.html
Mom's troubles up child's risk of behavior problems
When a mother suffers from mental health problems and other difficulties during her child's first year of life, the child is more likely to have behavior problems later on, new research shows. And the more problems a mother faces, the greater the risk. "The child's brain is really shaped by the early environment, and mom is a big part of that, especially in the first year of life," Dr. Robert C. Whitaker of Mathematica Policy Research, Inc., in Princeton, New Jersey the study's lead author, told Reuters Health. This study provides "evidence of how early in life there's a transfer of difficulty from one generation to the next," Whitaker said, adding: "Early in a child's life is an opportune time to break that cycle."
While there have been many studies of maternal problems and child behavior, Whitaker and his team note in the Archives of General Psychiatry, most have looked at these problems in isolation; for example, depression only, or drug use only. But such problems frequently appear together, they add. Whitaker's team studied the prevalence and effects of a constellation of maternal difficulties (mental health, substance use, and domestic violence) in 2,756 mothers from 18 large US cities. The mothers were evaluated one year after delivery and three years later. The investigators found that half of the women reported problems in at least one of the three areas, and nearly one-third of these women had problems in at least one other area.
The more problems a mother reported in the initial survey, the more likely her child was to have behavior problems at age three, the researchers found. For example, 9 percent of children whose mothers reported no problems had symptoms of anxiety or depression. If a mother had a problem in one area, a child's risk of anxiety or depression was 14 percent; 16 percent with problems in two areas; and 27 percent with problems in all three areas. The pattern was similar for aggression and inattention.
The findings show that a child's first year of life represents a valuable opportunity to intervene to prevent future problems, but also underscore the importance of treating the family as a whole, Whitaker said. "To meet children's mental health needs and their social and emotional needs, we really need to meet the mental health needs of their parents, and we need to look at the child's whole family," he explained.
If a parent is having problems, Whitaker added, it's important to get help. "If they feel like they're suffering from difficulties in any of these areas-substance abuse, domestic violence, mental health -- as much as possible they should feel comfortable asking for help, even if it's from their child's health care provider, because addressing those problems as they have them is one of the most important things they can do for their children."
SOURCE: Archives of General Psychiatry, May
2006.
Anne Harding
2 May 2006
Parental smoking linked to depression and anxiety in children
Parents who smoke not only risk making themselves sick, they could be making their children depressed, anxious or aggressive. Cincinnati scientists who studied 225 children, ages five to 11, found those with the highest levels of exposure to tobacco smoke had more behaviour problems, such as fidgeting, acting out and not paying attention in school. There was a clear dose-response effect: The bigger the exposure, the bigger the problems.
However, children breathing in even low levels of cigarette smoke had behaviour issues. "With tobacco, we're not really seeing a threshold where there's no effect," said Kimberly Yolton, an assistant professor of pediatrics at Cincinnati Children's Medical Center, who presented her data Sunday at the annual meeting of the Pediatric Academic Societies in San Francisco. "We're seeing effects on these outcomes at levels that are very low." All the children had asthma, but Yolton suspects the results would apply to any child living in a smoky home. "Even when we controlled for the asthma symptoms and the severity of the children's asthma, we still found an effect. What we're saying is, all children should avoid exposure to tobacco smoke."
According to a 1999 study commissioned by Physicians for a Smoke-Free Canada, more than 1.6 million Canadian children under the age of 12 are regularly exposed to cigarette smoke in their homes. Second-hand smoke has already been linked with ear infections, croup, bronchitis, tonsillitis, and even cancers and leukemias in children. Now, "exposure to environmental tobacco smoke is increasingly recognized as a risk factor for child behaviour problems," Yolton said. Yolton last year published a study showing exposure to second-hand smoke affects a child's reading and math skills.
In the new study, the Cincinnati developmental psychologist and colleagues scoured hospital billings records, looking for children with asthma. "We then made a million and a half phone calls," screening the families to see which children were living in houses where they were exposed to at least five cigarettes a day (the average was 14 cigarettes per day. The researchers took blood and hair samples, measuring cotinine, a substance the body produces when it breaks down nicotine, to get an accurate measure of how much tobacco smoke the children were actually exposed to. They interviewed parents and also took reports from the children's teachers.
Sharon Kirkey
May 01, 2006
http://www.canada.com/vancouversun/news/story.html?id=1d70dacf-e897-42b8-9194-f843e641e8ed&k=46515
Small changes may stop kids' ballooning waistlines
NEW YORK (Reuters Health) - Consuming one less soda or candy bar and walking an extra 2,000 steps every day may help prevent excessive weight gain in children, researchers report. The findings, presented Sunday during the Pediatric Academic Societies Meeting in San Francisco, are "really good news for families" in light of the widely-reported obesity epidemic among children, said Dr. James O. Hill of the University of Colorado Health Sciences Center. "With some very small changes you can begin to push back against childhood obesity," he told Reuters Health.
Researchers have targeted physical inactivity and diets high in fats and sugar as potential factors contributing to the epidemic of childhood obesity, yet there remains a lack of child-appropriate and effective strategies to address children's ballooning waistlines. Hill and his team investigated the effectiveness of the America on the Move Foundation's, Families on the Move Program designed to prevent excess weight gain in children. A total of 216 families, all of which had at least one overweight child, aged 7 to 14 years, were assigned to the on-the-move program or to a comparison group.
The 111 families in the intervention group were instructed to make two lifestyle changes: increase their physical activity by walking an extra 2,000 steps per day, and eliminate 100 calories from their daily diet by using the sugar substitute, Splenda, or Splenda-containing beverages in place of regular sugar. The comparison group of 105 families were told to self-monitor their usual physical activity levels and diet. By the end of the six-month study, children in both groups had experienced decreases in their average body mass index -- a measure of weight that takes height into consideration. Yet, roughly two in three children who participated in the Families on the Move Program were able to maintain or lower their weight simply by reducing their calories by less than the equivalent of an eight-ounce soda, according to Hill, and by walking about a mile more than usual every day.
In contrast, nearly half of the children in the comparison group showed increases in their body mass index, study findings indicate. While the study participants were encouraged to use Splenda, similar results may be obtained among families who use "anything that reduces sugar or anything that reduces fat," Hill said, adding that adults who participated in the program "didn't gain weight either." Participation in the program "didn't prevent all of the excessive weight," Hill emphasized, and did not lead to "huge changes" in weight either. "We're talking about a small change that can have a small positive impact," he said, noting that, in many cases, drastic reductions in weight are usually not maintained anyway. "I think a small change approach is the only way we're going to get a handle on childhood obesity," Hill said. The study was funded by McNeil Nutritionals, LLC, the makers of Splenda, and by a grant from the National Institutes of Health. For more information about the national, non-profit America on the Move Foundation, which was co-founded by Hill, or about the Families on the Move Program, visit www.americaonthemove.org
Charnicia E. Huggins
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