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EXTRACTS FROM THE “OTHER” JOURNALS
RELATING TO CHILDREN, YOUTH AND FAMILIES —
IN THE FIELDS OF HEALTH,
SUBSTANCE ABUSE, EDUCATION, PSYCHOLOGY, SCIENCE ...
October 2006
Genetic 'breakthough' offers hope to schizophrenia victims
Scientists have discovered a variation in a gene in people at risk of schizophrenia that strongly suggests they will develop the condition. Brain scans of young people predisposed to schizophrenia show that those who go on to develop the symptoms of the disorder have the mutated gene. While this does not mean scientists have found a "gene for schizophrenia", it provides strong evidence of a key genetic link and brings them one step closer to finding a cure. Last night, the mental health charity Sane described the research as exciting, and referred to the possibility of a breakthrough.
The researchers, from the University of Edinburgh, made their discovery after following 163 young people at risk of developing schizophrenia from their late teens for 10 years. Schizophrenia has a strong inherited element, and all the participants in the project - known as the Edinburgh High Risk Study - had two or more relatives who had developed the condition. The researchers, who report their results in the journal Nature Neuroscience, found that there was a clear link between one particular variation of the neuregulin gene - which is involved in the development of the mind and the wiring of the brain - and the risk of developing psychotic symptoms. People with this genetic variation were almost three times as likely to develop the symptoms of schizophrenia - with 100% going on to develop them, compared with 40% of participants across the study - a result viewed as "highly statistically significant".
While it is known that neuregulin is associated with schizophrenia, the research, funded by the Medical Research Council and led by Eve Johnstone, professor of psychiatry at the University of Edinburgh, is the first to pinpoint the genetic variant responsible. Jeremy Hall, a psychiatry lecturer at the university, and the study's lead author, said: "We think this is a breakthrough." Prof Johnstone praised the "altruism and courage" of the participants - some of whom knew they might be developing the illness.
Sarah Hall
30 October 2006
http://www.guardian.co.uk/medicine/story/0,,1934839,00.html
Depression is less likely in children who are hip to what peers think of them -- good or bad.
Truth is, it's best if they know
Truth sometimes hurts. But for children closing in on adolescence, a firm grasp on the truth about one's standing with classmates and peers can be healthy, even when it does hurt a bit.
A new study has found that children who can accurately assess how much — or little — their peers like them are less likely to develop symptoms of depression, including sadness and difficulties concentrating or sleeping. By comparison, children with unrealistically rosy or unfoundedly gloomy views of their standing appear more likely to be headed toward depression.
Many psychologists have speculated that the smiling child who believes she is the glowing sun in her classmates' universe will be protected from depression by that belief. They also surmised that the child who holds a negative view of his status among peers is more prone to maladjustment and depression.
That picture, says Florida State University psychologist Janet Kistner, may be a bit too simple. She and fellow researchers found that the child who is not regarded well by peers — and knows it — is actually less likely to grow more depressed over time than the child who believes that classmates like him when, in fact, they don't. The kid who can see that he is not so well-liked may be better able to change his behavior to make friends, Kistner says. The kid who's clueless about her effect on classmates may grow frustrated and sad as she misses social cues and fumbles gestures of friendship. "Realistic perceptions," Kistner says, "are a hallmark of mental health."
The study is the latest in a welter of efforts to identify which children and adolescents may be at heightened risk for developing depression and mental illness.
Some politicians, public health officials, mental health activists and pharmaceutical companies have worked to establish mental-health screening programs in schools and the community. Those initiatives, including a model program designed at Columbia University called TeenScreen, aim to steer kids who are more likely to develop depression toward help before their emotional difficulties lead them to risky behaviors, academic failure or suicide attempts. In recent years, six states — Ohio, Florida, Pennsylvania, Nevada, Iowa and New Mexico — have moved to adopt programs that screen schoolchildren for warning signs of mental illness, including depression. Elsewhere, individual school districts have followed suit.
Those efforts have proven controversial. Many parents fear their children will be labeled as mentally ill and marked for special attention because they have expressed sentiments typical of adolescents. Others caution that there are few services and scant psychiatric help available for the millions of children that could be identified. And many suspect such screens are drug company-sponsored efforts to build the market for antidepressants.
Researchers and clinicians, meanwhile, say they are far from having developed accurate predictors of a child developing depression. The younger the child, the murkier the crystal ball.
Dr. Daniel Pine, chief of child and adolescent research at the National Institute of Mental Health's Mood and Anxiety Disorders Program, says that the strongest signs that a child may develop depression are a personal history of anxiety in early life; a parent with past or current depression; and a childhood pattern of low-level depressive symptoms (sadness, difficulties with eating, sleeping or concentrating, loss of energy or interest in once-enjoyed activities).
Beyond those signals, Pine says, disruptions in peer and social relationships often come with depression. But whether those ruptures are the cause of a depressive episode or the result — or a little of both — is not known. "There are a lot of unanswered questions," he says.
In the study, published in the latest issue of the Journal of Abnormal Child Psychology, Kistner and fellow researchers at FSU surveyed 667 children in third, fourth and fifth grades, of average age a little over 9 years. Several weeks into the school year, each was shown a photographic roster of the class and asked to rate how well he liked each classmate and how much he believed each classmate liked him. The researchers compared classmates' opinions of a child with his own assessment of their regard.
During the same session, researchers asked students questions to measure their depressive symptoms. They found that those most inaccurate about their classmates' opinions of them were most likely to show increased signs of depression six months later.
Children who were widely disliked and who knew it were likely to have started the year with strong signs of depressed feelings. But as the year went on, most of their depressive symptoms either stayed the same or got a little better, although the researchers did not formally measure that relationship. They rarely got worse.
Among children younger than 8, Kistner cautions, inflated views of classmates' affection are commonplace, and should not be misread by parents as unhealthy. But as children enter the "'tween years" of puberty, they normally become more acute in their self-assessments.
Acuity in reading social signals varies widely among adults, and psychologists have observed that some never get much better than they were as pre-adolescents. In contrast to Kistner's findings with children, researchers have long noted that depressed adults are, in fact, more accurate judges of how well they perform tasks in experimental settings, a phenomenon known as "depressive realism." "That's a really fascinating time, Kistner says — and potentially a moment when the course of a child's future mental health could be swayed. Both a child with an inflated sense of popularity and one with an overly dark view are probably sending and receiving faulty social signals, she says, and becoming frustrated that the world is not responding as the child expects. They may not be timing it right, they may be missing cues," she says — and some simple social skills counseling might help.
Source: Journal of Abnormal Child Psychology
Melissa Healy
30 October 2006
http://www.latimes.com/features/health/la-he-realists30oct30,0,141646.story?coll=la-home-health
Web health info seekers tend not to check sources
Only one-fourth of Americans who search the Internet for health advice regularly check the source and date of the information they find to assess its quality, according to a survey released on Sunday by the Pew Internet Project.
About 10 million American adults -- or 7 percent of U.S. Internet users -- searched for information on a health topic or medical problem on a typical day in August, the non-profit think-tank said. That ranks health searches at about the same level of popularity as paying bills online, reading blogs or using the Internet to find a phone number or address.
Common health topics searched on the Web include specific diseases or medical treatments, exercise, nutrition, prescription drugs and alternative medicines, Pew said.
Just 15 percent of those surveyed said they always checked the source and date of the health information found online, while another 10 percent said they did so most of the time. Three-quarters of those surveyed said they checked the source and date sometimes, hardly ever or never, Pew said.
Pew researcher Susannah Fox said one possible reason why Internet users do not tend to check sources or dates is because of the health Web sites themselves. Only 2 percent of popular health sites display that information on their pages, according to a study by the U.S. Department of Health and Human Services that is scheduled for release soon, Fox said.
Most Web users look for health information with a general search engine such as Google or Yahoo, the study found. "The question is whether consumers are doing the best that they can by going to general search engines, Fox said. Several new search engines that focus only on medical topics have become available, including Healthline.com, Medstory.com, Healia.com, Mammahealth.com, and Kosmix.com. It will be neat to see if they are able to change consumers' behavior in searching for information on the Web," Fox said.
29 October 2006
Kids' activity pyramid aims for an interesting mix
Fitness experts have given a familiar physical activity guide for kids a splashy new look and a new name. They're hoping that MyActivity Pyramid, redesigned to match the MyPyramid developed by the US Department of Agriculture to replace the old Food Guide Pyramid, will encourage kids to get the exercise they need and have fun doing it. "It's just a way to show kids rather than tell kids how they can get their activity," Steve Ball, an assistant professor of exercise physiology at the University of Missouri-Columbia Extension, told Reuters Health.
The exercise recommendations, targeted to children aged 6 to 11, haven't changed from older versions of the pyramid, he notes. But while the standard recommendation for children is for at least one hour of activity daily, Ball said, kids really need much more. "Most kids are still getting this kind of minimum 60 minutes, but obesity rates are going up."
MyActivity Pyramid is made up of four layers intended to reflect kids' natural inclination to be active in a variety of ways, he adds. "We don't really want to promote continuous vigorous exercise for kids, because that can almost turn them off to it," he explained. "As parents, as teachers and administrators at schools, we need to provide kids with multiple opportunities to be active."
Everyday activities like walking, helping with chores, and climbing stairs are recommended "as often as possible," and make up the pyramid's base.
Next are Active Aerobics and Recreational Activities, exercise that boosts the heart rate and raises a sweat, such as jumping rope, playing basketball or soccer, and swimming, recommended at least three to five times a week.
Flexibility and Strength activities, such as yoga, rope climbing, push-ups and pull-ups and stretching, make up the next layer and should be done at least two or three times a week. "Inactivity" is at the pyramid's tip, and consists of playing video games, watching TV, and playing on the computer, which kids are urged to "cut down."
Given the increased homework load many kids face and the need to use computers, Ball notes, limiting inactivity can be tough. "Usually the stat that I use is no more than two hours of screen time a day, but a lot of people would say that's impossible."
Anne Harding
25 October 2006
YOU CAN DOWNLOAD THE ACTIVITY PYRAMID
HERE
Teens may resist some effects of drinking
New animal research suggests that teenagers' brains may be better at adapting to certain short-term effects of drinking. But that's not a good thing, researchers say.
In experiments with rats, scientists found that adolescent rodents developed an "acute tolerance" to alcohol, quickly recovering from the immediate effects alcohol had on their social behavior, while their adult counterparts remained impaired for a longer stretch. For rats, social behavior essentially consists of sniffing and play fighting. In human terms, the animals' alcohol-induced impairment was akin to being unable to speak with your drinking buddies.
The teenage rodents, however, quickly regained their social skills. Thirty minutes after being given alcohol, their social behavior appeared normal; in contrast, the adult animals were still unable to interact normally, according to findings published in the journal Alcoholism: Clinical & Experimental Research. Though the findings come from animals, there may well be comparable differences between human teenagers and adults, according to lead study author Dr. Elena I. Varlinskaya of Binghamton University in Binghamton, New York. This is concerning, she told Reuters Health, because this acute tolerance to alcohol's effects on social behavior could allow teenagers to drink more. Whereas adults might stop drinking when they feel their social skills slipping away, teenagers may have no such deterrent. "Teenagers drink primarily to be more social," Varlinskaya noted. So if their brains are better able to "counteract" the negative effects drinking can have on socializing, they may feel free to binge.
Indeed, the researchers note in their report, the findings might help explain why so many teenagers not only drink, but drink heavily. One recent study found that nearly one third of U.S. high school seniors said they'd binged in the past two weeks. And although teenagers' brains might counteract some immediate effects of drinking, there's evidence from animal research that they may be more vulnerable to long-term brain damage from alcohol abuse, according to Varlinskaya. One recent study in rats found that binge-drinking damaged parts of the adolescent brain that were left unharmed in adults. Varlinskaya said more research is needed to see whether such effects hold true in humans.
SOURCE: Alcoholism: Clinical & Experimental Research, November 2006.
Amy Norton
25 October 2006
Early puberty problematic among UK children
The disparity between the increasingly early age at which boys and girls are reaching puberty and their ability to function socially as mature adults may be a key factor in many public health problems facing adolescents today, UK researchers propose.
Doing a better job of helping young people with this transition could help address problems ranging from teen pregnancy to substance abuse to bullying, Dr. Mark A. Bellis and colleagues from Liverpool John Moores University argue. "Responding to early puberty means moving away from societal attitudes that equate protecting children with regarding them as firmly ensconced in childhood long after their physical journey into adulthood has begun," Bellis and his team write in an editorial published in the Journal of Epidemiology and Community Health.
The age of puberty has fallen in much of the developed world over the past 150 years, thanks to better nutrition and health care, the researchers note. Other less positive factors that may be accelerating the process include higher body fat levels among children and increased stress in families from divorce and single-parenthood, they add.
But while parents and schools may prefer to ignore the fact of earlier puberty, Bellis and his colleagues state, the commercial world has not. "Magazines, television and radio are increasingly using sexual imagery for marketing and story lines aimed at younger people, while versions of adult make-up and fashion lines are now specifically developed for the pubescent," they write. The violence and risk-taking many computer games promote may further stir up confusion in adolescents, without giving them the tools to cope with it, they add.
Rather than dealing with the consequences of young people's "ill-informed, health-damaging behavior," the researchers suggest, a clearer understanding of how early puberty affects young people from an individual and public health perspective could provide ways to address risk factors before such behavior occurs. Treating adolescents like children, "however well intentioned, simply denies them the vital information they require to complete this transition without damaging their health," Bellis and his colleagues conclude.
SOURCE: Journal of Epidemiology and Community Health
24 October 2006
Strategies to fight youthful obesity
Scientists say the childhood obesity epidemic in this country has to be halted. If not, the health of millions of American young people will be jeopardized. Currently, one-third of U.S. children and teens — about 25 million kids — are overweight or obese, increasing their risk of developing diabetes, high cholesterol and other health problems. Weight-loss researchers presented dozens of studies on children during the weekend at the annual meeting of the Obesity Society.
To get kids off the couch, parents should invest in a portable stair stepper (costs $70-$110) for their children to use while watching their favorite shows, says James Levine, an endocrinologist at Mayo Clinic in Rochester, Minn., who has studied differences in how much kids and adults move during the day. "This is so simple. We're not talking about joining the gym or redesigning your home. We're talking about getting a stepper and replacing the chair with it." He bases his recommendation on a new study in which he and colleagues had 15 normal-weight and overweight children, ages 8 to 12, wear sensors that measured their posture and physical activity for 10 days. They found that the normal-weight kids stood and moved for an average of 368 minutes a day; heavy kids for 282 minutes. That's an 86-minute difference. "It's a significant difference," says lead researcher Lorraine Lanningham-Foster, a senior research fellow at Mayo. "It's quite staggering and reflective of what we see in adults," Levine says. Other work by these researchers shows that overweight people sit about 2½ hours more a day than normal-weight ones.
Some folks do a lot more puttering, pacing and standing than others. Animal studies suggest some may be "hard-wired" to be more active than others, Levine says. Levine believes this may apply to people too. Some seem to be programmed to do more standing, walking and cleaning while others aren't hard-wired to move much at all. "The fact that these behaviors differ very early doesn't mean they are unchallengeable," he says. "But it does suggest that the wiring is in place very early in life."
Use low-calorie substitutes in favorite meals
Parents can shave calories from kids' favorite
meals without their children noticing, two nutrition experts say.
Researchers at Pennsylvania State University fed children, ages 2 to 5½,
two different types of macaroni and cheese. One was lower in fat; the
other was made with extra butter and oil. The kids liked both dishes
equally, but they ate 72 fewer calories with the lower-fat recipe.
"That's a big reduction in calories for kids, says nutrition researcher
Barbara Rolls. If parents are concerned about their child's weight, they
should use less fat in their cooking," Rolls says. And they should add
more vegetables and fruits when possible. Keep vegetables "relatively
naked," that is, don't put heavy cheese sauces and margarine on them,
she says.
In another study, children ages 5 and 6 consumed far more calories when they were served a very large portion (2 cups) of a high-fat macaroni and cheese than when they were offered about half as much of a lower-calorie version; 224 calories vs. 117, says Jennifer Orlet Fisher, an assistant professor in the pediatrics department at Baylor College of Medicine in Houston. "Most children did not finish the smaller portions of the mac and cheese, suggesting their intake of the larger portions was excessive," she says. Parents should let kids participate in serving themselves and encourage them to take smaller portions and then go back for more if they're still hungry, Fisher says. "Kids learn to like what is familiar to them. Parents can keep calories in check by getting into the habit of using low-fat cheese and less butter to make those kid favorites like mac and cheese," she says.
Offer the best food options
Who says kids don't listen when adults dish
out good advice? Researchers at Yale University had cafeteria personnel
at an elementary school ask students going through the lunch line,
"Would you like fruit or juice?" The students not only took the produce
and juice, but they also consumed almost all of it. "Parents need to be
more authoritative and clearly let children know that a balanced meal
includes a fruit and vegetable serving, says Marlene Schwartz of the
Rudd Center for Food Policy and Obesity at Yale. The key is to put the
foods you want them to eat right in front of them, rather than waiting
for them to request the food, or even asking if they would like it,"
says Schwartz.
23 October 2006
http://www.usatoday.com/news/health/2006-10-22-obesity-advice_x.htm
Children with obsessive-compulsive disorder helped by cognitive behavioral therapy
Cognitive behavioral therapy reduces the severity of obsessive compulsive disorder in children and adolescents, according to a new review. This form of treatment helps relieve the overall distress and reduces the interference that OCD symptoms can cause in young people's lives. Further, the evidence indicates that cognitive behavioral therapy (CBT) and medication are equally effective in treating pediatric OCD, say lead researcher Richard O'Kearney and colleagues. "When CBT is combined with medication, treatment is more effective than medication alone. Health professionals need to consider this therapy -- particularly in view of the controversy about prescribing psychotropic medications to children and teens," said O'Kearney, director of clinical training for psychology at the Australian National University, in Canberra.
This review appears in the October 18 issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates research in all aspects of health care. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.
OCD is can start at a very early age -- review participants were as young as 7 years old. The disorder affects an estimated 0.5 percent to 4 percent of children and adolescents. "Symptoms include repeated hand washing, checking behaviors, orderliness and various rituals that are not age-appropriate, O'Kearney said. Children with OCD can also show generally high levels of anxiety that is managed by the need to perform particular behaviors. These children may be frustrated if their rituals are interrupted. In children, however, the compulsions are sometimes not experienced as distressing to carry out."
But in the big picture, OCD is often associated with significant disruption and impairment of the child's family, social and academic life, and it can impact psychosocial development. Children and teens who struggle with this problem also have heightened risk for clinically significant psychiatric and psychosocial problems as adults. Cognitive behavioral therapy, which has been shown to work for adults, now appears to benefit children as well. The treatment includes a variety of techniques to help children challenge some of their unhelpful thoughts about threat, danger or the importance of controlling thoughts.
Exposure with response prevention technique is a core aspect of contemporary CBT treatment. Children with compulsive washing, for example, would be required in a graded way to touch objects that they fear lead to contamination, and prevent the washing, which neutralizes their fear.
O'Kearney said he was surprised to find so few high-quality studies that evaluated the effectiveness of pediatric CBT. The final review comprised four studies of randomized controlled trials or quasi-randomized trials, and three of these suggested at least some risk of bias. In all, the studies looked at 222 children and adolescents ranging in age from 7 to 18 years, with about an equal number of boys and girls. The participants were Australian, Dutch or American. CBT interventions ranged from 12 hours to 30 hours. There was no direct assessment of negative effects in these CBT studies, which were funded entirely by The Australian National University. The low drop-out rate of participants suggests that CBT may have been an acceptable approach to families involved, the researchers say.
Carol A. Mathews, M.D., with the department of psychiatry at the University of California, San Francisco, called the systematic review "excellent" and said it represents an important step forward in the understanding of the effectiveness of various types of treatment for pediatric OCD. Pediatric OCD is frequently underdiagnosed and undertreated, she said, and this could be because of limited treatment options parents have for their children. "This study shows convincingly that CBT is superior to placebo, not only in reducing the number of OCD symptoms, but also in effecting remission in many cases. The study also shows that CBT plus medication is more effective than medication alone in children -- an important confirmation of what has been believed clinically, but never proven," said Mathews, who was not involved with the study. The results of this paper provide clinicians and parents with an additional effective treatment option -- CBT or CBT plus medication -- a treatment that involves only about 14 to 21 hours, in general," Mathews said.
"Probably the most important issue related to our findings is that while the evidence suggests that CBT is as effective as medication, relatively few children and adolescents get CBT treatment," O'Kearney said. "Part of this is because of access and part is because primary care doctors often prescribe medicine before they refer patients to CBT. Hopefully this review will make them think more about this practice." O'Kearney said that although attempts have been made to use telephone and computer-assisted delivery to increase access, "overall, there need to be more trained CBT therapists skilled in treating pediatric OCD."
The Cochrane Library
22 October 2006
http://www.medicalnewstoday.com/medicalnews.php?newsid=54457
More children experiencing early puberty: Topical contact with sex hormones in environment cited
Parents often think their children grow up too quickly, but few are prepared for the problem that Dr. Michael Dedekian and his colleagues at the University of Massachusetts Medical School reported recently.
At the annual Pediatric Academic Society meeting in May in San Francisco, they presented a report that described how a preschool-age girl, and then her kindergarten-age brother, mysteriously began growing pubic hair. These cases were not isolated; in 2004, pediatric endocrinologists from San Diego reported a similar cluster of five children.
It turns out that there have been clusters of cases in which children have prematurely developed signs of puberty, outbreaks similar to epidemics of influenza or environmental poisonings. In 1979, the medical journal the Lancet described an outbreak of breast enlargement among hundreds of Italian schoolchildren, probably caused by estrogen contamination of beef and poultry. Similar epidemics in Puerto Rico and Haiti were tracked by the Centers for Disease Control and Prevention in the 1980s.
Increasingly -- although the science is still far from definitive and the precise number of such cases is highly speculative -- some physicians worry that children are at higher risk of early puberty as a result of the increasing prevalence of certain drugs, cosmetics and environmental contaminants, called "endocrine disruptors," that can cause breast growth, pubic hair development and other symptoms of puberty.
Most commonly, incidences of early puberty in children are traced to accidental drug exposures from products that are used incorrectly. Dedekian's first patient was evaluated for possible genetic endocrine problems and a rare brain tumor before the real cause of her puberty was discovered: It turned out that her testosterone level was almost 100 times normal -- in the range of an adult man. The same problem affected her brother.
The doctors found out that the children's father was using a concentrated testosterone skin cream bought from an Internet compounding pharmacy for cosmetic and sexual-performance purposes. From normal skin contact with their father, the children absorbed the testosterone, which caused pubic hair growth and genital enlargement. The boy, in particular, also developed some aggressive behavioral problems.
Sex hormones are potent because they are easily absorbed through the skin and resist degradation better than many other hormones. Unlike protein-based hormones like insulin, sex hormones like testosterone and estrogen are technically steroids, meaning they are derived from cholesterol.
Primarily made by the liver, cholesterol begins with tiny pieces of sugar that are joined, twisted and oxidized in a dizzying series to make an end product that resembles the interlinked rings of the Olympic emblem. Dr. Joseph L. Goldstein, a biochemist in Texas and a Nobel laureate, once called it "the most highly decorated small molecule in biology," because 13 Nobel Prizes have been awarded for its study. Through further processing, primarily in the gonads and adrenal glands, cholesterol is converted into estrogen and testosterone.
Dr. Kenneth Lee Jones, the former chief of pediatrics at UC San Diego, noted cases similar to those described by Dedekian in a 2004 report in the journal Pediatrics. At that time, unregulated "prohormones" like androstenedione, famously used by Mark McGwire, the former St. Louis Cardinals power hitter, and banned by federal law in 2005, were available as topical sprays used to enhance libido. Jones said the sprays used by adults in some households permeated the children's bedsheets, and the early puberty stopped when the adults stopped using the sprays and also discarded old sheets.
Darshak M. Sanghavi
22 October 2006
[Full Story]
http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2006/10/22/MNGTILRMVJ1.DTL
Sleeplessness may contribute to child obesity
Not getting enough shut-eye each night may play a role in youngsters becoming overweight, partly by disrupting normal metabolism, a doctor from the University of Bristol, UK, contends in a report released on Thursday.
Although there is a "strong genetic contribution to obesity," the current epidemic of obesity has been driven largely by environmental factors - an unhealthy diet and a lack of physical activity - Dr Shahrad Taheri points out in the Archives of Disease in Childhood. Moreover, there is an emerging body of research that suggests that sleep may impact energy balance and that short sleep duration may lead to metabolic changes that could help fuel the development of obesity, diabetes and cardiovascular disease.
Laboratory studies hint that as little as two to three nights of too little sleep in young adults can have profound negative effects on fat hormones. In one study, for example, the hormone ghrelin, which is released by the stomach to signal hunger, was nearly 15 percent higher in people sleeping only five hours per night versus the generally recommended eight hours.
Inadequate sleep disturbs other hormones as well, including insulin, the stress hormone cortisol, and growth hormone, which could boost the desire for fatty foods. Short sleep duration affects not only energy intake, but energy expenditure as well, since it results in tiredness that may curb physical activity levels.
Links between sleep deprivation and obesity seem to be particularly robust in children, Taheri notes, "in whom there is a linear dose-response relationship between shorter sleep and increased body weight."
In general, children and adults are sleeping less today than in years past, Taheri also points out, and the decline in nightly hours of shut-eye coincides with the rise in obesity.
Taheri blames diminishing sleep duration on computers, cell phones, TVs and other gadgets - all of which have become readily available to children and are increasingly found in their bedroom. Removing these devices from the bedroom and keeping strict bedtimes are essential to promoting adequate sleep and healthy sleep habits among children and adolescents, Taheri believes.
Getting an adequate amount of sleep each night may not be the only answer to skyrocketing rates of overweight and obesity among today's youth, "but its effect should be taken seriously," Taheri writes. Good sleep, coupled with a healthy diet and plenty of physical activity, "could be part of the obesity prevention approach," Taheri concludes.
SOURCE: Archives of Disease in Childhood, November 2006.
19 October 2006
http://www.iol.co.za/index.php?set_id=1&click_id=117&art_id=qw1161278463210B243
Children 'need sex advice sooner'
Children should be given advice on adult issues much sooner because of earlier puberty, a report says. It says social problems such as alcohol abuse, unprotected sex and self harm may result from children receiving information on these topics too late. The study, from Liverpool John Moores University Centre for Public Health, says the age at which puberty begins has come down for the past 150 years. It is published in the Journal of Epidemiology and Community Health. The report says there have been no attempts to develop young people faster, leaving "an increasing gap between physical puberty - changes to their bodies - and social puberty - when they are able to make decisions for themselves". This, it argues, can result in unprotected sex, substance abuse, self harm, violence and bullying.
Dr Mark Bellis, one of the report's authors, said: "Children who are now developing at an earlier stage need a different approach. Information often regarded as adult on sex, relationships and dealing with issues of conflict is currently given to them when it is too late. The gap between when children are developing and coming into adulthood and when adult information is dispensed is the longest it's ever been. So giving it over at a later stage can do more harm than good because children need to get to grips with the changes in their life sooner."
Developmental problems
Dr Bellis said, because of this delay in
receiving adult advice, children can develop problems with sexual
health, substance abuse and violence because they are not well-enough
equipped to deal with the difficulties they face in life. "What we don't
know, and what we should be looking at, is do we have children
developing early in poorer areas, which often have a high number of
single parent families without a father. We cannot say that puberty is
definitely happening earlier in poor areas. But what we are saying is
that there are all three factors in these poorer areas - social
problems, single-parent families and a high birth rate." He said better
nutrition and the reduction in child health diseases were "public health
reasons" for the earlier development of puberty. But he added that
another factor was the absence of a father in the parental home. Recent
studies in America show a strong relationship between a tendency for
puberty to happen earlier when a father is not present. We can't judge
children in the 21st century the same way that we did 100 years ago,
because they don't look the same and are at a different mental stage
then they were back then."
Gary Butler, professor of paediatrics at the University of Reading, said there was a need for sex education to be given earlier, but not because of puberty issues. "Giving information earlier needs to be done anyway but not as a result of the age children reach puberty. Puberty may be starting sooner but there's no difference in the age at which children become fertile. We need to tackle the issue of teenage pregnancies but that's separate from the biological issues."
Source: Journal of Epidemiology and Community
Health.
18 October 2006
http://news.bbc.co.uk/2/hi/health/6062670.stm
Sierra Leone: Malaria Kills 63 Percent Under-Five Children in Sierra Leone
A survey titled 'Access to Health Care in Post Sierra Leone" conducted by Medecins San Frontiere (MSF) Belgium and Holland in Kambia, Tonkolili, Bombali and Bo districts reveals that malaria accounts for 44 to 63% of under-five deaths in the country. The study also stated that malaria related deaths account for 25% to 39% of all deaths depending on the district. The report states that the high mortality rate of malaria in fewer than five children shows the vulnerability of these children.
The report shows that this type of mortality rate is extremely high in Bo district: 2.2 deaths/10.000/day, which is above the emergency threshold for malaria related deaths. The report states that the mortality figures are high and well above international recognized emergency threshold and that the crude mortality rate is almost four times as high as expected in sub-Saharan Africa.
The report also points out that 33% of respondent stated that they have decided to be using non official medical system such as traditional medications and ambulatory pharmacists (pepe doctors) because of lack of money. The report discloses that there is a very high rate of the use of the non official sector since it is easily accessible, as no consultation fee is needed.
Medecins San Frontiere
18 October 2006
Animal Study Links Teen Aggression With Prozac
Scientists have uncovered clues as to why children and adolescents may get more aggressive or even suicidal while taking the widely prescribed antidepressant Prozac.
A new study has found that juvenile hamsters became aggressive on low doses of Prozac (fluoxetine) but less aggressive on high doses. By contrast, adult hamsters were calm on both high and low doses of the drug. The bottom line: Adult and juvenile brains are different.
While intriguing, the study has some clear limitations, experts cautioned. "Just remember that a hamster is a hamster is a hamster," said Dr. Jon Shaw, director of child and adolescent psychiatry at the University of Miami Miller School of Medicine. Which is not to say that the findings don't have some value. "There are a lot of studies on the maturation and evolution of the central nervous system structure through adolescence, and nobody thinks the adult brain is [the same as] the child's brain. And this just reminds us that other studies are needed to try and understand what the difference means in terms of metabolism of drugs," Shaw added.
Pediatric use of antidepressant medications -- especially a newer class of drugs called selective serotonin reuptake inhibitors (SSRIs), of which Prozac is a member -- has been the subject of extended controversy. In October 2004, the U.S. Food and Drug Administration directed manufacturers of SSRIs, which include Celexa, Paxil, Prozac and Zoloft, to put a special "black-box" warning on the drugs' labeling. The warning alerts health-care providers about an increased risk of suicidality in children and teens using the medications. In July 2005, the FDA issued a public health advisory that raised the possibility that the risk of suicidality also applied to adults taking SSRIs, after several studies pointed to that possibility. Other studies, however, have found a lower incidence of youth suicide related to Prozac and other SSRIs. Prozac is the only medication approved to treat depression in children and adolescents.
For the new study, which was published in the October issue of Behavioral Neuroscience, researchers at the University of Texas at Austin injected hamsters with either high or low doses of Prozac. Two hours later, they created a threatening situation by putting a younger hamster in the home cage of another same-sex hamster for 10 minutes. Usually, male hamsters will respond to such situations with aggression. In these scenarios, the adult hamsters injected with either the high or low dose of Prozac were calmer. Juvenile hamsters, however, reacted differently to the different doses. Those on low doses were more aggressive while those on higher doses were less aggressive, though still not as calm as the adults. "We do know from adolescent studies that the brain continues to mature during adolescence, and even the early adult years, Shaw said. So, this study is an important study in that it reminds us that further research is really necessary to look at how an evolving central nervous system responds to different stimuli."
The study authors also pointed out that teens may have lower levels of the neurotransmitter serotonin in their system than adults, and it might not be enough for an SSRI to work with. It's also possible that some teens who become more aggressive and/or suicidal while taking SSRIs may have an unusual reaction to the drugs. "There is this paradoxical situation that the use of antidepressants reduces suicidal behavior both in adolescents and adult and, at the same time, there are some idiosyncratic situations where some individuals are more hyper aroused and possibly more aggressive," Shaw said.
Amanda Gardner
16 October 2006
http://www.livescience.com/healthday/535524.html
IRELAND REPORT
Study finds dramatic changes in sexual behaviour
There have been dramatic changes in the sexual behaviour of Irish people over recent decades as well as in their attitudes to issues such as the use of emergency contraception, a major new study has confirmed. Conducted by the Economic and Social Research Institute and the Royal College of Surgeons in Ireland, the research shows there is an increased trend among young men towards paying for sex and that significant numbers of people are engaging in risky sexual behaviour. The research, which is based on a telephone survey of almost 7,500 people across the State in the 18 to 64 year age bracket, says the incidence of sexually transmitted infections has increased by 243 per cent between 1998 and 2003.
However, despite this, 14 per cent of people surveyed, for example, did not use a condom when having sex with a person they had just met for the first time because "they trusted their partner" not to have a sexually transmitted disease.
The Irish Study of Sexual Health and Relationships, published yesterday, is the first large-scale study of its type to have been conducted in the State. It found attitudes towards abortion "have undergone immense change since the early 1980s", with 64 per cent of those surveyed now saying abortion is acceptable in at least some circumstances.
Furthermore it found just 6 per cent of people now think premarital sex is always wrong, compared to 71 per cent back in 1973. More than 90 per cent of people also believe emergency contraception should be available in Ireland, with 52 per cent of men and 42 per cent of women believing it should be available without prescription.
Minister for Health Mary Harney, who yesterday attended the publication of the report in Dublin, said it would be a matter for the Irish Medicines Board to decide whether the morning-after pill should be made available over the counter. "There are many arguments for making much medication available over the counter, she said. It is more convenient but clearly it can only be done if it is medically safe to do so."
The report, commissioned by the Department of Health and the Crisis Pregnancy Agency, also found the age at which Irish people first have sex is falling. Over the last 40 years, the age of first sex has dropped by five years for men and by six years for women. The median age at which young people first had sex in this study was found to be 17 years.
The report said serious attention should be given to reducing the cost of contraception in the Republic, especially the cost of condoms. The report had found that 32 per cent of women said the cost of the contraceptive pill would discourage them from using it, while some 15 per cent of all those surveyed said the cost of condoms would discourage their use.
Last night Progressive Democrats TD Fiona O'Malley said cost should not be a consideration when it came to contraception. She said condoms incurred VAT of 21 per cent, which means they were classified as a "luxury item" but she said it should be reduced. She would be asking Minister for Finance Brian Cowen to address this in the budget, she added.
The report said it was now time to develop a national sexual health strategy and to survey the attitudes and behaviours of under-18s and over-64s, the age groups excluded from this research.
Ms Harney said the growing number of young people having sex before 17 years of age was of concern. She said sex education was essential both at school and within the home and teachers and parents needed to be resourced to be able to provide it. It was a matter for the Health Service Executive and the Crisis Pregnancy Agency to devise an action plan on foot of the report's findings, she added.
Eithne Donnellan
17 October 2006
http://www.ireland.com/newspaper/front/2006/1017/1160606697344.html
Tough enforcement in early 20th century boosted popularity of dangerous drugs, University of Guelph professor tells forum
The folly of anti-drug laws
History is supposed to teach us lessons. But when it comes to drug use and abuse, two professors are arguing we as a society have failed to learn from the past. Catherine Carstairs, an assistant professor in history at the University of Guelph, argues the creation of anti-drug laws in the early part of the 20th century drove users underground led to the proliferation of more dangerous drugs. Tough drug enforcement in the mid-20th century served in part to make drug users look cooler in the eyes of disaffected youth, she also argued.
Andrew Hathaway, a sociologist and drug policy researcher at McMaster University in Hamilton, draws a parallel between Prohibition in the 1920s and today's drug laws. Alcohol prohibition led huge numbers of people to flout the law, created an environment that allowed organized crime to flourish, encouraged people to consume dangerous homemade concoctions and overburdened the justice system, he says, arguing things are much the same with drugs today.
The pair were speaking recently at a forum organized by The Community Safety and Crime Prevention Council and Ray of Hope, a Kitchener-based social service agency. The talk was part of a series of films, forums and workshops on substance use and abuse collectively known as In The Mind's Eye. The mostly-free series goes until Nov. 28.
In 19th-century North America, drugs were readily available, with heroin sold alongside Aspirin over pharmacy counters, Carstairs said. There were addicts, of course, but also many recreational users, largely from the Chinese community, which was growing particularly on Canada's west coast. It was common in those days for Chinese to smoke opium socially or ritually, much as Canadians of European descent drank alcohol at home, in bars, at weddings and funerals, Carstairs said.
The professor argued the social agitation against drugs that began in the early 20th century was rooted in racism. As the Asian population grew, so did anti-Asian sentiment, and some campaigners seized on the "dirty" Chinese habit of opium smoking as a reason to exclude them from Canada, she said. The fear of the "Asian influx" came to a head in 1907, when a white mob smashed up a number of businesses in Vancouver's Chinatown.
The then-deputy minister of labour, William Lyon Mackenzie King, was called upon to investigate the riot and the claims for compensation. One of the claims was from a perfectly legal opium manufacturing company. The future prime minister was appalled to hear there were opium companies operating openly in Canada.
A moral reform movement was on the rise at the same time, and in 1908, a law was passed to outlaw importing and selling opium. Three years later, possession was also outlawed and cocaine was included, Carstairs said. After World War One, soldiers returned home to an economy in recession and many blamed their unemployment on Chinese supposedly taking their jobs. One of the ways the "ferocious anti-Chinese racism" was manifested was in public hysteria over drugs. In newspaper accounts of the day, "the victims were always young white men and women and the villains were always the evil, nefarious Chinese traffickers," said Carstairs.
The result in the 1920s was more money for enforcement and stronger drug laws, including six-month minimum jail sentences for possession. In a sense, these measures were successful, in that many of the casual users gave up opium smoking. The down side was that dependent users looked for less conspicuous forms of opiates, such as morphine and heroin, which were more powerful. They also started injecting them rather than smoking them. "This change had deleterious consequences for their health, because not only are they using more powerful drugs, they're using them in a more powerful way," Carstairs said.
Drug use grew after the Second World War, especially among marginalized urban youth. Because being caught for possession meant automatic jail time, users took to carrying drugs in their mouths so they could swallow them if caught. Police organized stakeouts and grabbed suspected users by their necks so they couldn't swallow the evidence. Users fought back, often in groups. And so users started to gain a reputation for their toughness and solidarity, making drug use attractive in the eyes of rebellious youth who wanted a sense of belonging, Carstairs said.
Hathaway argued that just as prohibition made safe beer and wine difficult to obtain and led people to experiment with more potent and toxic homebrews, the impossibility of drug quality control has led to the sale of dangerous substances such as adulterated marijuana, ecstasy and crystal meth.
Just as Prohibition put bootlegging in the hands of mobsters, today's drug laws put the drug trade in the hands of often-violent organized crime, Hathaway said. The desire to alter consciousness is nearly universal, and many cultures past and present have managed to do it in a controlled manner, the professor argued."Harm reduction first and foremost accepts drug use as a fact. Not a moral issue. A fact."
But despite decades of recommendations and evidence that initiatives such as needle exchanges and safe-injection sites save lives, very few agencies in Canada take a harm-reduction approach, Hathaway said.
In response to an audience member's concern that legalizing or decriminalizing drugs would increase use, Hathaway responded that in the few U.S. and Australian states that have decriminalized marijuana, use hasn't increased compared to other states. "The debate hinges far less on the scientific evidence than deep-rooted moral schisms . . . and there's a tremendous financial stake in prohibition. There's a lot of jobs on the line."
Karen Kawawada
14 October 2006
Concerta safe for children with ADHD and epilepsy
Children with both attention-deficit attention disorder (ADHD) and epilepsy may safely take Concerta, a once-a-day formulation of methylphenidate, a team from Boston's Children's Hospital and Harvard University told the American Neurological Association meeting being held here this week.
Children with ADHD have a high risk of epilepsy, but studies of immediate-release methylphenidate have yielded conflicting results in children with both conditions. There have been no studies of the safety of an extended-release formulation such as Concerta, principal investigator Dr. Alcy Torres told Reuters Health.
This randomized, double-blind, placebo-controlled, crossover trial involved 27 children, mean age 10 years, with ADHD and epilepsy and who had been seizure-free with anti-epilepsy medication for at least one month prior to enrollment.
Patients received 18 mg, 36 mg or 54 mg Concerta for one week, and then crossed over to another arm of the study. "The addition of Concerta is safe...it did not induce seizures," Torres said. "There were no serious adverse events" and all minor events resolved within 48 hours of drug discontinuation. Adverse events associated with placebo were essentially the same as with active treatment, Torres noted.
Approximately 40 percent of children responded to the 18 mg dose, approximately 50 percent responded to the 36 mg dose and 75 percent of children responded to the 54 mg dose. The Harvard researchers are applying for an expansion in the labeling of Concerta. They are also conducting a similar study with the non-stimulant Strattera in this patient population. "This is what most practitioners are doing anyway," Torres commented.
Martha Kerr
11 October 2006
Tobacco companies appeal “light” cigarette ruling
Altria Group Inc. and other major tobacco companies have asked a U.S. federal appeals court to throw out a lower court's ruling that would allow smokers to sue en masse over claims that they were duped into believing light cigarettes were safer than regular ones, court papers showed on Tuesday.
Unless the appeal is granted, the tobacco companies said they "risk a multi-billion dollar verdict in a manifestly unlawful class action" scheduled to go to trial in January 2007.
Last month U.S. Judge Jack Weinstein in the Eastern District of New York granted class-action status to the case. The tobacco makers had said after that ruling they would appeal. Judge Weinstein "committed fundamental legal errors," and the U.S. Court of Appeals for the 2nd Circuit should toss out the ruling that certified the lawsuit as a class action case, the companies said in court papers filed on Friday but made public on Tuesday.
Plaintiffs contend that the tobacco companies took in nearly $200 billion in extra sales by misrepresenting "light" cigarettes. Light cigarettes were introduced in the 1970s. The case was filed under federal racketeering law. If the tobacco companies lose the case, damages could be tripled under that statute.
Besides Altria's Philip Morris USA unit, other defendants in the case include Reynolds American Inc.'s R.J. Reynolds Tobacco Co., Loews Corp.'s Lorillard Tobacco unit; Vector Group Ltd.'s Liggett Group and British American Tobacco Plc's British American Tobacco (Investments) Ltd.
11 October 2006
UCSF Pediatrics Resident Behind Juvenile Offenders Health Insurance Law
Adolescents in juvenile detention in California now have a better chance of receiving the critical health care services they need upon reemergence from incarceration in large part because of the efforts of a first-year UCSF Pediatrics Department resident.
The resident, Mana Golzari, MD, was the impetus behind SB1469, which requires county juvenile detention facilities to enroll eligible youth into MediCal and other state-sponsored health care programs. The legislation was introduced by California State Sen. Gil Cedillo (D-Los Angeles) in March and recently was signed into law by Gov. Arnold Schwarzenegger.
The 27-year-old said she hopes the new law, which goes into effect in January 2008, will improve the health status of a segment of the adolescent population with a “disproportionate share of adolescent morbidity and mortality.” In other words, they are among the sickest young people in the state.
Phyllis Brown
10 October 2006
http://pub.ucsf.edu/today/cache/news/200610097.html
Fears for the future as figures reveal Britons are fattest people in Europe
Britons are the fattest men and women of Europe, beating Slovakia and Greece by a small margin and with every likelihood that the next generation will hang on to the title, if current trends continue. Being overweight or obese is now the norm in the UK, with figures released by the government yesterday showing that two-thirds of men and almost 60% of women are unhealthily heavy. We are also passing the problem to our children: if nothing changes, nearly a third of boys and girls aged under 11 will be overweight or obese by 2010.
The study also highlights a north-south divide within England. Life expectancy is one year shorter for woman and two years shorter for men in the north of England compared with the south. The figures from the OECD, comparing the UK with 21 other European countries, emerged in a government document detailing the state of the nation's health, what has been achieved, and targets for the future.
Offsetting such success stories as the drop in cancer and heart disease deaths are the worrying upward trends in obesity and diabetes, mental ill-health and alcohol-related disease.
Caroline Flint, the public health minister, said that the UK led Europe in obesity for a combination of reasons, some of which were cultural and associated with shopping and family habits. "It has built up over time, she said. In the last 10 years or so, things seem to have got worse. It is partly what we eat but also what we do in terms of physical activity. It is complex. It is part of the way we live our lives and we have to think of 21st-century solutions."
The government has set itself the target of halting the year on year rise in obesity among children under 11 by 2010. But it does not set a similar target for stopping the weight gain in adults, aiming instead to encourage people to "want to change their lifestyles and take responsibility for their health". Ms Flint said it was not part of her job to tell people what to do.
Instead, the government is looking towards incentives, such as a voucher scheme offering money off fruit and vegetables being tried out in Cornwall, and more subliminal approaches. Next spring it will launch an obesity "social marketing strategy", based on research into the most effective ways of targeting messages to particular groups. The result of one such piece of research was anti-smoking adverts warning young people that the cigarette habit would leave them looking wrinkled and damage their sex drive.
She expressed hopes that supermarkets would help the crusade, showing parents how to prepare exotic fruits and vegetables in-store and allowing children to try them: "Parents are worried about buying food in case the children aren't going to like it. We have to be better at listening to people rather than assuming we know what they need."
The statistics for England show a marked north-south divide in every area of health. Life expectancy is one year shorter for women and two years shorter for men in the north of England compared with the south. Everybody received the same information about healthy living, said Ms Flint. The question was why some people act on the information, but others do not. Those households that were less healthy in the north of England were matched by some in London and parts of the south-east where there was poverty, she said, and problems. "If you haven't got a job, if you don't feel you have skills, if you look out of the door and the environment is not great, it is quite hard to think about your health," Ms Flint said.
To improve health, it was important to ensure children achieved in school and ended up getting jobs in which they felt good about themselves. The documents show that while life expectancy is at its highest level ever and infant mortality at its lowest, rising rates of diabetes - mostly resulting from obesity - could impede further progress. Between 1994 and 2003, diabetes increased by two-thirds in men and doubled in women. The disease is debilitating, costly to treat, and complications can include blindness and foot amputation.
While the government says it has made progress on bringing down smoking rates, improving the quality of housing and tacking child poverty, it admits concern over obesity and high levels of teenage pregnancy. England still has one of the highest rates of teenage pregnancy in western Europe, even though it has come down to its lowest level in 20 years.
There is a very mixed picture across the country. In some areas there has been a 42% reduction, but in others there has been a 42% increase. The government's target is to cut the under-18 conception rate by 50% by 2010. In teenage pregnancy, as in mental health, which is another problem area, higher rates go with greater deprivation. "Mental ill-health in adults rises as incomes fall," says the document.
Key data for England
- ·Levels of obesity in children aged two to 10 rose from 9.9% in 1995 to 14.3% in 2004. In 2003, 22% of men and 23% of women were obese. This figure will rise to 33% of men and 28% of women by 2010 if nothing is done.
- 8.2 million adults (38% of men and 16% of women) drink more than the recommended maximum units of alcohol per day (2-3 for women and 3-4 for men). One in five men and nearly one in 10 women drink twice this amount. A third of young men aged 16-26 and a quarter of young women binge drink.
- Twice as many men and women get lung cancer in deprived areas as in affluent areas. The death rates are about two and a half times higher. More than 106,000 people die from smoking each year.
- Death rates from heart disease, stroke and related illnesses are more than 25% higher in the north-west than the south-east.
- 28m working days were lost due to work-related ill health in 2004-05.
- Breastfed babies are five times less likely to be admitted to hospital with infections during their first year of life and are less likely to become obese in later childhood.
Sarah Boseley
11 October 2006
http://politics.guardian.co.uk/homeaffairs/story/0,,1892642,00.html
Northern Ireland: New survey on mental health
Far fewer people in Northern Ireland are owning up to mental ill health, new research has revealed. Previous findings claimed as many as one in four or one in five suffered. But a fresh Health Promotion Agency survey claimed the numbers admitting problems had fallen to 15%. "This is reinforced by the fact that just under half of those surveyed said they would be afraid of experiencing mental health problems and more than half said if they did, they wouldn`t want people knowing about it," according to a report out today.
A campaign aimed at destigmatising mental health issues, heightening public awareness and urging people to seek help is to be launched next year.
Key findings confirmed conflicting public attitudes and the research to be presented today at a seminar at Templepatrick to mark World Mental Health Day included claims that:
- 63% of people underestimated the numbers who might have problems at some point in their lives.
- 98% agreed that anyone can experience mental health difficulties.
- 54% said they would not want others to know if they were suffering.
- 46% said they would be afraid of experiencing problems themselves in the future.
- 91% agreed people suffering should have the same rights as anyone else.
- 46% said people with mental health problems should not be allowed to do important jobs, such as medicine or nursing.
- 41% agreed the public should be better protected from people with mental health problems.
Dr Brian Gaffney, the HPA chief executive said the findings illustrated the complexity of attitudes in Northern Ireland. He added: "Often people are either failing to recognise that they have a mental health problem, or are unwilling to disclose it. Everyone has mental health needs, but many people have a limited understanding of what mental health is and attitudes prevail based on fear or embarrassment. Stigma can lead to people being labelled, devalued or set apart from others, preventing them from seeking help and inhibiting their recovery."
Meanwhile at a separate seminar on adolescent mental health at Stormont later today, leading charities will urge the British government to implement a review which recommends a comprehensive child and adolescent health service in Northern Ireland. Failure to adopt a holistic approach will add to the growing strain on services and untold misery, according to Ruth Sutherland, director of Rethink.
With claims that an estimated 45,000 young people aged between 5-15 will suffer moderate to severe problems, she added: "They and their carers experience unnecessary distress from delays in accessing appropriate mental health services and there is often inadequate support afterwards for families. I am especially concerned about numbers of children presenting in acute mental health need that end up in adult units because no other appropriate provision is available to them."
Norman Porter, children`s services manager with Barnardos said schoolteachers needed additional training and support if they were to achieve early interventions that addressed emotional well-being and behavioural needs. He said: "There will be significant cost implications to attain this to provide training and supply teachers, and it is important that this funding is made available as a matter of priority."
Lelia Fitzsimons, assistant director of Voice of Young People in Care said proper support to promote recovery at an early stage was important. She added: "If we fail to adequately meet their needs - and clearly at the moment we are failing significantly - then these disorders may develop into major mental ill health later in life."
Report: Press Association
10 October 2006
http://u.tv/newsroom/indepth.asp?id=77221&pt=n
“Schizophrenia” should be dropped, say experts
Mental health experts called on Monday for the
term schizophrenia to be dropped, saying it has no scientific validity,
is imprecise and stigmatizing. "It is a harmful concept," said Professor
Marius Romme, a visiting professor of social psychiatry at the
University of Central England in Birmingham.
He added that symptoms such as delusions, hearing voices and
hallucinations are not the results of the illness but may be reactions
to traumatic and troubling events in life.
Speaking at a news conference, Richard Bentall, a professor of clinical
psychology at the University of Manchester, said the concept of
schizophrenia is scientifically meaningless. "It groups together a whole
range of different problems under one label -- the assumption is that
all of these people with all of these different problems have the same
brain disease," he added.
Schizophrenia affects about 1 percent of people in the United States and
Britain. Treatments such as atypical antipsychotic drugs focus on
eliminating the symptoms. But the drugs can cause side effects such as
weight gain, an increased risk of diabetes and sexual dysfunction.
Paul Hammersley of the University of Manchester who recently helped
launch The Campaign for the Abolition of the Schizophrenia Label (CASL),
said there is no agreement on the cause of the illness or its treatment.
CASL argues that the term schizophrenia is extremely damaging to those
to whom it is applied and implies unpredictability, being dangerous,
unable to cope and someone in need of life-long treatment. "It is like
cancelling someone's life," said Hammersley. "We generally believe this
word has to go."
Other psychiatrists agree that schizophrenia is an unsatisfactory term
that conveys bizarreness but they are concerned that discarding the term
could lead to problems classifying patients with psychosis. "If we don't
have some way of distinguishing between patients, then those with
bipolar disorder or obsessional disorder would be mixed up with those
currently diagnosed as having schizophrenia and might receive treatments
wholly inappropriate for them," said Robin Murray, a professor of
psychiatry at the Institute of Psychiatry in London. He suggested
replacing the term schizophrenia with the label dopamine dysregulation
disorder, which he said more accurately reflects what is happening in
the brain of someone who is psychotic.
Patricia Reaney
9 October 2006
http://today.reuters.com/news/articlenews.aspx?type=healthNews&storyID=2006-10-09T141616Z_01_L09260740_RTRUKOC_0_US-SCHIZOPHRENIA.xml
FDA approves drug for autism symptoms in children
A Johnson & Johnson drug received expanded federal approval Friday to treat aggression and other symptoms of autism in children. The new use for Risperdal is to treat irritability associated with autistic disorder, including temper tantrums, deliberate self-injury and aggression in children and adolescents, ages 5 to 16. The approval is the first for the use of a drug to treat behaviors associated with autism in children, the Food and Drug Administration said.
Risperdal, first approved by the FDA in 1993, has been used to treat schizophrenia and bipolar disorder in adults. The anti-psychotic drug is not a cure for autism, nor does it treat the condition itself, but it may provide relief for some children, according to Johnson & Johnson.
Autism is a complex developmental disability. It typically appears during a child's first three years of life, and it affects communication, social interaction and creative or imaginative play.
In 2005, the FDA declined to expand its approval of Risperdal, also known as risperidone, to include autism. The most common side effects of Risperdal include drowsiness, constipation, fatigue and weight gain.
6 October 2006
http://www.usatoday.com/news/health/2006-10-06-risperdal_x.htm
U.S. government launches autism study
The U.S. Centers for Disease Control and Prevention has announced a $5.9 million study in six states to try to find the causes of autism. The study, the next of the agency's promised initiatives to look more closely at the disorder, would look for factors that may put children at risk for autism spectrum disorders and other developmental disabilities, the CDC said.
It said 2,700 children aged 2 to 5 and their parents would take part in the five-year study. Researchers will look for infections or abnormal responses to infections in the child or parents, genetic factors, the mother's reproductive history, hormone levels, potential gastrointestinal problems in the child and other factors. "We hope this national study will help us learn more about the characteristics of children with ASDs, factors associated with developmental delays, and how genes and the environment may affect child development, said Dr. Jose Cordero, director of CDC's National Center on Birth Defects and Developmental Disabilities. By conducting the study in six different geographic areas across the country with diverse populations and by identifying children from multiple sources in each community, we hope to have a study sample that more closely represents children with ASDs, other developmental problems, and typical development across the country," Cordero added in a statement.
Autism spectrum disorders include a range of conditions marked by repetitive behaviors and social and communication problems. In May the CDC said the first national surveys of autism showed the condition occurs in up to 1 in every 175 children. The surveys indicated that boys were nearly four times more likely to have been diagnosed with autism than girls and that Hispanic children were less likely to have an autism diagnosis. The causes of autism are not clear and it is not clear whether the condition has become more common.
7 October 2006
Children ‘need daily hour of exercise’
Nursery children need an hour of physical exercise each day to burn off their energy and stave off the threat of obesity, researchers have warned. A Glasgow University team monitored a study group of 545 children who had the recommended adult level of exercise - 30 minutes, three times a week.
But that activity was not enough to affect the children's body mass index. The researchers concluded youngsters of that age need an hour of daily exercise and to eat healthily to avoid obesity. One in four children in England are obese, and schools are beginning tests to see if their pupils are overweight.
From next year, pupils will be weighed and measured as they start primary school and again before they leave. Parents of any obese four or 10 year olds can expect a letter telling them their child faces long-term health damage unless they lose weight. Based on current trends, one million children will be obese by 2010, experts estimate.
The authors of the latest study suggest exercise alone is unlikely to reduce this figure.
Little impact
Professor John Reilly and his team studied 545
children at 36 nurseries in Glasgow. The children had their weight and
height measured at the beginning of the study to work out their body
mass index (BMI) - a measure of what is a healthy and unhealthy weight
for a person. Half of the children participated in the exercise sessions
for the next 24 weeks, and their parents were also given guidance on
increasing physical play at home. The other children had no
intervention.
The researchers then measured the children's BMI again at six months and then a year later. Although the increased level of exercise did appear to help the children improve their movement skills, it had very little effect on BMI. An hour a day of activity. Professor Reilly and his team say children probably need to be even more active than this.
Dr Mike Knapton of the British Heart Foundation said it was "crucial" to encourage good exercise habits in young children, even if the benefits were not immediately obvious. He said: "Children get less active as they get older so it's vital that youngsters get regular physical activity to lay the foundations for good health as they grow up. "What this study does reinforce is that we need to try and get the whole package right from the earliest years, not just one lifestyle aspect. "We recommend that parents encourage their toddlers and young children to eat a healthy diet and have lots of active play time - at least an hour a day for kids over five - as a vital investment for long-term heart health."
Mr Tam Fry, honorary chairman of the Child Growth Foundation said: "Half an hour of physical activity should be a daily event for pre-school children. To measure its true impact on BMI the study should have required seven sessions a week- not three."
http://news.bbc.co.uk/2/hi/health/5409740.stm
Teachers urged to see learning in new light
Revenge can be sweet, and the sight of 400 teachers sitting in makeshift classrooms, pens in hand, would surely make any student smile. The Learning Brain Expo has brought hundreds of educators to the Caloundra Cultural Centre this week for a four-day conference which ends today. It was spearheaded by Focus Education Australia’s John Joseph, who has worked with up to 90,000 children in 13 countries including India, Turkey and New Zealand.
Mr Joseph has big dreams of changing the classroom structure in big ways. His ultimate goal is to have each student working on an individual program suited to their brain’s needs.“The dream and the reality are probably a long way apart because we have to work with the inefficiencies of budgets,’’ he said. “It would be lovely but you’d probably need to have much smaller class sizes and you probably wouldn’t have a year level structure anymore. “You’d probably move kids through when they’re demonstrating they’re ready to move on so you’d have more family group structures. I think it would benefit society and ultimately it will happen, but at the moment education is competing for scarce public dollars.’’
Mr Joseph has spent years encouraging the education system to challenge conventional study methods. He believes understanding how the brain works benefits students. “I got fascinated in why some kids do well in maths, some kids do well in sport ... understanding the brain seemed to hold the best answers,’’ Mr Joseph said. “I found you can actually get kids emotionally connected to learning and you actually have behaviour issues. I think to teach young people about how learning happens, how brains work, what the intellect is ... the whole thing is really a process that’s based on understanding learning.’’
Caloundra’s Meridan State College is one of a few Coast schools which have adopted Mr Joseph’s ideas. The head of junior school, Robyn Taplin, said the Year 3 and 4 students had spent a term learning about how the brain works and applying it to their classroom learning. “The children’s ability to set learning goals and understand their learning goals have been far more successful,’’ Mrs Taplin said. She believed the theory could become part of the education curriculum. “Teachers and educators are certainly becoming more aware of how essential it is to brain development.
Candice Holznagel
5 October 2006
Study finds one in three youngsters unfit
About a third of American youngsters age 12 to 19 fail treadmill tests measuring heart and respiratory health, and fatness and sedentary lifestyles are likely culprits, researchers said on Monday. The finding, published in the Archives of Pediatric and Adolescent Medicine, was based on tests done from a representative sample of 3,287 boys and girls between 1999 and 2000.
They were interviewed at home and then went to an examination center where they performed a treadmill exercise test consisting of a two-minute warm-up, two three-minute periods of exercise and a two-minute cool-down.
"Approximately one third of males and females ... failed to meet current standards of acceptable cardio respiratory endurance," the University of South Carolina study found. "This represents a significant public health problem because low physical fitness during adolescence tends to track into adulthood, and low-fit adults are at substantially increased risk for chronic disease morbidity and mortality," the study concluded. "The findings of this study suggest that youth who have high body mass index (a measure of weight), low levels of physical activity and high levels of sedentary behavior are likely to have low cardio respiratory fitness," it added.
Source: Archives of Pediatric and Adolescent
Medicine
3 October 2006
Oregon researcher: stigma associated with mental illness deters families from seeking treatment
Two new surveys find that youth ages 8-18, have an easier time understanding a physical illness rather than a mental illness, affecting how they perceive and treat peers, and how youth and their families seek treatment.
Approximately one in ten American children and youth experience a behavioral, emotional or mental health disorder that could be identified and treated. The Regional Research Institute at Portland State University's Graduate School of Social Work collaborated with the polling firm, Harris Interactive, to produce two surveys that illustrate how stigma associated with mental illness can dissuade young people and their families from seeking help (results listed below).
"This is the first large-scale study to examine youth perceptions about mental illness among their peers," said Janet Walker, from PSU's Regional Research Institute. "At one level, it's useful just to have this descriptive data, and to see how young people's perceptions and attitudes develop and change across the age groups.
But even more importantly, the findings will be useful in designing applied efforts to reduce stigma and to increase the extent to which appropriate and acceptable mental health care is available for youth who need it."
Youth's perception of mental illness
Over 1,300 youth (ages 8-18) nationwide were
asked questions in relation to a fictional character, with one of three
conditions: depression, attention deficit hyperactive disorder (ADHD) or
asthma. Based on responses surrounding these scenarios, results show
that youth expect that a child with depression or ADHD is more likely
than a classmate with asthma to be socially shunned.
More youth indicated that peers with depression would be made fun of by most students when they are not around than with ADHD or asthma. Fewer youth say that students at their school would invite a person with depression to parties or outings than with ADHD or asthma, and fewer would expect other students to sit with them to eat lunch.
Findings from the surveys provide insights into how youth perceive and treat peers with depression and ADHD, how much they know about the causes and symptoms of these mental health disorders and how the level of stigma associated with mental health disorders compares with the stigma associated with physical illness. The findings also provide information on youths' perceptions of the treat ability of mental health disorders and the dangerousness of peers who have a disorder.
Stigma and treatment of mental illness
Youth on the surveys indicated that if they
thought they had depression, they would most likely talk to a friend,
talk to their parents and pray. Many also would try harder to think and
act like normal or wait for it to go away. Youth appear to have a better
sense of what steps they might take if they thought they had asthma,
responding that they would most likely talk to a doctor, talk to their
parents or take medication.
Interestingly, about one in four youth reported thinking they have had depression, but only seven percent said that a doctor or psychologist has diagnosed them with depression. Fifteen percent of respondents said people in their family think that if you have depression you should not tell anyone outside the family, compared to only three percent for asthma.
According to the U.S. Department of Health and Human Services, an estimated 50 million Americans experience a mental disorder in any given year and only one-fourth of them actually receive mental health and other services.
For more information on the study please visit Here
http://www.newsshadycove.com/articles/index.cfm?artOID=332671&cp=11017
Obesity linked to too little sleep, again
The amount of time people spend sleeping may affect their weight, study results suggest.
The study looked at people living in rural areas. Previous studies conducted in urban and suburban areas have had similar results, which suggests that sleep loss may play a role in the increasing rates of obesity in the US.
Researchers have proposed that shorter sleep duration may affect levels of two weight-control hormones: reduced levels of leptin, a hormone associated with satiety, and increased levels of ghrelin, associated with hunger.
Dr. Neal D. Kohatsu, an epidemiologist at the California Department of Health Services in Sacramento, and his associates were interested in studying rural populations because obesity rates are higher and lifestyle patterns of nutrition, physical activity, work hours, and sleep differ from those in more populous areas.
Rural populations also have a higher prevalence of suicide and a greater propensity toward other risky health behaviors.
According to the researchers' report in the Archives of internal Medicine, theirs is the first study evaluating the relationship between sleep duration and body mass index (BMI) in rural settings. BMI reflects weight in relation to height, with 20-25 classified as normal, 25-30 as overweight, and over 30 as obese.
The team analyzed data collected in an agricultural county in southeastern Iowa, from a survey of a random sample of 990 employed adults. The subjects were asked about sleep duration, physical activity associated with employment, symptoms of depression, alcohol consumption, snoring, and other demographic information. Height and weight were measured during the same visit.
There was a straight-line relationship between a higher BMI and lesser amount of sleep. The average BMI ranged from 30.24 among individuals sleeping less than 6 hours per night, to 28.25 for those who slept more than 9 hours at a time.
Kohatsu's group speculates that "modest but sustained changes in sleep duration could have a clinically significant effect on weight." They acknowledge, however, that the study doesn't prove that reduced sleep causes obesity.
SOURCE: Archives of internal Medicine, September 18, 2006.
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