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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 ...
September 2006
Attention deficit treatment a family affair — report
Parents of kids on prescription drugs for attention deficit hyperactivity disorder are 10 times more likely to be on such a medication themselves, according to an analysis of U.S. prescription use released on Thursday.
Research by the prescription drug manager Medco Health Solutions Inc. (MHS.N: Quote, Profile, Research), which runs employee health plans for companies, examined prescription claims of 107,000 children and their parents during 2005.
In about 60 percent of the cases where child and parent were on ADHD medication, the child went on the prescription first, the study found.
Adult ADHD usually excludes the "H" – hyperactivity – according to doctors. That may be why it is less diagnosed in adults. It is also significantly less diagnosed in young girls, who tend not to be as hyperactive than boys.
"Moms are catching up in adulthood," said Robert Epstein, chief medical officer at Medco, which buys prescription drugs in bulk for about 55 million people.
Although the condition is more common in children, heredity does play a role and ADHD can linger into adulthood, according to experts.
"In adults, the hyperactivity part is gone, but the inattentive part doesn't go away," said Adelaide Robb, a child psychiatrist at Childrens' National Medical Center in Washington, D.C., which is not affiliated with the study.
Franklin Lakes, New Jersey-based Medco, which was spun off of drug maker Merck & Co. (MRK.N: Quote, Profile, Research) several years ago, says its analysis is the first to examine treatment trends, and that its findings give further backing to the role of genetics.
About 8 percent of children are estimated to have ADHD, according to the U.S. Centers for Disease Control and Prevention. About 25 percent of close relatives of kids with ADHD also have the disorder, which is marked by impulsiveness, hyperactivity and inattention.
About 2.5 million children have taken ADHD prescription drugs, the most widely known being Novartis AG's (NOVN.VX: Quote, Profile, Research) Ritalin, according to the CDC.
The study also looked at about 17,500 identical and non-identical twins, and found that when one twin is on an ADHD medication, the other twin is much more likely to be on a prescription, compared to non-twin siblings.
The U.S. Food and Drug Administration last month asked makers of all stimulants used to treat ADHD drugs to include warnings of possible risk of sudden death and serious heart problems.
Kim Dixon
28 September 2006
Parents Often Naive About Children's Drug Use
Parents are largely unaware of their children's alcohol and drug use, new research says.
In a study published in the October issue of Alcoholism: Clinical & Experiemental Research, researchers from Washington University in St. Louis sought to determine how helpful parents are in assessing their children's alcohol and drug use.
The researchers interviewed 591 adolescent-and-parent pairs about the teens' use of alcohol and drugs.
"The three most commonly used substances as reported by adolescents in our study were alcohol at 54 percent, tobacco at 44 percent and marijuana at 23 percent," Jean Bierut, associate professor of psychiatry at the university's school of medicine, said in a prepared statement.
But when the child reported alcohol or drug use, the parents often failed to report that their child had used a substance.
"Specifically, if a child reported having used alcohol, the parent said their child had used alcohol only 50 percent of the time. Similarly, when a child reported having used tobacco, the parent reported this on 55 percent of the time, and when a child reported having used marijuana, the parent report agreed only 47 percent of the time," said Bierut.
The older the child, the more likely the parent was aware of the substance use. "This is very troubling because research has shown that starting to use alcohol and drugs at a young age is a risk factor for developing substance abuse or dependence in the future," Bierut said.
SOURCE: Washington University School of Medicine
news release
24 September 2006
http://www.healthfinder.gov/news/newsstory.asp?docid=535042
Pack-a-day potato chips habit "threatens health"
Half of British children have a pack-a-day potato chips habit and are consuming the equivalent of five liters of cooking oil a year, the British Heart Foundation (BHF) warned on Friday. It released the figures as part of a campaign to educate the public about the amount of hidden salt, fat and sugar in common foods.
"I am concerned we are a nation drowning in excess oil, salt and sugar as we and our children continue to ignore the warnings and consume excessive amounts of unhealthy foods. Crips (potato chips) are just the tip of the iceberg," said Professor Peter Weissberg, medical director of the charity.
A typical 35 gram (1.2 ounce) packet of potato chips contains 2.5 teaspoons of oil. In a larger bag it rises to 3.5 teaspoons.
In a BHF survey of 1,153 children aged between eight and 15, an average 49 percent of youngsters ate at least one pack of potato chips a day. The figures ranged from a high of 60 percent in Scotland to a low of 30 percent in London. In Wales the figure was 50 percent.
One in five of the children questioned said they ate potato chips twice a day or more.
Britons' taste for them is so strong that as a nation they consume a tonne of potato chips every three minutes, enough to fill an Olympic size swimming pool every 14 hours, the BHF said, referring to a Mintel report. "The BHF believes having a daily dose of such a high-fat, nutritionally poor product is a threat to children's long-term health," said Weissberg in a statement.
"Daily unhealthy snacking is a worrying habit," he added. "Rising rates of childhood obesity and cases of type 2 diabetes paint a particularly grim picture for the future."
British Heart Foundation
25 September 2006
http://today.reuters.com/news/articlenews.aspx?type=healthNews&storyID=2006-09-25T135545Z_01_L21517921_RTRUKOC_0_US-BRITAIN-CRISPS.xml
CANADA
Meth report released
After close to a year of crisscrossing the province and meeting with community leaders, law enforcement, health care providers and drug users, the Premier’s Task Force on Crystal Meth released its final report last week. The task force was chaired by Colleen Klein, the wife of Premier Ralph Klein, and Dr. Bob Westbury. Among the task force’s 11 other members was Drayton Valley Mayor Diana McQueen.
The report contains a total of 83 recommendations covering a wide range of issues, all targetted to fight the spread of the drug in Alberta. Methamphetamine is a cheap and highly addictive drug which has become increasingly widespread in Western Canada over the last few years. The drug is relatively cheap to produce and has become particularly popular among young people.
However, meth can have a serious impact on a user’s physical and mental health. “What we really learned is that the effects of meth compared even to some other drugs is really quite devastating,” said McQueen in an interview last week.
The report’s recommendations are divided into six broad categories which include taking a province-wide approach to the problem, healing and treatment, supporting Aboriginal communities and improving services and assessing results.
However the bulk of the recommendations focus on preventing people from using the drug in the first place and on getting tough with users and dealers. “With the help of community leaders across the province, the task force’s recommendations will stop the abuse and negative impacts of crystal meth on our communities, workplaces, families and young people,” said Klein in a statement to the media. “We can and must work collectively to fight against the damage of this drug.
” Among the report’s recommendations are the creation of 300 more detox and treatment beds across the province, more flexible privacy laws to allow doctors and treatment facilities to share patient information and the immediate creation of a fund to help reduce meth use among youth.
The report also calls for tougher penalties for meth-related crimes and the creation of more specialized police units to combat the spread of the drug. “The report is the first step,” said McQueen. “The second step is implementation. This issue is so important across the province that regardless of who the next leader is they’re going to have to get behind the report and work with the recommendations.”
The full report is available on the Government of Alberta website at
www.gov.ab.ca.
Graham Long
26 September 2006
http://www.draytonvalleywesternreview.com/Top Stories/256483.html
BC: Report urges review of drugs
The B.C. government is being urged to look at how prescription drugs are given to children in government care, after a new report revealed kids in care are up to 12 times more likely to be prescribed stimulant drugs like Ritalin.
A joint special report from B.C.'s child and youth officer and the provincial health officer showed children in care are prescribed mental-health drugs at significantly higher rates than those in the general population. Kids in care, for example, receive Ritalin-type prescriptions at a rate 8.5 to 12 times higher.
"It does raise a concern when 10 times as many children in care are being prescribed these medications," child and youth officer Jane Morley told 24 hours in an interview yesterday. "... There's some research that suggests that [Ritalin-type drugs] could have secondary effects that aren't good, and also we don't know for sure how effective it is."
Morley said the Ministry of Children, as the "responsible parent" for children in its care, should consult with B.C.'s College of Physicians and Surgeons to determine if kids in care are being over- prescribed. It may turn out, said Morley, that prescription rates are fine as they are. "It's not that we're saying it's necessarily wrong, but we've got to be cautious about it."
A 2000 review by the College found the province had a five-fold increase in Ritalin use, mainly due to more frequent diagnoses of attention-deficit and hyperactivity disorder. It concluded Ritalin was being prescribed responsibly.
Morley's report also showed that compared to the general population, kids in government care had higher rates of death and injury, depression, early pregnancy, and were also four times as likely to be diagnosed with a mental disorder.
Irwin Loy
21 September 2006
http://vancouver.24hrs.ca/News/2006/09/21/1872508-sun.html
Children eating 'too many' crisps
Scottish children are putting their long term health at risk by eating too many crisps, according to a leading charity. A British Heart Foundation survey found 60% of eight to 15-year-olds admitted eating at least one packet a day.
According to the charity, this is the equivalent of a child drinking almost five litres of cooking oil every year.
The findings, from a sample of 1,153 youngsters, were released to coincide with its Food4Thought campaign. The British Heart Foundation's (BHF) campaign aims to highlight the risks of daily unhealthy snacking. A new advert will feature a young girl drinking from a bottle of cooking oil with the caption - "what goes into crisps goes into you".
The charity wants to make children and their parents more aware of the salt, fat and sugar found in snacks and ready meals. It is also calling for a ban on television and internet adverts for junk food, which are aimed at children.
BHF medical director Professor Peter Weissberg said: "Daily unhealthy snacking is a worrying habit. "Rising rates of childhood obesity and cases of Type 2 diabetes paint a particularly grim picture for the future. This campaign is about challenging our children, alerting them to what's lurking in their snacks, takeaways and ready meals."
According to BHF, further figures from their research demonstrate that across the UK we eat our way through a tonne of crisps every three minutes. The charity said this would fill an Olympic size swimming pool every 14 hours and a telephone box every 43 seconds.
Prof Weissberg warned: "Crisps are just the tip of the iceberg. If you consider all the other unhealthy foods our kids are consuming, the fat just continues to pile up."
22 September 2006
http://news.bbc.co.uk/2/hi/uk_news/scotland/5369296.stm
U.S. study finds fear on-off switch in brain
U.S. researchers said on Wednesday they had identified an "on-off" switch in the brain that controls the emotional response to fear, and said it might some day be manipulated to help patients with anxiety disorders.
The team at Columbia University Medical Center used a simple attention test and a type of real-time brain scan called functional magnetic resonance imaging, which can catch the brain in action.
It showed an area in the rostral cingulate or rACC region of the brain was involved in turning on or off the fear response in the amygdala -- the almond-shaped brain center where emotional responses to fear are processed.
"People are exposed to an ever-increasing amount of stimuli in our everyday lives, and so we realized that the brain must employ a processing mechanism to prioritize and refine responses -- we don't run away from every loud sound or unexpected sight," said Dr. Joy Hirsch, who led the study, published in the journal Neuron.
They used a test called the Stroop test to try to activate whatever region must be involved. The Stroop test measures mental flexibility by forcing people to choose between a word's meaning and its color. For instance, someone may be asked to read a list of words such as "red", "yellow", or "green" in which the word "red" might be written in blue ink, "yellow" in pink ink and so on.
People usually respond more quickly if the color and word match.
Hirsch's team adapted this test, using photographs of fearful and happy faces, with "FEAR" or "HAPPY" written across the images. They gave the test to 19 healthy volunteers and ran the brain scan at the same time. The rostral cingulate seemed to light up just before the amygdala was activated, they reported. For instance, the amygdala activated at first if FEAR was written across a happy face, and then the rostral cingulate would activate, apparently as the image of the smiling face registered, after which the amygdala would calm down, they said. But the amygdala stayed activated for longer, and the rostral cingulate stayed unlit longer, if a fearful face also carried the "FEAR" label.
Hirsch said it is important to have a circuit to control the fear response.
Some patients with anxiety disorders and depression may eventually be helped by the findings, said Dr. Eric Kandel, a Howard Hughes Medical Institute senior investigator and professor in brain sciences who worked on the paper. "For example, if someone with anxiety has a disturbed functioning of part of the amygdala or a disturbed functioning of rostral cingulate control mechanism, and treatment could be based on the individual's specific problem," Kandel said.
20 September 2006
Music lessons help young child memories: study
Jennifer Kwan Parents who spend time and money to
teach their children music, take heart -- a new Canadian study shows
young children who take music lessons have better memories than their
nonmusical peers.
The study, to be published in the online edition of the journal Brain on Wednesday, showed that after one year of musical training, children performed better in a memory test than those who did not take music classes.
"(The research) tells us that if you take music lessons your brain is getting wired up differently than if you don't take music lessons," Laurel Trainor, professor of psychology, neuroscience and behavior at McMaster University in Hamilton, Ontario, told Reuters. "This is the first study to show that brain responses in young, musically trained and untrained children change differently over the course of a year," said Trainor who led the study.
Over a year they took four measurements in two groups of children aged between four and six -- those taking music lessons and those taking no musical training outside school -- and found developmental changes over periods as short as four months.
The children completed a music test in which they were asked to discriminate between harmonies, rhythms and melodies, and a memory test in which they had to listen to a series of numbers, remember them and repeat them back.
Trainor said while previous studies have shown that older children given music lessons had greater improvements in IQ scores than children given drama lessons, this is the first study to identify these effects in brain-based measurements in young children.
She said it was not that surprising that children studying music improved in musical listening skills more than children not studying music. "On the other hand, it is very interesting that the children taking music lessons improved more over the year on general memory skills that are correlated with nonmusical abilities such as literacy, verbal memory, Visio spatial processing, mathematics and IQ," she said.
Jennifer Kwan
19 September 2006
http://today.reuters.com/news/articlenews.aspx?type=healthNews&storyID=2006-09-19T231016Z_01_N19443231_RTRUKOC_0_US-CHILDREN.xml
Scientists link acne drug to depression
Experiments on animals have lent support to claims that a drug used widely in the treatment of acne can cause depression.
Roaccutane is highly effective in treating serious cases of acne, but in recent years the drug has been implicated in causing serious side-effects, including suicidal behaviour. The packaging spells out these risks, but why it should have this effect has never been clear; nor has it been proven that the drug is responsible, since adolescents with severe acne may feel depressed anyway.
A team at the University of Bath and the University of Texas in Austin investigated the effect of Roaccutane on mice, and reports the results in Neuropsychopharmacology. “You can’t ask a mouse if it is depressed,” Sarah Bailey, of the University of Bath, said yesterday. “So we used two tests to model behaviour.” Both involved putting the mice under stress. In one, they were put in water and forced to swim; in the other, suspended by their tails.
Under these circumstances mice will normally swim, climb or thrash around to try to escape, interspersed with periods of immobility when they appear to be resigned.
A mouse that is depressed will spend longer in the immobile state than one that is healthy. So the team gave Roaccutane to adolescent mice in doses equivalent to those given to human adolescents, and found that the periods of immobility significantly increased. The conclusion, Dr Bailey said, was that Roaccutane tended to increase depression-related behaviour in adolescent mice.
The drug belongs to a class of chemicals called retinoids, which have an effect on the way genes are “read” by the body, and reduce the rate at which new brain cells are generated. Roaccutane has been shown to damage the foetus in the womb, and precautions are taken to ensure that it is not used by women who are likely to become pregnant. However, recent findings suggest that brain-cell generation may be important not only in foetuses but also in adolescents and even adults, Dr Bailey said. The suspicion is that Roaccutane may influence the system responsible for producing the mood hormone serotonin, lowering the levels.
The evidence on those given the drug suggests that perhaps only 5 to 10 per cent are vulnerable to the effect. But there have been suggestions that retinoids may be implicated in Alzheimer’s disease and schizophrenia, so understanding more about how they work could lead to new treatments.
Roche, the makers of Roaccutane, said in a statement: “While no causal link has been established between Roaccutane and either depression or suicide, we are constantly monitoring all available safety databases on Roaccutane worldwide.”
13 Million users
- Roaccutane was first marketed in the early 1980s to treat severe acne.
- It belongs to a class of chemicals called retinoids, related to vitamin A
- Produced by Roche, the pharmaceutical company, it is known as Accutane in the United States.
- More than 13 million people worldwide have been treated with the drug.
- The World Health Organisation reports 720 cases of psychiatric problems arising from the use of Roaccutane, including 84 suicides and suicide attempts.
Source: Neuropsychopharmacology
Nigel Hawkes
19 September 2006
http://www.timesonline.co.uk/article/0,,2-2363681,00.html
More gym class not the answer to kids' weight woes
State laws requiring schools to devote more time to gym class have made little difference in American children's activity levels or waistlines, according to a new report.
Since the 1960s, the percentage of U.S. adolescents who are overweight has ballooned from 4.5 percent to 15.5 percent. Many experts have blamed that trend, in part, on the demise of physical education (PE) in U.S. schools.
In response, states have in recent years been passing, or at least introducing, legislation to require students to spend more time in gym class.
The new report, published in the journal Education Next, does not claim PE doesn't matter, but it does argue that merely increasing the number of minutes kids spend in gym class is not the answer to the epidemic of childhood inactivity and obesity. "We're not saying PE can't work," said lead report author John Cawley, an associate professor of policy analysis and management at Cornell University in Ithaca, New York.
However, he told Reuters Health, any health benefits of PE depend not only on quantity but quality -- including the types of activity and the amount of time students are actually exercising vigorously during gym class. There needs to be a critical examination of the curriculum, said Cawley, noting that even the U.S. Department of Education has criticized PE classes as too often employing an approach of "roll out the balls and let them play."
Cawley and his colleagues arrived at their conclusions after analyzing state PE requirements, along with data from a federal survey that regularly monitors the health and behavior of U.S. high school students. The data collected for the years 1999, 2001 and 2003, which included a pooled sample of 44,164 students, were reviewed.
The researchers found that, in general, when PE requirements were raised, students' overall physical activity levels remained largely unchanged. There was also no evidence of PE having an effect on students' risk of being overweight.
Girls did report a small increase in their levels of vigorous exercise -- an extra 8 minutes a week, on average. But much of the gain was offset by a decrease in the amount of time girls spent in moderate activities outside of gym class.
It's possible, Cawley said, that girls who tend to be sedentary cut back on daily physical activity even more when they're required to spend more time in PE.
More effort needs to go toward improving the quality of PE programs, the study authors conclude. So far, there's been little research into what actually gets students more active, let alone what works for weight control. "The real risk," Cawley said, "is that states will think they've addressed the issue (with time requirements), and then move on to something else."
SOURCE: Education Next, Fall 2006.
Amy Norton
15 September 2006
Malaria therapy could save lives of 800,000 children
THE lives of 800,000 children who die of malaria in Africa every year could be saved using a radical new treatment, according to research out today.
The technique was found to reduce the mortality rate among child patients - from between 20 and 40 per cent among those given conventional treatments to less than five per cent - in what was described as a "major breakthrough" in the fight against the killer disease.
About a million children die from malaria in Africa each year but if the treatment works as well as the two preliminary studies suggest, it could save the lives of more than 800,000.
The scientists behind the work - paediatricians at Imperial College London and the Wellcome Trust's Kenya Medical Research Institute Centre in Kilifi - said they planned further trials in three African countries to confirm the results.
The method involves giving replacement fluids in the form of a modified drip. Life-saving fluids cannot usually be given as they make the patient's condition worse by contributing to inflammation of the brain. However, the scientists found that adding albumin, a molecule which holds water inside blood vessels, to the fluid avoided this problem.
Dr Kathryn Maitland, a senior lecturer in paediatrics at Imperial College, said the new technique could have a significant impact, assuming the funds could be found to pay for it. "The observation that treating children with severe malaria with albumin infusion can reduce the mortality rate by more than 80 per cent represents a major breakthrough towards improved treatment of this devastating illness," she said. "However, administration of fluid to children critically ill with malaria is contrary to prevailing practice, and albumin is not available in most African hospitals."
Dr Maitland, who worked with Professor Michael Levin at Imperial and colleagues in Kenya on the eight-year project, stressed the need for further evidence to warrant spending money on the new form of fluid, which is more expensive than a simple saline drip. "It is essential that the results are reproduced in larger studies before we advise on any change in practice," she said. "The results of this trial have gone some way to answering the question of whether this form of supportive treatment saves lives, and we are now seeking funding for a trial involving more than 1,000 children in Ghana, Gambia and Kenya to confirm these findings in the poorest parts of the world."
A paper published by the journal PLoS today reveals the results of a study of 88 critically ill children who were given the albumin-based fluid or a cheaper, synthetic version. Only two per cent of those given the former died, compared with 16 per cent of those given the synthetic fluid.
Combining this data with other earlier studies showed there was a "highly significant reduction" in mortality, to below five per cent in children treated with albumin.
The studies were carried out in Kenya using methods usually available only on paediatric intensive care units in developed countries.
The researchers said an international effort would be required to make this treatment readily available in hospitals throughout Africa. Malaria kills between one and three million people a year, most of them children in sub-Saharan Africa. The disease is caused by a parasite which eats the red blood cells of the host, causing fever and anaemia. In the worst cases it leads to coma and death.
The main thrust of public health work to date has been to eradicate mosquitoes, which spread the parasite, and use drugs to prevent or treat the disease.
Ian Johnston
15 September 2006
http://news.scotsman.com/scitech.cfm?id=1362572006
Report: One in five children will become obese
One in five children is predicted to be obese by the end of the decade. But efforts to turn that tide are scattershot and underfunded, and the government killed one of the few programs proven to work, specialists said Wednesday.
Programs that target youngsters' growing waistlines are sprouting around the country, an encouraging sign that the threat to children's health is being taken seriously, said the report by the Institute of Medicine. But no one knows which programs really help kids slim down, said the institute said in calling for research to identify best methods.
More troubling, the country lacks the national leadership needed to speed change, lamented an expert panel convened by the scientific group. "Is this as important as stockpiling antibiotics or buying vaccines? I think it is," said Dr. Jeffrey Koplan of Emory University, who led the IOM's panel. "This is a major health problem. It's of a different nature than acute infectious threats, but it needs to be taken just as seriously." To reinforce that point, Wednesday's report spotlighted the government's VERB campaign, a program once touted as spurring a 30 percent increase in exercise among the preteens it reached. It ended this year with Bush administration budget cuts.
VERB encouraged 9- to 13-year-olds to take part in physical activities, like bike riding or skateboarding. Slick ads, at a cost of $59 million last year, portrayed exercise as cool at an age when outdoor play typically winds down and adolescent slothfulness sets in. The demise of the program "calls into question the commitment to obesity prevention within government," the panel concluded.
Koplan was more blunt, calling it a waste of taxpayer money to develop a program that works and then dismantle it.
The Centers for Disease Control and Prevention is "trying to do everything we can to package the research and lessons learned from VERB so it can inform campaigns local groups might take on throughout the country," responded CDC spokesman Jeff McKenna.
The report cites other examples of promising federal programs that have yet to reach their potential. Kids gobbled fruits and vegetables in an Agriculture Department school snack program, but it only reaches 14 states. And CDC's main anti-obesity initiative had enough money this year to fund just 28 states starting childhood nutrition and exercise programs.
The report also lauded some creative state and local efforts, including:
- A California program, started in Marin County, to build new sidewalks and bike paths that's getting more children to walk or bike to school.
- A community garden project in Harlem to increase inner-city youngsters' access to healthful food and safe recreation.
- An effort by Arkansas schools notify parents when students are overweight. Combined with new school menus and physical activity programs, the initiative recently reported a leveling off of the state's child obesity rate.
The IOM, which advises the government on health matters, in 2004 called for a joint attack on childhood obesity by parents, schools, communities, the food industry and government. Wednesday's report was the first checkup. "We still are not doing enough to prevent childhood obesity, and the problem is getting worse," concluded Koplan, a former CDC director. "The current level of public and private sector investments does not match the extent of the problem."
More than individual programs, a full-scale social change is needed so that healthful eating and physical activity becomes the norm, added panelist Toni Yancey of the University of California, Los Angeles. Some 17 percent of U.S. youngsters already are obese, and millions more are overweight. Obesity can lead to diabetes, high blood pressure and cholesterol, sleep problems and other disorders.
Wednesday's report shows "what the country is doing is like putting a Band-Aid on a brain tumor," said Margo Wootan of the consumer advocacy Center for Science in the Public Interest.
CNN
13 September 2006
http://edition.cnn.com/2006/HEALTH/09/13/child.obesity.ap/index.html
Study: Little drug research on children
Finding out how prescription drugs affect children isn't easy, even for pediatricians, a new study says. That's because very little research on children and drugs is published in medical journals that help guide doctors on treatment. The result is that some prescribe the wrong dose or use drugs that could be harmful to kids.
"Ironically, some of the times when drugs do work (in children), they're still not getting published," said Dr. Danny Benjamin, an associate professor at Duke University who led the study and also works for the U.S. Food and Drug Administration. He said an FDA program meant to encourage drug companies to test how drugs affect children has led to hundreds of studies. The problem is that about half the time, the results don't get published in peer-reviewed medical journals, mainly because researchers and sponsors don't submit them for publication, Benjamin said. Drug companies that conduct or sponsor pediatric research are motivated mostly to get their products on the market, "not to tend to the public health concerns," Benjamin said.
Also, parents often are reluctant to let their children participate in studies. So the research often involves many institutions with a few children at each location, which complicates compiling data and submitting them for publication, Benjamin said.
Examples the authors cited include unpublished data suggesting that an anesthesia drug might increase children's risk of death when used for sedation. Also, unpublished data has suggested that some steroid creams used for skin rashes in adults could cause a hormone imbalance in children. "People slather this on children, particularly babies," said study co-author Dr. Dianne Murphy, director of the FDA's office of pediatric therapeutics.
In both cases, precautions are listed on the drug label but not in much detail. They also appear on the FDA's Web site, but that's not where doctors usually look for such information, the researchers said. "We've just got to get the data out to people who are caring for children," Benjamin said. His study appears in today's Journal of the American Medical Association. JAMA is among the top peer-reviewed journals but editor-in-chief Dr. Catherine DeAngelis said few studies submitted to JAMA involve the effects of medication on children.
The researchers studied the impact of 1997 legislation authorizing a measure that grants drug companies longer patent protection when they agree to study a medication's effects in children. Between 1998 and 2004, 253 pediatric studies were submitted to the FDA under this program but only 45 percent were published in peer-reviewed journals, the researchers found.
Dr. Peter Lurie of the watchdog organization Public Citizen's Health Research Group said drug companies and academics need to push harder to publish. "It really is like the tree falling in the woods. The study is of no use whatsoever if it never reaches the practicing physician," Lurie said.
Scott Lassman of Pharmaceutical Research and
Manufacturers of America, an industry trade group, said drug companies
shouldn't be faulted. While he agreed publication in a peer-reviewed journal
is "the gold standard for getting information out," Lassman said
companies often present data at medical conferences and or post them in
an online industry database,
http://www.clinicalstudyresults.org
Lindsey Tanner
12 September 2006
http://www.lasvegassun.com/sunbin/stories/thrive/2006/sep/12/091203273.html
Some antidepressants raise violence risk: study
Newer antidepressants, already suspected of raising the risk of suicide,
may also cause a few people to become violent, researchers reported on
Monday.
They found that people who took GlaxoSmithKline's antidepressant Paxil
were twice as likely to have what was called a "hostility event" as
those given a placebo.
Paxil, known generically as paroxetine, is in a class of drugs called
selective serotonin reuptake inhibitors or SSRIs.
They came under scrutiny when some doctors reported that teenagers
taking the drugs might be more likely to commit suicide.
In 2004, the U.S. Food and Drug Administration concluded there was a
higher risk of suicidal behavior among children and teenagers and
ordered strong label warnings on several SSRI drugs. It has urged close
monitoring of adults.
David Healy and David Menkes from Cardiff University in Britain and
Andrew Herxheimer from the Cochrane Center used several sources of
information to see what the risk of violent behavior was among people
taking SSRIs.
They included data on paroxetine presented to Britain's Committee on
Safety of Medicines Expert Working Group by GlaxoSmithKline, legal cases
and e-mails from 1,374 patients in response to a British television
program on the subject.
They found that 60 out of 9,219 people who took Paxil or 0.65 percent,
had "a hostility event," compared to 20 of 6,455 given a placebo, or
0.31 percent.
Writing in the online journal Public Library of Science-Medicine, the
researchers said, however, that such violence was likely to be rare.
"The new issues highlighted by these cases need urgent examination
jointly by jurists and psychiatrists in all countries where
antidepressants are widely used," they wrote.
"When violence is a suspected outcome, every case has to be considered
carefully, on the principle that individuals are responsible for their
conduct, unless there is clear evidence of compromised function that
cannot be otherwise explained."
Public Library of Science-Medicine
11 September 2006
http://today.reuters.com/news/articlenews.aspx?type=healthNews&storyID=2006-09-12T004203Z_01_N11235219_RTRUKOC_0_US-ANTIDEPRESSANTS.xml
Children who snore more likely to wet bed: study
Children who snore are about four times more likely than those who don't to wet the bed, a new study from Greece shows.
Bedwetting and snoring have been linked in both adults and children, Dr. Emmanouel I. Alexopoulos of Larissa University Hospital and colleagues note in their report Treating the cause of snoring -- for example, by removing the adenoids and tonsils, can also stop bedwetting.
To clarify the relationship between snoring and bedwetting, the researchers evaluated 1,821 children between the ages of 5 to 14 years old, 2.4% of whom had a history of bedwetting. Those who snored more than three times a week, 7.4% of the total, were classified as habitual snorers.
Among the habitual snorers, the researchers found that 7.4% wet the bed compared with 2% of the children who did not snore, making children who snored 3.5 times more likely to wet the bed.
However, the researchers found, less than one quarter of the children who wet the bed also snored, which suggests it is unlikely that there is a common underlying cause for both.
There is evidence that people who snore produce more urine at night, while trying to breathe through obstructed airways may cause abdominal pressure that could also contribute to incontinence, Alexopoulos and his team note.
Based on the findings, pediatricians should ask the parents of their young patients who snore about bedwetting, and vice versa, they conclude.
SOURCE: Urology, August 2006.
11 September 2006
UN: More die from suicide than wars, murders
More people kill themselves each year than die from wars and murders combined, but most suicides could be prevented, two international experts on suicide said on Friday.
Some 20 million to 60 million try to kill themselves each year, but only about a million of them succeed, said Dr. Jose Manoel Bertolote, a mental health official at the World Health Organization in Geneva.
The ones who do end their lives "are tragic situations where help could have been provided," said Brian Mishara, president of the International Association for Suicide Prevention in Gondrin, France.
The two men spoke to reporters on the sidelines of a U.N. seminar marking this Sunday's World Suicide Prevention Day.
- Suicide rates could be reduced if countries would limit access to pesticides, guns and medication and do a better job of treating people with depression, alcoholism and schizophrenia, Mishara said.
- About a third of all suicides around the world are caused by pesticides, said Bertolote.
- Dentists, veterinarians and doctors are particularly at risk for suicide -- not because of their high-stress professions but because they have access to lethal chemicals and know how to handle them, Bertolote said.
- Those who lose a job abruptly are more likely to kill themselves than people living in poor social conditions for long periods, he said.
- Also, people living in countries where suicide is illegal like Singapore, Lebanon and India are less likely to seek help if they have suicidal thoughts, for fear the government may punish them, Mishara said. "Those laws don't appear to have a dissuasive effect, but rather make it more difficult for people to come forth and get help," he said.
Matthew Verrinder
8 September 2006
Canada: Youth smoking continues to decline
Cigarettes are being smoked by 18 per cent of young Albertans in grades
5 through 9, shows Health Canada’s most recent survey on youth tobacco
use.
The report found 81.9 per cent of young Albertans have never tried a cigarette, a number that places the province in the middle of the pack nationally.
Cigarette use was most rare in B.C., where 87.9 per cent of youth have never puffed tobacco, and most common in Quebec, where only 69 per cent have never touched a smoke.
Overall, the 2004-2005 survey showed 21 per cent of Canadian youth had tried tobacco, which represents a 50 per cent reduction over a 10-year period from the rate in 1994.
The national survey questioned 29,000 Canadian students on their smoking habits.
6 September 2006
http://www.canada.com/calgaryherald/news/story.html?id=4fbc5c7e-7d48-437c-bfa3-6d907cd85d6e&k=0
Some online games may enhance sociability
Video games involving multiple players serve as informal gathering places akin to old-time pubs and coffee shops, and can thereby boost the players' social connections, researchers argue in a new study.
In their report, Constance Steinkuehler of the University of Wisconsin-Madison and Dmitri Williams of the University of Illinois at Urbana-Champaign question the perception that kids who play computer games are isolating themselves, at least when they are playing so-called massively multiplayer online games (MMOs).
"By providing spaces for social interaction and relationships beyond the workplace and home, MMOs have the capacity to function as one form of a new 'third space' for informal sociability," Steinkuehler and Williams write. While such sociability won't offer "deep emotional support," they add, it has the benefit of exposing players to a wide range of viewpoints and a more diverse social environment.
The effects of the Internet on society are still being debated, the researchers note in an article in the Journal of Computer-Mediated Communication. Some claim the Web allows people to build connections and communities, while others say such virtual links are just a poor substitute for the real thing.
The researchers sought to investigate the role of MMOs, in which players inhabit "avatars" or on-screen representations of characters within virtual worlds and chat with other players by text or voice, in players' social lives.
They studied whether one game, "Asheron's Call I and II," built players' "social capital" by dividing 750 people into game-playing and non-playing groups. They also conducted a two-year study of the activities and perceptions of a group of people playing the MMO "Lineage."
Steinkuehler and Williams conclude that the games helped players gather a type of social capital known as "bridging," which involves making informal connections with others, while they didn't generally help people build stronger social bonds. Such "weaker" social links are important, the researchers say, because they offer players the opportunity to be exposed to diverse worldviews that they may not encounter in the real world.
Players who did become more deeply involved in the games did run the risk of having virtual relationships replace real-life ones, however, the researchers note. However, to see these online communities as an entirely bad thing is short-sighted, they say.
"To argue that MMO game play is isolated and passive media consumption in place of informal social engagement is to ignore the nature of what participants actually do behind the computer screen," they state. "In the case of MMOs, game play is more akin to playing five-person poker in a neighborhood tavern that is accessible from your own living room."
SOURCE: Journal of Computer-Mediated Communication, August 2006.
6 September 2006
Maltreatment common for U.S. children
A substantial percentage of young U.S. adults say they suffered some form of neglect or abuse as children, researchers reported Tuesday.
Of nearly 15,200 young adults in a national health study, 41 percent said that as children, they'd been left home alone when an adult should have been present. And more than one-quarter said their parents or other caregivers had hit, slapped or kicked them.
The findings, published in the journal Pediatrics, suggest that child maltreatment -- in the form of abuse or neglect -- is common among U.S. children, and the consequences can be serious.
Young adults who reported childhood maltreatment were also more likely to report drug and alcohol abuse, violent behavior, depression and poor health during their teens.
Though studies have been investigating child abuse and neglect for years, the true scope of the problem, including its long-term consequences, has not been fully clear, the lead author of the new report told Reuters Health. "It's a hard thing to measure well," said Dr. Jon M. Hussey of the University of North Carolina, Chapel Hill. Data based on cases reported to child welfare services, for example, capture only a portion of the problem, he explained.
For their study, Hussey and his colleagues used data from a national survey that followed thousands of U.S. adolescents through young adulthood. As adults, they reported whether they'd ever suffered any of several types of child maltreatment. "Supervision neglect," or being left home alone at a young age, was the most common form of maltreatment, followed by physical abuse. Of the 28 percent of study participants who said they'd been physically abused, half said it happened three or more times.
In addition, about 12 percent said they'd suffered physical neglect -- instances in which their parents failed to provide for their basic needs, like keeping them clean or giving them clothing or enough food. Another 4.5 percent said they were sexually abused as children.
Each of these forms of maltreatment appeared to carry long-term consequences, Hussey's team found. As teenagers, study participants who'd suffered childhood maltreatment were at greater risk of various health and behavioral problems.
Past studies have suggested that childhood neglect and abuse can have far-reaching effects, Hussey noted. "I think one of the contributions of this study is validate those past findings," he said.
The results also put a spotlight on the problem of childhood neglect, which is more common than physical and sexual abuse but draws less public awareness. "I hope the findings will attract attention to the problem of child neglect," Hussey said.
SOURCE: Pediatrics, September 2006.
Amy Norton
5 September 2006
Treatment with 'friendly' bacteria could counter autism in children
Probiotic bacteria given to autistic children improved their concentration and behaviour so much that medical trials collapsed because parents refused to accept placebos, a scientist revealed yesterday. The effect of the bacteria was so pronounced that some of the parents taking part in what was supposed to be a blind trial realised their children were taking something other than a placebo. A number then refused to give their children the placebo when they were due to switch, resulting in the collapse of the trial.
Glenn Gibson, a microbiologist who ran the study of 40 autistic children aged between four and eight, said this meant it was difficult to draw any firm conclusions and he is planning to carry out further research. However, he said parents had told him the probiotic bacteria was having a beneficial effect, resulting in "better concentration and better behaviour".
One parent said it was "heartbreaking" to have to stop their child taking it. "It was really challenging for us and the parents. I'd really like to go back to it and do it in a better way, with perhaps more professional help from people who know how to deal with autistic children," said Prof Gibson. "The trial ultimately failed because of the large number of drop-outs. About half the kids dropped out. Some of the parents worked out their child was on the test and didn't want to move on to the placebo."
Autistic children often suffer bowel conditions and Prof Gibson said a previous study had found high levels of a "bad" bacteria called clostridia in the gut. The probiotic was then designed to reduce the levels of clostridia and promote "friendly" bacteria instead to see what effect this would have.
Prof Gibson, from Reading University, said the children appeared to show fewer signs of autism when taking the probiotic supplement, which was given in a powder once a day. "Very subjectively, we asked the parents to fill in diaries about the mood of the children. We got very positive feedback generally," he said. He said that certain kinds of clostridia produced neuro- toxins, which potentially could be the cause of autism or a contributory factor. However, he said this was speculation and the apparent improvement could also simply be because the children had felt better. "If your gut is not behaving yourself, you feel rough," Prof Gibson said.
The first bacteria in the gut is received from the mother during birth and then comes from the outside environment, with diet playing an important role. "They [infants] may be under medication for an infection and that may have an effect," Prof Gibson said. "There are all sorts of different factors that may affect that [the bacterial make-up of the gut]."
There was a scare over widely discredited claims that autism was linked to the MMR - measles, mumps and rubella - vaccine given to children. Asked whether he thought childhood vaccines could have an effect, Prof Gibson said: "No. I don't think there is anything in this MMR business at all." It is estimated that 535,000 people in the UK have some kind of autism, including a milder form called Asperger's Syndrome. The condition affects four times as many boys as girls for reasons that are not clearly understood.
A spokeswoman for the National Autistic Society (NAS), the UK's leading charity for people with the condition and their families, said it followed new research into possible treatments with great interest. She went on: "There is anecdotal evidence that certain vitamins and diets do have benefits for some people with autism. However, a great deal more research remains to be done in this area. "The NAS looks forward to seeing the results of the further research that Professor Gibson hopes to conduct in the future." She said that "rigorous scientific evaluation" was necessary to gauge the effects of any new treatment. A whole range of therapies had been tried in the past, from medication and behavioural therapy to aromatherapy and swimming with dolphins, with varying degrees of success.
Ian Johnston
5 September 2006
http://news.scotsman.com/scitech.cfm?id=1308572006
Mom's vitamin E may affect child's asthma risk
Women who get enough vitamin E during
pregnancy may help lower their child's future risk of asthma, a study
suggests. The findings, published in the American Journal of Respiratory
and Critical Care Medicine, add to evidence that vitamin E may aid in
lung and immune system development. It's too soon, however, to advise
pregnant women to take vitamin E supplements, the study's lead author
told Reuters Health. "It should be strongly emphasized that women should
eat healthily during pregnancy and not take vitamin E supplements just
because of this study," said Dr. Graham Devereux of the University of
Aberdeen in the UK.
A balanced diet, he noted, should include various sources of vitamin E, such as vegetable oils, nuts, fatty fish, leafy green vegetables and fortified cereals. One of the problems with vitamin E supplements, Devereux explained, is that previous studies have found it to be no help in preventing various conditions for which it seemed promising -- from cancer to the pregnancy complication pre-eclampsia.
Still, the new study builds on previous work by Devereux and his colleagues suggesting that adequate vitamin E during pregnancy benefits children's lung health. In the earlier research, they'd found that 2-year-olds whose mothers got relatively little vitamin E during pregnancy had an elevated risk of wheezing. These latest findings show that at age 5, these same children were more likely than their peers to be diagnosed with asthma.
The study included 1,861 children whose mothers were recruited during pregnancy. The researchers surveyed the women on their diet habits during pregnancy and assessed children's diets and respiratory health at age 5. They found that children whose mothers had the lowest vitamin E intake during pregnancy were still more likely to suffer wheezing at age 5, and were about twice as likely to have doctor-diagnosed asthma. These mothers got anywhere from 2 to 6 milligrams (mg) of vitamin E per day -- well short of the 15 mg that U.S. health authorities recommend for women, pregnant or not.
Devereux and his colleagues also measured women's blood levels of vitamin E during pregnancy. They found that 5-year-olds whose mothers had higher vitamin E levels tended to have better scores on lung function tests. It's possible, Devereux said, that supplements containing modest doses of vitamin E -- like the recommended 15 mg -- would be beneficial during pregnancy. But studies need to investigate that possibility before any recommendations are made, he stressed.
SOURCE: American Journal of Respiratory and Critical Care Medicine, September 2006.
Amy Norton
1 September 2006
Children of smokers are linked to bad behaviour
SMOKERS' children are more likely to binge drink, experiment with drugs, skip school, steal, vandalise and have under-age sex, according to a new study. The survey of more than 830 teenagers found those whose parents smoked were generally worse behaved.
Professor Colin Pritchard, who led the study, today called for warnings about the social and psychological impact of smoking as well as the standard physical health warnings on cigarette packets. "Children with smoking parents went binge drinking at almost twice the rate of non-smoking parents, double the drinking in pubs, higher use of cannabis and double the rate of hard drug misuse," he said.
"They also are twice as likely to truant and steal, cause more vandalism and, more importantly, 46 per cent, compared with 18 per cent of children of non-smoking parents, had under-age sex and 19 per cent, compared with six per cent, had unprotected sex. "There are some socioeconomic factors linked to these findings - smokers generally have less good jobs than non-smokers and have higher unemployment.
"It is not the economics as such, but it seems it is the message that these parents inadvertently give their children. "Parents who smoke should be aware of the linked consequences."
http://news.scotsman.com/education.cfm?id=1287622006
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