Worth Noting An Update on Injuries in High School Sports An estimated 7.2 million high school students participated in sports in 2005-2006, but despite the documented health benefits of increased physical activity (weight management, improved self-esteem, increased strength and endurance), sports have a downside—high school athletes are estimated to sustain 2 million injuries a year, involving 50,000 doctor’s visits and 30,000 hospitalizations. A survey of a representative sample of U.S. high schools conducted by a children’s hospital in Ohio found that participation in the nine most common high school sports (baseball, football, wrestling for boys, softball and volleyball for girls, and basketball and soccer for boys and girls) resulted in injuries at the rate of 2.4 injuries per 1,000 athlete exposures--practices and competitions. Most commonly reported injuries were sprains, contusions, fractures, concussion, and an "other" category that includes lacerations or dislocations and health-related events such as heat illness, skin infections, and asthma attacks. Noting that history of an injury is often a risk factor for future injury, the Centers for Disease Control and Prevention, which sponsored the Ohio survey, called attention to general recommendations for reducing risk of injury, such as adequate hydration and use of appropriate protective equipment in practices and competitions, use of block and tackle with the head up to reduce risk of neck injuries in football, and techniques for handling concussion. Child Health Institute Launches New Website The component of the National Institutes of Health (NIH) that conducts and supports research on the health of children, adults, families, and communities launched a new website in September aimed at providing easier access to information for the general public and scientists. Described as useful to people who need health information, as well as scientists who need research information, the new National Institute of Child Health and Human Development (NICHD) site is expected to provide information on health conditions ranging from autism to reading disabilities, as well as links to clinical trials and the Institute’s public information campaigns. NICHD notes that it sponsors research on development before and after birth; maternal, child, and family health; reproductive biology and population issues; and medical rehabilitation. The new website can be accessed at http://www.nichd.nih.gov. A New Broadly Available Lead Screening Test The U.S. Food and Drug Administration in September announced availability of a "simple and portable lead test system" that will make it possible for more than 115,000 point-of-care locations nationwide, including healthcare clinics, mobile health units, and schools, to test children and adults for lead poisoning and to get immediate results while the patient is still present. The test, called the LeadCare II Blood Lead Test System, involves a finger stick or venous whole blood sample. Results are available in as little as three minutes, reducing the need for a follow-up visit. The FDA points out that lead poisoning in children typically results from ingesting dust from deteriorating lead-based paint or drinking water from corroding plumbing. Although there may be no symptoms, lead poisoning can result in headaches, stomach cramps, memory loss, high blood pressure, and seizures, and has been linked to learning disabilities and developmental delays in children. The Centers for Disease Control and Prevention (CDC) estimates that more than 300,000 children under six each year have blood levels that exceed 10 milligrams per deciliter, the threshold used to indicate lead poisoning; and the American Academy of Pediatrics (AAP) estimates that one out of four homes with children under age six has lead contamination. Information on the LeadCare II Blood Lead Test System is available at www.fda.gov/cdrh/oivd/leadtest-qa.html. The following information appeared during the month of September 2006 in the News Alerts section of the website of the Center for Health and Health Care in Schools, at www.healthinschools.org. September 6, 2006 Mark McClellan, a physician and economist who has headed the federal government’s Centers for Medicare and Medicaid Services (CMS) since 2004, said yesterday that he will resign that post in five weeks, possibly to join a think tank where he will write about health care in the United States. McClellan, who was commissioner of the Food and Drug Administration before moving to CMS two years ago, has indicated for some time that he intended to resign. No replacement to the CMS has been named by the White House, which is expected to have difficulty recruiting for the sensitive position during the final years of the current administration. September 7, 2006 Current illicit drug use by young people 12 to 17 years old is continuing to decline, representing "a fundamental shift in drug use among young people," according to the acting deputy director of the federal Substance Abuse and Mental Health Services Administration (SAMHSA). Citing data from the 2005 National Survey on Drug Use and Health showing a decline from 11.6 percent of the age group using drugs in 2002 to 9.9 percent in 2005, officials suggested that teens may be getting the message that drug use damages their futures and may be "turning away from destructive patterns that damaged previous generations." If so, teens aren’t getting much encouragement from the baby boom generation—SAMHSA noted that among adults aged 50 to 59, the rate of current illicit drug use increased from 2.7 percent to 4.4 percent between 2002 and 2005. The statistics were released by SAMHSA today as part of National Alcohol and Drug Addiction Recovery Month, a national campaign to persuade people to seek help with drug addiction. September 11, 2006 Many of the federally mandated Local Wellness Policies schools were supposed to have in place at the beginning of the current school year do not meet minimum guidelines for nutrition and physical education, according to a preliminary survey of 112 school districts in 42 states by the organization Action for Healthy Kids. The Child Nutrition and Special Supplemental (WIC) Reauthorization Act passed by Congress in 2004 required every school district participating in federally subsidized school breakfast and lunch programs to develop and launch a Local Wellness Policy by the start of the 2006-2007 school year, with the policy to include goals for nutrition education and physical activity and nutrition guidelines for all foods and beverages available on school campuses during the school day. As of July this year, however, Action for Healthy Kids found compliance with the federal mandate varied widely across school districts, with only half meeting all of the minimum federal requirements. Forty percent of the plans failed to designate a person or persons responsible for implementing the wellness policy, 19 percent did not address issues of implementation or evaluation, 18 percent did not include goals for physical education, and 14 percent did not specify goals for nutrition education. Action for Healthy Kids noted that its survey was not comprehensive and provided only a "snapshot" of local policies. Further information is available at www.ActionForHealthyKids.org/wellnesstool/index.html. September 13, 2006 In an interim report released today, the Institute of Medicine of the National Academy of Sciences said there is still a substantial underinvestment of the resources needed to address the growing problem of childhood obesity, and interventions generally remain fragmented and small-scale. The report, "Progress in Preventing Childhood Obesity: "How Do We Measure Up?" looks at what has happened since the Institute called attention to childhood obesity in a 2005 report titled "Health in the Balance," that offered a blueprint for government, industry, media, community, school, and family actions. The new report concludes that while many prevention policies and programs are currently under way to increase physical activity and promote healthful eating among children and youth, lack of systematic monitoring and evaluation have hindered the development of a research base to identify, apply, and disseminate the lessons learned. Among suggested next steps for confronting the obesity epidemic, the new report repeats recommendations that schools should bolster physical education and physical activity requirements and standards, and that efforts should be made to extend obesity prevention to preschool, childcare, and after-school programs. The report also says schools should receive "adequate and sustained" resources from federal and state government funding to implement relevant changes in the school environment, including increased physical activity and consumption of foods and beverages that support a healthful diet. The full text of the report is available at http://www.nap.edu. September 13, 2006 Otitis media, or inflammation of the inner ear, is the most common diagnosis for which antibiotics are prescribed for children, and it is also a condition which often clears up on its own when untreated. In light of growing concerns about overuse of antibiotics in medicine, leading to antibiotic resistance, a number of clinics and pediatricians have adopted a "wait-and-see prescription" approach, in which parents whose children are diagnosed with otitis media are given a prescription for an antibiotic but are asked to delay filling it for a few days while they watch their children’s progress. A number of studies have indicated that this approach works when children are seen by their regular pediatricians, but a new study reported in today’s issue of the Journal of the American Medical Association found the same effects when children were diagnosed in hospital emergency rooms. The emergency room parents were given prescriptions but asked to hold off on filling them unless their children’s conditions worsened. All of the patients received ibuprofen and otis analgesic drugs for use at home during the "wait-and-see" period. Researchers reported that in the study, use of antibiotics by children between 6 months and 12 years of age was reduced by 56 percent and no serious adverse effects were reported for patients. Full text of the JAMA article "Wait-and-See Prescription for the Treatment of Acute Otitis Media" is available from the principal investigator at spirod@ohs.edu. September 15, 2006 The Centers for Disease Control and Prevention (CDC) announced today that 2005 childhood immunization rates for vaccines routinely recommended for children between 19 and 35 months of age remained at or near record highs, and for the first time in the past ten years, rates for the full series of recommended vaccines did not vary significantly by race and ethnicity. According to CDC’s annual National Immunization Survey released today, estimated immunization coverage rates in 2005 ranged from 79.5 percent for children of multiple race, 77.1 percent for Asian, 76.3 percent for black, 76 percent for white, and 75.6 percent for Hispanic children. CDC officials credit the federal Vaccines for Children program, which provides free vaccines for uninsured and underinsured children, and the 317 program, which encourages partnerships with healthcare providers to immunize children in working poor families who cannot afford the deductibles needed for full vaccination, for the relatively high coverage levels. As in recent years, there was wide variation in coverage levels among states and urban areas, ranging from 90.7 percent in Massachusetts to 62.9 percent in Vermont and from 84.5 percent for Jefferson County, Alabama (Birmingham) to 58.8 percent for Clark County, Nevada (Las Vegas). September 18, 2006 In a policy statement issued September 15, the American Academy of Pediatrics (AAP) said it is opposed to use of retail-based clinics in supermarkets, pharmacies, and large retail stores as a source of medical care for infants, children, and adolescents. The AAP is especially concerned that such clinics may provide lower quality of care, especially for children with special health needs, and that the clinics lack access to a central health record. Also, tests and diagnoses are given without proper follow-up, the AAP charged, and there are public health issues concerning exposure to contagious diseases in a retail environment. The AAP also expressed opposition to the practice of some retail-based clinics of waiving or lowering co-pays or offering other financial incentives for visits. Conceding that retail-based clinics are likely to continue to exist, however, the AAP recommends that the clinics support the medical home by referring patients back to primary care physicians for further care, communicate with the patient’s pediatrician or other primary care physician within 24 hours of a visit, and follow guidelines for care of children developed by medical organizations. The complete policy statement is available at http://www.aap.org/ September 19, 2006 Through a combination of sponsorships, incentive programs, and "appropriation of space," public schools currently expose between 26.6 million and 30.3 million students to advertising of foods of minimal nutritional value or foods high in fat and sugar, according to a study conducted by the Commercialism in Education Research Unit at Arizona State University. In an analysis of a stratified sample of U.S. schools at elementary, middle, and high levels, researchers found that 67 percent of schools have food company sponsors for sports teams, clubs, or scholarships; 71 percent of schools accept food company sponsorship of incentives such as free goods or coupons for academic achievement; and 40 percent of schools display brands, logos, or names on vending machines, scoreboards, sports fields, or in the form of corporate "naming rights" for school facilities. Commercial sponsorships are often cited as a needed source of extra income for schools, but in the Arizona study, 68 percent of schools that participated in advertising reported receiving no income at all from those activities and only 5 percent reported receiving more than $10,000. And despite widespread current acceptance of food-company sponsorship, 69 percent of the school officials contacted said they would favor increased regulation of advertising in schools by corporations that sell foods of minimal nutritional value or foods high in fat and sugar. Details of the study can be found at http://www.asu.edu/educ/epsl/CERU/CERU_2006_Research_Writing.htm. September 20, 2006 Noting that at least 17 states face federal funding shortfalls of as much as $900 million for the State Children’s Health Insurance Program (SCHIP) in the 2007 fiscal year that begins October 1, Senator Jay Rockefeller (D-WV) introduced legislation September 19 to keep funds moving to the states pending reauthorization of SCHIP next year. Rockefeller noted that "No one can dispute the success of the SCHIP program in enrolling and providing coverage for more than 6 million children nationwide," but he said recent increases in the number of uninsured children "will only get worse" if the funding shortfall is not addressed before Congress adjourns next month. The Senate bill, S. 3913, and companion legislation introduced in the House (H.R. 6098) would redistribute unused previous-year SCHIP funds and would authorize additional federal appropriations to enable states to continue or expand SCHIP coverage in fiscal 2007. Congressional failure to take the necessary action would mean additional children would go without needed access to health care and would "run counter to the goals Congress set out when we created SCHIP in 1997," Rockefeller said. September 21, 2006 New recommendations released today by the federal Centers for Disease Control and Prevention (CDC) would make voluntary HIV screening a routine part of medical care for patients aged 13 to 64. New approaches to early detection are needed, the CDC said, because, currently, a quarter-million Americans with HIV don’t know they have it and 40 percent of those who are diagnosed have been infected for a year or more before they find out, making it too late for them to fully benefit from treatment or to protect their partners. The new recommendations, developed over a three-year period, call for:
The CDC notes that the new recommendations address HIV screening in healthcare settings only and "do not apply to non-clinical settings such as community centers and outreach programs." "Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health Care Settings," are published in the September 22, 2006, issue of the CDC’s Morbidity and Mortality Weekly Report and can be accessed at http://www.cdc.gov/mmwr. September 26, 2006 Almost 8,000 visits to hospital emergency rooms in 2004 involved misuse of two drugs widely prescribed to treat attention deficit hyperactivity disorder (ADHD), according to data compiled by the Substance Abuse and Mental Health Services Administration (SAMHSA). In its latest Drug Abuse Warning Network release, SAMHSA notes that emergency room visits involved methyphenidate (marketed as Ritalin or Concerta) or amphetamine-dextroamphetamine (marketed as Adderal), with a third of patients having ingested ADHD medication alone and two-thirds having used it in combination with other drugs, including alcohol, illicit drugs, and other pharmaceuticals. SAMHSA notes that many emergency room visits for non-medical use of ADHD involved persons 12 to 17 years of age, but misuse of ADHD drugs also has increased in persons 18 to 24 years of age, largely because college students are believed to use the drugs for their stimulant properties as study aids. While the proportion of young people in both age groups who misuse ADHD drugs is relatively low, SAMHSA cautions that the Food and Drug Administration has called for label warnings on ADHD medications warning of increased potential for cardiac problems such as hypertension, cardiac arrest, and stroke, with the possibility of medical problems exacerbated when ADHD medication is used improperly or in combination with other drugs. September 28, 2006 The Federal Communications Commission (FCC) announced yesterday that it will join a coalition of representatives of the food, television, and advertising industries, together with consumer groups and health experts, to address the question of whether television ads viewed by children are related to overweight and obesity. What we know, said FCC Chairman Kevin Martin, is that "while the amount of television viewed by American kids has been increasing in the past twenty-five years, so have their waistlines." Martin noted that research shows children under 6 cannot distinguish between program content and advertising, and children under 10 do not have the cognitive ability to understand a commercial’s persuasive intent. He also pointed out that "children’s advertising is big business," with fast food companies alone spending $3 billion a year targeting kids. The FCC said after the task force completes its review, the agency will summarize what has been learned and will "encourage" best practices for industry and continued education for parents. |
