December 1, 2008, 6:00 PM CT

Childhood vaccines cause financial burden

The costs that health care providers are charged and reimbursed for childhood vaccines vary widely, and the high cost of some immunizations is leading to significant financial strain for some physicians, as per a pair of new studies from the University of Michigan Health System.

The findings suggest that a number of physicians appear to be paying too much and receiving too little reimbursement, but they can use this new data to help improve both areas, the scientists say.

"Physicians need to be better business people, and negotiate better prices and payments," says lead author Gary L. Freed, M.D., MPH, chief of the Division of General Pediatrics and director of the Child Health Evaluation and Research (CHEAR) Unit at the U-M Health System's Mott Children's Hospital. Freed is the immediate past chair of the U.S. Department of Health and Human Services' National Vaccine Advisory Committee.

With vaccines for children enrolled in Medicaid funded by the public sector through the federal Vaccines for Children Program, prices are negotiated annually with vaccine manufacturers by the Centers for Disease Control and Prevention. But the data from the new studies support the belief that costs and reimbursements are widely variable in private practices.

"Until now, nobody knew what anyone was paying," Freed notes. "This information will change the way in which physicians negotiate prices." The studies appear in the recent issue of the journal Pediatrics........ Posted by: JoAnn      Read more         Source

November 19, 2008, 8:20 PM CT

Ban on fast food TV advertising

A ban on fast food advertisements in the United States could reduce the number of overweight children by as much as 18 percent, as per a new study being published this month in the Journal of Law and Economics The study also reports that eliminating the tax deductibility linked to television advertising would result in a reduction of childhood obesity, though in smaller numbers.

The study was conducted by scientists from the National Bureau of Economic Research (NBER) with funding from the National Institutes of Health. NBER economists Shin-Yi Chou of Lehigh University, Inas Rashad of Georgia State University, and Michael Grossman of City University of New York Graduate Center co-authored the paper, which measures the number of hours of fast food television advertising messages viewed by children on a weekly basis.

The authors observed that a ban on fast food television advertisements during children's programming would reduce the number of overweight children ages 3-11 by 18 percent, while also lowering the number of overweight adolescents ages 12-18 by 14 percent. The effect is more pronounced for males than females.

Though a ban would be effective, the authors also question whether such a high degree of government involvementand the costs of implementing such policiesis a practical option. Should the U.S. pursue that path, they would follow Sweden, Norway and Finland as the only countries to have banned commercial sponsorship of children's programs......... Posted by: JoAnn      Read more         Source

November 14, 2008, 5:36 AM CT

Families, friends, schools and neighborhoods

Characteristics present in the four social environments in which young people livefamilies, peers, schools, and neighborhoodscontribute both positively and negatively to whether teens misuse alcohol, with risk from one area possibly being magnified or decreased by attributes of another.

That's the finding of a new longitudinal study conducted by scientists at the University of North Carolina at Chapel Hill, the University of California at Davis, and the University of California at Irvine. The study appears in the November/December 2008 issue of the journal Child Development

Prior research on teen drinking has focused mostly on individuals' ties to friends and family members. This study suggests the need for a more inclusive view of the social world of adolescents and highlights the importance of examining the connections between all of the social environments in which they live.

The scientists used data from 6,544 teens ages 11 to 17 enrolled in three public school systems in North Carolina, surveying them every six months for a total of five times. The adolescents were in grades 6, 7, and 8 when they were first surveyed, and in grades 8, 9, and 10 at the end of the study. The study used information from the teens to measure their misuse of alcohol, including heavy drinking, and to gauge negative consequences linked to drinking, such as getting into fights......... Posted by: JoAnn      Read more         Source

November 14, 2008, 5:34 AM CT

Relationships with caregivers key to children's stress

How children are affected by out-of-home care depends not only on the qualities of their teacher and the classroom, but also on the nature of the children's relationship with their caregivers. That's the finding of a new study on the level of the stress hormone cortisol in children in full-day child care.

Cortisol, the primary stress hormone in humans, tends to be at its highest levels in the early morning and gradually declines over the course of the day. But recent research has observed that a number of preschoolers in full-day child care have increases in cortisol from morning to afternoon.

This study observed that children in classrooms with closer to 10 children were more likely to show cortisol decreases from morning to afternoon, while children in classrooms with closer to 20 children tended to show greater increases in cortisol across the day. Children with more clingy relationships with their teachers showed greater rises in cortisol from morning to afternoon, and children with more conflicted relationships with their teachers showed greater cortisol boosts during a one-on-one session with their teachers. Conflicted relationships were said to occur when teachers tried to control resistant children, when children perceived their teachers as unfriendly, or when teachers or children reported that the teachers found the interaction frustrating......... Posted by: JoAnn      Read more         Source

November 6, 2008, 8:17 PM CT

Unusual use of toys in infancy a clue to later autism

Scientists at the UC Davis M.I.N.D. Institute have observed that infants later diagnosed with autism exhibited unusual exploration of objects long before being diagnosed. Studying a group of children at high risk for developing autism, the scientists observed that those eventually diagnosed with the disorder were more likely to spin, repetitively rotate, stare at and look out of the corners of their eyes at simple objects, including a baby bottle and a rattle, as early as 12 months of age.

These findings could help pediatricians diagnose and treat autism earlier, reducing some of the social and educational challenges linked to the disorder.

"There is an urgent need to develop measures that can pick up early signs of autism, signs present before 24 months," said M.I.N.D. researcher Sally Ozonoff, first author of the current study, which was reported in the recent issue of Autism, the journal of the National Autistic Society.

The American Academy of Pediatrics has recommended that all infants be screened for autism twice before their second birthdays. Currently, pediatricians look for the hallmark social and communication signs of autism, which include language delays and lack of interest in people.

"The finding that the unusual use of toys is also present early in life means that this behavior could easily be added to a parent check-list or quickly assessed during a visit to a pediatrician's office," Ozonoff said......... Posted by: JoAnn      Read more         Source

October 28, 2008, 5:08 AM CT

Green neighborhoods may reduce childhood obesity

Childhood obesity can lead to type 2 diabetes, asthma, hypertension, sleep apnea and emotional distress. Obese children and youth are likely to be obese as adults, experience more cardiovascular disease, hypertension and stroke and incur higher healthcare costs. In an article reported in the December 2008 issue of the American Journal of Preventive Medicine, scientists report that children living in inner city neighborhoods with higher "greenness" experienced lower weight gains in comparison to those in areas with less green space.

Scientists from the University of Washington, Indiana University-Purdue University and Indiana University School of Medicine followed more than 3800 children, predominantly African-American and poor, aged 3-16 over a two-year period. Using satellite imaging data to measure vegetation coverage, the researchers observed that higher greenness was significantly linked to lower body mass index (BMI) changes in those children. In prior studies of adults, residential density tended to predict physical activity levels, with highly urban environments leading to more walking, less driving and lower BMI. The current study did not find this correlation for children.

Children and youth in urban environments may be active in a wider variety of open spaces (e.g., yards, parks, vacant lots) and less likely to constrain activity to streets and sidewalks. Greenness might indicate proximity to parks, playfields or other open spaces that promote either physical activity or increased time spent outdoors in active play......... Posted by: JoAnn      Read more         Source

October 27, 2008, 5:42 AM CT

Vaccinating family members offers important flu protection to newborns

Vaccinating new mothers and other family members against influenza before their newborns leave the hospital creates a "cocooning effect" that may shelter unprotected children from the flu, a virus that can be life-threatening to infants, as per scientists at Duke Children's Hospital.

The hospital-based outreach tested in this study proved effective at boosting immunization rates in parents particularly new fathers and siblings who otherwise may not be vaccinated.

"The Centers for Disease Control and Prevention does not recommend vaccinating newborns for flu because they're too young, however they're a part of the population that is at highest risk," explains Emmanuel (Chip) Walter, MD, a pediatric infectious disease specialist at Duke Children's Hospital. He presented the findings of the CDC-funded study at the annual ICAAC/IDSA meeting in Washington, DC.

"Newborns have the highest rate of hospitalizations due to influenza when in comparison to any other age group of children. Their rates of influenza-related hospitalization are similar to people age 80 and older. And, in some seasons the influenza-associated mortality rate is highest among infants. We want to protect the newborn by vaccinating the entire family, and send parents home with one less thing to worry about"......... Posted by: JoAnn      Read more         Source

October 15, 2008, 5:42 PM CT

A walk in the park improves attention in children with ADHD

For children with Attention Deficit Hyperactivity Disorder (ADHD) tasks that require concentration such as doing homework or taking a test can be very difficult. A simple, inexpensive remedy may be a "dose of nature".

A study conducted at the University of Illinois shows that children with ADHD demonstrate greater attention after a 20-minute walk in a park than after a similar walk in a downtown area or a residential neighborhood.

The study, conducted by child environment and behavior scientists Andrea Faber Taylor and Frances E. Kuo was published in a recent issue of the Journal of Attention Disorders

"From our prior research, we knew there might be a link between spending time in nature and reduced ADHD symptoms," said Faber Taylor. "So to confirm that link we conducted a study in which we took children on walks in three different settings one particularly "green" and two less "green" and kept everything about the walks as similar as possible".

Some children took the "green" walk first; others took it second or last. After each walk, an experimenter who didn't know which walk the child had been on tested their attention using a standard neurocognitive test called Digit Span Backwards, in which a series of numbers are said aloud and the child recites them backwards. It's a test in which practice doesn't improve your score......... Posted by: JoAnn      Read more         Source

October 9, 2008, 10:21 PM CT

Steroid Treatment Offers No Benefit In Preemies

Results of a multicenter study led by Johns Hopkins Children's Center challenge the longstanding practice of treating premature babies with hydrocortisone, a steroid believed to fight inflammation and prevent lung disease. The scientists observed that such therapy offers little or no benefit and that low cortisol levels are not even necessarily harmful. High cortisol levels, conversely, appeared to increase the risk of dangerous bleeding in the brain and require that babies be monitored aggressively to ward off life-threatening complications, as per the study reported in the recent issue of Pediatrics.

Premature babies and adults with a condition known as relative adrenal insufficiency have abnormally low levels of the stress hormone cortisol. The standard therapy for this condition in newborns has been hydrocortisone treatment. These findings, however, shed new light on the clinical meaning of low cortisol levels in preemies, showing that contrary to common belief, low blood concentrations of this hormone do not put extremely low-birth-weight babies (those born weighing less than 2.2 pounds) at higher risk for retinopathy of prematurity - a potentially blinding eye condition - inflammation and lung disease.

Scientists also found no difference in health outcomes between babies with low cortisol levels who were treated with hydrocortisone and those given a placebo. While hydrocortisone had no adverse effects on a baby's health, it also did nothing to prevent or reduce respiratory diseases, infections, hemorrhages or retinopathy......... Posted by: JoAnn      Read more         Source

October 6, 2008, 10:18 PM CT

Free drug samples carry risks for children

Cambridge, MA.Free prescription drug samples distributed to children may be unsafe, as per a research studyby physicians from Cambridge Health Alliance and Hasbro Children's Hospital. The national study, the first to look at free drug sample use among children, appears in the October 2008 issue of Pediatrics

The authors, who also serve as scientists at Harvard Medical School and the Warren Alpert Medical School of Brown University, observed that children usually receive free drug samples from their doctors. One out of every 20 American children received free drug samples in 2004. Among children who took at least one prescription drug in that year, nearly one in 10 got free samples.

The U.S. Food and Drug Administration identified significant new safety concerns for four of the top 15 most frequently distributed samples in 2004. These four medications acquired new black box warnings or had significant revisions to existing black box warnings issued since 2004. In addition, two of the top 15 sample medications given to children were schedule II controlled substances (drugs controlled and monitored by the Drug Enforcement Agency due to high potential for abuse). Distribution of these medications, Strattera (atomoxetine) and Adderall (amphetamine/dextroamphetamine), carries risk, particularly when drug sample closets in physician's offices (or home medicine cabinets) are not strictly monitored......... Posted by: JoAnn      Read more         Source