Archive | December, 2015

Yale School of Public Health study: Mothers-to-be, babies benefit from group prenatal care

25 Dec

The Ontario Ministry of Children and Youth Services explains why healthy babies are important. “Healthy babies are more likely to develop into healthy children, and healthy children are more likely to grow up to be healthy teenagers and healthy adults.” http://www.children.gov.on.ca/htdocs/English/topics/earlychildhood/health/index.aspx

Science Daily reported in Mothers-to-be, babies benefit from group prenatal care, study finds:

Group prenatal care can substantially improve health outcomes for both mothers and their infants, a new study led by the Yale School of Public Health has found.

The paper was published online Dec. 21 in The American Journal of Public Health.

Women who received group — rather than individual — prenatal care were 33% less likely to have infants who were small for gestational age. In addition, group-care recipients had reduced risk for preterm delivery and low birthweight. Babies born to these women also spent fewer days in the neonatal intensive care unit. In addition, mothers with more group prenatal care visits were less likely to become pregnant again quickly after giving birth, an important outcome known as “birth spacing” that reduces the risk of having another baby at risk for preterm delivery.

“Few clinical interventions have had an impact on birth outcomes,” said Professor Jeannette R. Ickovics, the study’s lead author. “Group prenatal care is related to improved health outcomes for mothers and babies, without adding risk. If scaled nationally, group prenatal care could lead to significant improvements in birth outcomes, health disparities, and healthcare costs,” she added.

The research team conducted a randomized controlled trial in 14 health centers in New York City, and compared the birth outcomes of women who received CenteringPregnancy Plus group prenatal care to those who received traditional individual care. The more than 1,000 women in the study were placed in groups of 8 to 12 women at the same gestational point in their pregnancy, and were cared for by a clinician and a medical assistant. The study found that the higher the number of group visits attended, the lower the rates of adverse birth outcomes….             http://www.sciencedaily.com/releases/2015/12/151221193406.htm

Citation

Mothers-to-be, babies benefit from group prenatal care, study finds

Date:       December 21, 2015

Source:   Yale University

Summary:

Group prenatal care can substantially improve health outcomes for both mothers and their infants, a new study has found. Women who received group — rather than individual — prenatal care were 33% less likely to have infants who were small for gestational age, had reduced risk for preterm delivery and low birthweight, and babies born to these women also spent fewer days in the neonatal intensive care unit.

Journal Reference:

  1. Jeannette R. Ickovics, Valerie Earnshaw, Jessica B. Lewis, Trace S. Kershaw, Urania Magriples, Emily Stasko, Sharon Schindler Rising, Andrea Cassells, Shayna Cunningham, Peter Bernstein, Jonathan N. Tobin. Cluster Randomized Controlled Trial of Group Prenatal Care: Perinatal Outcomes Among Adolescents in New York City Health Centers. American Journal of Public Health, 2015; e1 DOI: 10.2105/AJPH.2015.302960

Here is the press release from Yale:

Mothers-to-be and babies benefit from group prenatal care, study finds

December 21, 2015

Group prenatal care can substantially improve health outcomes for both mothers and their infants, a new study led by the Yale School of Public Health has found.

The paper published online Dec. 21 in The American Journal of Public Health.

Women who received group—rather than individual—prenatal care were 33% less likely to have infants who were small for gestational age. In addition, group-care recipients had reduced risk for preterm delivery and low birthweight. Babies born to these women also spent fewer days in the neonatal intensive care unit. Additionally, mothers with more group prenatal care visits were less likely to become pregnant again quickly after giving birth, an important outcome known as “birth spacing” that reduces the risk of having another baby at risk for preterm delivery.

“Few clinical interventions have had an impact on birth outcomes,” said Professor Jeannette R. Ickovics, the study’s lead author. “Group prenatal care is related to improved health outcomes for mothers and babies, without adding risk. If scaled nationally, group prenatal care could lead to significant improvements in birth outcomes, health disparities, and healthcare costs,” she added.

The research team conducted a randomized controlled trial in 14 health centers in New York City, and compared the birth outcomes of women who received CenteringPregnancy Plus group prenatal care to those who received traditional individual care. The more than 1,000 women in the study were placed in groups of eight to 12 women of the same gestational age, and were cared for by a clinician and a medical assistant. The study found that the higher the number of group visits attended, the lower the rates of adverse birth outcomes.

CenteringPregnancy group prenatal care includes the same components as individual visits, but all care (with the exception of matters that require privacy) take place in the group setting. Group visits build in additional time for education, skill building, and the opportunity to discuss and learn from the experience of peers, as well as more face time with caregivers.

Despite the opportunity for frequent visits, many mothers in at-risk groups, such as adolescents or those from low-income areas, still experience a high rate of negative birth outcomes. The study focused on adolescent women, ages 14 to 21, in disadvantaged areas, with no other known health risks to their pregnancies.

Going forward, researchers need to identify the reasons why group sessions yielded better outcomes, whether it is the additional time for education, the built-in social support, or other factors.

Additional studies are also needed to understand what influences patients to stick to group care session schedules, and to analyze cost-effectiveness. Future studies could also reveal whether the positive results from this study indicate that the group care model could be broadened to include other types of patients. Ickovics and colleagues are currently working with the United Health Foundation, UnitedHealth Innovation Group, and collaborators at Vanderbilt University and the Detroit Medical Center/Wayne State University to address many of these issues and to identify factors that could impact efforts to scale up and sustainability with a new model of group prenatal care, called Expect With Me.

Other Yale School of Public Health study authors include Valerie Earnshaw, Jessica Lewis, Trace Kershaw, Emily Stasko and Shayna Cunningham; and Urania Magriples of the Yale School of Medicine. Other co-authors included Sharon Schindler of Rising from the Centering Healthcare Institute in Boston, Jonathan Tobin and Andrea Cassells from the Clinical Directors Network in New York, and Peter Bernstein from the Albert Einstein College of Medicine in New York.                                                                   http://publichealth.yale.edu/news/article.aspx?id=11746

The program is called “Expect With Me.”

United Health Foundation describes the program:

Expect With Me

Yale School of Public Health and United Health Foundation have partnered to develop a new model of prenatal care designed to improve mothers’ and babies’ health and well-being during pregnancy, birth and infancy.  Prenatal care is delivered to pregnant women in a group setting, providing valuable education, skills, social and emotional support.

While expecting mothers typically spend 10-20 minutes with their doctors at each visit in traditional prenatal care, Expect With Me features 10 two-hour care sessions during the second and third trimesters. Each care session includes a physical assessment by a health care provider, and a focused group discussion session.

Expect With Me also includes a secure web portal and social networking features that enable expectant mothers to stay connected between care sessions and have access to a strong support network. Incentives, gaming and videos help patients engage, follow care recommendations and promote better health for both mothers and babies.

“Our goal in piloting this new prenatal care model is to improve the health of mothers and babies, and to improve perinatal health outcomes and reduce incidences of low birth weight and preterm birth.”

—Kate Rubin, United Health Foundation president.                                                                                                 http://www.unitedhealthfoundation.org/Initiatives/HealthCommunities/ExpectWithMe.aspx

The key is regular prenatal care.

The Eunice Kennedy Shriver National Institute of Child Health and Human Development reports in What is prenatal care and why is it important?

Prenatal Care

Women who suspect they may be pregnant should schedule a visit to their health care provider to begin prenatal care. Prenatal visits to a health care provider include a physical exam, weight checks, and providing a urine sample. Depending on the stage of the pregnancy, health care providers may also do blood tests and imaging tests, such as ultrasound exams. These visits also include discussions about the mother’s health, the infant’s health, and any questions about the pregnancy.

Preconception and prenatal care can help prevent complications and inform women about important steps they can take to protect their infant and ensure a healthy pregnancy. With regular prenatal care women can:

  • Reduce the risk of pregnancy complications. Following a healthy, safe diet; getting regular exercise as advised by a health care provider; and avoiding exposure to potentially harmful substances such as lead and radiation can help reduce the risk for problems during pregnancy and ensure the infant’s health and development. Controlling existing conditions, such as high blood pressure and diabetes, is important to avoid serious complications in pregnancy such as preeclampsia.
  • Reduce the infant’s risk for complications. Tobacco smoke and alcohol use during pregnancy have been shown to increase the risk for Sudden Infant Death Syndrome. Alcohol use also increases the risk for fetal alcohol spectrum disorders, which can cause a variety of problems such as abnormal facial features, having a small head, poor coordination, poor memory, intellectual disability, and problems with the heart, kidneys, or bones.2 According to one recent study supported by the NIH, these and other long-term problems can occur even with low levels of prenatal alcohol exposure.3

In addition, taking 400 micrograms of folic acid daily reduces the risk for neural tube defects by 70%.4 Most prenatal vitamins contain the recommended 400 micrograms of folic acid as well as other vitamins that pregnant women and their developing fetus need.1,5 Folic acid has been added to foods like cereals, breads, pasta, and other grain-based foods. Although a related form (called folate) is present in orange juice and leafy, green vegetables (such as kale and spinach), folate is not absorbed as well as folic acid.

  • Help ensure the medications women take are safe. Certain medications, including some acne treatments6 and dietary and herbal supplements,7 are not safe to take during pregnancy.

Learn more about prenatal and preconception care.

http://www.nichd.nih.gov/health/topics/preconceptioncare/Pages/default.aspx

http://www.nichd.nih.gov/health/topics/pregnancy/conditioninfo/Pages/prenatal-care.aspx

See, Prenatal care fact sheet http://www.womenshealth.gov/publications/our-publications/fact-sheet/prenatal-care.html

Our goal as a society should be a healthy child in a healthy family who attends a healthy school in a healthy neighborhood. ©

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Nationwide Children’s Hospital study: Antibiotics alone can be an effective treatment for children with appendicitis

20 Dec

The National Institute of Diabetes and Digestive and Kidney Diseases provide facts about appendicitis:

Definition and Facts for Appendicitis

What is appendicitis?

Appendicitis is inflammation of your appendix.

How common is appendicitis?

In the United States, appendicitis is the most common cause of acute abdominal pain requiring surgery. Over 5% of the population develops appendicitis at some point.1

Who is more likely to develop appendicitis?

Appendicitis most commonly occurs in the teens and twenties but may occur at any age.1

What are the complications of appendicitis?

If appendicitis is not treated, it may lead to complications. The complications of a ruptured appendix are

  • peritonitis, which can be a dangerous condition. Peritonitis happens if your appendix bursts and infection spreads in your abdomen. If you have peritonitis, you may be very ill and have
    • ​​​​fever
    • nausea
    • severe tenderness in your abdomen
    • vomiting
  • ​an abscess of the appendix called an appendiceal abscess.​

1 Acute Abdomen and Surgical Gastroenterology. The Merk Manual website. http://www.merckmanuals.com/professional/gastrointestinal_disorders/acute_abdomen_and_surgical_gastroenterology/appendicitis.htmlExternal Link Disclaimer. Updated June, 2014. Assessed October 2014.                                 http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/appendicitis/Pages/definition-facts.aspx

Appendicitis can be a serious illness because of the complications.

Seattle Children’s Hospital describes appendicitis symptoms:

Symptoms of Appendicitis

It’s important to know the symptoms of appendicitis so you can get help quickly.

For children 2 years old and younger, the most common signs of appendicitis are pain in the lower belly, vomiting and swelling in the belly. An older child may first complain of pain near the belly button. Over time, the pain moves to the lower-right belly. In most cases, the pain doesn’t get better even if the child lies still. Movement usually makes the pain worse.

Your child may also have these symptoms:

  • Not wanting to eat
  • Feeling sick to their stomach
  • Vomiting
  • Diarrhea
  • Low-grade fever
  • Swollen or bloated belly

If the appendix bursts, your child may get a high fever because of the spreading infection.

If you think your child may have appendicitis, call your doctor or bring your child to our Emergency Department right away. Don’t give your child anything to eat or drink, including medicine for pain, unless your doctor tells you to. Appendicitis treatment usually includes surgery to remove the appendix.

Appendicitis Diagnosis

It can be hard to tell if appendicitis is the reason a child’s belly hurts. The doctor will ask for a detailed history of your child’s illness and examine your child’s belly, looking for tender spots. We might use a blood test or urine test — or take images of the inside of your child’s abdomen — to make sure we know exactly what is causing the symptoms.

We can often diagnose appendicitis using ultrasound. This saves children from being exposed to the radiation that goes along with X-rays or CT (computed tomography) scans.                                 http://www.seattlechildrens.org/medical-conditions/digestive-gastrointestinal-conditions/appendicitis-symptoms/

A Nationwide Children’s Hospital study concludes antibiotics alone can be an effective treatment for children with appendicitis.

Science Daily reported in Antibiotics alone can be a safe, effective treatment for children with appendicitis:

Using antibiotics alone to treat children with uncomplicated acute appendicitis is a reasonable alternative to surgery when chosen by the family. A study led by researchers at Nationwide Children’s Hospital found that three out of four children with uncomplicated appendicitis have been successfully treated with antibiotics alone at one year follow-up. Compared to urgent appendectomy, non-operative management was associated with less recovery time, lower health costs and no difference in the rate of complications at one year.

“Families who choose to treat their child’s appendicitis with antibiotics, even those who ended up with an appendectomy because the antibiotics didn’t work, have expressed that for them it was worth it to try antibiotics to avoid surgery,” said Peter C. Minneci, MD who led the study published online Dec. 16 in JAMA Surgery with Katherine J. Deans, MD. The pair are co-directors of the Center for Surgical Outcomes Research and principal investigators in the Center for Innovation in Pediatric Practice in The Research Institute at Nationwide Children’s. “These patients avoided the risks of surgery and anesthesia, and they quickly went back to their activities.”

“Surgery has long been the ‘gold standard’ of care for treating appendicitis because by removing the appendix we eliminate the chance that the appendicitis will ever come back,” said Dr. Deans. “However, early in our careers we noticed that patients with appendicitis who were placed on antibiotics overnight until their surgery the following morning felt better the next day. So, Pete and I asked ourselves: do they really need to have surgery?”

In the first study conducted and published in the United States examining non-operative management for appendicitis, they enrolled 102 patients age 7 to 17 who were diagnosed with uncomplicated acute appendicitis at Nationwide Children’s between October 2012 and October 2013. Participants had early/mild appendicitis, meaning that they experienced abdominal pain for no more than 48 hours; had a white blood cell count below 18,000; underwent an ultrasound or CT scan to rule out rupture and to verify that their appendix was 1.1 centimeter thick or smaller; and had no evidence of an abscess or fecalith, which is hard stone-like piece of stool.

Thirty-seven families chose antibiotics alone and 65 opted for surgery. Those patients in the non-operative group were admitted to the hospital and received IV antibiotics for at least 24 hours, followed by oral antibiotics after discharge for a total of 10 days. Among those patients, 95% showed improvement within 24 hours and were discharged without undergoing surgery. Rates of appendicitis-related medical care within 30 days were similar between the groups with two patients in the non-operative group readmitted within 30 days for an appendectomy. At one year after discharge, three out of four patients in the non-operative group did not have appendicitis again and have not undergone surgery.

Appendicitis, caused by a bacterial infection in the appendix, is the most common reason for emergency abdominal surgery in children, sending more than 70,000 young people to the operating room each year. Although many of these cases are severe and require surgery, there are a good number that would be candidates for treatment with antibiotics alone, Dr. Minneci said…

According to the study results, patients who were transferred to Nationwide Children’s from other institutions expressed concerns about the distance and time necessary to come back if the appendicitis recurred. These families opted for surgery more often. Patients whose families spoke primary languages other than English were more likely to choose antibiotics as a course of treatment due to cultural values to avoid surgery if at all possible….

http://www.sciencedaily.com/releases/2015/12/151216134409.htm

Citation:

Antibiotics alone can be a safe, effective treatment for children with appendicitis

Date:      December 16, 2015

Source: Nationwide Children’s Hospital

Summary:

Using antibiotics alone to treat children with uncomplicated acute appendicitis is a reasonable alternative to surgery when chosen by the family. A new study has found that three out of four children with uncomplicated appendicitis have been successfully treated with antibiotics alone at one year follow-up. Compared to urgent appendectomy, non-operative management was associated with less recovery time, lower health costs and no difference in the rate of complications at one year.

Journal Reference:

  1. Peter C. Minneci, Justin B. Mahida, Daniel L. Lodwick, Jason P. Sulkowski, Kristine M. Nacion, Jennifer N. Cooper, Erica J. Ambeba, R. Lawrence Moss, Katherine J. Deans. Effectiveness of Patient Choice in Nonoperative vs Surgical Management of Pediatric Uncomplicated Acute Appendicitis. JAMA Surgery, 2015; 1 DOI: 10.1001/jamasurg.2015.4534

Non-operative management of early, acute appendicitis in children: Is it safe and effective?

Jeff Armstrong,

Neil Merritt,

Sarah Jones,

Leslie Scott,

Andreana Bütter

DOI: http://dx.doi.org/10.1016/j.jpedsurg.2014.02.071

Article Info

Publication History

Published Online: February 21, 2014Accepted: February 13, 2014Received: February 10, 2014

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Abstract

Purpose

The purpose of this study was to determine if early, acute appendicitis in children can be safely and effectively managed with antibiotics alone.

Methods

A retrospective review was performed of children (<18  yrs) treated non-operatively (NOM) for early, acute appendicitis since May 2012. These were compared to patients treated with appendectomy between January 2011 and October 2011 (OM). Inclusion criteria included: (a) symptoms <48 h, (b) localized peritonitis, and (c) ultrasound findings consistent with early, acute appendicitis.

Results

Twelve patients (66% female, mean age 12.2,SD = 4.2 yrs) were treated non-operatively, while 12 (50% female, mean age 12.5,SD = 3.2 yrs) were treated operatively. Two NOM children (16.7%) required initial appendectomy. One patient developed recurrent appendicitis requiring appendectomy 7 months post-discharge. Four other NOM patients returned with symptoms but did not require admission or surgery. Two OM patients (8.3%) had hospital visits and admissions related to surgical site infections. Mean length of stay (LOS) for the first visit was 1.5 days (SD = 1.0d) (NOM) vs. 1.3 days (SD = 0.5d) (OM) (p = 0.61). Including first and subsequent admissions, mean LOS was 1.8 days (SD = 1.1d) (NOM) vs. 1.7 days (SD = 1.5d) (OM) (p = 0.97).

Conclusion

Early acute appendicitis in appropriately selected children can be successfully treated non-operatively. Randomized trials with longer follow-up are required.

Key words:

Appendicitis, Non-operative management, Antibiotics

 

Here is the press release from Nationwide Children’s Hospital:

Antibiotics Alone Can Be a Safe, Effective Treatment for Children with Appendicitis

Columbus, OH – 12/16/2015

Using antibiotics alone to treat children with uncomplicated acute appendicitis is a reasonable alternative to surgery when chosen by the family. A study led by researchers at Nationwide Children’s Hospital found that three out of four children with uncomplicated appendicitis have been successfully treated with antibiotics alone at one year follow-up. Compared to urgent appendectomy, non-operative management was associated with less recovery time, lower health costs and no difference in the rate of complications at one year.

“Families who choose to treat their child’s appendicitis with antibiotics, even those who ended up with an appendectomy because the antibiotics didn’t work, have expressed that for them it was worth it to try antibiotics to avoid surgery,” said Peter C. Minneci, MD who led the study published online Dec. 16 in JAMA Surgery with Katherine J. Deans, MD. The pair are co-directors of the Center for Surgical Outcomes Research and principal investigators in the Center for Innovation in Pediatric Practice in The Research Institute at Nationwide Children’s. “These patients avoided the risks of surgery and anesthesia, and they quickly went back to their activities.”

“Surgery has long been the ‘gold standard’ of care for treating appendicitis because by removing the appendix we eliminate the chance that the appendicitis will ever come back,” said Dr. Deans. “However, early in our careers we noticed that patients with appendicitis who were placed on antibiotics overnight until their surgery the following morning felt better the next day. So, Pete and I asked ourselves: do they really need to have surgery?”

In the first study conducted and published in the United States examining non-operative management for appendicitis, they enrolled 102 patients age 7 to 17 who were diagnosed with uncomplicated acute appendicitis at Nationwide Children’s between October 2012 and March 2013. Participants had early/mild appendicitis, meaning that they experienced abdominal pain for no more than 48 hours; had a white blood cell count below 18,000; underwent an ultrasound or CT scan to rule out rupture and to verify that their appendix was 1.1 centimeter thick or smaller; and had no evidence of an abscess or fecalith, which is hard stone-like piece of stool.

Thirty-seven families chose antibiotics alone and 65 opted for surgery. Those patients in the non-operative group were admitted to the hospital and received IV antibiotics for at least 24 hours, followed by oral antibiotics after discharge for a total of 10 days. Among those patients, 95% showed improvement within 24 hours and were discharged without undergoing surgery. Rates of appendicitis-related medical care within 30 days were similar between the groups with two patients in the non-operative group readmitted within 30 days for an appendectomy. At one year after discharge, three out of four patients in the non-operative group did not have appendicitis again and have not undergone surgery.

Appendicitis, caused by a bacterial infection in the appendix, is the most common reason for emergency abdominal surgery in children, sending more than 70,000 young people to the operating room each year. Although many of these cases are severe and require surgery, there are a good number that would be candidates for treatment with antibiotics alone, Dr. Minneci said.

“We believe that the results of our study reflect the effectiveness of offering non-operative management to patients and their families in clinical practice. The patient choice design allows the patient and family’s preference to be aligned with their choice of therapy,” said Dr. Deans. “Most parents are concerned about having surgery, in general. They’re also very concerned about anesthesia. Some parents are very concerned about appendicitis coming back. It’s really a matter of aligning your preferences, your values, what you think is most important to you, with the treatment that is best for you and your family.”

For example, explained Dr. Minneci, if the family is so afraid of a recurrence that they visit the Emergency Department every time their child has abdominal pain, then their child will likely undergo increased imaging and eventually undergo an appendectomy. In that case, letting them choose an appendectomy upfront may be better for the child.

According to the study results, patients who were transferred to Nationwide Children’s from other institutions expressed concerns about the distance and time necessary to come back if the appendicitis recurred. These families opted for surgery more often. Patients whose families spoke primary languages other than English were more likely to choose antibiotics as a course of treatment due to cultural values to avoid surgery if at all possible.

Both researchers, who are also Assistant Professors of Surgery and Pediatrics in The Ohio State University College of Medicine, say further studies are needed to see if the results they saw in this study apply in other health systems, and emphasize that the perceptions of both patient-families and surgeons can impact the study results. Their intention is to follow all the children in this study as long as possible to see if those treated with non-operative management continue to thrive.

Click here to watch a video about one of our patients who benefited from antibiotics for appendicitis. 

Nearly 200 children a day undergo emergency appendectomies in the U.S., but a new study by researchers at Nationwide Children`s Hospital in Columbus, Ohio found surgery wasn`t always necessary. Experts were able to successfully treat the majority of children with uncomplicated appendicitis with antibiotics alone. – See more at: http://www.nch.multimedianewsroom.tv/story.php?id=1108&enter=#sthash.zp5AD7M0.dpuf

Nearly 200 children a day undergo emergency appendectomies in the U.S., but a new study by researchers at Nationwide Children`s Hospital found surgery was not always necessary. Experts were able to successfully treat the majority of children with uncomplicated appendicitis with antibiotics alone.

Full citation:

Minneci PC, Mahida JB, Lodwick, DL, Sulkowski JP, Nacion KM, Cooper JN, Ambeba, EJ, Moss RL, Deans KJ. The effectiveness of patient choice in non-operative versus surgical management of uncomplicated acute appendicitis. JAMA Surgery. 2015 Dec 16 [Epub ahead of print].

http://www.nationwidechildrens.org/news-room-articles/antibiotics-alone-can-be-a-safe-effective-treatment-for-children-with-appendicitis?contentid=150302

Moi blogs about education issues so the reader could be perplexed sometimes because moi often writes about other things like nutrition, families, and personal responsibility issues. Why? The reader might ask? Children will have the most success in school if they are ready to learn. Ready to learn includes proper nutrition for a healthy body and the optimum situation for children is a healthy family. Many of society’s problems would be lessened if the goal was a healthy child in a healthy family.

Resources:

Appendicitis                                                                                                                     http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0022755/

Appendicitis in Children                                                                     http://kidshealth.org/parent/infections/stomach/appendicitis.html

Where information leads to Hope. ©

Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART©
http://drwildaoldfart.wordpress.com/

Dr. Wilda Reviews ©
http://drwildareviews.wordpress.com/

Dr. Wilda ©
https://drwilda.com/

 

Council of State Governments Justice Center report: Little State Oversight of Educational Services Provided to Incarcerated Youth

15 Dec

Sophia Kerby wrote in the Center for American Progress report, The Top 10 Most Startling Facts About People of Color and Criminal Justice in the United States: A Look at the Racial Disparities Inherent in Our Nation’s Criminal-Justice System:

  1. According to the Bureau of Justice Statistics, one in three black men can expect to go to prison in their lifetime. Individuals of color have a disproportionate number of encounters with law enforcement, indicating that racial profiling continues to be a problem. A report by the Department of Justice found that blacks and Hispanics were approximately three times more likely to be searched

  2. While people of color make up about 30 percent of the United States’ population, they account for 60 percent of those imprisoned. The prison population grew by 700 percent from 1970 to 2005, a rate that is outpacing crime and population rates. The incarceration rates disproportionately impact men of color: 1 in every 15 African American men and 1 in every 36 Hispanic men are incarcerated in comparison to 1 in every 106 white men.

  3. during a traffic stop than white motorists. African Americans were twice as likely to be arrested and almost four times as likely to experience the use of force during encounters with the police.

  4. Students of color face harsher punishments in school than their white peers, leading to a higher number of youth of color incarcerated. Black and Hispanic students represent more than 70 percent of those involved in school-related arrests or referrals to law enforcement. Currently, African Americans make up two-fifths and Hispanics one-fifth of confined youth today.

  5. According to recent data by the Department of Education, African American students are arrested far more often than their white classmates. The data showed that 96,000 students were arrested and 242,000 referred to law enforcement by schools during the 2009-10 school year. Of those students, black and Hispanic students made up more than 70 percent of arrested or referred students. Harsh school punishments, from suspensions to arrests, have led to high numbers of youth of color coming into contact with the juvenile-justice system and at an earlier age.

  6. African American youth have higher rates of juvenile incarceration and are more likely to be sentenced to adult prison. According to the Sentencing Project, even though African American juvenile youth are about 16 percent of the youth population, 37 percent of their cases are moved to criminal court and 58 percent of African American youth are sent to adult prisons.

  7. As the number of women incarcerated has increased by 800 percent over the last three decades, women of color have been disproportionately represented. While the number of women incarcerated is relatively low, the racial and ethnic disparities are startling. African American women are three times more likely than white women to be incarcerated, while Hispanic women are 69 percent more likely than white women to be incarcerated.

  8. The war on drugs has been waged primarily in communities of color where people of color are more likely to receive higher offenses. According to the Human Rights Watch, people of color are no more likely to use or sell illegal drugs than whites, but they have higher rate of arrests. African Americans comprise 14 percent of regular drug users but are 37 percent of those arrested for drug offenses. From 1980 to 2007 about one in three of the 25.4 million adults arrested for drugs was African American.

  9. Once convicted, black offenders receive longer sentences compared to white offenders. The U.S. Sentencing Commission stated that in the federal system black offenders receive sentences that are 10 percent longer than white offenders for the same crimes. The Sentencing Project reports that African Americans are 21 percent more likely to receive mandatory-minimum sentences than white defendants and are 20 percent more like to be sentenced to prison.

  10. Voter laws that prohibit people with felony convictions to vote disproportionately impact men of color. An estimated 5.3 million Americans are denied the right to vote based on a past felony conviction. Felony disenfranchisement is exaggerated by racial disparities in the criminal-justice system, ultimately denying 13 percent of African American men the right to vote. Felony-disenfranchisement policies have led to 11 states denying the right to vote to more than 10 percent of their African American population.

  11. Studies have shown that people of color face disparities in wage trajectory following release from prison. Evidence shows that spending time in prison affects wage trajectories with a disproportionate impact on black men and women. The results show no evidence of racial divergence in wages prior to incarceration; however, following release from prison, wages grow at a 21 percent slower rate for black former inmates compared to white ex-convicts. A number of states have bans on people with certain convictions working in domestic health-service industries such as nursing, child care, and home health care—areas in which many poor women and women of color are disproportionately concentrated. http://www.americanprogress.org/issues/race/news/2012/03/13/11351/the-top-10-most-startling-facts-about-people-of-color-and-criminal-justice-in-the-united-states/

The question becomes is there anything that can be done to stop individual involvement in criminal activity and/or violent crime.

Denisa R. Superville wrote in the Education Week article, In Many States, Prospects Are Grim for Incarcerated Youths:

The quality of schooling for tens of thousands of incarcerated juveniles falls far short of the education their peers receive in public schools, advocates say, raising major concerns about the prospects of one of the most vulnerable groups of students.

Even as the number of incarcerated juveniles dropped significantly over the past decade, only 13 states provide students who are behind bars with the same types of educational and vocational services, including GED preparation, credit recovery, and postsecondary courses, that students in schools receive, a survey of juvenile-corrections agencies by the Council of State Governments Justice Center shows.

In a report released last month, the council found that many states do not hold schools inside juvenile correctional facilities—which can be run by the states, private companies, or nonprofit organizations—accountable for providing students with curricula aligned with a state’s college- and career-readiness standards. And many do not have rigorous oversight of educational programs at those facilities as they do for regular public schools.

While the number of juveniles in state custody has dropped in the past decade and a half, from more than 75,000 in 1997 to just under 36,000 in 2013, the proportion of juveniles in privately run and locally run facilities grew from 46 percent to 61 percent. That trend makes it harder to ensure that all students have access to programs of the same quality. (The council’s survey did not include all facilities where juveniles are locked up, including those in adult prisons.)

And students are not just shortchanged educationally when they are incarcerated, the report says. A number of states do not provide transition services to help juveniles re-enter the community, leaving it up to students, their parents, schools, and communities to figure out what to do once they are released, according to the report….

Related Stories

http://www.edweek.org/ew/articles/2015/12/09/in-many-states-prospects-are-grim-for.html

Citation:

The Council of State Governments Justice Center, “Locked Out: Improving Educational and Vocational Outcomes for Incarcerated Youth” (New York: The Council of State Governments Justice Center, 2015).       https://csgjusticecenter.org/wp-content/uploads/2015/11/LOCKED_OUT_Improving_Educational_and_Vocational_Outcomes_for_Incarcerated_Youth.pdf

Here is the press release from the Council of State Governments:

Study Highlights Little State Oversight of Educational Services Provided to Incarcerated Youth

November 5, 2015

By the CSG Justice Center Staff

A first-of-its-kind report released today by The Council of State Governments (CSG) Justice Center found that most incarcerated youth do not have access to the same educational services as their peers in the community, and little accountability exists to ensure educational standards are met in lock-up.

The report, “Locked Out: Improving Educational and Vocational Outcomes for Incarcerated Youth,” reveals that despite spending between $100,000 and $300,000 per incarcerated child in secure facilities, only 13 states provide all incarcerated youth with access to the same types of educational services that students have in the community. Meanwhile, only nine states offer community-equivalent vocational services to all kids in lock-up.

“On average, what states spend on these kids while they are locked up is at least three times the cost of a Harvard tuition,” said Michael Thompson (pictured left), director of the CSG Justice Center. “Policymakers making this level of investment should be asking what type of education they expect to be provided to these youth.”

While most youth incarcerated 10 years ago were in facilities operated by state government, nearly two-thirds of youth locked up in the U.S. today are held in facilities operated by local government agencies or nonprofit or for-profit organizations.

The survey, conducted by the CSG Justice Center and in partnership with the Council of Juvenile Correctional Administrators, asked leaders in each state: Who is responsible for educating kids incarcerated in this patchwork of institutions? The report found that in more than 80 percent of states, no single state agency is charged with this authority, leaving an absence of leadership and, ultimately, accountability for ensuring youth make sufficient progress towards college and career readiness. The report also found:

  • Fewer than one in three states is able to document what percentage of youth released from a juvenile correctional facility subsequently obtain a high school diploma;
  • In nearly half of the states, it is up to the parent or guardian of the youth, or perhaps a community-based organization advocating on his or her behalf, to get that young person enrolled in a public school or another educational setting after his/her release from a correctional facility;
  • In more than one-third of states, youth released from a facility are automatically enrolled in an alternative educational setting, which often do not meet state curricular and performance standards and suffer from lower graduation rates that traditional public schools.

“This report shines a light on a group of youth who, for most people, are out-of-sight, out-of-mind,” said Susan Burke (pictured right), director of Utah’s Juvenile Justice Services. “For the first time, it’s clear that more state oversight is warranted to ensure all youth receive the necessary educational services they need to succeed later in life. I’m looking forward to working with leaders in the education community to figure out what we do about this important problem.”

On any given day, there are about 60,000 youth incarcerated in the U.S. This report examines the more than half of these young people—two-thirds of whom are black or Latino—who have been committed to the custody of the state, on average for three to 12 months. Incarcerated youth overall tend to be several grade levels behind their peers, more likely to have an educational disability, and have been suspended multiple times and/or expelled from local schools.

“Measurement and accountability have been the hallmarks of the public education system,” said Kent McGuire, president and CEO of the Southern Education Foundation. “But those values haven’t been applied as rigorously to the education provided to kids who are incarcerated. Educationally, these kids have fallen way behind their peers. It’s hard to think of a group of youth more acutely in need of educational services.”

The report also offers a host of recommendations focused on ensuring all incarcerated youth have access to the same educational and vocational services as their peers in the community, collecting and reporting student outcome data for youth incarcerated, and improving continuity of educational services after a youth is released from incarceration.

“With the progress we’ve already seen from states lowering their juvenile incarceration rates, it’s important that attention shift to improving services to help ensure these kids are not just reentering society, but succeeding in it,” said Michael Lawlor, undersecretary of Criminal Justice Policy and Planning for Connecticut Gov. Dannel Malloy and chair of the CSG Justice Center. “Every state can learn from this national report and the recommendations it provides.”

The report is a product of the National Reentry Resource Center, a project of the CSG Justice Center, and was made possible through funding from the U.S. Department of Justice’s Bureau of Justice Assistance, and developed in partnership with the Office of Juvenile Justice and Delinquency and Prevention.                                                                                                                                                               https://csgjusticecenter.org/youth/posts/study-highlights-little-state-oversight-of-educational-services-provided-to-incarcerated-youth/

It is going to take coordination between not only education institutions, but a strong social support system to get many of these children through school. This does not mean a large program directed from Washington. But, more resources at the local school level which allow discretion with accountability. For example, if I child is not coming to school because they have no shoes or winter coat, then the child gets new shoes and/or a coat. School breakfast and lunch programs must be supported and if necessary, expanded. Unfortunately, schools are now the early warning system for many families in crisis.

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University of Texas Health Sciences study: Children born with cleft lip or palate and spina bifida are at an increased risk for abuse

11 Dec

The American Psychological Association lists the reasons children are abused in Why Do Adults Hurt Children?

It takes a lot to care for a child. A child needs food, clothing and shelter as well as love and attention. Parents and caregivers want to provide all those things, but they have other pressures, too. Sometimes adults just can’t provide everything their children need.

Adults may not intend to hurt the children they care for. But sometimes adults lose control, and sometimes they hurt children.

Adults may hurt children because they:

  • Lose their tempers when they think about their own problems.

  • Don’t know how to discipline a child.

  • Expect behavior that is unrealistic for a child’s age or ability.

  • Have been abused by a parent or a partner.

  • Have financial problems.

  • Lose control when they use alcohol or other drugs….                                                                       http://www.apa.org/pi/families/resources/abuse.aspx

A University of Texas Health Sciences study concludes that children born with cleft lip or palate and spina bifida are at an increased risk for abuse.

The Centers for Disease Control and Prevention describes what a cleft lip or palate are:

What is Cleft Lip?

The lip forms between the fourth and seventh weeks of pregnancy. As a baby develops during pregnancy, body tissue and special cells from each side of the head grow toward the center of the face and join together to make the face. This joining of tissue forms the facial features, like the lips and mouth. A cleft lip happens if the tissue that makes up the lip does not join completely before birth. This results in an opening in the upper lip. The opening in the lip can be a small slit or it can be a large opening that goes through the lip into the nose. A cleft lip can be on one or both sides of the lip or in the middle of the lip, which occurs very rarely. Children with a cleft lip also can have a cleft palate.

What is Cleft Palate?

The roof of the mouth (palate) is formed between the sixth and ninth weeks of pregnancy. A cleft palate happens if the tissue that makes up the roof of the mouth does not join together completely during pregnancy. For some babies, both the front and back parts of the palate are open. For other babies, only part of the palate is open.

Other Problems

Children with a cleft lip with or without a cleft palate or a cleft palate alone often have problems with feeding and speaking clearly and can have ear infections. They also might have hearing problems and problems with their teeth….                                                                                                   http://www.cdc.gov/ncbddd/birthdefects/CleftLip.html

Another group of children at high risk of abuse are those with spina bifida. The Mayo Clinic describes spina bifida:

Spina bifida is part of a group of birth defects called neural tube defects. The neural tube is the embryonic structure that eventually develops into the baby’s brain and spinal cord and the tissues that enclose them.

Normally, the neural tube forms early in the pregnancy and closes by the 28th day after conception. In babies with spina bifida, a portion of the neural tube fails to develop or close properly, causing defects in the spinal cord and in the bones of the spine.

Spina bifida occurs in various forms of severity. When treatment for spina bifida is necessary, it’s done surgically, although such treatment doesn’t always completely resolve the problem….                   http://www.mayoclinic.org/diseases-conditions/spina-bifida/basics/definition/CON-20035356

Children with a medical condition are vulnerable to abuse.

Alyson Sulaski Wyckoff , Associate Editor of AAP wrote in Maltreatment of child under 2 more likely if certain birth defects present:

Children younger than 2 years were more likely to be maltreated if they had spina bifida or cleft lip/palate than if they had Down syndrome, according to a population-based study of 3 million children born in Texas from 2002-’09.

Birth defects occur in one in 33 U.S. births, and children with disabilities face an increased risk for maltreatment and out-of-home placement. It is not known how the risk might vary by type of birth defect.

The study was conducted to assess whether the risks and predictors of maltreatment vary by three types of birth defects: Down syndrome (intellectual impairment), cleft lip with or without cleft palate (facial malformation and speech impairment) and spina bifida (physical disability). Children with these disabilities were compared to an unaffected group.

The risk of any type of maltreatment was significantly higher for children with spina bifida and cleft lip/palate, an increase of 58% and 40%, respectively, even after adjusting for child-, family-, and neighborhood-level factors. Children with Down syndrome, however, were not at increased risk of maltreatment before age 2.

The study also found that children with birth defects are at risk for different types of maltreatment than other children. The risk of medical neglect was three to six times higher in the three birth defects groups compared with the unaffected group, which may be related to the medical complexity of the children’s conditions.

Maltreated children tended to be males and those born prematurely. Parents were the most frequent perpetrators, especially those living in poverty.

The risk of maltreatment was elevated for children whose mothers were young, white non-Hispanic, unmarried and who did not indicated paternity information on birth certificates. They were more likely to have a high school education or less, to have given birth previously and to have had the birth covered by Medicaid.

Future studies could inform policies and services aimed at improving outcomes of at-risk families by targeting populations with the highest risk for maltreatment, the authors noted.

Children with developmental delays, including those with the birth defects examined in this study, qualify for early childhood intervention services (Part C) under the Individuals With Disabilities Education Act, but many qualifying children do not receive these services, the study points out….                                                                                                                                                   http://www.aappublications.org/news/2015/12/01/Maltreatment120115

Citation:

Children with specific birth defects at increased risk for abuse

Date:           December 10, 2015

Source:       University of Texas Health Science Center at Houston

Summary:

Children born with cleft lip or palate and spina bifida are at an increased risk for abuse before the age of two, according to researchers. The researchers found that compared to children without birth defects the risk of maltreatment in children with cleft lip and/or palate was increased by 40 percent and for children with spina bifida, the risk was increased by 58 percent.

Journal Reference:

  1. B. S. Van Horne, K. B. Moffitt, M. A. Canfield, A. P. Case, C. S. Greeley, R. Morgan, L. E. Mitchell. Maltreatment of Children Under Age 2 With Specific Birth Defects: A Population-Based Study. PEDIATRICS, 2015; 136 (6): e1504 DOI: 10.1542/peds.2015-1274                                  http://www.sciencedaily.com/releases/2015/12/151210140510.htm

Here is the press release from UT Health Sciences:

Public Release: 10-Dec-2015

UTHeath study: Children with specific birth defects at increased risk for abuse

University of Texas Health Science Center at Houston

HOUSTON – (Dec. 10, 2015) – Children born with cleft lip or palate and spina bifida are at an increased risk for abuse before the age of 2, according to researchers from The University of Texas Health Science Center at Houston (UTHealth).The results were published in the December issue of the journal Pediatrics.

In the study, researchers found that compared to children without birth defects the risk of maltreatment in children with cleft lip and/or palate was increased by 40 percent and for children with spina bifida, the risk was increased by 58 percent. These rates were especially high during the first year of life. However, children with Down syndrome were not at an increased risk compared to children with no birth defects.

“A baby with Down syndrome develops just like any other baby unless they have another congenital defect. When they start missing developmental milestones is when the intellectual impairments associated with Down syndrome become more apparent. Additionally, they typically do not have the same level of medical complexity as babies with cleft lip with or without cleft palate and spina bifida, who likely have a lot of medical needs and complications. If you’ve just given birth and have to deal with a lot more complexity and care, it’s hard,” said Bethanie Van Horne, Dr.P.H., assistant director of state initiatives at UTHealth’s Children’s Learning Institute. Van Horne conducted the study as part of her dissertation at UTHealth School of Public Health.

Cleft lip and cleft palate are birth defects that occur when a baby’s lip or mouth do not form properly during pregnancy. A baby can have a cleft lip, a cleft palate, or both a cleft lip and cleft palate. Spina bifida is a neural tube defect that affects the spine and is usually apparent at birth. Children with spina bifida have physical impairments ranging from mild to severe depending where on the spine the opening is located.

The researchers drew data from several sources from 2002 to 2011: birth and death records from the Texas Department of State Health Services Vital Statistics Unit, surveillance of children born with birth defects from the Texas Birth Defects Registry and child maltreatment information from the Texas Department of Family and Protective Services.

In Texas, maltreatment is defined as neglectful supervision, physical abuse, physical neglect, medical neglect, sexual abuse, abandonment, emotional abuse or refusal to assume parental responsibility.

Among children with substantiated abuse, the risk of medical neglect was three to six times higher among all three birth defect groups than in the unaffected group. The complexity of their medical conditions may be a contributing factor for the increased risk of medical neglect versus other forms of neglect, according to Van Horne.

Researchers also studied how family factors affected risk of abuse. Children were more likely to be abused or neglected if their mothers had less than a high school education, had more children and used Medicaid. This was true even if a child did not have a birth defect. Van Horne said that poverty was likely the main factor in this finding.

“Physicians and medical personnel have to understand that the risk for abuse varies by specific disability. In general, when children are born with medical complexities like a birth defect, we need to be really supportive of those families. If we can identify them early and start services, we can help them understand what’s to come. A lot of providers do this, but we can do more,” said Van Horne.

###

Karen B. Moffitt, M.P.H., Mark A. Canfield, Ph.D., and Amy P. Case, Ph.D., from the Birth Defects Epidemiology and Surveillance Branch of the Texas Department of State Health Services were study co-authors, as was Christopher Greeley, M.D., a former faculty member at UTHealth, who is now with Texas Children’s Hospital. Co-authors from the School of Public Health included Robert Morgan, Ph.D., and Laura E. Mitchell, Ph.D.

The study, titled ‘Maltreatment of Children under Age 2 with Specific Birth Defects: A Population-Based Study,’ was funded through a cooperative agreement (#5U01DD000494-04) between the Centers for Disease Control and Prevention and the Texas Department of State Health Services, as well as through funding from the Title V Block Grant at the Texas Department of State Health Services.

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.                   http://www.eurekalert.org/pub_releases/2015-12/uoth-usc121015.php

Stepparents and Abuse

It is difficult to find statistics on abuse by step-parents, but one study out of Sweden, Step-parents abuse children to death more often provide some food for thought.

258 children under the age of 16 were killed by their parents between 1965 and 1999. 23 of the children (9%) were abused to death. Stepchildren are more often killed by abuse than children who are killed by their biological parents, according to new research from the University of Stockholm. More than half of the 258 children were killed in connection with a conflict between the parents e.g. divorce or custody battle. Most of these children died in connection with the extended suicide where the perpetrator took or tried to take his own life. The men who murdered their children also often took the life of their partner. On the other hand, no woman tried to kill their partner when she murdered the children, writes senior lecturer Hans Temrin and PhD student Johanna Nordlund at The University of Stockholm.

The Department of Justice (DOJ) has statistics about infanticide but it is difficult to determine specific abuse by step-parents because of the reporting.

Note: Parents includes stepparents.

Of all children under age 5 murdered from 1976-2005 —

  • 31% were killed by fathers

  • 29% were killed by mothers

  • 23% were killed by male acquaintances

  • 7% were killed by other relatives

  • 3% were killed by strangers

Of those children killed by someone other than their parent, 81% were killed by males.

How to Spot Signs of Abuse

Child Information Welfare Gateway has an excellent guide for how to spot child abuse and neglect The full list of symptoms is at the site, but some key indicators are:

                         The Child:

Shows sudden changes in behavior or school performance

Has not received help for physical or medical problems brought to the parents’ attention

Has learning problems (or difficulty concentrating) that cannot be attributed to specific physical or psychological causes

Is always watchful, as though preparing for something bad to happen

Lacks adult supervision

Is overly compliant, passive, or withdrawn

Comes to school or other activities early, stays late, and does not want to go home

The Parent:

Shows little concern for the child

Denies the existence of—or blames the child for—the child’s problems in school or at home

Asks teachers or other caregivers to use harsh physical discipline if the child misbehaves

Sees the child as entirely bad, worthless, or burdensome

Demands a level of physical or academic performance the child cannot achieve

Looks primarily to the child for care, attention, and satisfaction of emotional needs

The Parent and Child:

Rarely touch or look at each other

Consider their relationship entirely negative

State that they do not like each other                                                                                                                  https://www.childwelfare.gov/pubPDFs/whatiscan.pdf#page=5&view=Recognizing%20Signs%20of%20Abuse%20and%20Neglect

If people suspect a child is being abused, they must get involved. Every Child Matters can very useful and can be found at http://www.everychildmatters.org/ and another organization, which fights child abuse is the National Coalition for Child Protection Reform http://nccpr.info/   People must push for tougher standards against child abuse.

Many Single Parents are not Going to Like these Comments

Queen Victoria had it right when she was rumored to have said something to the effect that she did not care what two consenting single adults did as long as they did not do it in the streets and scare the horses. A consenting single parent does not have the same amount of leeway as a consenting childless single adult because the primary responsibility of any parent is raising their child or children. People have children for a variety of reasons from having an unplanned pregnancy because of irresponsibility or hoping that the pregnancy is the glue, which might save a failing relationship, to those who genuinely want to be parents. Still, being a parent is like the sign in the china shop, which says you break it, it’s yours. Well folks, you had children, they are yours. Somebody has to be the adult and be responsible for not only their care and feeding, but their values. I don’t care if he looks like Brad Pitt or Denzel Washington. I don’t care if she looks like Angelina Jolie or Halle Berry or they have as much money as Bill Gates or Warren Buffet, if they don’t like children or your children, they have to be kicked to the curb. You cannot under any circumstances allow anyone to abuse your children or you. When you partner with a parent, you must be willing to fully accept their children. If you can’t and they are too gutless to tell you to hit the road, I’ll do it for them. Hit the road.

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Tulane University study: Don’t want to raise a psychopath? Be sensitive to a child’s distress

9 Dec

Both the culture and the economy are experiencing turmoil. For some communities, the unsettled environment is a new phenomenon, for other communities, children have been stressed for generations. According to the article, Understanding Depression which was posted at the Kids Health site:

Depression is the most common mental health problem in the United States. Each year it affects 17 million people of all age groups, races, and economic backgrounds.
As many as 1 in every 33 children may have depression; in teens, that number may be as high as 1 in 8. http://kidshealth.org/parent/emotions/feelings/understanding_depression.html

Jyoti Madhusoodanan and Nature magazine reported in the Scientific American article, Stress Alters Children’s Genomes:

Growing up in a stressful social environment leaves lasting marks on young chromosomes, a study of African American boys has revealed. Telomeres, repetitive DNA sequences that protect the ends of chromosomes from fraying over time, are shorter in children from poor and unstable homes than in children from more nurturing families…
http://www.scientificamerican.com/article/stress-alters-childrens-genomes/?WT.mc_id=SA_Facebook

Not only are the child’s gene’s altered, but there are behavioral indications of the stress being felt by the child.

Science Daily reported in Don’t want to raise a psychopath? Be sensitive to a child’s distress:

How do you stop a child, especially one who has experienced significant adversity, from growing up to be a psychopath? Responsive, empathetic caregiving — especially when children are in distress — helps prevent boys from becoming callous, unemotional adolescents, according to a new Tulane University study of children raised in foster care.

The research, which was published in the Journal of the American Academy of Child and Adolescent Psychiatry, is the first to show that an intervention can prevent the precursors to psychopathy. The destructive condition affects approximately 1 percent of the population and is characterized by callous interpersonal interactions and lack of guilt or empathy.

Researchers measured levels of callous-unemotional behavior in 12-year-olds from the Bucharest Early Intervention Project, a cohort of children abandoned in Romanian orphanages in the early 2000s and followed longitudinally ever since. Half of these children were placed in high-quality foster care as toddlers, while others grew up in institutional care. Researchers compared their results with children who had never been orphans. The study is led by Dr. Charles H. Zeanah from Tulane, Nathan A. Fox from the University of Maryland, and Charles A. Nelson from Harvard Medical School.

Overall, children reared in orphanages had significantly higher levels of callous-unemotional traits compared to children who had never been institutionalized. Boys placed in foster care had lower levels of callous-unemotional traits than those who did not receive the intervention. What explained the difference? Researchers observed children with their caregivers as toddlers and found that the more sensitive caregivers were to a young child’s distress, the less callous and more empathic the boys were in adolescence.

Lead author Kathryn Humphreys, a who conducted the study as a postdoctoral fellow in infant mental health at Tulane, says the findings can help child welfare advocates target and support specific caregiver behaviors when reaching out to families.

“If we can intervene early to help kids in their development, it not only helps them but also the broader society,” she says. “The best way to do that is making sure children are placed in homes with responsive caregivers and helping caregivers learn to be more responsive to their child’s needs.” Don’t want to raise a psychopath? Be sensitive to a child’s distress: New study is the first to show that an intervention can prevent the precursors to psychopathy

Citation

Don’t want to raise a psychopath? Be sensitive to a child’s distress  New study is the first to show that an intervention can prevent the precursors to psychopathy

Date:        December 3, 2015

Source:   Tulane University

Summary:

How do you stop a child, especially one who has experienced significant adversity, from growing up to be a psychopath? Responsive, empathetic caregiving — especially when children are in distress — helps prevent boys from becoming callous, unemotional adolescents, according to a new study of children raised in foster care.

Journal Reference:

  1. Kathryn L. Humphreys, Lucy McGoron, Margaret A. Sheridan, Katie A. McLaughlin, Nathan A. Fox, Charles A. Nelson, Charles H. Zeanah. High-Quality Foster Care Mitigates Callous-Unemotional Traits Following Early Deprivation in Boys: A Randomized Controlled Trial. Journal of the American Academy of Child & Adolescent Psychiatry, 2015; 54 (12): 977 DOI: 10.1016/j.jaac.2015.09.010

Here is the press release from Tulane University:

Don’t want to raise a psychopath? Be sensitive to a child’s distress

December 3, 2015

Keith Brannon
Phone: 504-862-8789
kbrannon@tulane.edu

How do you stop a child, especially one who has experienced significant adversity, from growing up to be a psychopath? Responsive, empathetic caregiving – especially when children are in distress – helps prevent boys from becoming callous, unemotional adolescents, according to a new Tulane University study of children raised in foster care.

The research, which was published in the Journal of the American Academy of Child and Adolescent Psychiatry, is the first to show that an intervention can prevent the precursors to psychopathy.

Researchers measured levels of callous-unemotional behavior in 12-year-olds from the Bucharest Early Intervention Project, a cohort of children abandoned in Romanian orphanages in the early 2000s and followed longitudinally ever since. Half of these children were placed in high-quality foster care as toddlers, while others grew up in institutional care. Researchers compared their results with children who had never been orphans. The study is led by Dr. Charles H. Zeanah from Tulane, Nathan A. Fox from the University of Maryland, and Charles A. Nelson from Harvard Medical School.

Overall, children reared in orphanages had significantly higher levels of callous-unemotional traits compared to children who had never been institutionalized. Boys placed in foster care had lower levels of callous-unemotional traits than those who did not receive the intervention. What explained the difference? Researchers observed children with their caregivers as toddlers and found that the more sensitive caregivers were to a young child’s distress, the less callous and more empathic the boys were in adolescence.

Lead author Kathryn Humphreys, a who conducted the study as a postdoctoral fellow in infant mental health at Tulane, says the findings can help child welfare advocates target and support specific caregiver behaviors when reaching out to families.

“If we can intervene early to help kids in their development, it not only helps them but also the broader society,” she says. “The best way to do that is making sure children are placed in homes with responsive caregivers and helping caregivers learn to be more responsive to their child’s needs.”                                                                                                    Tulane University – Don’t want to raise a psychopath? Be sensitive to a child’s distress                           http://tulane.edu/news/releases/how-to-prevent-raising-a-psychopath.cfm

If you or your child needs help for depression or another illness, then go to a reputable medical provider. There is nothing wrong with taking the steps necessary to get well.

Related:

GAO report: Children’s mental health services are lacking

https://drwilda.com/2013/01/12/gao-report-childrens-mental-health-services-are-lacking/

Schools have to deal with depressed and troubled children

https://drwilda.com/2011/11/15/schools-have-to-deal-with-depressed-and-troubled-children/

University of Cambridge study: Saliva test may detect depression in kids

https://drwilda.com/2014/02/23/university-of-cambridge-study-saliva-test-may-detect-depression-in-kids/

Study: Some of the effects of adverse stress do not go away

https://drwilda.com/2012/11/09/study-some-of-the-effects-of-adverse-stress-do-not-go-away/

American Psychological Association: Kids too stressed out to be healthy

https://drwilda.com/2014/02/12/american-psychological-association-kids-too-stressed-out-to-be-healthy/

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Dr. Wilda Reviews: Johnsonville Naturals Sausage

6 Dec

Moi was contacted by a representative for Johnsonville Naturals Sausage to provide a review of a new product entering the Seattle market. The reasons moi agreed to write the review are moi has used Johnsonville products for years and was familiar with the company as well as she was curious about the product. This is a compensated review. Here is a bit about moi’s lifestyle which makes this review relevant to many folk. She is a busy blogger and researcher and often has little time to cook gourmet meals. Often it is look in the fridge and throw together a meal from what is on hand. Given that meals have to be quick, moi attempts to have balanced meals from the various food groups.

Over the years, moi has used the following Johnsonville products:

Butcher Shop Style Smoked Bratwurst

Johnsonville Butcher Shop Style Smoked Bratwurst will transport you to a time when hearty flavor and generous portions were the hallmarks of quality craftsmanship. This sausage is made with premium all natural pork and a natural casing that delivers a “snap” that any butcher would be proud of!

Butcher Shop Style Cheddar Cheese & Bacon

Take flavor to the next level with Johnsonville Butcher Shop Style Cheddar Cheese & Bacon Sausage! This big link blends a perfect flavor pairing of creamy cheddar cheese chunks with delicious smoky bacon… mmm!

Butcher Shop Style Andouille

This Butcher Shop Style Andouille Sausage is packed with authentic Cajun taste and only premium all natural pork. Let this BIG link transport you right to the heart of the BIG EASY with its BIG flavor and natural casing “snap!”

http://www.johnsonville.com/lines/smoked.html

According to the package ingredients, there are ingredients like “potassium lactate, corn syrup, dextrose, monosodium, glutamate, sodium phosphate, sodium diacete, maltodextrin and collagen casing.” Until moi wrote this review, she never noticed the ingredients. The reasons the products were purchased by moi in the past were the Johnsonville name, product taste and the fact that Safeway has frequent specials and moi stocks up.

Like many folk, moi has become concerned about processed meat. Atli Arnarson wrote in the Business Insider article, Why processed meat is bad for you:

Processed meat is generally considered unhealthy.

It has been linked with diseases like cancer and heart disease in numerous studies….

There is no doubt that processed meat contains many harmful chemicals that are not naturally present in fresh meat….

What is Processed Meat?

Processed meat is meat that has been preserved by curing, salting, smoking, drying or canning.

Food products categorized as processed meat include:

  • Sausages, hot dogs, salami.
  • Bacon, ham.
  • Salted and cured meat, corned beef.
  • Smoked meat.
  • Dried meat, beef jerky.
  • Canned meat.

On the other hand, meat that has been frozen or undergone mechanical processing like cutting and slicing is still considered unprocessed….

Nevertheless, studies consistently find strong links between processed meat consumption and various chronic diseases.

These include: High blood pressure, heart disease, chronic obstructive pulmonary disease (COPD), and bowel and stomach cancer.

The studies on processed meat consumption in humans are all observational in nature.

They can show that people who eat processed meat are more likely to get these diseases, but they can not prove that the processed meat caused them….                                                                               http://www.businessinsider.com/why-processed-meat-is-bad-for-you-2015-7

When given the opportunity to preview a product which purported to be more natural, moi jumped at the chance.

The Johnsonville Naturals Line has four products:

Original Brats

A delicious brat recipe made with 100% all natural ingredients. Sure to be a favorite at picnics, barbecues or any occasion.

Mild Italian Sausage

Made with all natural ingredients and the perfect blend of Italian herbs and spices for an authentic flavor in any recipe or on the grill.

Original Breakfast Sausage

Our one-of-a-kind original breakfast sausage recipe made with 100% all natural ingredients that will bring family and friends to the table.

Maple Breakfast Sausage

Made with real Vermont maple syrup and other all natural ingredients for a sweet and savory breakfast taste.

http://www.johnsonville.com/lines/naturals.html

According to the label of the Original Bratwurst, the ingredients are “Pork, water and less than 2% of the following: salt, butter flavor (maltodextrin, anhydrous milk fat, mpmfat milk solids, natural flavors, sugar, natural flavors, contains milk.” The Mild Italian Sausage ingredients are “Pork, water and less than 2% of the following: salt, natural sugar, spice, paprika, natural flavors.”

Two products were tested by moi in breakfast, lunch, dinner, and snack recipes. For breakfast, moi used the Original Bratwurst in a scramble. She sliced the bratwurst into thin slices, browned them and added to an egg scramble of mushrooms, red, orange and yellow peppers, with onion. This scramble was topped with shredded cheddar cheese and paired with hash browns. A splash of hot sauce was the final touch. The difference between the original brats and the naturals was the seasoning. The subtle, but noticeable seasoning of the naturals made the scramble more flavorful. For lunch, the brats were used again. Again they were sliced and browned. Moi took some green onions and the brats and added them to a can of loaded potato soup which was microwaved. The soup was paired with a small salad and Ciabatta roll. The dinner test involved moi’s favorite pasta dish. Take spinach or kale and add peppers, mushrooms, onions, and olives along with the browned sliced Italian sausage and mix with either fettucine or linguini topped with shredded cheese. The taste of the Italian sausage was a noticeable, but not an overpowering, seasoned taste which complemented the vegetables. When sliced and broiled, the Italian sausage also makes a good snack. Place a broiled Italian Naturals slice on a French bread round, topped with a quarter sized cheese slice and melt under the broiler. An olive slice makes the perfect garnish and glass of wine the perfect complement. All of the recipes used by moi involve no formal culinary training, used food probably in most fridges, and took no longer than 15 minutes.

The Johnsonville Naturals line is at a higher price point than the original line and the key question for the consumer is whether the higher price is worth switching to the Naturals Sausage. Most consumers will probably decide on whether they will become regular consumers based upon price because the product taste and quality is superior. Moi is guessing most consumers don’t read the product labels. They will either eat processed meat or they won’t eat processed meat based upon concerns other than product label. The reason moi will be making the switch is a simpler ingredient list, a more flavorful product and the price differential is not that great. Since moi is not a dietitian she cannot comment about what the natural claim means. She is like most consumers and when she does read the labels, she noticed the Naturals label was simpler. The product test convinced moi to spend the extra money on the Naturals line because of taste and convenience.

Dr. Wilda gives the Johnsonville Naturals line definite thumbs up.

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Duke University study: Income-based school assignment policy influences diversity, achievement

3 Dec

Many educators have long recognized that the impact of social class affects both education achievement and life chances after completion of education. There are two impacts from diversity, one is to broaden the life experience of the privileged and to raise the expectations of the disadvantaged. Social class matters in not only other societies, but this one as well.

A few years back, the New York Times did a series about social class in America. That series is still relevant. Janny Scott and David Leonhardt’s overview, Shadowy Lines That Still Divide http://www.nytimes.com/2005/05/15/us/class/shadowy-lines-that-still-divide.html    describes the challenges faced by schools trying to overcome the disparity in education. The complete series can be found at Social Class   http://www.nytimes.com/pages/national/class/index.html

Science Daily reported in Income-based school assignment policy influences diversity, achievement:

When Wake County Public Schools switched from a school assignment policy based on race to one based on socioeconomic status, schools became slightly more segregated, according to new research from Duke University’s Sanford School of Public Policy.

However, segregation increased much more rapidly in four other large North Carolina school districts that simply dropped race-based strategies and did not attempt to pursue diversity in other ways.

“While we found some decline in the degree of racial diversity associated with Wake County schools after adoption of the socioeconomic plan versus the prior race-based plan, there was significantly less diversity in the school districts that were not using either plan,” said William A. Darity Jr., Samuel DuBois Cook Professor of Public Policy in the Sanford School.

In addition, Wake County math and reading scores rose slightly and the achievement gap between black and white students narrowed after the switch. In the four other N.C. districts, scores fell among black students after race-based school assignment stopped.

The research was published online in the journal Urban Education on Nov. 27.

“The main message is, we may not want to give up on using diversity-based policies to achieve integration and address opportunity gaps and achievement gaps,” said lead author Monique McMillian. McMillian, an educational psychologist, is an associate professor at Morgan State University in Maryland and an affiliate of Duke University’s Research Network on Racial and Ethnic Inequality….                                                                                                                             http://www.sciencedaily.com/releases/2015/11/151130182251.htm

Citation:

Income-based school assignment policy influences diversity, achievement

Date:      November 30, 2015

Source:   Duke University

Summary:

When public schools in Wake County, North Carolina switched from a school assignment policy based on race to one based on socioeconomic status, schools became slightly more segregated but the achievement gap lessened, according to new research.

Journal Reference:

  1. M. M. McMillian, S. Fuller, Z. Hill, K. Duch, W. A. Darity. Can Class-Based Substitute for Race-Based Student Assignment Plans? Evidence From Wake County, North Carolina. Urban Education, 2015; DOI: 10.1177/0042085915613554

Here is the press release from Duke University:

Mixed Results for Income-based K-12 Assignment

Segregation still increased in Wake County plan, but not as much as in other counties

November 30, 2015 |

Durham, NC – When Wake County Public Schools switched from a school assignment policy based on race to one based on socioeconomic status, schools became slightly more segregated, according to new research from Duke University’s Sanford School of Public Policy.

However, segregation increased much more rapidly in four other large North Carolina school districts that simply dropped race-based strategies and did not attempt to pursue diversity in other ways.

“While we found some decline in the degree of racial diversity associated with Wake County schools after adoption of the socioeconomic plan versus the prior race-based plan, there was significantly less diversity in the school districts that were not using either plan,” said William A. Darity Jr., Samuel DuBois Cook Professor of Public Policy in the Sanford School.

In addition, Wake County math and reading scores rose slightly and the achievement gap between black and white students narrowed after the switch. In the four other N.C. districts, scores fell among black students after race-based school assignment stopped.

The research was published online in the journal Urban Education on Nov. 27.

“The main message is, we may not want to give up on using diversity-based policies to achieve integration and address opportunity gaps and achievement gaps,” said lead author Monique McMillian. McMillian, an educational psychologist, is an associate professor at Morgan State University in Maryland and an affiliate of Duke University’s Research Network on Racial and Ethnic Inequality.

North Carolina school districts stopped using race-based assignment plans in the late 1990s after a series of court cases struck down the practice in various settings around the country.

In 2000, Wake implemented a new assignment policy based on income and achievement, in which no school would consist of more than 40 percent students receiving free or reduced lunch, nor more than 25 percent of students performing below grade level. (In 2010, the Wake County school board voted to stop using an income-based policy. However, income remains a component — albeit a smaller component — of the current assignment policy.)

McMillian saw the change as an opportunity to investigate how the different policies affect school integration and student achievement.

She, Darity and their colleagues analyzed data from Wake and four other large N.C. school districts: Charlotte-Mecklenburg, Cumberland County, Guilford County and Winston-Salem/Forsyth County. Like Wake, these school districts had previously used race-based assignment policies, but unlike Wake, they switched to a combination of neighborhood schools and school choice.

The researchers analyzed data from 1992 to 2009, including demographic data about schools and students, and 10 years of end-of-grade test scores for third through eighth graders.

McMillian said the study was largely descriptive. It’s not possible, therefore, to say whether the new school assignment policy alone caused Wake’s test score gains or reduced the achievement gap between white and black students. Other factors may have contributed as well, such as changes in other district policies or implementation of the No Child Left Behind Act of 2001, she said.

McMillian said the study provides “tentative evidence that income-based assignment policies improve achievement and increase diversity.”

—–

CITATION: “Can Class-Based Substitute for Race-Based Student Assignment Plans?: Evidence from Wake County, N.C.” McMillian, M.M.; Fuller, S.C.; Hill, Z.; Duch, K.; and Darity, Jr., W.A. Urban Education. DOI: 10.1177/0042085915613554

More Information

Contact: Karen Kemp

Phone: (919) 613-7315

Email: kkemp@duke.edu

© 2015 Office of News & Communications
615 Chapel Drive, Box 90563, Durham, NC 27708-0563
(919) 684-2823; After-hours phone (for reporters on deadline): (919) 812-6603

People tend to cluster in neighborhoods based upon class as much as race. Good teachers tend to gravitate toward neighborhoods where they are paid well and students come from families who mirror their personal backgrounds and values. Good teachers make a difference in a child’s life. One of the difficulties in busing to achieve equity in education is that neighborhoods tend to be segregated by class as well as race. People often make sacrifices to move into neighborhoods they perceive mirror their values. That is why there must be good schools in all segments of the country and there must be good schools in all parts of this society. A good education should not depend upon one’s class or status.   See, How do upper-class parents prepare their kids for success in the world? http://sandiegoeducationreport.org/talkingtokids.html

Moi wrote about the intersection of race and class in Michael Petrilli’s decision: An ed reformer confronts race and class when choosing a school for his kids. It is worth reviewing that post. https://drwilda.com/tag/class-segregation/ Lindsey Layton wrote in the Washington Post article, Schools dilemma for gentrifiers: Keep their kids urban, or move to suburbia?

When his oldest son reached school age, Michael Petrilli faced a dilemma known to many middle-class parents living in cities they helped gentrify: Should the family flee to the homogenous suburbs for excellent schools or stay urban for diverse but often struggling schools?

Petrilli, who lived in Takoma Park with his wife and two sons, was torn, but he knew more than most people about the choice before him. Petrilli is an education expert, a former official in the Education Department under George W. Bush and executive vice president at the Thomas B. Fordham Institute, a right-leaning education think tank.
He set out to learn as much as he could about the risks and benefits of socioeconomically diverse schools, where at least 20 percent of students are eligible for the federal free or reduced-price lunch program. And then he wrote about it….

Petrilli said he wanted his son to have friends from all backgrounds because he believes that cultural literacy will prepare him for success in a global society.

But he worried that his son might get lost in a classroom that has a high percentage of poor children, that teachers would be focused on the struggling children and have less time for their more privileged peers.
As Petrilli points out in the book, this dilemma doesn’t exist for most white, middle-class families. The vast majority — 87 percent — of white students attend majority white schools, Petrilli says, even though they make up just about 50 percent of the public school population.

And even in urban areas with significant African American and Latino populations, neighborhood schools still tend to be segregated by class, if not by race. In the Washington region, less than 3 percent of white public school students attend schools where poor children are the majority, according to Petrilli.

Gentrification poses new opportunities for policymakers to desegregate schools, Petrilli argues….

In the end, Petrilli moved from his Takoma Park neighborhood school — diverse Piney Branch Elementary, which is 33 percent low-income — to Wood Acres Elementary in Bethesda, where 1 percent of the children are low-income, 2 percent are black and 5 percent are Hispanic. http://www.washingtonpost.com/local/education/schools-dilemma-for-urban-gentrifiers-keep-their-kids-urban-or-move-to-suburbia/2012/10/14/02083b6c-131b-11e2-a16b-2c110031514a_story.html

Often, schools are segregated by both race and class. Class identification is very important in education because of class and peer support for education achievement and the value placed on education by social class groups. Moi does not condemn Mr. Petrilli for doing what is best for his family because when the rubber meets the road that is what parents are supposed to do. His family’s situation is just an example of the intersection of race and class in education.

The lawyers in Brown were told that lawsuits were futile and that the legislatures would address the issue of segregation eventually when the public was ready. Meanwhile, several generations of African Americans waited for people to come around and say the Constitution applied to us as well. Generations of African Americans suffered in inferior schools. This society cannot sacrifice the lives of children by not addressing the issue of equity in school funding in a timely manner.

The next huge case, like Brown, will be about equity in education funding. It may not come this year or the next year. It, like Brown, may come several years after a Plessy. It will come. Equity in education funding is the civil rights issue of this century.

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