Tag Archives: CDC

University of St. Thomas study: Sleep problems equal to marijuana use and drinking in predicting poor academic performance in college

4 Jun

Moi has posted quite a bit about the effect of sleep deprivation on children and teens. A study of older men published in the Journal Sleep details the effect of sleep deprivation on older men. The bottom line is that no matter one’s age, in order to fully function, people need adequate rest. See, Study: Poor sleep quality can lead to cognitive problems in older men https://drwilda.com/2014/04/02/study-poor-sleep-quality-can-lead-to-cognitive-problems-in-older-men/

Sarah Klein reported in the Huffington Post article, Sleep Problems Equal To Binge Drinking, Marijuana Use In Predicting Poor Academic Performance:

While the temptations to stay up late are many, a small new study suggests a very good reason for college students to hit the hay. Those who are poor sleepers are more likely to get worse grades and to withdraw from a course, according to a new study. In fact, the effects of poor sleep were about as strong as binge drinking and marijuana use on a student’s academic performance.
The researchers analyzed data from over 43,000 students included in the spring 2009 American College Health Association’s National College Health Assessment (NCHA). After controlling for potentially confounding factors that might predict how a college student fares academically, like clinical depression, feelings of isolation or chronic health problems, the researchers found that getting poor sleep was a strong predictor of problems at school.
While few students are likely to have a clinical sleep disorder, Roxanne Prichard, Ph.D., associate professor of psychology at the University of St. Thomas in St. Paul, Minnesota tells The Huffington Post, about 60 percent say they have some kind of problem sleeping. But for all the effort colleges put into anti-drinking and de-stressing campaigns, little time or money is spent to promote better sleep — and doing so could help both students and the colleges themselves, she says…. http://www.huffingtonpost.com/2014/06/03/sleep-drinking-marijuana_n_5433148.html?utm_hp_ref=education&ir=Education

Citation:

Poor sleep equal to binge drinking, marijuana use in predicting academic problems

Date: June 2, 2014
Source: American Academy of Sleep Medicine
Summary:
College students who are poor sleepers are much more likely to earn worse grades and withdraw from a course than healthy sleeping peers, new research shows. Results show that sleep timing and maintenance problems in college students are a strong predictor of academic problems. The study also found that sleep problems have about the same impact on grade point average (GPA) as binge drinking and marijuana use.
See, Poor sleep equal to binge drinking, marijuana use in predicting academic problems http://www.sciencedaily.com/releases/2014/06/140602102011.htm

Here is the press release from the American Academy of Sleep Medicine:

FOR IMMEDIATE RELEASE
American Academy of Sleep Medicine
Sunday, June 1, 2014

CONTACT: Lynn Celmer, 630-737-9700, ext. 9364, lcelmer@aasmnet.org

Poor sleep equal to binge drinking, marijuana use in predicting academic problems
DARIEN, IL – A new study shows that college students who are poor sleepers are much more likely to earn worse grades and withdraw from a course than healthy sleeping peers.
Results show that sleep timing and maintenance problems in college students are a strong predictor of academic problems even after controlling for other factors that contribute to academic success, such as clinical depression, feeling isolated, and diagnosis with a learning disability or chronic health issue. The study also found that sleep problems have about the same impact on grade point average (GPA) as binge drinking and marijuana use. Its negative impact on academic success is more pronounced for freshmen. Among first-year students, poor sleep— but not binge drinking, marijuana use or learning disabilities diagnosis—independently predicted dropping or withdrawing from a course. Results were adjusted for potentially confounding factors such as race, gender, work hours, chronic illness, and psychiatric problems such as anxiety.
“Well-rested students perform better academically and are healthier physically and psychologically,” said investigators Roxanne Prichard, PhD, associate professor of psychology and Monica Hartmann, professor of economics at the University of St. Thomas in St. Paul, Minnesota.
The research abstract was published recently in an online supplement of the journal Sleep and will be presented Tuesday, June 3, in Minneapolis, Minnesota, at SLEEP 2014, the 28th annual meeting of the Associated Professional Sleep Societies LLC.
Data from the Spring 2009 American College Health Association National College Health Assessment (NCHA) were analyzed to evaluate factors that predict undergraduate academic problems including dropping a course, earning a lower course grade and having a lower cumulative GPA. Responses from over 43,000 participants were included in the analysis.
According to Prichard, student health information about the importance of sleep is lacking on most university campuses.
“Sleep problems are not systematically addressed in the same way that substance abuse problems are,” she said. “For colleges and universities, addressing sleep problems early in a student’s academic career can have a major economic benefit through increased retention.”
For a copy of the abstract, “What Is The Cost Of Poor Sleep For College Students? Calculating The Contribution to Academic Failures Using A Large National Sample,” or to arrange an interview with Roxanne Prichard or an AASM spokesperson, please contact AASM Communications Coordinator Lynn Celmer at 630-737-9700, ext. 9364, or lcelmer@aasmnet.org.
Established in 1975, the American Academy of Sleep Medicine (AASM) improves sleep health and promotes high quality patient centered care through advocacy, education, strategic research, and practice standards. With about 9,000 members, the AASM is the largest professional membership society for physicians, scientists and other health care providers dedicated to sleep medicine. For more information, visit http://www.aasmnet.org.

According to the Centers for Disease Control (CDC), insufficient sleep is a public health epidemic.

In the article, Insufficient Sleep Is a Public Health Epidemic, the CDC reports:

How Much Sleep Do We Need? And How Much Sleep Are We Getting?
How much sleep we need varies between individuals but generally changes as we age. The National Institutes of Health suggests that school-age children need at least 10 hours of sleep daily, teens need 9-105 hours, and adults need 7-8 hours. According to data from the National Health Interview Survey, nearly 30% of adults reported an average of ≤6 hours of sleep per day in 2005-2007.3 In 2009, only 31% of high school students reported getting at least 8 hours of sleep on an average school night.4
Sleep Hygiene Tips
The promotion of good sleep habits and regular sleep is known as sleep hygiene. The following sleep hygiene tips can be used to improve sleep.
• Go to bed at the same time each night and rise at the same time each morning.
• Avoid large meals before bedtime.
• Avoid caffeine and alcohol close to bedtime.
• Avoid nicotine.
(Sleep Hygiene Tips adapted from the National Sleep Foundation ) http://www.cdc.gov/features/dssleep/

More Americans of all ages need to begin getting a good night’s sleep.

Resources:

National Sleep Foundation’s Teens and Sleep
http://www.sleepfoundation.org/article/sleep-topics/teens-and-sleep

Teen Health’s Common Sleep Problems
http://kidshealth.org/teen/your_body/take_care/sleep.html

CBS Morning News’ Sleep Deprived Kids and Their Disturbing Thoughts http://www.cbsnews.com/2100-500165_162-6052150.html

Psychology Today’s Sleepless in America http://www.psychologytoday.com/blog/sleepless-in-america

National Association of State Board’s of Education Fit, Healthy and Ready to Learn http://eric.ed.gov/?id=ED465734

U.S. Department of Education’s Tools for Success
http://www2.ed.gov/parents/academic/help/tools-for-success/index.html

Related:

Another study: Sleep problems can lead to behavior problems in children https://drwilda.com/2013/03/30/another-study-sleep-problems-can-lead-to-behavior-problems-in-children/

Stony Brook Medicine study: Teens need sleep to function properly and make healthy food choices https://drwilda.com/2013/06/21/stony-brook-medicine-study-teens-need-sleep-to-function-properly-and-make-healthy-food-choices/

University of Massachusetts Amherst study: Preschoolers need naps Does school start too early? https://drwilda.com/tag/too-little-sleep-raises-obesity-risk-in-children/

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/

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States getting tough about requiring childhood vaccinations

19 May

Michaeleen Doucleff reported in the NPR story, How Vaccine Fears Fueled The Resurgence Of Preventable Diseases:

For most of us, measles and whooping cough are diseases of the past. You get a few shots as a kid and then hardly think about them again.
But that’s not the case in all parts of the world — not even parts of the U.S.
As an interactive maphttp://www.cfr.org/interactives/GH_Vaccine_Map/index.html#mapfrom the Council on Foreign Relations illustrates, several diseases that are easily prevented with vaccines have made a comeback in the past few years. Their resurgence coincides with changes in perceptions about vaccine safety….
http://www.npr.org/blogs/health/2014/01/25/265750719/how-vaccine-fears-fueled-the-resurgence-of-preventable-diseases?utm_medium=Email&utm_campaign=20140202&utm_source=mostemailed

There are many myths regarding vaccination of children.

Evie Blad reported in the Education Week article, States Tightening Loopholes in School Vaccine Laws:

As outbreaks of preventable diseases have spread around the country in recent years, some states have been re-evaluating how and why they allow parents to opt their children out of vaccines required for school attendance.
Requiring vaccines before school admission has been a key component of a decades-long campaign that had nearly rid the United States of some of its most severe illnesses, from the measles to whooping cough, public-health experts say. But they also warn that broad “personal belief” exemptions that don’t relate to a child’s medical condition or a family’s religious beliefs have made it too easy to bypass vaccines, poking a sizable hole in the public-health safety net.
While some parents act out of a sense of personal conviction, others do so simply because they don’t have time to schedule an appointment, said Stephanie L. Wasserman, the executive director of the Colorado Children’s Immunization Coalition, an Aurora, Colo.-based group that seeks to increase vaccine coverage in the state.
“We want to close that convenience loophole,” she said. “When you choose not to immunize, there are consequences not only to your child and your family; there are consequences to your community as well.”
Since 2011, Washington, Oregon, California, and Vermont have revised their personal exemption processes.
In Colorado—a state with one of the highest opt-out rates in the country and the most recent one to examine its vaccine-exemption policies—a bill passed this month would draw schools into the public health fight….
Laws at a Glance
While all states have school vaccination laws on the books, states vary on how much leeway parents have to opt their children out of required vaccinations.
50 states require specified vaccines for students, but allow exemptions for medical reasons.
48 states grant exemptions for people who have religious beliefs against immunizations. (Mississippi and West Virginia do not allow this exemption.)
19 states allow exemptions for those who object to immunizations for personal or moral beliefs.
SOURCE: National Conference of State Legislatures
http://www.edweek.org/ew/articles/2014/05/14/31vaccines.h33.html

Dina Fine Maron wrote in the Daily Beast article, 6 Top Vaccine Myths:

To sort through the onslaught of information and misinformation about childhood immunizations, we asked Austin, Texas-based pediatrician Ari Brown, coauthor of “Baby 411: Clear Answers and Smart Advice for your Baby’s First Year,” to debunk some of the most common vaccination myths.

Myth 1: It’s not necessary to vaccinate kids against diseases that have been largely eradicated in the United States.
Reality: Although some diseases like polio and diphtheria aren’t often seen in America (in large part because of the success of the vaccination efforts), they can be quite common in other parts of the world. The Centers for Disease Control and Prevention warns that travelers can unknowingly bring these diseases into the United States, and if we were not protected by vaccinations, these diseases could quickly spread throughout the population….

Myth 2: Mercury is still in kids’ vaccines.
Reality: At the center of this issue is a preservative called thimerosal (a compound containing mercury) that once was a common component in many vaccines because it allowed manufacturers to make drugs more cheaply and in multidose formulations. But public concern, new innovations and FDA recommendations led to its removal from almost all children’s vaccines manufactured after 2001. (More thimerosal background can be found at the FDA’s Web site) Since flu vaccines are not just for children, manufacturers still put thimerosal in some flu-shot formulations. You can ask your pediatrician for the thimerosal-free version, says Brown.
If your child does not have asthma and is at least 2 years old, Brown recommends the FluMist nasal-spray vaccination over the flu shot. “It seems to have better immune protection and it could help your child avoid another shot,” she says. (Caveat: the spray does contain a live version of the virus, which can result in a slight increase in flulike symptoms).

Myth 3: Childhood vaccines cause autism.
Reality: There is no scientific evidence that this link exists. Groups of experts, including the American Academy of Pediatrics and the Institute of Medicine (IOM), agree that vaccines are not responsible for the growing number of children now recognized to have autism…..

Myth 4: Getting too many vaccines can overwhelm the immune system and cause adverse reactions or even serious illness.
Reality: Children’s immune systems are capable of combating far more antigens (weak or killed viruses) than they encounter via immunizations. In fact, the jury is still out on if there’s an actual limit on how many the body can handle—though one study puts the number around a theoretical 10,000 vaccines in one day.(Visit the American Academy of Pediatrics’ site or the Network for Immunization Information for more information)
Currently, “There is even less of a burden on the immune system [via vaccines] today than 40 years ago,” says Edgar Marcuse, a professor of pediatrics at the University of Washington who works on immunization policy and vaccines…..

Myth 5: It’s better to let my kid get chickenpox “naturally.”
Reality: Before the chickenpox vaccine was licensed in 1995, parents sometimes brought their child to a party or playground hoping that their child might brush up against a pox-laden kid to get their dose of chickenpox over since cases were usually less severe for children than adults. But pediatricians say severe complications are possible with chickenpox—including bacterial infections that could result in a child’s hospitalization or death….

Myth 6: The flu shot causes the flu.
Reality: The flu shot does not contain a live virus, so your child can’t get the flu from this shot. But, after the shot, it’s not uncommon to feel a bit achy while the immune system mounts its response. Remember that for two weeks following the shot, your child can still get the flu, so be sure to help your child avoid that feverish kid next door.http://www.thedailybeast.com/newsweek/2009/02/22/six-top-vaccine-myths.html

A question in the current climate is what can be done to make parents responsible for putting other children at risk.

Jed Lipinksi wrote in the Slate article, Endangering the Herd: The case for suing:

As you’d expect, the growing anti-vaccination movement responded in fury. After Caplan wrote a related post for the Harvard Law Blog, angry comments poured in. “This article is industry propaganda at its worst,” one commenter declared. Another wrote: “Caplan would have familiar company in fascist Germany.” The blog eventually shut down the comments for violations of the site’s policies against “abusive and defamatory language” and the sharing of personal information.
Here’s why the anti-vaxxers are wrong and Caplan and his co-authors are right to raise the idea of suing or criminally charging them: Parents who choose not to vaccinate their kids for reasons of personal belief pose a serious danger to the public.
Measles vaccines are about 95 percent effective when given to children. That leaves a 5 percent chance that kids who are vaccinated will contract measles. This means that no matter what, the disease still poses a public health risk, but we rely on others to get vaccinated to hugely reduce the likelihood of outbreaks. That’s the process known as herd immunity.
Unvaccinated children threaten the herd. Take the San Diego measles outbreak of 2008. After unknowingly contracting the disease on a trip to Switzerland, an unvaccinated 7-year-old boy infected 11 other unvaccinated kids, according to the Centers for Disease Control and Prevention. The majority of the cases occurred in kids whose parents had requested personal belief exemptions (or PBEs) through the state of California, one of 17 states to allow them. But three of the infected were either too young or medically unable to be vaccinated. And overall, 48 children too young to be vaccinated were quarantined, at an average cost to the family of $775 per child. The CDC noted that all 11 cases were “linked epidemiologically” to the 7-year-old boy and that the outbreak response cost the public sector $10,376 per case.
Today, several states blame a rise in preventable diseases on the declining child vaccination rates. In Michigan, less than 72 percent of children have received their state-mandated measles, mumps, and rubella (MMR) vaccines. In New York, as Caplan noted in his blog post, pockets of Brooklyn’s Hasidic Jewish community are experiencing a mini measles epidemic. Thirty cases have been confirmed so far. According to Dr. Yu Shia Lin of Maimonides Medical Center, some members of the community avoid the measles vaccine because they think it causes autism. The most visible proponent of this idea, former Playboy Playmate Jenny McCarthy, will receive a giant new platform for her viewpoints when she joins the daytime gossipfest The View on Sept. 9.
The belief that the MMR vaccine causes autism goes back to a 1998 study published in the Lancet by a British gastroenterologist named Andrew Wakefield. In 2010, after years of criticism, the journal finally retracted Wakefield’s study, announcing that it was “utterly clear, without any ambiguity at all, that the statements in the paper were utterly false.” Britain’s General Medical Council later revoked Wakefield’s medical license, noting that he’d failed to disclose his role as a paid consultant to lawyers representing parents who thought vaccines had harmed their kids. The CDC makes clear there is no connection between vaccines and autism.
Yet this dangerous idea persists. Often, it persists among people who are simply doing what they think is best for their kids. Which is why it’s necessary to take extra measures to ensure nonvaccinators understand the risk they pose to other people’s children….
There are legal obstacles to penalizing parents who don’t vaccinate their kids. Courts are generally less likely to impose liability on someone who fails to act than they are on someone who acts recklessly. Also, proving cause and effect will sometimes be difficult. Then again, to win damages, a plaintiff would only have to prove that it’s “more likely than not” that a nonvaccinated child infected another person.parents who don’t vaccinate their kids—or criminally charging them….http://www.slate.com/articles/news_and_politics/jurisprudence/2013

It is just a matter of time before there will be lawsuits regarding whether a parent owed a duty to the public to vaccinate their child.

Here is information from the 6 Top Vaccine Myths regarding vaccination schedules:
For Health Care Professionals
Birth-18 Years and Catch-up
• View combined schedules (birth-18 years and catch-up)
http://www.cdc.gov/mmwr/preview/mmwrhtml/su6201a2.htm
• Print combined schedules (including intro, summary of changes, references…) [355 KB, 7 pages]

Click to access mmwr-0-18yrs-catchup-schedule.pdf

• Print combined schedules in color (chart in landscape format) [202 KB, 5 pages] also in black & white [348 KB, 5 pages]

Click to access mmwr-0-18yrs-catchup-schedule.pdf

• Print full MMWR supplement (birth-18 years, catch-up, adult, adult medical and other indications, adult contraindications and precautions) [1MB, 21 pages]

Click to access mm62e0128.pdf

• Order free copies from CDC
http://wwwn.cdc.gov/pubs/ncird.aspx#schedules
For Everyone
Easy-to-read Schedules for All Ages
Easy-to-read formats to print, tools to download, and ways to prepare for your office visit.
• Infants and Children (birth through 6 years old)Find easy-to-read formats to print, create an instant schedule for your child, determine missed or skipped vaccines, and prepare for your office visit…
http://www.cdc.gov/vaccines/schedules/easy-to-read/child.html
• Preteens & Teens (7 through 18 years old)Print this friendly schedule, take a quick quiz, fill out the screening form before your child’s doctor visit, or download a tool to determine vaccines needed…
http://www.cdc.gov/vaccines/schedules/easy-to-read/preteen-teen.html
• Adults (19 years and older)Print the easy-to-read adult schedule, take the quiz, or download a tool to
• determine vaccines needed…
http://www.cdc.gov/vaccines/schedules/easy-to-read/adult.html
http://www.cdc.gov/vaccines/schedules/

Here is information from the American Academy of Pediatrics regarding vaccination.
http://www2.aap.org/immunization/ Parents must consult their doctors about vaccinations.

Related:

3rd World America: Tropical diseases in poor neighborhoods

3rd World America: Tropical diseases in poor neighborhoods

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/

Tags: , , , , , , , , , , , , , , , , ,

Study: Poor sleep quality can lead to cognitive problems in older men

2 Apr

Moi has posted quite a bit about the effect of sleep deprivation on children and teens. A study of older men published in the Journal Sleep details the effect of sleep deprivation on older men. The bottom line is that no matter one’s age, in order to fully function, people need adequate rest.

Science Daily reported in the article, Poor sleep quality linked to cognitive decline in older men:

A new study of older men found a link between poor sleep quality and the development of cognitive decline over three to four years. Results show that higher levels of fragmented sleep and lower sleep efficiency were associated with a 40 to 50 percent increase in the odds of clinically significant decline in executive function, which was similar in magnitude to the effect of a five-year increase in age. In contrast, sleep duration was not related to subsequent cognitive decline.
“It was the quality of sleep that predicted future cognitive decline in this study, not the quantity,” said lead author Terri Blackwell, MA, senior statistician at the California Pacific Medical Center Research Institute (CPMCRI) in San Francisco, Calif. “With the rate of cognitive impairment increasing and the high prevalence of sleep problems in the elderly, it is important to determine prospective associations with sleep and cognitive decline.”
The study involved 2,822 community-dwelling older men at six clinical centers in the U.S. Participants had a mean age of 76 years. The study is published in the April 1 issue of the journal Sleep.
“This study provides an important reminder that healthy sleep involves both the quantity and quality of sleep,” said American Academy of Sleep Medicine President Dr. M. Safwan Badr. “As one of the pillars of a healthy lifestyle, sleep is essential for optimal cognitive functioning.”
The population-based, longitudinal study was conducted by a research team led by Dr. Katie Stone, senior scientist at CPMCRI in San Francisco, Calif. Institutions represented by study collaborators include the University of California, San Francisco; University of California, San Diego; Harvard Medical School; University of Minnesota; and several Veterans Affairs medical centers….
http://www.sciencedaily.com/releases/2014/03/140331170557.htm

Citation:

VOLUME 37, ISSUE 04

ASSOCIATION OF SLEEP QUALITY WITH SUBSEQUENT COGNITIVE DECLINE IN OLDER MEN
Associations of Objectively and Subjectively Measured Sleep Quality with Subsequent Cognitive Decline in Older Community-Dwelling Men: The MrOS Sleep Study
http://dx.doi.org/10.5665/sleep.3562
Terri Blackwell, MA1; Kristine Yaffe, MD2; Alison Laffan, PhD1; Sonia Ancoli-Israel, PhD3; Susan Redline, MD, MPH4; Kristine E. Ensrud, MD, MPH5; Yeonsu Song, PhD1; Katie L. Stone, PhD1
1Research Institute, California Pacific Medical Center, San Francisco, CA; 2Departments of Psychiatry, Neurology, and Epidemiology, University of California, San Francisco, San Francisco VA Medical Center, San Francisco, CA; 3Department of Psychiatry and Medicine, University of California, San Diego, La Jolla, CA and the Veterans Affairs San Diego Center of Excellence for Stress and Mental Health, San Diego, CA; 4Departments of Medicine, Brigham and Women’s Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; 5Center for Chronic Disease Outcomes Research, Veterans Affairs Medical Center, Minneapolis, MN; Department of Medicine and Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
Study Objectives:
To examine associations of objectively and subjectively measured sleep with subsequent cognitive decline.
Design:
A population-based longitudinal study.
Setting:
Six centers in the United States.
Participants:
Participants were 2,822 cognitively intact community-dwelling older men (mean age 76.0 ± 5.3 y) followed over 3.4 ± 0.5 y.
Interventions:
None.
Measurements and Results:
Objectively measured sleep predictors from wrist actigraphy: total sleep time (TST), sleep efficiency (SE), wake after sleep onset (WASO), number of long wake episodes (LWEP). Self-reported sleep predictors: sleep quality (Pittsburgh Sleep Quality Index [PSQI]), daytime sleepiness (Epworth Sleepiness Scale [ESS]), TST. Clinically significant cognitive decline: five-point decline on the Modified Mini-Mental State examination (3MS), change score for the Trails B test time in the worse decile. Associations of sleep predictors and cognitive decline were examined with logistic regression and linear mixed models. After multivariable adjustment, higher levels of WASO and LWEP and lower SE were associated with an 1.4 to 1.5-fold increase in odds of clinically significant decline (odds ratio 95% confidence interval) Trails B test: SE < 70% versus SE ≥ 70%: 1.53 (1.07, 2.18); WASO ≥ 90 min versus WASO < 90 min: 1.47 (1.09, 1.98); eight or more LWEP versus fewer than eight: 1.38 (1.02, 1.86). 3MS: eight or more LWEP versus fewer than eight: 1.36 (1.09, 1.71), with modest relationships to linear change in cognition over time. PSQI was related to decline in Trails B performance (3 sec/y per standard deviation increase).
Conclusions:
Among older community-dwelling men, reduced sleep efficiency, greater nighttime wakefulness, greater number of long wake episodes, and poor self-reported sleep quality were associated with subsequent cognitive decline.
Citation:
Blackwell T; Yaffe K; Laffan A; Ancoli-Israel S; Redline S; Ensrud KE; Song Y; Stone KL. Associations of objectively and subjectively measured sleep quality with subsequent cognitive decline in older community-dwelling men: the MrOS sleep study. SLEEP 2014;37(4):655-663.

Here is the press release from the American Academy of Sleep Medicine:

Poor sleep quality linked to cognitive decline in older men
American Academy of Sleep Medicine
Monday, March 31, 2014
FOR IMMEDIATE RELEASE
CONTACT: Lynn Celmer, 630-737-9700, ext. 9364, lcelmer@aasmnet.org
DARIEN, IL – A new study of older men found a link between poor sleep quality and the development of cognitive decline over three to four years.
Results show that higher levels of fragmented sleep and lower sleep efficiency were associated with a 40 to 50 percent increase in the odds of clinically significant decline in executive function, which was similar in magnitude to the effect of a five-year increase in age. In contrast, sleep duration was not related to subsequent cognitive decline.
“It was the quality of sleep that predicted future cognitive decline in this study, not the quantity,” said lead author Terri Blackwell, MA, senior statistician at the California Pacific Medical Center Research Institute (CPMCRI) in San Francisco, Calif. “With the rate of cognitive impairment increasing and the high prevalence of sleep problems in the elderly, it is important to determine prospective associations with sleep and cognitive decline.”
The study involved 2,822 community-dwelling older men at six clinical centers in the U.S. Participants had a mean age of 76 years. The study is published in the April 1 issue of the journal Sleep.
“This study provides an important reminder that healthy sleep involves both the quantity and quality of sleep,” said American Academy of Sleep Medicine President Dr. M. Safwan Badr. “As one of the pillars of a healthy lifestyle, sleep is essential for optimal cognitive functioning.”
The population-based, longitudinal study was conducted by a research team led by Dr. Katie Stone, senior scientist at CPMCRI in San Francisco, Calif. Institutions represented by study collaborators include the University of California, San Francisco; University of California, San Diego; Harvard Medical School; University of Minnesota; and several Veterans Affairs medical centers.
An average of five nights of objective sleep data were collected from each participant using a wrist actigraph. Cognitive function assessment included evaluation of attention and executive function using the Trails B test. According to the authors, executive function is the ability for planning or decision making, error correction or trouble shooting, and abstract thinking. Results were adjusted for potential confounding factors such as depressive symptoms, comorbidities and medication use.
The underlying mechanisms relating disturbed sleep to cognitive decline remain unknown, the authors noted. They added that additional research is needed to determine if these associations hold after a longer follow-up period.
Funding was provided by the National Heart, Lung, and Blood Institute (NHLBI) for the Outcomes of Sleep Disorders in Men Study, an ancillary study of the parent Osteoporotic Fractures in Men (MrOS) Study, which was supported by the National Institutes of Health (NIH).
To request a copy of the study,“Associations of Objectively and Subjectively Measured Sleep Quality with Subsequent Cognitive Decline in Older Community-Dwelling Men: The MrOS Sleep Study,” or to arrange an interview with the study author or an AASM spokesperson, please contact Communications Coordinator Lynn Celmer at 630-737-9700, ext. 9364, or lcelmer@aasmnet.org.
The monthly, peer-reviewed, scientific journal Sleep is published online by the Associated Professional Sleep Societies LLC, a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society. The AASM is a professional membership society that improves sleep health and promotes high quality patient centered care through advocacy, education, strategic research, and practice standards (www.aasmnet.org). A searchable directory of AASM accredited sleep centers is available at http://www.sleepeducation.com.

According to the Centers for Disease Control (CDC), insufficient sleep is a public health epidemic.

In the article, Insufficient Sleep Is a Public Health Epidemic, the CDC reports:

How Much Sleep Do We Need? And How Much Sleep Are We Getting?
How much sleep we need varies between individuals but generally changes as we age. The National Institutes of Health suggests that school-age children need at least 10 hours of sleep daily, teens need 9-105 hours, and adults need 7-8 hours. According to data from the National Health Interview Survey, nearly 30% of adults reported an average of ≤6 hours of sleep per day in 2005-2007.3 In 2009, only 31% of high school students reported getting at least 8 hours of sleep on an average school night.4
Sleep Hygiene Tips
The promotion of good sleep habits and regular sleep is known as sleep hygiene. The following sleep hygiene tips can be used to improve sleep.
• Go to bed at the same time each night and rise at the same time each morning.
• Avoid large meals before bedtime.
• Avoid caffeine and alcohol close to bedtime.
• Avoid nicotine.
(Sleep Hygiene Tips adapted from the National Sleep Foundation ) http://www.cdc.gov/features/dssleep/

More Americans of all ages need to begin getting a good night’s sleep.

Resources:

National Sleep Foundation’s Teens and Sleep http://www.sleepfoundation.org/article/sleep-topics/teens-and-sleep

Teen Health’s Common Sleep Problems http://kidshealth.org/teen/your_body/take_care/sleep.html

CBS Morning News’ Sleep Deprived Kids and Their Disturbing Thoughts
http://www.cbsnews.com/2100-500165_162-6052150.html

Psychology Today’s Sleepless in America
http://www.psychologytoday.com/blog/sleepless-in-america

National Association of State Board’s of Education Fit, Healthy and Ready to Learn
http://eric.ed.gov/?id=ED465734

U.S. Department of Education’s Tools for Success http://www2.ed.gov/parents/academic/help/tools-for-success/index.html

Related:

Another study: Sleep problems can lead to behavior problems in children

Another study: Sleep problems can lead to behavior problems in children

Stony Brook Medicine study: Teens need sleep to function properly and make healthy food choices https://drwilda.com/2013/06/21/stony-brook-medicine-study-teens-need-sleep-to-function-properly-and-make-healthy-food-choices/

University of Massachusetts Amherst study: Preschoolers need naps Does school start too early? https://drwilda.com/tag/too-little-sleep-raises-obesity-risk-in-children/

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Preventable diseases are on the rise because of fears of vaccines

8 Feb

Michaeleen Doucleff reported in the NPR story, How Vaccine Fears Fueled The Resurgence Of Preventable Diseases:

For most of us, measles and whooping cough are diseases of the past. You get a few shots as a kid and then hardly think about them again.
But that’s not the case in all parts of the world — not even parts of the U.S.
As an interactive map http://www.cfr.org/interactives/GH_Vaccine_Map/index.html#map from the Council on Foreign Relations illustrates, several diseases that are easily prevented with vaccines have made a comeback in the past few years. Their resurgence coincides with changes in perceptions about vaccine safety.
Since 2008 folks at the think tank CFR have been plotting all the cases of measles, mumps, rubella, polio and whooping cough around the world. Each circle on the map represents a local outbreak of a particular disease, while the size of the circle indicates the number of people infected in the outbreak.
As you flip through the various maps over the years, two trends clearly emerge: Measles has surged back in Europe, while whooping cough is has become a problem here in the U.S.
Childhood immunization rates plummeted in parts of Europe and the U.K. after a 1998 study falsely claimed that the vaccine for measles, mumps and rubella was linked to autism.
That study has since been found to be fraudulent. But fears about vaccine safety have stuck around in Europe and here in the U.S.
Viruses and bacteria have taken full advantage of the immunization gaps.
In 2011, France reported a massive measles outbreak with nearly 15,000 cases. Only the Democratic Republic of Congo, India, Indonesia, Nigeria and Somalia suffered larger measles outbreaks that year.
In 2012, the U.K. reported more than 2,000 measles cases, the largest number since 1994.
Here in the U.S., the prevalence of whooping cough shot up in 2012 to nearly 50,000 cases. Last year cases declined to about 24,000 — which is still more than tenfold the number reported back in the early ’80s when the bacteria infected less than 2,000 people.
So what about countries in Africa? Why are there so many big, colorful circles dotting the continent? For many parents there, the problem is getting access to vaccines, not fears of it.
http://www.npr.org/blogs/health/2014/01/25/265750719/how-vaccine-fears-fueled-the-resurgence-of-preventable-diseases?utm_medium=Email&utm_campaign=20140202&utm_source=mostemailed

There are many myths regarding vaccination of children.

Dina Fine Maron wrote in the Daily Beast article, 6 Top Vaccine Myths:

To sort through the onslaught of information and misinformation about childhood immunizations, we asked Austin, Texas-based pediatrician Ari Brown, coauthor of “Baby 411: Clear Answers and Smart Advice for your Baby’s First Year,” to debunk some of the most common vaccination myths.
Myth 1: It’s not necessary to vaccinate kids against diseases that have been largely eradicated in the United States.
Reality: Although some diseases like polio and diphtheria aren’t often seen in America (in large part because of the success of the vaccination efforts), they can be quite common in other parts of the world. The Centers for Disease Control and Prevention warns that travelers can unknowingly bring these diseases into the United States, and if we were not protected by vaccinations, these diseases could quickly spread throughout the population. At the same time, the relatively few cases currently in the U.S. could very quickly become tens or hundreds of thousands of cases without the protection we get from vaccines. Brown warns that these diseases haven’t disappeared, “they are merely smoldering under the surface.”
Most parents do follow government recommendations: U.S. national immunization rates are high, ranging from 85 percent to 93 percent, depending on the vaccine, according to the CDC. But according to a 2006 study in the Journal of the American Medical Association, the 20 states that allow personal-belief opt outs in addition to religious exemptions saw exemptions grow by 61 percent, to 2.54 percent between 1991 and 2004.
Brown is concerned that parents who opt out or stagger the vaccine schedule can end up having to deal with confusing follow-up care, which could produce an increase in disease outbreaks like last summer’s measles epidemic. A 2008 study in the American Journal of Epidemiology reported that when there are more exemptions, children are at an increased risk of contracting and transmitting vaccine-preventable diseases.
For more on the pros and cons of staggering or skipping vaccinations, visit MSN’s guide or read this U.S. News and World Report piece. For information on vaccine safety, check out the CDC’s information page. To search for your state’s vaccine requirements, see the National Network for Immunization Information.
Myth 2: Mercury is still in kids’ vaccines.
Reality: At the center of this issue is a preservative called thimerosal (a compound containing mercury) that once was a common component in many vaccines because it allowed manufacturers to make drugs more cheaply and in multidose formulations. But public concern, new innovations and FDA recommendations led to its removal from almost all children’s vaccines manufactured after 2001. (More thimerosal background can be found at the FDA’s Web site) Since flu vaccines are not just for children, manufacturers still put thimerosal in some flu-shot formulations. You can ask your pediatrician for the thimerosal-free version, says Brown.
If your child does not have asthma and is at least 2 years old, Brown recommends the FluMist nasal-spray vaccination over the flu shot. “It seems to have better immune protection and it could help your child avoid another shot,” she says. (Caveat: the spray does contain a live version of the virus, which can result in a slight increase in flulike symptoms).
Myth 3: Childhood vaccines cause autism.
Reality: There is no scientific evidence that this link exists. Groups of experts, including the American Academy of Pediatrics and the Institute of Medicine (IOM), agree that vaccines are not responsible for the growing number of children now recognized to have autism.
Earlier this month, the law supported scientists’ conclusions in this arena with three rulings from a section of the U.S. Court of Federal Claims, which stated that vaccines were not the likely cause of autism in three unrelated children. The U.S. Department of Health and Human Services said in an online statement following the ruling, “The medical and scientific communities have carefully and thoroughly reviewed the evidence concerning the vaccine-autism theory and have found no association between vaccines and autism.” Noting the volume of scientific evidence disproving this link, an executive member of one of the nation’s foremost autism advocacy groups, Autism Speaks, recently stepped down from her position because she disagrees with the group’s continued position that there is a connection between the vaccines and autism.
Get Newsweek on your Tablet
Myth 4: Getting too many vaccines can overwhelm the immune system and cause adverse reactions or even serious illness.
Reality: Children’s immune systems are capable of combating far more antigens (weak or killed viruses) than they encounter via immunizations. In fact, the jury is still out on if there’s an actual limit on how many the body can handle—though one study puts the number around a theoretical 10,000 vaccines in one day.(Visit the American Academy of Pediatrics’ site or the Network for Immunization Information for more information)
Currently, “There is even less of a burden on the immune system [via vaccines] today than 40 years ago,” says Edgar Marcuse, a professor of pediatrics at the University of Washington who works on immunization policy and vaccines. He points to the whooping-cough vaccine as an example where there are far fewer antigens in the shot than the earlier version administered decades ago. Brown says she supports following the recommended schedule for vaccinations, which outlines getting as many as five shots in one day at a couple check-ups. (The CDC’s recommended vaccination schedule can be found here.) “I have kids, and I wouldn’t recommend doing anything for my patients that I wouldn’t do for my own kids,” she says.
The CDC reports that most vaccine adverse events are minor and temporary, such as a sore arm or mild fever and “so few deaths can plausibly be attributed to vaccines that it is hard to assess the risk statistically.” Of all deaths reported to the Health and Human Services’ Vaccine Adverse Events Reporting site between 1990 and 1992, only one is believed to be even possibly associated with a vaccine. The Vaccine Safety Datalink Project, an initiative of the CDC and eight health-care organizations, looks for patterns in these reports and determines if a vaccine is causing a side effect or if symptoms are largely coincidental.
If you have concerns about following the recommended vaccination, schedule don’t wait until a check-up. Set up a consultation appointment with your pediatrician, or even outline a strategy for care with your doctor during your pregnancy.
Myth 5: It’s better to let my kid get chickenpox “naturally.”
Reality: Before the chickenpox vaccine was licensed in 1995, parents sometimes brought their child to a party or playground hoping that their child might brush up against a pox-laden kid to get their dose of chickenpox over since cases were usually less severe for children than adults. But pediatricians say severe complications are possible with chickenpox—including bacterial infections that could result in a child’s hospitalization or death. (More information on the chickenpox vaccine is available at the CDC’s Web site.)
Now that there’s a vaccine for chickenpox, more than 45 states require the shots (unless your child already had the chicken pox or can prove natural immunity). Two shots usually guarantees your child a way out of being bedecked in calamine lotion for two feverish weeks, but some individuals do still come down with a milder form of the pox. Most pediatricians recommend getting the shot.
Myth 6: The flu shot causes the flu.
Reality: The flu shot does not contain a live virus, so your child can’t get the flu from this shot. But, after the shot, it’s not uncommon to feel a bit achy while the immune system mounts its response. Remember that for two weeks following the shot, your child can still get the flu, so be sure to help your child avoid that feverish kid next door. http://www.thedailybeast.com/newsweek/2009/02/22/six-top-vaccine-myths.html

A question in the current climate is what can be done to make parents responsible for putting other children at risk.

Jed Lipinksi wrote in the Slate article, Endangering the Herd: The case for suing:

As you’d expect, the growing anti-vaccination movement responded in fury. After Caplan wrote a related post for the Harvard Law Blog, angry comments poured in. “This article is industry propaganda at its worst,” one commenter declared. Another wrote: “Caplan would have familiar company in fascist Germany.” The blog eventually shut down the comments for violations of the site’s policies against “abusive and defamatory language” and the sharing of personal information.
Here’s why the anti-vaxxers are wrong and Caplan and his co-authors are right to raise the idea of suing or criminally charging them: Parents who choose not to vaccinate their kids for reasons of personal belief pose a serious danger to the public.
Measles vaccines are about 95 percent effective when given to children. That leaves a 5 percent chance that kids who are vaccinated will contract measles. This means that no matter what, the disease still poses a public health risk, but we rely on others to get vaccinated to hugely reduce the likelihood of outbreaks. That’s the process known as herd immunity.
Unvaccinated children threaten the herd. Take the San Diego measles outbreak of 2008. After unknowingly contracting the disease on a trip to Switzerland, an unvaccinated 7-year-old boy infected 11 other unvaccinated kids, according to the Centers for Disease Control and Prevention. The majority of the cases occurred in kids whose parents had requested personal belief exemptions (or PBEs) through the state of California, one of 17 states to allow them. But three of the infected were either too young or medically unable to be vaccinated. And overall, 48 children too young to be vaccinated were quarantined, at an average cost to the family of $775 per child. The CDC noted that all 11 cases were “linked epidemiologically” to the 7-year-old boy and that the outbreak response cost the public sector $10,376 per case.
Today, several states blame a rise in preventable diseases on the declining child vaccination rates. In Michigan, less than 72 percent of children have received their state-mandated measles, mumps, and rubella (MMR) vaccines. In New York, as Caplan noted in his blog post, pockets of Brooklyn’s Hasidic Jewish community are experiencing a mini measles epidemic. Thirty cases have been confirmed so far. According to Dr. Yu Shia Lin of Maimonides Medical Center, some members of the community avoid the measles vaccine because they think it causes autism. The most visible proponent of this idea, former Playboy Playmate Jenny McCarthy, will receive a giant new platform for her viewpoints when she joins the daytime gossipfest The View on Sept. 9.
The belief that the MMR vaccine causes autism goes back to a 1998 study published in the Lancet by a British gastroenterologist named Andrew Wakefield. In 2010, after years of criticism, the journal finally retracted Wakefield’s study, announcing that it was “utterly clear, without any ambiguity at all, that the statements in the paper were utterly false.” Britain’s General Medical Council later revoked Wakefield’s medical license, noting that he’d failed to disclose his role as a paid consultant to lawyers representing parents who thought vaccines had harmed their kids. The CDC makes clear there is no connection between vaccines and autism.
Yet this dangerous idea persists. Often, it persists among people who are simply doing what they think is best for their kids. Which is why it’s necessary to take extra measures to ensure nonvaccinators understand the risk they pose to other people’s children….
There are legal obstacles to penalizing parents who don’t vaccinate their kids. Courts are generally less likely to impose liability on someone who fails to act than they are on someone who acts recklessly. Also, proving cause and effect will sometimes be difficult. Then again, to win damages, a plaintiff would only have to prove that it’s “more likely than not” that a nonvaccinated child infected another person.parents who don’t vaccinate their kids—or criminally charging them…. http://www.slate.com/articles/news_and_politics/jurisprudence/2013/08/anti_vaxxers_why_parents_who_don_t_vaccinate_their_kids_should_be_sued_or.html

Related:

3rd World America: Tropical diseases in poor neighborhoods https://drwilda.com/2012/08/20/3rd-world-america-tropical-diseases-in-poor-neighborhoods/

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Brown University – Hasbro Children’s Hospital study: School violence is a very big issue

19 Jan

The Centers for Disease Control (CDC) writes about school violence:

In the United States, an estimated 50 million students are enrolled in pre-kindergarten through 12th grade. Another 15 million students attend colleges and universities across the country. While U.S. schools remain relatively safe, any amount of violence is unacceptable. Parents, teachers, and administrators expect schools to be safe havens of learning. Acts of violence can disrupt the learning process and have a negative effect on students, the school itself, and the broader community.
2013 Understanding School Violence Fact Sheet Adobe PDF file [PDF 250KB]

Click to access school_violence_fact_sheet-a.pdf

School violence is youth violence that occurs on school property, on the way to or from school or school-sponsored events, or during a school-sponsored event.
What is School Violence?
School violence is a subset of youth violence, a broader public health problem. Violence is the intentional use of physical force or power, against another person, group, or community, with the behavior likely to cause physical or psychological harm. Youth Violence typically includes persons between the ages of 10 and 24, although pathways to youth violence can begin in early childhood.
Examples of violent behavior include:
Bullying
Fighting (e.g., punching, slapping, kicking)
Weapon use
Electronic aggression
Gang violence
School violence occurs:
On school property
On the way to or from school
During a school-sponsored event
On the way to or from a school-sponsored event
Data Sources:
Centers for Disease Control and Prevention, Youth Risk Behavior Surveillance System (YRBSS) 2009 National Youth Risk Behavior Survey Overview. Available from URL: http://www.cdc.gov/healthyyouth/yrbs/pdf/us_overview_yrbs.pdf.

School violence is a growing issue.

Linda Carroll of NBC News reported in the story, School violence lands more than 90,000 a year in the ER, study finds:

Despite all the lip service given to battling bullying, many kids are still being seriously hurt while on school grounds, a new study shows. Each year more than 90,000 school children suffer “intentional” injuries severe enough to land them in the emergency room, according to the study published in Pediatrics.
Though there was a decrease in the number of intentional injuries at school over the last 10 years, it was minor, said study co-author Dr. Siraj Amanullah, an assistant professor of emergency medicine and pediatrics at the Alpert Medical School at Brown University.
“We were surprised,” Amanullah said. “With so much emphasis on school safety and bullying now, we expected a bigger decline. Ninety-thousand per year is quite huge.”
And keep in mind, Amanullah said, the study was only looking at kids who turned up in the ER. This could just be the tip of the iceberg.
“Bullying is so underreported,” said Amanullah, adding that children are still reluctant to tell anyone because often little gets done about it. “We were hoping this study would bring more attention to the problem.”
Amanullah and his colleagues pored through data from the National Electronic Injury Surveillance System — All Injury Program collected from January of 2001 through December of 2008. The ER reports include a plethora of detail, including the type of injury, whether it occurred at school and whether it was the result of an accident or was intentional.
While cuts and bruises were the most common injuries at 40 percent, fractures accounted for 12 percent, brain injuries for 10 percent and sprains and strains another 7 percent. The vast majority of injuries — 96 percent — were the result of an assault, with most perpetrators identified as friends or acquaintances. A full 10 percent of the assaults involved multiple perpetrators.
Part of the problem may be the adults that kids model themselves after. An article published in the same issue of Pediatrics reported that bullying behavior by coaches is quite high — and that the schools often make excuses for the behavior if it’s a winning coach.
A survey cited in the article found that 45 percent of kids “reported verbal misconduct by coaches, including name-calling and insulting them during play.”
During the study period, a total of 7,397,301 injuries occurred at school, of which 736,014 were intentional. The new study shows “that almost 10 percent of injuries are intentional, which means there’s a lot of violence going on in the schools that doesn’t include football, or hockey, or volleyball or tripping and falling and getting hurt,” said Patrick Tolan, a professor at the University of Virginia and director of Youth-Nex, the U.Va. Center to Promote Effective Youth Development.
Part of the solution may be increased monitoring of the kids, Tolan said. “Every school should assume they have an issue,” he added. “They should be looking at where and how both intentional and unintentional injuries are occurring….” http://www.nbcnews.com/health/school-violence-lands-more-90-000-year-er-study-finds-2D11898820

Citation:

Emergency Department Visits Resulting From Intentional Injury In and Out of School
1. Siraj Amanullah, MD, MPHa,b,c,
2. Julia A. Heneghan, MDc,d,
3. Dale W. Steele, MD, MSa,b,
4. Michael J. Mello, MD, MPHa,c, and
5. James G. Linakis, PhD, MDa,b,c
+ Author Affiliations
1. Departments of aEmergency Medicine and
2. bPediatrics, Alpert Medical School of Brown University, Providence, Rhode Island;
3. cInjury Prevention Center, Rhode Island Hospital, Providence, Rhode Island; and
4. dDepartment of Pediatrics, Rainbow Babies and Children’s Hospital, University Hospitals Case Medical Center, Cleveland, Ohio
Abstract
BACKGROUND AND OBJECTIVE: Previous studies have reported concerning numbers of injuries to children in the school setting. The objective was to understand temporal and demographic trends in intentional injuries in the school setting and to compare these with intentional injuries outside the school setting.
METHODS: Data from the National Electronic Injury Surveillance System–All Injury Program from 2001 to 2008 were analyzed to assess emergency department visits (EDVs) after an intentional injury.
RESULTS: There were an estimated 7 397 301 total EDVs due to injuries sustained at school from 2001 to 2008. Of these, an estimated 736 014 (10%) were reported as intentional (range: 8.5%–10.7% for the study time period). The overall risk of an EDV after an intentional injury in school was 2.33 (95% confidence interval [CI]: 1.93–2.82) when compared with an EDV after an intentional injury outside the school setting. For intentional injury–related EDVs originating in the school setting, multivariate regression identified several demographic risk factors: 10- to 14-year-old (odds ratio [OR]: 1.58; 95% CI: 1.10–2.27) and 15- to 19-year-old (OR: 1.69; 95% CI: 1.01–2.82) age group, black (OR: 4.14; 95% CI: 2.94–5.83) and American Indian (OR: 2.48; 95% CI: 2.06–2.99) race, and Hispanic ethnicity (OR: 3.67; 95% CI: 2.02–6.69). The odds of hospitalization resulting from intentional injury–related EDV compared with unintentional injury–related EDVs was 2.01 (95% CI: 1.50–2.69) in the school setting. These odds were found to be 5.85 (95% CI: 4.76–7.19) in the outside school setting.
CONCLUSIONS: The findings of this study suggest a need for additional prevention strategies addressing school-based intentional injuries.

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

Hasbro Children’s Hospital National Study Finds High Number of Pediatric Injuries Caused by Violence at School
1/14/2014
________________________________________
Siraj Amanullah, MD, MPH, an emergency medicine attending physician at Hasbro Children’s Hospital, recently led a study that found children between the ages of five and 19 still experience a substantial number of intentional injuries while at school. The study, titled “Emergency Department Visits Resulting from Intentional Injury In and Out of School,” has been published online ahead of print in the journal Pediatrics.
Amanullah’s team analyzed data from the National Electronic Injury Surveillance System All Injury Program from 2001 to 2008 to assess emergency department (ED) visits after an intentional injury. Of an estimated 7.39 million emergency department visits due to injuries occurring at school, approximately 736,014 (10 percent) were reported as intentional, such as those from bullying and peer-to-peer violence.
“This study is the first of its kind to report such a national estimate,” said Amanullah. “The 10 percent number may not seem large, but it is alarmingly high when you consider that such a significant number of intentional injuries are occurring in the school setting, where safety measures meant to prevent these sorts of injuries, are already in place.”
The study also identified gender and age disparities. Boys were most likely to be identified as at risk for intentional injury-related ED visits from within the school setting, along with all students in the 10- to 14-year age group; whereas girls were most at risk for intentional injury-related ED visits from outside of the school setting, along with the 15- to 19-year age group.
Additionally, both African-American and Hispanic ethnicities were found to be associated with higher risks for intentional injury in the school setting compared to outside school. “The important point about these disparities related to specific ethnicities and specific age groups is that the findings suggest that preventive safety efforts in the school setting may need to be tailored for the groups that carry much of this injury burden,” said Amanullah.
James Linakis, MD, PhD, associate director of pediatric emergency medicine at Hasbro Children’s Hospital and co-author of the study, added, “We know that the risk of hospitalization was found to be higher from intentional injury-related ED visits versus unintentional injuries.” Linakis continued, “In supervised environments such as schools, we have a great opportunity to implement additional prevention strategies and reduce the number of seriously injured children who we are seeing in emergency departments nationwide.”
The study highlights the continued public health impact of bullying and peer-to-peer violence. While there are substantial numbers of emergency department visits due to intentional injuries occurring in U.S. schools, there are still likely many others that do not result in ED visits.
Michael Mello, MD, MPH, director of the Injury Prevention Center at Hasbro Children’s Hospital who also contributed to the study, added a reminder that these injuries not only affect the physical health, but also the emotional health of children, families and both victim and perpetrator. “As parents, guardians and physicians we need to keep talking to our children and patients about this physical and mental health burden. It is our responsibility to address the issue of violence and bullying, both in and out of school, just like prevention efforts for any other medical illness,” said Mello. http://www.lifespan.org/Newsroom/News.aspx?NewsId=64730/Hasbro-Children%E2%80%99s-Hospital-National-Study-Finds-High-Number-of-Pediatric-Injuries–Caused-by-Violence-at-School/#null

One of the best concise guides to preventing school violence is the National PTA Checklist.

The National PTA Checklist recommends the following actions:

1. Talk to Your Children
Keeping the lines of communication open with your children and teens is an important step to keeping involved in their schoolwork, friends, and activities. Ask open-ended questions and use phrases such as “tell me more” and “what do you think?” Phrases like these show your children that you are listening and that you want to hear more about their opinions, ideas, and how they view the world. Start important discussions with your children—about violence, smoking, drugs, sex, drinking, death—even if the topics are difficult or embarrassing. Don’t wait for your children or teens to come to you.
2. Set Clear Rules and Limits for Your Children
Children need clearly defined rules and limits set for them so that they know what is expected of them and the consequences for not complying. When setting family rules and limits, be sure children understand the purpose behind the rules and be consistent in enforcing them.
Discipline is more effective if children have been involved in establishing the rules and, oftentimes, in deciding the consequences. Remember to be fair and flexible—as your children grow older, they become ready for expanded rights and changes in rules and limits. Show your children through your actions how to adhere to rules and regulations, be responsible, have empathy toward others, control anger, and manage stress.
3. Know the Warning Signs
Knowing what’s normal behavior for your son or daughter can help you recognize even small changes in behavior and give you an early warning that something is troubling your child. Sudden changes—from subtle to dramatic—should alert parents to potential problems. These could include withdrawal from friends, decline in grades, abruptly quitting sports or clubs the child had previously enjoyed, sleep disruptions, eating problems, evasiveness, lying, and chronic physical complaints (stomachache or headaches).
4. Don’t Be Afraid to Parent; Know When to Intervene
Parents need to step in and intervene when children exhibit behavior or attitudes that could potentially harm them or others. And you don’t have to deal with problems alone—the most effective interventions have parent, school, and health professionals working together to provide on-going monitoring and support.
5. Stay Involved in Your Child’s School
Show your children you believe education is important and that you want your children to do their best in school by being involved in their education. Get to know your child’s teachers and help them get to know you and your child. Communicate with your child’s teachers throughout the school year, not just when problems arise. Stay informed of school events, class projects, and homework assignments. Attend all parent orientation activities and parent-teacher conferences. Volunteer to assist with school functions and join your local PTA. Help your children seek a balance between schoolwork and outside activities. Parents also need to support school rules and goals.
6. Join Your PTA or a Violence Prevention Coalition
According to the National Crime Prevention Council, the crime rate can decrease by as much as 30 percent when a violence prevention initiative is a community-wide effort. All parents, students, school staff, and members of the community need to be a part of creating safe school environments for our children. Many PTAs and other school-based groups are working to identify the problems and causes of school violence and possible solutions for violence prevention.
7. Help to Organize a Community Violence Prevention Forum
Parents, school officials, and community members working together can be the most effective way to prevent violence in our schools.
8. Help Develop A School Violence Prevention and Response Plan
School communities that have violence prevention plans and crisis management teams in place are more prepared to identify and avert potential problems and to know what to do when a crisis happens. The most effective violence prevention and response plans are developed in cooperation with school and health officials, parents, and community members. These plans include descriptions of school safety policies, early warning signs, intervention strategies, emergency response plans, and post-crisis procedures.
9. Know How to Deal With the Media in a Crisis
Good public relations and media relations start with understanding how the media works and what they expect from organization’s that issue press releases, hold press conferences, and distribute media kits.
10. Work to Influence Lawmakers
Writing an editorial for the local newspaper, holding a petition drive, speaking before a school board meeting, or sending a letter to your legislator can be effective ways to voice your opinion and gain support from decision makers for violence prevention programs in your community. Working with other concerned parents, teachers, and community members, you can influence local, state and even federal decisions that affect the education, safety, and well-being of our children. http://www.pta.org/content.cfm?ItemNumber=984

School violence is a complex set of issues and there is no one solution. The school violence issue mirrors the issue of violence in the larger society. Trying to decrease violence requires a long-term and sustained focus from parents, schools, law enforcement, and social service agencies.

Resources:
A Dozen Things Students Can Do to Stop School Violence http://www.sacsheriff.com/crime_prevention/documents/school_safety_04.cfm

A Dozen Things. Teachers Can Do To Stop School Violence. http://www.ncpc.org/cms-upload/ncpc/File/teacher12.pdf

Preventing School Violence: A Practical Guide http://www.indiana.edu/~safeschl/psv.pdf

Related:

Violence against teachers is becoming a bigger issue https://drwilda.com/2013/11/29/violence-against-teachers-is-becoming-a-bigger-issue/

Hazing remains a part of school culture https://drwilda.com/2013/10/09/hazing-remains-a-part-of-school-culture/

FEMA issues Guide for Developing High-Quality School Emergency Operations Plans https://drwilda.com/2013/07/08/fema-issues-guide-for-developing-high-quality-school-emergency-operations-plans/

Study: 1 in 3 teens are victims of dating violence https://drwilda.com/2013/08/05/study-1-in-3-teens-are-victims-of-dating-violence/

Pediatrics article: Sexual abuse prevalent in teen population https://drwilda.com/2013/10/10/pediatrics-article-sexual-abuse-prevalent-in-teen-population/

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/

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FEMA issues Guide for Developing High-Quality School Emergency Operations Plans

8 Jul

As the Sandy Hook massacre demonstrated, unfortunately, schools have to prepare for school violence and school emergencies. The Centers for Disease Control (CDC) provides the following statistics in School Violence: Data & Statistics:

Fact Sheets
Understanding School Violence Fact Sheet  [PDF 254 KB]
This fact sheet provides an overview of school violence.
Behaviors that Contribute to Violence on School Property  [PDF 92k]
This fact sheet illustrates the trends in violence-related behaviors among youth as assessed by CDC’s Youth Risk Behavior Surveillance System (YRBSS). YRBSS monitors health risk behaviors that contribute to the leading causes of death and disability among young people in the United States, including violence.
Understanding Youth Violence  [PDF 313KB]
This fact sheet provides an overview of youth violence.
Youth Violence: Facts at a Glance  [PDF 128KB]
This fact sheet provides up-to-date data and statistics on youth violence.
Data Sources
School Associated Violent Death Study
CDC has been collecting data on school-associated violent deaths since 1992. This data system, which was developed in partnership with the Departments of Education and Justice, monitors school-associated violent deaths at the national level. Information is collected from media databases, police, and school officials. A case is defined as a fatal injury (e.g., homicide or suicide) that occurs (1) on school property; (2) on the way to/from school; or (3) during or on the way to/from a school sponsored event. Only violent deaths associated with U.S. elementary and secondary schools, public and private, are included.  Data obtained from this study play an important role in monitoring and assessing national trends in school-associated violent deaths, and help to inform efforts to prevent fatal school violence.
Indicators of School Crime and Safety
The U.S. Department of Education and Department of Justice publish a report on school crime and student safety each year. The report provides the most recent data available from many independent sources, including findings from national surveys of students, teachers, and principals. The report covers topics such as victimization, teacher injury, bullying, school conditions, fights, weapons, and student use of drugs and alcohol. The indicators of crime and safety are compared across different population subgroups and over time. Data on crimes that occur away from school are also offered as a point of comparison where available.
School Health Policies and Programs Study
The School Health Policies and Programs Study (SHPPS) is the largest, most comprehensive assessment of school health policies and programs. It is conducted at state, district, school, and four classroom levels across the country. The CDC-sponsored study provides data to help improve school health policies and programs. SHPPS is conducted every six years; the first administration was in 1994 and the most recent, in 2006. The study assesses eight components of school health programs at the elementary, middle/junior, and senior high school levels that are related to adolescent risk behaviors, including violence. These components are health education; physical education; health services; mental health and social services; school policy and environment; food services; faculty and staff health promotion; and family and community involvement.
Youth Risk Behavior Surveillance System
CDC monitors risk behaviors, such as violence, that contribute to the leading causes of death among youth in the United States. CDC administers a nationwide survey every two years in public and private high schools so investigators can examine behaviors related to fighting, weapon carrying, bullying, dating and sexual violence, and suicide.
Youth Violence National and State Statistics at a Glance
This web site provides statistics that illustrate trends and patterns in youth violence. Users will find national and state-level data on youth homicide, nonfatal assaults, and violent crime arrests.
References
1.Centers for Disease Control and Prevention. School-associated student homicides—United States, 1992–2006. MMWR 2008;57(02):33–36.
http://www.cdc.gov/violenceprevention/youthviolence/schoolviolence/data_stats.html

The Federal Emergency Management Agency (FEMA) has released Guide for Developing High-Quality School Emergency Operations Plans.

Jaclyn Zubrzycki and Nirvi Shah write about FEMA’s guidelines for emergencies in schools in the Education Week article, Feds’ Advice on School Intruders Worries Some Experts:

New guidelines from the Obama administration for planning for emergencies at schools following the December shooting at Sandy Hook Elementary School in Newtown, Conn., touch on everything from school design and storm shelters to planning emergency drills and balancing privacy and safety.
But one facet of the plan, released June 18, is on active-shooting situations, and some of the recommendations in those scenarios make school safety experts nervous—namely, a suggestion that school employees try to fight an intruder when given no other choice.
While the White House document says this should be done as a last resort, that message is easily lost, said Michael Dorn, the executive director of the Atlanta-based Safe Havens International, which advises schools on safety and emergency planning. In his experience, when school employees are given the idea that in rare circumstances, fighting or disarming a shooter is an option, it’s the only thing that comes to mind for far less serious scenarios. In drills, school employees have become so focused on fighting a shooter they have forgotten to take the basic step of locking their classroom doors.
“Though [school shootings] are catastrophic, they’re rare,” Mr. Dorn said.
The new guidelines were written jointly by the U.S. departments of Education, Homeland Security, Justice, and Health and Human Services, the Federal Bureau of Investigation, and the Federal Emergency Management Agency.
What’s Inside
President Barack Obama promised the agencies would join forces on the advice as part of a larger set of promises and recommendations he made in January on curbing gun violence. The 75-page guide deals with prevention, protection, mitigation, response, and recovery from technological, human-caused, natural, and biological threats.
A student helps block the classroom door with furniture during a mock lockdown drill in January at Moody High School in Corpus Christi, Texas. “This is our first time empowering [students] not to be victims,” said Principal Sandra Clement of the drill.
—Rachel Denny Clow/Corpus Christi Caller-Times/AP
The document is meant to be a guide and contains no mandates for schools. It compiles lessons and best practices from agencies and schools that have had to cope with various emergencies in the past and from previous federal guidance on school emergency planning.
The publication details a six-part process for schools looking to develop emergency plans: forming a collaborative team, understanding threats, determining goals and objectives, developing specific courses of action, reviewing plans, and implementing and maintaining the plan. Schools are encouraged to reach out to other local agencies as they assess the threats they face and their capacity to respond. http://www.edweek.org/ew/articles/2013/07/10/36safety.h32.html?tkn=UPTFcbIk8VXWICr054xiiTeDXhOZPalcsoT0&cmp=clp-edweek

Citation:

Guide for Developing High-Quality School Emergency Operations Plans  [open pdf – 2MB]
“Each school day, our nation’s schools are entrusted to provide a safe and healthy learning environment for approximately 55 million elementary and secondary school students1in public and nonpublic schools. Families and communities expect schools to keep their children and youths safe from threats (human-caused emergencies such as crime and violence) and hazards (natural disasters, disease outbreaks, and accidents). In collaboration with their local government and community partners, schools can take steps to plan for these potential emergencies through the creation of a school Emergency Operations Plan (school EOP). Lessons learned from school emergencies highlight the importance of preparing school officials and first responders to implement emergency operations plans. By having plans in place to keep students and staff safe, schools play a key role in taking preventative and protective measures to stop an emergency from occurring or reduce the impact of an incident. Although schools are not traditional response organizations, when a school-based emergency occurs, school personnel respond immediately. They provide first aid, notify response partners, and provide instructions before first responders arrive. They also work with their community partners, i.e., governmental organizations that have a responsibility in the school emergency operations plan to provide a cohesive, coordinated response. Community partners include first responders (law enforcement officers, fire officials, and emergency medical services personnel) as well as public and mental health entities. We recommend that planning teams responsible for developing and revising school EOPs use this document to guide their efforts. It is recommended that districts and individual schools compare existing plans and processes against the content and processes outlined in this guide. To gain the most from it, users should read through the entire document prior to initiating their planning efforts and then refer back to it throughout the planning process.”
Publisher:
United States. Federal Emergency Management Agency
Date:
2013-06
Copyright:
Public Domain
Retrieved From:
U.S. Department of Homeland Security: http://www.dhs.gov/
Format:
pdf
Media Type:
application/pdf
URL:
https://www.hsdl.org/?view&did=739248

School EOP dissects the guide in High-Quality School Emergency Operations Plans:

Lessons learned from school emergencies highlight the importance of preparing school officials and first responders to implement emergency operations plans. By having plans in place to keep students and staff safe, schools play a key role in taking preventative and protective measures to stop an emergency from occurring or reduce the impact of an incident. Although schools are not traditional response organizations, when a school-based emergency occurs, school personnel respond immediately. They provide first aid, notify response partners, and provide instructions before first responders arrive. They also work with their community partners, i.e., governmental organizations that have a responsibility in the school emergency operations plan to provide a cohesive, coordinated response. Community partners include first responders (law enforcement officers, fire officials, and emergency medical services personnel) as well as public and mental health entities.
We recommend that planning teams responsible for developing and revising school EOPs use this document to guide their efforts. It is recommended that districts and individual schools compare existing plans and processes against the content and processes outlined in this guide. To gain the most from it, users should read through the entire document prior to initiating their planning efforts and then refer back to it throughout the planning process.
The guide is organized in four sections:
1.The principles of school emergency management planning.
2.A process for developing, implementing, and continually refining a school EOP with community partners (e.g., first responders and emergency management personnel) at the school building level.
3.A discussion of the form, function, and content of school EOPs.
4.“A Closer Look,” which considers key topics that support school emergency planning, including addressing an active shooter, school climate, psychological first aid, and information-sharing.
As the team that developed this guide began its work to respond to the president’s call for model emergency management plans for schools, it became clear that there is a need to help ensure that our schools’ emergency planning efforts are aligned with the emergency planning practices at the national, state, and local levels. Recent developments have put a new emphasis on the process for developing EOPs.
National preparedness efforts, including planning, are now informed by Presidential Policy Directive (PPD) 8, which was signed by the president in March 2011 and describes the nation’s approach to preparedness. This directive represents an evolution in our collective understanding of national preparedness, based on the lessons learned from terrorist attacks, hurricanes, school incidents, and other experiences.
PPD-8 defines preparedness around five mission areas: Prevention, Protection, Mitigation, Response, and Recovery.
Prevention,2 for the purposes of this guide, means the capabilities necessary to avoid, deter, or stop an imminent crime or threatened or actual mass casualty incident. Prevention is the action schools take to prevent a threatened or actual incident from occurring.
Protection means the capabilities to secure schools against acts of violence and manmade or natural disasters. Protection focuses on ongoing actions that protect students, teachers, staff, visitors, networks, and property from a threat or hazard.
Mitigation means the capabilities necessary to eliminate or reduce the loss of life and property damage by lessening the impact of an event or emergency. In this document, “mitigation” also means reducing the likelihood that threats and hazards will happen.
Response means the capabilities necessary to stabilize an emergency once it has already happened or is certain to happen in an unpreventable way; establish a safe and secure environment; save lives and property; and facilitate the transition to recovery.
Recovery means the capabilities necessary to assist schools affected by an event or emergency in restoring the learning environment.
Emergency management officials and emergency responders engaging with schools are familiar with this terminology. These mission areas generally align with the three timeframes associated with an incident: before, during, and after.
The majority of Prevention, Protection, and Mitigation activities generally occur before an incident, although these three mission areas do have ongoing activities that can occur throughout an incident. Response activities occur during an incident, and Recovery activities can begin during an incident and occur after an incident. To help avoid confusion over terms and allow for ease of reference, this guide uses “before,” “during,” and “after.”
As schools plan for and execute response and recovery activities through the emergency operations plan, they should use the concepts and principles of the National Incident Management System (NIMS). One component of NIMS is the Incident Command System (ICS), which provides a standardized approach for incident management, regardless of cause, size, location, or complexity. By using ICS during an incident, schools will be able to more effectively work with the responders in their communities. For more information on ICS and NIMS, please see the Resources section.
While some of the vocabulary, processes, and approaches discussed in this guide may be new to the education community, they are critical. The vocabulary, processes, and approaches are critical to the creation of emergency management practices and plans that are integrated with the efforts of first responders and other key stakeholders, and that incorporate everything possible to keep children safe. If a school system has an existing plan, revising and adapting that plan using the principles and process described in this guide will help ensure alignment with the terminology and approaches used across the nation.
http://schooleop.org/

Unfortunately, schools are forced to think about and prepare for the worst and the unthinkable.

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/
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CDC reports teen pregnancy rate down, thankfully

27 May

 

 

In Talking to your teen about risky behaviors, moi said: There are no perfect people, no one has a perfect life and everyone makes mistakes. Unfortunately, children do not come with instruction manuals, which give specific instructions about how to relate to that particular child. Further, for many situations there is no one and only way to resolve a problem. What people can do is learn from their mistakes and the mistakes of others. Sharon Jayson writes in the USA Today article, More children born to unmarried parents:

 

A growing number of firstborns in the USA have unmarried parents, reflecting dramatic increases since 2002 in births to cohabiting women, according to government figures out today.

 

The percentage of first births to women living with a male partner jumped from 12% in 2002 to 22% in 2006-10 — an 83% increase. The percentage of cohabiting new fathers rose from 18% to 25%. The analysis, by the National Center for Health Statistics, is based on data collected from 2006 to 2010….

 

The percentage of first births to cohabiting women tripled from 9% in 1985 to 27% for births from 2003 to 2010….http://www.usatoday.com/news/health/wellness/story/2012-04-10/CDC-marriage-cohabitation-children/54186600/1#.T4Z8NWHELEQ.email

 

This is a demographic disaster for children as devastating as the hurricane “Katrina.”

 

One way to promote healthier lifestyles for children is to keep their parents in school so that they can complete their education. One overlooked aspect of Title IX is the mandate that pregnant teens have access to education.

 

In Teaching kids that babies are not delivered by UPS, moi said:

 

It is time for some speak the truth, get down discussion. An acquaintance who practices family law told me this story about paternity. A young man left Seattle one summer to fish in Alaska. He worked on a processing boat with 30 or40 others. He had sex with this young woman. He returned to Seattle and then got a call from her saying she was pregnant. He had been raised in a responsible home and wanted to do the right thing for this child. His mother intervened and demanded a paternity test. To make a long story, short. He wasn’t the father. In the process of looking out for this kid’s interests, my acquaintance had all the men on the boat tested and none of the other “partners” was the father. Any man that doesn’t have a paternity test is a fool.

 

If you are a slut, doesn’t matter whether you are a male or female you probably shouldn’t be a parent.

 

How to tell if you are a slut?

 

  1. If you are a woman and your sex life is like the Jack in the Box 24-hour drive through, always open and available. Girlfriend, you’re a slut.

 

  1. If you are a guy and you have more hoes than Swiss cheese has holes. Dude, you need to get tested for just about everything and you are a slut. 

 

Humans have free will and are allowed to choose how they want to live. What you do not have the right to do is to inflict your lifestyle on a child. So, the responsible thing for you to do is go to Planned Parenthood or some other outlet and get birth control for yourself and the society which will have to live with your poor choices. Many religious folks are shocked because I am mentioning birth control, but most sluts have few religious inklings or they wouldn’t be sluts. A better option for both sexes, if this lifestyle is a permanent option, is permanent birth control to lessen a contraception failure. People absolutely have the right to choose their particular lifestyle. You simply have no right to bring a child into your mess of a life. I observe people all the time and I have yet to observe a really happy slut. Seems that the lifestyle is devoid of true emotional connection and is empty. If you do find yourself pregnant, please consider adoption.

 

Let’s continue the discussion. Some folks may be great friends, homies, girlfriends, and dudes, but they make lousy parents. Could be they are at a point in their life where they are too selfish to think of anyone other than themselves, they could be busy with school, work, or whatever. No matter the reason, they are not ready and should not be parents. Birth control methods are not 100% effective, but the available options are 100% ineffective in people who are sexually active and not using birth control. So, if you are sexually active and you have not paid a visit to a family planning clinic, then you are not only irresponsible, you are Eeeevil. Why do I say that, you are playing Russian Roulettewith the life of another human being, the child. You should not ever put yourself in the position of bringing a child into the world that you are unprepared to parent, emotionally, financially, and with a commitment of time. So, if you find yourself in a what do I do moment and are pregnant, you should consider adoption. https://drwilda.com/2012/01/22/teaching-kids-that-babies-are-not-delivered-by-ups/

 

Nirvi Shah reported in the Education Week article, Teen Pregnancy Rate at Its Lowest, Again, CDC Says:

 

The teen pregnancy rate is at a record low, again, the Centers for Disease Control and Prevention said Thursday. And the steady declines from 2007 to 2011 mark the most longest period in recent history for which the drop persevered.

 

The rate of births among girls ages 15 to 19 has been record-settingly low for the last few years, falling almost without exception since 1991. In the latest figures, the CDC said the overall rate dropped 25 percent since 2007, from 41.5 births per 1,000 teenagers to 31.3 births in 2011—and that’s about a 50 percent drop in the rate since 1991. The overall number of births also dropped to 329,797, a 26 percent decrease from 2007 to 2011.

 

(If this drop sounds familiar, I wrote about similar numbers from preliminary CDC teen pregnancy data in the fall.)

 

One highlight: Declines in birth rates among Hispanic teenagers were the largest of any group, with rates falling by at least 40 percent in 22 states and the District of Columbia. In 2007, the birth rate among Hispanic teenager was 21 percent higher than the rate for blacks, but by 2011, the rate for Hispanic teenagers was only 4 percent greater.

 

The teen pregnancy rates fell at least 30 percent in seven states from 2007 to 2011 with even steeper declines in Arizona and Utah—of 35 percent. There was no significant change in two states: North Dakota and West Virginia.

 

Giving birth as a teenager can affect a young woman’s health, economic security, and every other aspect of life.

 

In general, the CDC said the drop is the result of a combination of things, including strong teen pregnancy-prevention messages. (These new Chicago ads are stunners, and a recent teen pregnancy-prevention campaign in New York has turned particularly bold, too.)

 

The CDC said the most recent data from the National Survey of Family Growth show that more teens are using contraception when they first have sex and using a combination of condoms and hormonal birth control. http://blogs.edweek.org/edweek/rulesforengagement/2013/05/teen_pregnancy_rate_at_its_lowest_again_cdc_says.html

 

Parents and guardians must have age-appropriate conversations with their children and communicate not only their values, but information about sex and the risks of sexual activity. https://drwilda.wordpress.com/2012/01/22/teaching-kids-that-babies-are-not-delivered-by-ups/

 

The National Council to Prevent Teen Pregnancy has produced the report, Teen Pregnancy & High School Dropout: What Communities Can Do to Address These Issues:

 

In 2008, births to teens who lived in counties and cities where 25 persistently low-achieving schools are located accounted for 16 percent of all teen births in the United States, according to a new report released today by The National Campaign to Prevent Teen Pregnancy. The report, Teen Pregnancy & High School Dropout: What Communities Can Do to Address These Issues, notes that these same 25 school districts also accounted for 20 percent of all high school dropouts in the United States and are home to many of the nation’s lowest-performing high schools, often referred to as “dropout factories,” where only 60 percent or fewer of students graduate on time.

The new report, produced in collaboration with America’s Promise Alliance, underscores the clear link between teen pregnancy and dropping out of school and highlights what a number of communities across the United States are doing to directly confront these issues. With the help of school districts, public agencies, and community-based organizations, these communities—from California to New York and Texas to Tennessee —are using innovative strategies and activities to help students avoid pregnancy and complete their high school education.

For example, some school districts, such as the New York City Public Schools, have used results from surveys of parents to overcome resistance to programs designed to prevent teen pregnancy. Other districts, such as Harris County Schools in Houston, TX have organized information sessions to educate parents, teachers, and school leaders about the connection between teen pregnancy and school completion as a way to enlist more support for school-based teen pregnancy prevention programs. And in West Virginia, the state school system has partnered with the state health department and community-based organizations to hold in-person or online professional development courses for teachers to improve the delivery of pregnancy prevention programs.

“We are heartened by the work being done in communities across the U.S. to highlight the close connection between preventing teen pregnancy and educational attainment,” said Sarah Brown, CEO of The National Campaign to Prevent Teen and Unplanned Pregnancy. “We encourage school leaders, policymakers, state and local officials, business leaders, and others to collaborate and develop novel strategies like those highlighted in this report to help young people avoid pregnancy and complete their high school education.”

Since its peak in 1990, the U.S. teen pregnancy rate has declined 42 percent and the teen birth rate is now at an all-time low. Despite this impressive progress, it is still the case that nearly three in 10 girls in this country will become pregnant before the age of 20. The United States has the highest rate of teen pregnancies in the developed world—approximately 750,000 pregnancies to teens each year.

The United States continues to also confront a high school dropout crisis. Each year, one in four U.S. public high school students fail to graduate with a diploma—that’s more than one million dropouts annually or one every 26 seconds. Although recent studies found the national graduation rate has increased to 75.5 percent, over the last decade less than half of all states made significant progress and only one state (Wisconsin) has achieved the Grad Nation campaign goal of a 90 percent graduation rate.

“The connection between teen pregnancy and dropout rates is a no-brainer,” said John Gomperts, president and CEO, America’s Promise Alliance. “What this report does is reinforce the importance of focusing on those school districts and communities where the dropout problem is the greatest. By turning around those communities that are struggling the most we won’t just see fewer dropouts and teen parents—we’ll see a stronger economy, more vibrant communities, and a more hopeful nation.”

The report highlights other existing data linking teen pregnancy and dropping out of high school, including:

  • Parenthood is a leading cause of school dropout among teen girls. Thirty percent of teen girls who have dropped out of high school cited pregnancy or parenthood as a key reason, and the rate is higher for minority students: 36 percent of Hispanic girls and 38 percent of African American girls cited pregnancy or parenthood as a reason they dropped out;

  • One in three (34%) young women who had been teen mothers earned neither a diploma nor a GED, compared with only six percent of young women who had not had a teen birth;

  • Less than two percent of young teen mothers (those who have a baby before age 18) attain a college degree by age 30; and

  • Over the course of a lifetime, a college graduate will earn, on average, $1 million more than a high school dropout. Over the course of his or her lifetime, a single high school dropout costs the nation approximately $260,000 in lost earnings, taxes, and productivity.

The National Campaign to Prevent Teen and Unplanned Pregnancy, an America’s Promise partner, is a nonprofit, nonpartisan initiative supported almost entirely by private donations. Its mission is to promote values, behavior, and policies that reduce both teen pregnancy and unplanned pregnancy among young adults. By increasing the proportion of children born into welcoming, intact families who are prepared to take on the demanding task of raising the next generation, the organization’s efforts will improve the well-being of children and strengthen the nation.

 

Parents must be involved in the discussion of sex with their children and discuss THEIR values long before the culture has the chance to co-op the children. Moi routinely posts information about the vacuous and troubled lives of Sex and the City aficionados and troubled pop tarts like Lindsey Lohan and Paris Hilton. Kids need to know that much of the life style glamorized in the media often comes at a very high personal cost. Parents not only have the right, but the duty to communicate their values to their children.

 

Related:

 

Talking to your teen about risky behaviors                                      https://drwilda.com/2012/06/07/talking-to-your-teen-about-risky-behaviors/

 

Many young people don’t know they are infected with HIV https://drwilda.com/tag/disproportionate-numbers-of-young-people-have-hiv-dont-know-it/

 

Dropout prevention: More schools offering daycare for students https://drwilda.com/2013/01/14/dropout-prevention-more-schools-offering-daycare-for-students/

 

Title IX also mandates access to education for pregnant students https://drwilda.com/2012/06/19/title-ix-also-mandates-access-to-education-for-pregnant-students/

 

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/

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Many young people don’t know they are infected with HIV

27 Nov

Moi wrote about HIV in the article, People MUST talk: AIDS epidemic in Black community:

Aside from the devastation that a poor economy has wrecked upon the Black community, a scourge that few are talking about is the AIDS epidemic in the Black community. NPR reports in the story, AIDS In Black America: A Public Health Crisis:

Of the more than 1 million people in the U.S. infected with HIV, nearly half are black men, women and children — even though blacks make up about 13 percent of the population. AIDS is the primary killer of African-Americans ages 19 to 44, and the mortality rate is 10 times higher for black Americans than for whites.

A new Frontline documentary, Endgame: AIDS in Black America, explores why the HIV epidemic is so much more prevalent in the African-American community than among whites. The film is produced, written and directed by Renata Simone, whose series The Age of AIDS appeared on Frontline in 2006.

On Thursday’s Fresh Air, Simone is joined by Robert Fullilove, a professor of clinical sociomedical studies at Columbia University’s Mailman School of Public Health, and chairman of the HIV/AIDS advisory committee at the Centers for Disease Control and Prevention.

“When I started doing this work in 1986, roughly 20 percent of all of the people in the United States who were living with AIDS were African-American,” Fullilove tells Fresh Air‘s Terry Gross. “The most recent statistics from the Centers for Disease Control indicate that 45 percent of all the new cases of HIV infection are amongst African-Americans. … If we continue on the current trend, in the year 2015, especially in the South, it will probably be the case that 5 to 6 percent of all African-American adults who are sexually active will be infected with the virus.”

Endgame explores how politics, social factors and cultural factors allowed the AIDS epidemic to spread rapidly in the African-American community over the past three decades. The film — shot in churches, harm-reduction clinics, prisons, nightclubs and high school classrooms — tells personal stories from children who were born with the virus, public health officials and educators who run HIV clinics, and clergy members around the country, many of whom have been divided on their response to the epidemic.

The film also explores how the war on drugs in the 1980s and 1990s affected the spread of HIV in communities where large percentages of African-American men were incarcerated. http://www.npr.org/2012/07/05/156292172/aids-in-black-america-a-public-health-crisis

The Centers for Disease Control (CDC) and Preventions studies a variety of diseases. https://drwilda.com/2012/08/02/people-must-talk-aids-epidemic-in-black-community/

Nirvi Shah is reporting in the Education Week article, Disproportionate Numbers of Young People Have HIV, Don’t Know It:

About 1 in 15 people living in the United States who has HIV is 13 to 24 years old—and more than half of these young people don’t know they have the disease, new estimates from the Centers for Disease Control and Prevention show, and the agency says schools must work harder to prevent HIV’s spread.

These estimates, shared today by the CDC, are from 2009. In all, about 1.1 million people in the United States have HIV, the agency reported.

The CDC estimates that about 70 out of 100,000 teenagers and young adults have HIV and they accounted for 12,000 cases—about 26 percent—diagnosed in 2010. Meanwhile, 13- to 24-year-olds represent only about 21 percent of the total population. The majority of the new cases, about 60 percent, were among black teens and young adults. Another 20 percent of the new cases were among Latinos of the same age.

The infection rate among young people is disproportionately high, the CDC said, while the percentage of people in the same age group tested was disproportionately low.

In 2009, people ages 13 to 24 comprised 6.7 percent of persons living with HIV, but more than half, nearly 60 percent, didn’t know they were infected, the CDC said, the highest rate for any age group. http://blogs.edweek.org/edweek/rulesforengagement/2012/11/disproportionate_numbers_of_yo.html

Here is a portion of press release from the Centers for Disease Control:

Vital Signs: HIV Infection, Testing, and Risk Behaviors Among Youths — United States

Early Release

November 27, 2012 / 61(Early Release);1-6

Abstract

Background: In 2009, 6.7% of the estimated 1.1 million persons living with human immunodeficiency virus (HIV) infection in the United States were youths (defined in this report as persons aged 13–24 years); more than half of youths with HIV (59.5%) were unaware of their infection.

Methods: CDC used National HIV Surveillance System data to estimate, among youths, prevalence rates of diagnosed HIV infection in 2009 and the number of new infections (incidence) in 2010. To assess the prevalence of risk factors and HIV testing among youths, CDC used the 2009 and 2011 Youth Risk Behavior Surveillance System for 9th–12th grade students and the 2010 National Health Interview Survey (NHIS) for persons 18–24 years.

Results: Prevalence of diagnosed HIV was 69.5 per 100,000 youths at the end of 2009. Youths accounted for 12,200 (25.7%) new HIV infections in 2010. Of these, 7,000 (57.4%) were among blacks/African Americans, 2,390 (19.6%) among Hispanics/Latinos, and 2,380 (19.5%) among whites; 8,800 (72.1%) were attributed to male-to-male sexual contact. The percentage of youths tested for HIV overall was 12.9% among high school students and 34.5% among those aged 18–24 years; it was lower among males than females, and lower among whites and Hispanics/Latinos than blacks/African Americans.

Conclusions: A disproportionate number of new HIV infections occurs among youths, especially blacks/African Americans, Hispanics/Latinos, and men who have sex with men (MSM). The percentage of youths tested for HIV, however, was low, particularly among males.

Implications for Public Health: More effort is needed to provide effective school- and community-based interventions to ensure all youths, particularly MSM, have the knowledge, skills, resources, and support necessary to avoid HIV infection. Health-care providers and public health agencies should ensure that youths are tested for HIV and have access to sexual health services, and that HIV-positive youths receive ongoing health-care and prevention services.

Introduction

The risk for acquiring human immunodeficiency virus (HIV) infection during adolescence and early adulthood starts with initiation of sexual behavior or injection drug use, and initiation of contributing behaviors such as use of alcohol and other drugs. The prevalence of HIV in potential sex partners, the percentage of HIV-infected persons unaware of their status, and the frequency of risky sexual behaviors and injection drug use contribute to the level of risk. In 2009, youths (defined in this report as persons aged 13–24 years), who represented 21% of the U.S. population, comprised 6.7% of persons living with HIV. More than half (59.5%) were unaware of their infection, the highest for any age group (1). All persons need to understand the threat of HIV and how to prevent it (2). Youths, particularly those at highest risk, need effective school-based, school-linked, and community-based interventions (3) that make them aware of their risk for HIV and help delay initiation of sexual activity, increase condom use for those who are sexually active, and decrease other behaviors, such as alcohol and drug use, that contribute to HIV risk. This report describes, among youths, 1) rates of those living with a diagnosis of HIV infection at the end of 2009, 2) the estimated number of new HIV infections in 2010, 3) the percentage that have been tested for HIV, and 4) the percentage that engage in selected risk behaviors.

Conclusions and Comment

Based on the most recent data available from 2009 and 2010, youths represent 6.7% of persons living with HIV in the United States and account for 25.7% of new HIV infections. Of new HIV infections among youths, 45.9% were among black/African American males, the majority of which were attributed to male-to-male sexual contact. Nationwide, the percentage of youths who had ever been tested for HIV was low compared with other age groups (1): 12.9% among high school students (22.2% among those who ever had sexual intercourse) and 34.5% among persons aged 18–24 years.

The higher HIV prevalence among blacks/African Americans overall (nearly three times higher than among Hispanics/Latinos and nearly eight times higher than among whites [1]) and MSM overall (nearly 40 times higher than other men [5]) contributes to the disproportionate number of new HIV infections among black/African American youths and young MSM. Because of this disparity, black/African American youths are at higher risk for infection even with similar levels of risk behaviors (6). Other research has found that among young MSM, other factors such as stigma, discrimination (7), less condom use, more alcohol and drug use, and having sex with older partners (8) contribute to even higher risk for HIV acquisition. This analysis also found that young MSM were significantly less likely to use condoms during last sexual intercourse, more likely to drink alcohol or use drugs before last sexual intercourse, and more likely to have four or more partners during their lifetime compared with young men who had sexual intercourse only with females. These behaviors are associated with substantial risk for infection. In one study among MSM, the attributable risk for new HIV infection was 29% for using alcohol or drugs before sex and 32% for having four to nine sex partners (9). Further, in a study of primarily young MSM, 75% of those with acute HIV infection reported sex under the influence of drugs or alcohol compared with 31% of HIV-uninfected MSM. Moreover, the risk for HIV infection doubled for MSM with a sex partner 5 years older and quadrupled with a sex partner 10 years older (8).

More than half (59.5%) of youths with HIV are unaware of their infection (1). Although the number of new HIV infections is highest among males, fewer males have been tested for HIV than females. Routine HIV testing as part of regular medical care is recommended by CDC for all persons aged 13–64 years (10) and by the American Academy of Pediatrics for all youths by age 16–18 years and all sexually active youths regardless of age (11). Better adherence to these guidelines, especially for males, is needed to increase early HIV diagnosis and facilitate treatment that improves health and reduces transmission.

Interventions for youths have been proven effective for delaying initiation of sexual activity, increasing condom use, and reducing other risk behaviors, such as drug and alcohol use.¶¶ The Community Preventive Services Task Force recommends risk reduction interventions in school and community settings to prevent HIV among adolescents (3). Individual- and group-level HIV prevention interventions provide knowledge, skill building, and increased motivation to adopt behaviors that protect against HIV infection, and some are designed specifically for youths at high risk for HIV.

For young MSM (those aged 18–29 years), “Mpowerment” is an effective community-level intervention that has been shown to reduce unprotected anal intercourse, the sexual behavior that carries the greatest risk for HIV transmission (12). However, additional individual- and group-level interventions specifically designed for young MSM, and young black/African American MSM in particular, are needed. Evidence-based behavioral HIV interventions for high risk youths can be adapted to address the unique needs of young MSM and to communicate the substantial risks associated with having sex with partners who are more likely to be infected, particularly those who are older.

Multicomponent school-based interventions, including classroom-based curricula and school-wide environmental changes, have been shown to decrease unprotected sex and increase condom use among youths (3). Policies can support these efforts by promoting in schools an inclusive environment for sexual minorities that reduces stigma and discrimination (13) and requiring evidence-based HIV prevention education (3) for all students. In addition, community organizations, schools, and health-care providers can establish procedures that reduce barriers and protect confidentiality (i.e., procedures that do not disclose information to unauthorized persons unless required under state law) for youths seeking sexual health services (14) and facilitate access to education and other HIV prevention services.

Early diagnosis and treatment can reduce HIV progression and prevent transmission, but youths are less likely to be tested, access care, remain in care, and achieve viral suppression (15). Youth-friendly, culturally competent, confidential, and convenient health services facilitate access to and retention in care.*** Comprehensive health services, including HIV/sexually transmitted infection screening, treatment, and prevention services, and adjunct services, such as mental health, drug and alcohol treatment, and housing assistance, are necessary for youths at highest risk of acquiring or transmitting HIV. Because young MSM often acquire HIV from older, HIV-positive partners (8), regular testing, care, and treatment for adult MSM also are essential to prevent HIV infections among youths.

Limitations of the estimates of new HIV infections have been described previously (15). In addition, the findings in this report are subject to at least three more limitations. First, YRBS data apply only to youths who attend school and therefore are not representative of all persons in this age group. Nationwide, in 2009, of persons aged 16–17 years, approximately 4% were not enrolled in a high school program and had not completed high school (4). Second, NHIS excludes active military personnel and those who live outside of households (e.g., persons who are incarcerated, in long-term–care institutions, or homeless), who might be at greater risk for HIV infection than persons in households. Finally, data from YRBS and NHIS are self-reported and subject to recall bias and potential underreporting of sensitive information, such as HIV risk factors and HIV testing.

To achieve the goals of the National HIV/AIDS Strategy for the United States (i.e., to reduce the number of persons who become infected with HIV and reduce disparities), public health agencies, in conjunction with families, educators, and health-care practitioners, must educate youths about HIV before they begin engaging in risk behaviors, especially young gay and bisexual males, particularly blacks/African Americans, who face a disproportionately higher risk (2). To delay the onset of sexual activity, increase condom use among those who are sexually active, and decrease injection drug use, multicomponent school- and community-based approaches that provide access to condoms, HIV testing and treatment, and behavioral interventions for those at highest risk are needed.

Reported by

Suzanne K. Whitmore, DrPH, Laura Kann, PhD, Joseph Prejean, PhD, Linda J Koenig, PhD, Bernard M. Branson, MD, H. Irene Hall, PhD, Amy M. Fasula, PhD, Angie Tracey, Jonathan Mermin, MD, Linda A. Valleroy, PhD, Div of HIV/AIDS Prevention, Div of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC. Corresponding contributor: Suzanne K. Whitmore, swhitmore@cdc.gov, 404-639-1556. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm61e1127a1.htm?s_cid=mm61e1127a1_e

The Centers for Disease Control has many resources about HIV testing:

Positive? Negative? Not sure?

What You Need to Know About HIV:

Frequently Asked Questions About HIV and STD Testing

“There is nothing more frightful than ignorance in action.”
Johann Wolfgang von Goethe, Collected Works

Dr. Wilda says this about that ©

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

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People MUST talk: AIDS epidemic in Black community

2 Aug

Aside from the devastation that a poor economy has wrecked upon the Black community, a scourge that few are talking about is the AIDS epidemic in the Black community. NPR reports in the story, AIDS In Black America: A Public Health Crisis:

Of the more than 1 million people in the U.S. infected with HIV, nearly half are black men, women and children — even though blacks make up about 13 percent of the population. AIDS is the primary killer of African-Americans ages 19 to 44, and the mortality rate is 10 times higher for black Americans than for whites.

A new Frontline documentary, Endgame: AIDS in Black America, explores why the HIV epidemic is so much more prevalent in the African-American community than among whites. The film is produced, written and directed by Renata Simone, whose series The Age of AIDS appeared on Frontline in 2006.

On Thursday’s Fresh Air, Simone is joined by Robert Fullilove, a professor of clinical sociomedical studies at Columbia University’s Mailman School of Public Health, and chairman of the HIV/AIDS advisory committee at the Centers for Disease Control and Prevention.

“When I started doing this work in 1986, roughly 20 percent of all of the people in the United States who were living with AIDS were African-American,” Fullilove tells Fresh Air‘s Terry Gross. “The most recent statistics from the Centers for Disease Control indicate that 45 percent of all the new cases of HIV infection are amongst African-Americans. … If we continue on the current trend, in the year 2015, especially in the South, it will probably be the case that 5 to 6 percent of all African-American adults who are sexually active will be infected with the virus.”

Endgame explores how politics, social factors and cultural factors allowed the AIDS epidemic to spread rapidly in the African-American community over the past three decades. The film — shot in churches, harm-reduction clinics, prisons, nightclubs and high school classrooms — tells personal stories from children who were born with the virus, public health officials and educators who run HIV clinics, and clergy members around the country, many of whom have been divided on their response to the epidemic.

The film also explores how the war on drugs in the 1980s and 1990s affected the spread of HIV in communities where large percentages of African-American men were incarcerated. http://www.npr.org/2012/07/05/156292172/aids-in-black-america-a-public-health-crisis

The Centers for Disease Control (CDC) and Preventions studies a variety of diseases.

Here are the statistics for the Black community and AIDS from the CDC:

The Numbers

New HIV Infections

  • In 2009, black men accounted for 70% of the estimated new HIV infections among all blacks. The estimated rate of new HIV infection for black men was more than six and a half times as high as that of white men, and two and a half times as high as that of Latino men or black women.
  • In 2009, black men who have sex with men (MSM)1 represented an estimated 73% of new infections among all black men, and 37% among all MSM. More new HIV infections occurred among young black MSM (aged 13–29) than any other age and racial group of MSM. In addition, new HIV infections among young black MSM increased by 48% from 2006–2009.
  • In 2009, black women accounted for 30% of the estimated new HIV infections among all blacks. Most (85%) black women with HIV acquired HIV through heterosexual sex. The estimated rate of new HIV infections for black women was more than 15 times as high as the rate for white women, and more than three times as high as that of Latina women.

Estimates of New HIV Infections in the United States, 2009, for the Most-Affected Subpopulations

Shown here is a vertical bar chart entitled, “Estimates of New HIV Infections in the United States, 2009, for the Most-Affected Subpopulations”. White MSM = 11,400Black MSM = 10, 800Women = 6,000Latino MSM = 5,400Black Heterosexual Men =2,400White Heterosexual Women = 1,700Black Male IDUs = 1,700Latina Heterosexual Women = 1,200Black Female IDUs =940Subpopulations representing 2% or less of the overall US epidemic are not reflected in this chart.

Subpopulations representing 2% or less of the overall US epidemic are not reflected in this chart.

HIV and AIDS Diagnoses2 and Deaths

  • From 2006–2009, the estimated number and rate of HIV diagnoses among blacks remained stable in the 40 states with long-term confidential name-based HIV reporting.
  • At some point in their lifetimes, an estimated 1 in 16 black men and 1 in 32 black women will be diagnosed with HIV infection.
  • In 2009, an estimated 16,741 blacks were diagnosed with AIDS in the US, a number that has slowly decreased since 2006.
  • By the end of 2008, an estimated 240,627 blacks with an AIDS diagnosis had died in the US. In 2007, HIV was the ninth leading cause of death for all blacks and the third leading cause of death for black women and black men aged 35–44.

Prevention Challenges

African Americans face a number of challenges that contribute to the higher rates of HIV infection.

The greater number of people living with HIV (prevalence) in African American communities and the fact that African Americans tend to have sex with partners of the same race/ethnicity means that they face a greater risk of HIV infection with each new sexual encounter.

African American communities continue to experience higher rates of other sexually transmitted infections (STIs) compared with other racial/ethnic communities in the US. The presence of certain STIs can significantly increase the chance of contracting HIV. Additionally, a person who has both HIV and certain STIs has a greater chance of infecting others with HIV.

The socioeconomic issues associated with poverty, including limited access to high-quality health care, housing, and HIV prevention education, directly and indirectly increase the risk for HIV infection and affect the health of people living with and at risk for HIV infection.

Lack of awareness of HIV status can affect HIV rates in communities. Approximately 1 in 5 adults and adolescents in the US living with HIV are unaware of their HIV status. This translates to approximately 116,750 persons in the African American community. Late diagnosis of HIV infection is common, which creates missed opportunities to obtain early medical care and prevent transmission to others. The sooner an individual is diagnosed and linked to appropriate care, the better the outcome.

Stigma, fear, discrimination, homophobia, and negative perceptions about HIV testing can also place too many African Americans at higher risk. Many at risk for infection fear stigma more than infection and may choose instead to hide their high-risk behavior rather than seek counseling and testing.

What CDC Is Doing

CDC and its partners are pursuing a high-impact prevention approach to advance the goals of the National HIV/AIDS Strategy and maximize the effectiveness of current HIV prevention methods. This approach focuses on implementing programs that have shown the greatest potential to reduce new HIV infections in populations and geographic areas at highest risk and on a scale large enough to yield the greatest possible impact on the HIV epidemic. Examples of activities addressing African American communities include:

  • The Act Against AIDS campaign delivers culturally appropriate messages about HIV infection. “Take Charge. Take the Test.” encourages African American women to get tested for HIV. “Testing Makes Us Stronger,” is aimed at increasing HIV testing among black MSM. For more information, visit www.actagainstaids.org.
  • An active part of the Act Against AIDS campaign, the Act Against AIDS Leadership Initiative (AAALI), is a $16 million, six-year partnership between CDC and the country’s leading organizations that represent the populations hardest hit by HIV. AAALI was initially formed to provide critical funding and to intensify HIV prevention efforts in black communities, but has since expanded to include organizations that focus on black MSM and the Latino community.
  • Expanded Testing Initiative (ETI). In 2010, CDC announced a second three-year expanded HIV testing program that builds on an initiative started in 2007 to increase HIV testing among African Americans. In the first three years of the project, more than 2.8 million tests were conducted and 18,432 people were newly diagnosed with HIV. Most of the people who were tested (57.4%) and diagnosed with HIV (66.0%) were African American. ETI includes 30 health jurisdictions and focuses on increasing HIV testing among African Americans and Latinos, as well as MSM and injection drug users of all races and ethnicities. Funding for the program was increased from $36 million per year to more than $50 million per year.
  • In September 2011, CDC awarded $55 million for HIV Prevention Projects for Young Men of Color Who Have Sex with Men (YMCSM) and Young Transgender (YTG) Persons of Color, to provide effective HIV prevention services over five years to YMCSM and YTG persons of color and their partners regardless of age, gender, and race/ethnicity.
  • CDC provides support and technical assistance to health departments and community-based organizations to deliver effective prevention interventions for African Americans. Efforts include
    • WILLOW, which emphasizes gender pride among HIV-positive African American women, informs them how to identify and maintain supportive social networks and healthy relationships, and learn coping strategies and safe sex communication skills;
    • Sister to Sister and SIHLE provide culturally sensitive health information to empower and educate African American women and adolescent females;
    • Nia educates African American heterosexual men about HIV/AIDS and its effect on their communities and motivates risk-reduction behaviors by effective condom use;
    • d-up: Defend Yourself!! and Many Men, Many Voices address social, cultural, and religious norms, promote condom use, and assist black MSM in recognizing and handling HIV risk-related racial and sexual bias. For information, visit www.effectiveinterventions.org.

CDC also supports research to reduce HIV risk among African Americans. http://www.cdc.gov/hiv/topics/aa/

This epidemic cannot be swept under the carpet any longer.

Resources:

HIV/AIDS in the African-American Community http://www.thebody.com/index/whatis/africanam.html

Black Aids Institute http://www.blackaids.org/

Fighting AIDS/HIV in the African American Community http://sociology.chass.ncsu.edu/chd/AIDS_HIV_ResourceManualMay21.pdf

Dr. Wilda says this about that ©

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CDC report: Contraceptive use among teens

24 Jul

In No one is perfect: People sometimes fail, moi said:

There are no perfect people, no one has a perfect life and everyone makes mistakes. Unfortunately, children do not come with instruction manuals, which give specific instructions about how to relate to that particular child. Further, for many situations there is no one and only way to resolve a problem. What people can do is learn from their mistakes and the mistakes of others. Craig Playstead has assembled a top ten list of mistakes made by parents and they should be used as a starting point in thinking about your parenting style and your family’s dynamic. https://drwilda.wordpress.com/2011/12/06/no-one-is-perfect-people-sometimes-fail/ Still, parents must talk to their children about life risks.  https://drwilda.wordpress.com/2012/06/07/talking-to-your-teen-about-risky-behaviors/

The Centers for Disease Control (CDC)has published a study about the sexual activity of children.

Here is the press release for the CDC report, Sexual Experience and Contraceptive Use Among Female Teens — United States, 1995, 2002, and 2006–2010:

Sexual Experience and Contraceptive Use Among Female Teens — United States, 1995, 2002, and 2006–2010

Weekly

May 4, 2012 / 61(17);297-301

The 2010 U.S. teen birth rate of 34.3 births per 1,000 females reflected a 44% decline from 1990 (1). Despite this trend, U.S. teen birth rates remain higher than rates in other developed countries; approximately 368,000 births occurred among teens aged 15–19 years in 2010, and marked racial/ethnic disparities persist (1,2). To describe trends in sexual experience and use of contraceptive methods among females aged 15–19 years, CDC analyzed data from the National Survey of Family Growth collected for 1995, 2002, and 2006–2010 (3). During 2006–2010, 57% of females aged 15–19 years had never had sex (defined as vaginal intercourse), an increase from 49% in 1995. Younger teens (aged 15–17 years) were more likely not to have had sex (73%) than older teens (36%); the proportion of teens who had never had sex did not differ by race/ethnicity. Approximately 60% of sexually experienced teens reported current use of highly effective contraceptive methods (e.g., intrauterine device [IUD] or hormonal methods), an increase from 47% in 1995. However, use of highly effective methods varied by race/ethnicity, with higher rates observed for non-Hispanic whites (66%) than non-Hispanic black (46%) and Hispanic teens (54%). Addressing the complex issue of teen childbearing requires a comprehensive approach to sexual and reproductive health that includes continued promotion of delayed sexual debut and increased use of highly effective contraception among sexually experienced teens.

Nationally representative data on females aged 15–19 years were obtained from three survey cycles of the National Survey of Family Growth (NSFG): 1995, 2002, and 2006–2010. NSFG is an in-person, household survey conducted by CDC’s National Center for Health Statistics using a stratified, multistage probability sample of females and males aged 15–44 years. The response rate for females was 76%. Survey topics included self-reported sexual activity and contraceptive use (4). Respondents who answered “yes” to ever having vaginal intercourse were considered sexually experienced.

Respondents who were pregnant, postpartum, seeking pregnancy, or who had not had sex during the interview month were excluded from analyses on contraceptives used during the interview month. The remaining respondents were classified as currently using contraception (specifying up to four methods) or not currently using contraception. Current contraceptive users were classified further by their most effective method used (according to typical use effectiveness estimates for pregnancy prevention) (3), based on the following hierarchy: 1) users of highly effective methods, including respondents who used long-acting reversible contraception (i.e., intrauterine device [IUD] or implant), pill, patch, ring, or injectable contraception (with or without dual use of condoms), or who were sterilized or had a partner who was sterilized (both were rare for teens); 2) users of moderately effective methods, including respondents who used condoms alone; and 3) users of less effective methods, including respondents who used withdrawal, periodic abstinence, rhythm method, emergency contraception, diaphragm, female condom, foam, jelly, cervical cap, sponge, suppository, or insert.

Weighted least squares regression was used to assess the significance of trends in abstinence and contraceptive use over time. Differences in bivariate proportions between racial/ethnic and age subgroups were assessed using a standard two-tailed t-test without adjustment for multiple comparisons. Comparisons are statistically significant at p<0.05. All analyses were conducted using data management and statistical software to account for the complex sample design of the NSFG.

During 2006–2010, more than half (56.7%) of female teens had never had sex (Table), reflecting a 16% increase relative to the 1995 estimate of 48.9%. The proportion of teens who had never had sex did not differ significantly across racial/ethnic groups* (whites = 57.6%, blacks = 53.6%, Hispanics = 56.2%) (Table). Although the proportion of teens who had never had sex increased for all racial/ethnic groups from 1995 to 2006–2010, this increase was greatest for blacks (34% increase) and Hispanics (29% increase) compared with whites (15% increase). During 2006–2010, 72.9% of females aged 15–17 years had never had sex, compared with 36.5% of females aged 18–19 years.

During 2006–2010, among female teens who had sex during the interview month, but who were not pregnant, postpartum, or seeking pregnancy, 59.8% used a highly effective contraceptive method during the interview month (12.0% used a highly effective method with a condom and 47.8% used a highly effective method without a condom), 16.3% used a moderately effective method (i.e., condoms alone), 6.1% used a less effective method, and 17.9% did not use any contraception (Figure). A trend toward increasing use of highly effective methods was noted from 1995 to 2006–2010. Estimates for 2006–2010 reflect a relative 26% increase in use of highly effective methods, 43% decrease for moderately effective methods, 27% increase for less effective methods, and 7% decrease for no method use compared with 1995.

During 2006–2010, white teens (65.7%) reported a higher prevalence of highly effective method use than black teens (46.5%) and Hispanic teens (53.7%) (Figure). Nonuse of any contraceptive method was significantly higher among blacks (25.6%) and Hispanics (23.7%) compared with whites (14.6%). Among whites, the use of highly effective methods increased from 48.9% in 1995 to 65.7% in 2006–2010 (34% relative increase). Smaller increases were observed for Hispanics (19% relative increase) and blacks (4% relative increase). Method nonuse among whites decreased from 18.1% in 1995 to 14.6% in 2006–2010 (19% decline); however, rates increased among blacks from 21.4% in 1995 to 25.6% in 2006–2010 (20% increase). For females aged 15–17 years, the use of highly effective methods increased from 46.0% during 1995 to 56.5% during 2006–2010 (23% increase). For females aged 18–19 years, the use of highly effective methods increased from 48.4% during 1995 to 61.8% during 2006–2010 (28% increase). Rates of nonuse among younger teens declined from 23.9% to 19.5% (19% decline) but remained relatively stable for older teens at 16.3% in 1995 and 16.9% during 2006–2010.

Reported by

Crystal Pirtle Tyler, PhD, Lee Warner, PhD, Joan Marie Kraft, PhD, Alison Spitz, MPH, Lorrie Gavin, PhD, Violanda Grigorescu, MD, Carla White, MPH, Wanda Barfield, MD, Div of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC. Corresponding contributor:Crystal Pirtle Tyler, ctyler@cdc.gov, 770-488-5200.

Editorial Note

In 2010, the U.S. teen birth rate declined to the lowest level in seven decades of reporting and reached record lows for teens of all racial/ethnic and age groups (1). Declines since 1995 likely reflect significant increases in the proportion of female teens who were abstinent, and among sexually experienced female teens, increases in the proportion using highly effective contraception (5).

The proportion of female teens who never have had sex is now comparable across racial/ethnic groups, largely because of proportionately larger increases in delayed sexual debut observed since 1995 among black teens and Hispanic teens compared with white teens. Disparities persist, however, in the use of highly effective methods of contraception. Use of these methods remains highest among white teens, and increases over time have occurred at a greater rate among whites compared with blacks and Hispanics.

Achieving the HealthyPeople 2020 objective† of reducing teen pregnancy by 10% will require a comprehensive approach to sexual and reproductive health that includes continued promotion of delayed sexual debut and increased use of highly effective contraception among sexually experienced teens. Condoms, the method used by many teens, can provide effective protection against unintended pregnancy when used consistently and correctly; however, during 2006–2010, only about half (49%) of female teens who used a condom for contraception reported consistent use in the past month (6). Dual use of condoms with a highly effective method of contraception can provide pregnancy protection with the added benefit of preventing sexually transmitted infections, including infection with human immunodeficiency virus, which affects teens disproportionately. Given that hormonal contraception and IUDs can be obtained only from a health-care provider, yearly reproductive health visits for teens who are sexually experienced or contemplating sexual activity can facilitate discussions about the advantages of delaying sexual debut, access to contraception, and the subsequent reduction of teen pregnancy (7,8).

An analysis of data from CDC’s Pregnancy Risk Assessment Monitoring System on female teens who had delivered a live infant within 2–6 months and reported that their pregnancy was unintended found that half were not using contraception when they got pregnant (9). Ways to reduce barriers to decrease teen pregnancy include encouraging teens to delay sexual debut, offering teens convenient practice hours, culturally competent and confidential counseling and services, and low-cost or free services and methods.

The findings in this report are subject to at least three limitations. First, estimates of contraceptive use are self-reported; however, NSFG was designed specifically to minimize potential sources of response error (4). Second, current use of a contraceptive method during the interview month does not necessarily reflect sustained use over time. Finally, data were not available to examine current sexual activity or contraceptive use among female teens aged <15 years, who accounted for 4,500 births in 2010 (1).

Several actions can be taken to reduce teen pregnancy further. Schools and community- based organizations can 1) provide evidence-based sexual and reproductive health education,§ 2) support parents’ efforts to speak with their children about advantages of delaying sexual debut and of delaying pregnancy, and 3) connect teens to health-care providers for reproductive health services. Health-care providers should be informed that no contraceptive method is contraindicated for teens solely on the basis of age (10) and encouraged to promote highly effective contraception, preferably with the dual use of condoms. Teen pregnancy might be reduced further if health-care professionals provide culturally competent, evidence-based sexual and reproductive health counseling on the importance of correct and consistent use of contraception, and offer an array of contraceptive methods to teens who have had sex or are about to initiate sexual activity.

Acknowledgments

Gladys M. Martinez, PhD, Stephanie J. Ventura, MA, Joyce C. Abma, PhD, Div of Vital Statistics, National Center for Health Statistics; John M. Douglas, Jr, MD, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC.

References

  1. Hamilton BE, Martin JA, Ventura SJ. Births: preliminary data for 2010. Natl Vital Stat Rep 2011;60(2).
  2. United Nations. Demographic yearbook 2009. New York, NY: United Nations; 2010. Available at http://unstats.un.org/unsd/demographic/products/dyb/dyb2.htmExternal Web Site Icon. Accessed February 28, 2012.
  3. Trussell J. Contraceptive failure in the United States. Contraception 2011;83:397–404.
  4. Groves RM, Mosher WD, Lepkowski J, Kirgis NG. Planning and development of he continuous National Survey of Family Growth. Vital Health Stat 2009;1(48).
  5. Santelli JS, Lindberg LD, Finer LB, Singh S. Explaining recent declines in adolescent pregnancy in the United States: the contribution of abstinence and improved contraceptive use. Am J Public Health 2007;97:150–6.
  6. Martinez G, Copen CE, Abma JC. Teenagers in the United States: sexual activity, contraceptive use, and childbearing, 2006–2010 National Survey of Family Growth. Vital Health Stat 2011;23(31).
  7. American College of Obstetricians and Gynecologists, Committee on Adolescent Health. The initial reproductive health visit. Committee opinion no. 460. Obstet Gynecol 2010;116:240–3.
  8. Hagan JF, Shaw JS, Duncan PM. Bright futures: guidelines for health supervision of infants, children and adolescents. 3rd ed. Elk Grove Village, IL: American Academy of Pediatrics; 2008.
  9. CDC. Prepregnancy contraceptive use among teens with unintended pregnancies resulting in live births—Pregnancy Risk Assessment Monitoring System (PRAMS), 2004–2008. MMWR 2012;61:25–9.
  10. CDC. U.S. medical eligibility criteria for contraceptive use, 2010. MMWR 2010;59(No. RR-4).

* Persons identified as Hispanic might be of any race; persons in all other racial/ethnic categories are non-Hispanic.

† Objective FP-8, available at http://www.healthypeople.gov/2020/topicsobjectives2020/pdfs/familyplanning.pdf Adobe PDF fileExternal Web Site Icon.

§ The Community Preventive Services Task Force recommends comprehensive risk reduction interventions. Additional information is available at http://www.thecommunityguide.org/news/2012/crrandaeinterventions.htmlExternal Web Site Icon

For a good summary of the report, More teens using condoms over past two decades http://www.wtop.com/267/2955744/US-targets-AIDS-stigma

In Talking to kids about sex, early and often, moi said: 

The blog discussed the impact of careless, uninformed, and/or reckless sex in the post, A baby changes everything: Helping parents finish school http://us.mg5.mail.yahoo.com/2011/12/26/a-baby-changes-everything-helping-parents-finish-school/ Let’s continue the discussion. Some folks may be great friends, homies, girlfriends, and dudes, but they make lousy parents. Could be they are at a point in their life where they are too selfish to think of anyone other than themselves, they could be busy with school, work, or whatever. No matter the reason, they are not ready and should not be parents. Birth control methods are not 100% effective, but the available options are 100% ineffective in people who are sexually active and not using birth control. So, if you are sexually active and you have not paid a visit to Planned Parenthood or some other agency, then you are not only irresponsible, you are Eeeevil. Why do I say that? You are playing “Russian Roulette” with the life of another human being, the child. You should not ever put yourself in the position of bringing a child into the world that you are unprepared to parent, emotionally, financially, and with a commitment of time. So, if you find yourself in a what do I do moment and are pregnant, you should consider adoption. Before reaching that fork in the road of what to do about an unplanned pregnancy, parents must talk to their children about sex and they must explain their values to their children. They must explain why they have those values as well.  https://drwilda.wordpress.com/2012/01/01/talking-to-kids-about-sex-early-and-often/

Related:

Study: Girls as young as six think of themselves as sex objects        https://drwilda.wordpress.com/2012/07/18/study-girls-as-young-as-six-think-of-themselves-as-sex-objects/

Study: Low-income populations and marriage https://drwilda.wordpress.com/2012/07/14/study-low-income-populations-and-marriage/

Title IX also mandates access to education for pregnant students https://drwilda.wordpress.com/2012/06/19/title-ix-also-mandates-access-to-education-for-pregnant-students/

Teaching kids that babies are not delivered by UPS                       https://drwilda.wordpress.com/2012/01/22/teaching-kids-that-babies-are-not-delivered-by-ups/

Talking to your teen about risky behaviors                https://drwilda.wordpress.com/2012/06/07/talking-to-your-teen-about-risky-behaviors/

Dr. Wilda says this about that ©

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