Tag Archives: health

Sitting on your fat butt can make you stupid

27 Sep

Here’s today’s COMMENT FROM AN OLD BLACK FART: sitting on your fat butt can make you stupid. Science Daily reported in Types of athletic training affect how brain communicates with muscles:

Using endurance training or strength and resistance training not only prepares an athlete for different types of sports, they can also change the way the brain and muscles communicate with each other.

A University of Kansas study shows that the communication between the brain and quadriceps muscles of people who take part in endurance training, such as running long distances, is different than those who regularly took part in resistance training and those who were sedentary. The findings may offer clues to the type of physical activity humans are most naturally suited to.

Trent Herda, assistant professor of health, sport and exercise sciences, and Michael Trevino, a doctoral student, conducted studies in which they measured muscle responses of five people who regularly run long distances, five who regularly lift weights and five sedentary individuals who regularly do neither. The studies have been published in the Journal of Sports Sciences and Muscle and Nerve.

Among the findings, Herda and Trevino showed that the quadriceps muscle fibers of the endurance trainers were able to fire more rapidly.

“The communication between the brains and their muscles was slightly different than the resistance trainers and sedentary individuals,” Herda said of endurance trainers. “This information also suggested that resistance trainers and those who are sedentary were more likely to fatigue sooner, among other things.”

Survey participants were 15 healthy volunteers. The endurance trainers had consistently taken part in a structured running program for at least three years prior to the study and ran an average of 61 miles a week and did not take part in resistance training. The resistance trainers had consistently taken part in a weight-training program for at least four years prior to the study. They took part in resistance training four to eight hours per week and reported doing at least one repetition of a back squat of twice their body mass. One reported doing a squat of 1.5 times his or her body weight, but none engaged in aerobic activity such as swimming, jogging or cycling. The sedentary participants did not take part in any structured physical exercise for three years prior to the study…http://www.sciencedaily.com/releases/2015/09/150918132022.htm

Although, the University of Kansas study looked at how different types of exercise affect the communication of the brain with muscles, this is in accord with the Health and Fitness Association (Association) post, The Exercise–Brain Connection.

According to the Association:

Cognitive Function
A sedentary lifestyle affects the brain—and in turn lessens mental capacity. Sibley and Etnier (2003) found a clear connection between how much schoolchildren exercised and their cognitive performance: the more aerobic exercise the children engaged in, the better they performed on verbal, perceptual and mathematical tests. The same pattern of results was found in older adults: aerobic training improved cognitive performance (Colcombe & Kramer 2003), and active lifestyles decreased age-related risks for cognitive impairment and dementia (Yaffe et al. 2009). Not surprisingly, these cognitive effects were accompanied by clear changes in brain structure and function…. http://www.ideafit.com/fitness-library/the-exercisendashbrain-connection

Jennifer Larino of the Times-Picayune (NOLA) reported in Couch potato crisis? More Americans ‘totally sedentary,’ Wall Street Journal reports:

The number of Americans who say they have participated in no physical activity in the past year has hit its highest point since 2007, The Wall Street Journal reports.
The report cites figures from the annual Physical Activity Council, which reports about 28 percent of Americans age 6 and over were “totally sedentary” last year, meaning they did not participate at least once in any of the more than 100 physical activities the survey listed. That is about 83 million Americans total.
That is the highest level of inactivity since the survey fine-tuned its sports and fitness list, excluding activities such as billiards and darts, the report says….http://www.nola.com/news/index.ssf/2015/04/more_americans_totally_sedenta.html

This rise in the number of sedentary individuals affects both the national health, but the ability to participate in the democratic process. A stretch, the reader might opine. Consider this quote from Jon Gruber, the architect of Obamacare:

Lack of transparency is a huge political advantage. And basically, call it the stupidity of the American voter or whatever, but basically that was really really critical for the thing to pass
3 Jonathan Gruber Videos: Americans “Too Stupid to…
http://www.youtube.com/watch?v=Adrdmmh7bMoCached
https://www.youtube.com/watch?v=Adrdmmh7bMo

See, Obama promised Obamacare wouldn’t do exactly what Gruber says it will do http://www.cnn.com/2014/11/18/politics/gruber-obamacare-promises/index.html

Bottom line, pun intended is that sedentary folk harm their health, the wealth of the country paying increased health care costs and the political dynamic because they don’t have the mental or physical energy to participate giving the Jon Grubers of the world, free reign.

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University of North Carolina Chapel Hill study: Stress felt by children shows up in their art

9 Dec

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

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

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

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

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

Will Huntsberry of NPR wrote in the article, Kids’ Drawings Speak Volumes About Home:

When children reach 6 years old, their drawings matter.

Not because of those purple unicorns or pinstripe dragons but because of how kids sketch themselves and the very real people in their lives.

In a new study, researchers found that children who experienced chaos at home — including high levels of noise, excessive crowding, clutter and lack of structure — were more likely to draw themselves at a distance from their parents or much smaller in size relative to other figures.

In some cases, these kids drew themselves with drooping arms and indifferent or sad faces.

Their drawings were a reflection of this simple fact: Chaos at home meant parents were interacting with them less and, in many cases, the interactions that were happening were shorter and interrupted.

As a result, kids ended up with a depreciated sense of self, says Roger Mills-Koonce, who led the study with Bharathi Zvara at UNC-Chapel Hill. To be clear, Mills-Koonce did not blame parents or caretakers but called this kind of stress in the home a “function of poverty….”                                                                                                                                http://www.npr.org/blogs/ed/2014/12/08/368693069/kids-drawings-speak-volumes-about-home

Citation:

The Mediating Role of Parenting in the Associations Between Household Chaos and Children’s Representations of Family Dysfunction

Zvara, B. J., Mills-Koonce, W. R., Garrett-Peters, P., Wagner, N. J., Vernon-Feagans, L., Cox, M., & the Family Life Project Key Contributors

2014

From the abstract: “Children’s drawings are thought to reflect their mental representations of self and their interpersonal relations within families. Household chaos is believed to disrupt key proximal processes related to optimal development. The present study examines the mediating role of parenting behaviors in the relations between two measures of household chaos, instability and disorganization, and how they may be evidenced in children’s representations of family dysfunction as derived from their drawings. The sample (N = 962) is from a longitudinal study of rural poverty exploring the ways in which child, family, and contextual factors shape development over time. Findings reveal that, after controlling for numerous factors including child and primary caregiver covariates, there were significant indirect effects from cumulative family disorganization, but not cumulative family instability, on children’s representation of family dysfunction through parenting behaviors. Results suggest that the proximal effects of daily disorganization outweigh the effects of periodic instability overtime.”

Related Project(s):

Children Living in Rural Poverty: The Continuation of the Family Life Project
Family Life Project

Available here: Attachment & Human Development

Or, you may utilize your local academic library to locate this copyrighted material.

Citation: Zvara, B. J., Mills-Koonce, W. R., Garrett-Peters, P., Wagner, N. J., Vernon-Feagans, L., Cox, M., & the Family Life Project Key Contributors. (2014). The mediating role of parenting in the associations between household chaos and children’s representations of family dysfunction. Attachment & Human Development. Advance online publication. doi:10.1080/14616734.2014.966124

DOI: 10.1080/14616734.2014.966124

http://fpg.unc.edu/resources/mediating-role-parenting-associations-between-household-chaos-and-childrens-representation

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

Related:

Schools have to deal with depressed and troubled children

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

School psychologists are needed to treat troubled children

https://drwilda.wordpress.com/2012/02/27/school-psychologists-are-needed-to-treat-troubled-children/

Resources:

  1. About.Com’s Depression In Young Children                                                          http://depression.about.com/od/child/Young_Children.htm
  2. Psych Central’s Depression In Young Children                                                      http://depression.about.com/od/child/Young_Children.htm
  3. Psychiatric News’ Study Helps Pinpoint Children With Depression http://psychnews.psychiatryonline.org/newsarticle.aspx?articleid=106034
  4. Family Doctor’s What Is Depression?                                                                               http://familydoctor.org/familydoctor/en/diseases-conditions/depression.html
  5. WebMD’s Depression In Children                                                                                     http://www.webmd.com/depression/guide/depression-children
  6. Healthline’s Is Your Child Depressed?                                                                                   http://www.healthline.com/hlvideo-5min/how-to-help-your-child-through-depression-517095449
  7. Medicine.Net’s Depression In Children http://www.onhealth.com/depression_in_children/article.htm

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University of Illinois Urbana- Champaign study: ADHD kids may benefit with FITKids exercise intervention

21 Oct

Moi wrote in ADHD coaching to improve a child’s education outcome:
The American Academy of Child and Adolescent Psychiatry discusses the primary symptoms of ADHD in the article, What Is ADHD:

The primary symptoms of ADHD are hyperactivity, impulsivity, and inattention.
Hyperactive children always seem to be in motion. A child who is hyperactive may move around touching or playing with whatever is around, or talk continually. During story time or school lessons, the child might squirm around, fidget, or get up and move around the room. Some children wiggle their feet or tap their fingers. A teenager or adult who is hyperactive may feel restless and need to stay busy all the time.
Impulsive children often blurt out comments without thinking first. They may often display their emotions without restraint. They may also fail to consider the consequences of their actions. Such children may find it hard to wait in line or take turns. Impulsive teenagers and adults tend to make choices that have a small immediate payoff rather than working toward larger delayed rewards….

ADHD News has a synopsis of the ADHD news     http://www.medicalnewstoday.com/categories/adhd

https://drwilda.com/2012/03/31/adhd-coaching-to-improve-a-childs-education-outcome/

Julia Lawrence of Education News reported about a Quebec study in the article, Study: ADHD Drugs Don’t Improve Academic Performance in Kids:

Shirley S. Wang of The Wall Street Journal writes about one such study published in June which looked at academic outcomes of Quebec students prescribed ADHD drugs like Ritalin and Adderall over a span of 11 years. Researchers concluded that boys who were taking drugs academically underperformed peers with the same symptoms who were not medicated. The working paper published by the National Bureau of Economic Research also reported that girls who took ADHD drugs had higher incidence of emotional problems than ones who did not.

“The possibility that [medication] won’t help them [in school] needs to be acknowledged and needs to be closely monitored,” says economics professor Janet Currie, an author on the paper and director of the Center for Health & Wellbeing, a health policy institute at Princeton University. Kids may not get the right dose to see sustained benefits, or they may stop taking the medication because side effects or other drawbacks outweigh the benefits, she says.

Why drugs that claim to improve concentration, focus and emotional control don’t lead to academic improvement is a question that has puzzled researchers for some time — and answering the question could be the key to effective ADHD treatment in children. Finding an effective treatment regime could help a lot of kids; according to Centers for Disease Control and Prevention, there are 2.7 million children currently on ADHD drugs of some kind in the United States alone.

http://www.educationnews.org/parenting/study-adhd-drugs-dont-improve-academic-performance-in-kids/#sthash.HkASci3N.dpuf

This study is in accord with research from Yale University.

Geneva Pittman of Reuters wrote in the article, Be cautious of mind-altering drugs for kids: doctors:

Focusing on stimulants typically used to treat attention deficit hyperactivity disorder, or ADHD, researchers said the number of diagnoses and prescriptions have risen dramatically over the past two decades.

Young people with the disorder clearly benefit from treatment, lead author Dr. William Graf emphasized, but the medicines are increasingly being used by healthy youth who believe they will enhance their concentration and performance in school.

According to the National Institute on Drug Abuse, 1.7 percent of eighth graders and 7.6 percent of 12th graders have used Adderall, a stimulant, for nonmedical reasons.
Some of those misused medicines are bought on the street or from peers with prescriptions; others may be obtained legally from doctors.

“What we’re saying is that because of the volume of drugs and the incredible increase… the possibility of overdiagnosis and overtreatment is clearly there,” said Graf, from Yale University in New Haven, Connecticut.

In their statement, published in the journal Neurology, he and his colleagues say doctors should not give prescriptions to teens who ask for medication to enhance concentration against their parents’ advice. http://www.reuters.com/article/2013/03/13/us-medications-kids-idUSBRE92C17H20130313

A University of Illinois study indicates that exercise might be an effective therapy.

James Hamlin wrote in the Atlantic article: Exercise Is ADHD Medication:

Physical movement improves mental focus, memory, and cognitive flexibility; new research shows just how critical it is to academic performance.

Mental exercises to build (or rebuild) attention span have shown promise recently as adjuncts or alternatives to amphetamines in addressing symptoms common to Attention Deficit Hyperactivity Disorder (ADHD). Building cognitive control, to be better able to focus on just one thing, or single-task, might involve regular practice with a specialized video game that reinforces “top-down” cognitive modulation, as was the case in a popular paper in Nature last year. Cool but still notional. More insipid but also more clearly critical to addressing what’s being called the ADHD epidemic is plain old physical activity.

This morning the medical journal Pediatrics published research that found kids who took part in a regular physical activity program showed important enhancement of cognitive performance and brain function. The findings, according to University of Illinois professor Charles Hillman and colleagues, “demonstrate a causal effect of a physical program on executive control, and provide support for physical activity for improving childhood cognition and brain health.” If it seems odd that this is something that still needs support, that’s because it is odd, yes. Physical activity is clearly a high, high-yield investment for all kids, but especially those attentive or hyperactive. This brand of research is still published and written about as though it were a novel finding, in part because exercise programs for kids remain underfunded and underprioritized in many school curricula, even though exercise is clearly integral to maximizing the utility of time spent in class…..                                                                                                                       http://www.theatlantic.com/health/archive/2014/09/exercise-seems-to-be-beneficial-to-children/380844/?single_page=true

Citation:

Effects of the FITKids Randomized Controlled Trial on Executive Control and Brain Function

  1. Charles H. Hillman, PhDa,
  2. Matthew B. Pontifex, PhDb,
  3. Darla M. Castelli, PhDc,
  4. Naiman A. Khan, PhD, RDa,
  5. Lauren B. Raine, BSa,
  6. Mark R. Scudder, BSa,
  7. Eric S. Drollette, BSa,
  8. Robert D. Moore, MSa,
  9. Chien-Ting Wu, PhDd, and
  10. Keita Kamijo, PhDe

+ Author Affiliations

1.     aDepartment of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana-Champaign, Illinois; 2.     bDepartment of Kinesiology, Michigan State University, East Lansing, Michigan; 3.     cDepartment of Kinesiology and Health Education, University of Texas at Austin, Austin, Texas; 4.     dDepartment of Exercise Science, Schreiner College, Kerrville, Texas; and 5.     eSchool of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan

Abstract

OBJECTIVE: To assess the effect of a physical activity (PA) intervention on brain and behavioral indices of executive control in preadolescent children.

METHODS: Two hundred twenty-one children (7–9 years) were randomly assigned to a 9-month afterschool PA program or a wait-list control. In addition to changes in fitness (maximal oxygen consumption), electrical activity in the brain (P3-ERP) and behavioral measures (accuracy, reaction time) of executive control were collected by using tasks that modulated attentional inhibition and cognitive flexibility.

RESULTS: Fitness improved more among intervention participants from pretest to posttest compared with the wait-list control (1.3 mL/kg per minute, 95% confidence interval [CI]: 0.3 to 2.4; d = 0.34 for group difference in pre-to-post change score). Intervention participants exhibited greater improvements from pretest to posttest in inhibition (3.2%, 95% CI: 0.0 to 6.5; d = 0.27) and cognitive flexibility (4.8%, 95% CI: 1.1 to 8.4; d = 0.35 for group difference in pre-to-post change score) compared with control. Only the intervention group increased attentional resources from pretest to posttest during tasks requiring increased inhibition (1.4 µV, 95% CI: 0.3 to 2.6; d = 0.34) and cognitive flexibility (1.5 µV, 95% CI: 0.6 to 2.5; d = 0.43). Finally, improvements in brain function on the inhibition task (r = 0.22) and performance on the flexibility task correlated with intervention attendance (r = 0.24).

CONCLUSIONS: The intervention enhanced cognitive performance and brain function during tasks requiring greater executive control. These findings demonstrate a causal effect of a PA program on executive control, and provide support for PA for improving childhood cognition and brain health.

Key Words:

  • Accepted July 25, 2014.

After-school exercise program enhances cognition in 7-, 8- and 9-year-olds

Date:         September 29, 2014

Source:           University of Illinois at Urbana-Champaign

Summary:

A nine-month-long, randomized controlled trial involving 221 prepubescent children found that those who engaged in moderate-to-vigorous physical activity for at least 60 minutes a day after school saw substantial improvements in their ability to pay attention, avoid distraction and switch between cognitive tasks, researchers report.

Here is the press report from the University of Illinois Urbana- Champaign:

After-school exercise program enhances cognition in 7-, 8- and 9-year-olds

Email Share

9/29/2014 | Diana Yates, Life Sciences Editor | 217-333-5802; diya@illinois.edu

CHAMPAIGN, Ill. — A nine-month-long, randomized controlled trial involving 221 prepubescent children found that those who engaged in moderate-to-vigorous physical activity for at least 60 minutes a day after school saw substantial improvements in their ability to pay attention, avoid distraction and switch between cognitive tasks, researchers report in the journal Pediatrics.

Fitness, cognitive function and brain function improved in children in the FITKids exercise intervention group, researchers report. | Photo by L. Brian Stauffer

Half of the study subjects were randomly assigned to the after-school program and the rest were placed on a wait list. All participants underwent cognitive testing and brain imaging before and after the intervention.

“Those in the exercise group received a structured intervention that was designed for the way kids like to move,” said University of Illinois kinesiology and community health professor Charles Hillman, who led the study. “They performed short bouts of exercise interspersed with rest over a two-hour period.”

The intervention, called FITKids, was based on the CATCH exercise program, a research-based health promotion initiative that was initially funded by the National Institutes of Health and now is used by schools and health departments across the U.S.

The children in the FITKids exercise group wore heart-rate monitors and pedometers during the intervention.

“On average, kids’ heart rates corresponded with a moderate-to-vigorous level of exercise intensity, and they averaged about 4,500 steps during the two-hour intervention,” Hillman said. The children were active about 70 minutes per day.

As expected, fitness increased most in the intervention group over the course of the study.

“We saw about a six percent increase in fitness in children in the FITKids intervention group,” Hillman said. Fitness improved less than one percent in the wait-list control group, he said.

Children in the exercise group also demonstrated substantial increases in “attentional inhibition,” a measure of their ability to block out distractions and focus on the task at hand. And they improved in “cognitive flexibility,” which involves switching between intellectual tasks while maintaining speed and accuracy. Children in the wait-list control group saw minimal improvements in these measures, in line with what would be expected as a result of normal maturation over the nine months, Hillman said.

“Kids in the intervention group improved two-fold compared to the wait-list kids in terms of their accuracy on cognitive tasks,” he said. “And we found widespread changes in brain function, which relate to the allocation of attention during cognitive tasks and cognitive processing speed. These changes were significantly greater than those exhibited by the wait-list kids.

“Interestingly, the improvements observed in the FITKids intervention were correlated with their attendance rate, such that greater attendance was related to greater change in brain function and cognitive performance,” Hillman said.

The study did not distinguish improvements that were the result of increased fitness from those that might stem from the social interactions, stimulation and engagement the children in the intervention group experienced, Hillman said.

“Other research at Georgia Regents University led by Catherine Davis has actually used social and game-playing as their control group, and showed that the cognitive effects of their physical activity intervention are above-and-beyond those that are gained just through social interactions,” he said.

The FITKids program is designed to get children socially engaged in exercise, which is part of what makes it an effective intervention, Hillman said.

“The fact is that kids are social beings; they perform physical activity in a social environment,” he said. “A big reason why kids participate in a structured sports environment is because they find it fun and they make new friends. And this intervention was designed to meet those needs as well.”

The Eunice Kennedy Shriver National Institute of Child Health and Human Development at the National Institutes of Health funded this research.

Editor’s note: To reach Charles Hillman, call 217-244-2663; email chhillma@illinois.edu.

The paper, “Effects of the FITKids Randomized Controlled Trial on Executive Control and Brain Function,” is available online or from the U. of I. News Bureau.

Physically fit children are not only healthier, but are better able to perform better in school. Our goal as a society should be:

A healthy child in a healthy family who attends a healthy school in a healthy neighborhood ©

Reference Links:

Edge Foundation ADHD Coaching Study Executive Summary

http://edgefoundation.org/wp-content/uploads/2011/01/Edge-Foundation-ADHD-Coaching-Research-Report.pdf

Edge Foundation ADHD Coaching Study Full Report

http://edgefoundation.org/wp-content/uploads/2011/01/Edge-Foundation-ADHD-Coaching-Research-Report.pdf

ADHD and College Success: A free guide

http://www.edgefoundation.org/howedgehelps/add-2.html

ADHD and ExecutiveFunctioning

http://edgefoundation.org/blog/2010/10/08/the-role-of-adhd-and-your-brains-executive-functions/

Executive Function, ADHD and Academic Outcomes

http://www.helpforld.com/efacoutcomes.pdf

Louisiana study: Fit children score higher on standardized tests

https://drwilda.com/2012/05/08/louisiana-study-fit-children-score-higher-on-standardized-tests/

If you suspect that your child might have ADHD, you should seek an evaluation from a competent professional who has knowledge of this specialized area of medical practice.

Related:

Studies: ADHD drugs don’t necessarily improve academic performance

https://drwilda.com/2013/07/14/studies-adhd-drugs-dont-necessarily-improve-academic-performance/

ADHD coaching to improve a child’s education outcome

https://drwilda.com/2012/03/31/adhd-coaching-to-improve-a-childs-education-outcome/

An ADHD related disorder: ‘Sluggish Cognitive Tempo’

https://drwilda.com/2014/04/12/an-adhd-related-disorder-sluggish-cognitive-tempo/

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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Centers for Disease Control report: Nearly 8 in 10 children miss developmental screenings

17 Sep

The goal of this society should be to raise healthy and happy children who will grow into concerned and involved adults who care about their fellow citizens and environment. A physical examination is important for children to make sure that there are no health problems. The University of Arizona Department of Pediatrics has an excellent article which describes Pediatric History and Physical Examination http://www.peds.arizona.edu/medstudents/Physicalexamination.asp

PHYSICAL EXAMINATION
Every child should receive a complete systematic examination at regular intervals. One should not restrict the examination to those portions of the body considered to be involved on the basis of the presenting complaint.
Approaching the Child
Adequate time should be spent in becoming acquainted with the child and allowing him/her to become acquainted with the examiner. The child should be treated as an individual whose feelings and sensibilities are well developed, and the examiner’s conduct should be appropriate to the age of the child. A friendly manner, quiet voice, and a slow and easy approach will help to facilitate the examination.
Observation of the Patient
Although the very young child may not be able to speak, one still may receive much information from him/her by being observant and receptive. The total evaluation of the child should include impressions obtained from the time the child first enters until s/he leaves; it should not be based solely on the period during which the patient is on the examining table. In general, more information is obtained by careful inspection than from any of the other methods of examination.
Sequence of Examination
Skill, tact and patience are required to gather an optimal amount of information when examining a child. There is no routine one can use and each examination should be individualized. Ham it up and regress. Get down to the child’s level and try to gain his trust. The order of the exam should conform to the age and temperament of the child. For example, many infants under 6 months are easily managed on the examining table, but from 8 months to 3 years you will usually have more success substituting the mother’s lap. Certain parts of the exam can sometimes be done more easily with the child in the prone position or held against the mother. After 4 years, they are often cooperative enough for you to perform the exam on the table again.
Wash your hands with warm water before the examination begins. You will impress your patient’s mother and not begin with an adverse reaction to cold hands in your patients. With the younger child, get to the heart, lungs and abdomen before crying starts. Save looking at the throat and ears for last. If part of the examination is uncomfortable or painful, tell the child in a warm, honest, but determined tone that this is necessary. Looking for animals in their ears or listening to birdies in their chests is often another useful approach to the younger child.
If your bag of tricks is empty and you’ve become hoarse from singing and your lips can no longer bring forth a whistle, you may have to turn to muscle. Various techniques are used to restrain children and experience will be your best ally in each type of situation.
Remember that you must respect modesty in your patients, especially as they approach pubescence. Some time during the examination, however, every part of the child must have been undressed. It usually works out best to start with those areas which would least likely make your patient anxious and interfere with his developing confidence in you.

The article goes on to describe how the physical examination is conducted and what observations and tests are part of the examination. The Cincinnati Children’s Hospital describes the Process of the Physical Examination http://www.cincinnatichildrens.org/health/p/exam/

Christina Samuels reported in the Education Week article, CDC: Nearly Eight in 10 Children Miss Developmental Screenings:

Only about 21 percent of parents in 2007 reported that they were asked to fill out a questionnaire from their health-care provider asking about their child’s developmental, communication, or social behaviors—an essential step in steering children to early-intervention services, according to the Centers for Diseases Control and Prevention in Atlanta.
The CDC released the information Sept. 10 as part of an analysis on the use of several preventive services for infants, children and adolescents. In general, children are not receiving enough preventive care, the agency concluded. CDC recommendations are that young children be screened for developmental delays at 9, 18, and either 24 or 30 months, and for autism spectrum disorder at 18 months and at either 24 or 30 months.
For its analysis, the CDC turned to the 2007 National Survey of Children’s Health and focused on children from 10 to 47 months olds. Children were not more or less likely to be screened based on gender, race or ethnicity, family structure, parental education, household income, or location. However, parents were the least likely to report an official screening if the child had not had insurance in the past year; only 9 percent of parents reported that request.
The study did note that a majority of parents, about 52 percent, reported that a health-care advisor asked them informally if they had any concerns about their child’s learning, development, or behavior. However, indications of a parental concern or risk for a developmental delay did not result in additional screening for those children, and informal inquiries are less likely to pick up on the children who need help, the report said. Health-care providers may be overrelying on their own judgment or distrustful of parent reports, the researchers hypothesized.
The CDC noted other gaps in the preventive screening that connect to potential disabilities. Using surveys collected in 2009 and 2010, the CDC found that 50 percent of infants who failed their hearing screening were not documented to have received testing needed to diagnose hearing loss.
Also, 67 percent of children ages 1 to 2 years were not tested for blood lead or results were not reported to CDC in 2010; lead exposure can lead to serious negative consequences for a child’s developing brain. http://blogs.edweek.org/edweek/early_years/2014/09/cdc_nearly_eight_in_10_children_miss_developmental
_screenings.html

Here are the key findings from the CDC report:

Key Findings
Morbidity and Mortality Weekly Report published a supplement that examined the use of selected clinical preventive services among infants, children, and adolescents in the United States. This supplement indicates that millions of U.S. infants, children, and adolescents did not receive key clinical preventive services. Increased use of clinical preventive services could improve the health of infants, children, and adolescents and promote healthy lifestyles that will enable them to achieve their full potential.
Read the full article: Use of Selected Clinical Preventive Services to Improve Health of Infants, Children, and Adolescents¬¬ – United States, 1999-2011
Main Findings from this Report
Use of clinical preventive services among U.S. infants, children, and adolescents is not optimal. There are large disparities by demographics, geography, and healthcare coverage and access in the use of these services. This report provides a baseline snapshot of use of selected clinical preventive services for U.S. infants, children, and adolescents prior to 2012, before or shortly after implementation of the Affordable Care Act.
Report findings include:
• Breastfeeding: One in six (17%) pregnant women did not receive breastfeeding counseling during prenatal care visits in 2010.1
• Hearing: Half (50%) of infants who failed their hearing screening were not documented to have received testing needed to diagnose hearing loss during 2009–2010.2
• Child Development: In 2007, parents of almost eight in ten (79%) children aged 10–47 months were not asked by healthcare providers to complete a formal screen for developmental delays in the past year.3
• Lead Poisoning: Two-thirds (67%) of children aged 1–2 years were not tested for blood lead or results were not reported to CDC in 2010.4
• Vision: According to their parents, approximately one in five (22%) children aged 5 years never had their vision checked by a healthcare provider during 2009–2010. Approximately one in four children did not have their blood pressure measurement documented at clinic visits during 2009–2010.5
• Hypertension: Approximately one in four (24%) outpatient clinic visits for preventive care made by 3–17 year-olds during 2009–2010 had no documentation of blood pressure measurement.6
• Dental: In 2009, more than half (56%) of children and adolescents did not visit the dentist in the past year, and nearly nine of ten (86%) children and adolescents did not receive a dental sealant or a topical fluoride application in the past year.7
• Human Papillomavirus (HPV) Vaccination: Nearly half (47%) of female adolescents aged 13–17 years had not received their recommended first dose of HPV vaccine in 2011, and almost two-thirds (65%) had not received all three recommended vaccine doses.8
• Tobacco: Approximately one in three (31%) outpatient clinic visits made by 11–21 year-olds during 2004–2010 had no documentation of tobacco use status, and eight of ten (80%) of those who screened positive for tobacco use did not receive any cessation assistance.9
• Chlamydia: During 2006–2010, almost two-thirds (60%) of sexually active females aged 15–21 years did not receive chlamydia screening in the past year.10
• Reproductive Health: During 2006–2010, approximately one in four (24%) sexually experienced females aged 15–19 years and more than one in three (38%) sexually experienced males aged 15–19 years did not receive a reproductive health service from a healthcare provider in the past year.11
These findings come from the second of a series of periodic reports from CDC to monitor and report on progress made in increasing the use of clinical preventive services to improve population health. There are many important clinical preventive services for infants, children, and adolescents. Healthcare providers, parents, and guardians can find out more about the preventive care children need by visiting http://www.cdc.gov/prevention.
About this Study collapsed
Clinical Preventive Services collapsed
The Affordable Care Act collapsed
CDC’s Activities http://www.cdc.gov/childpreventiveservices/key-findings.html

See, Developmental Monitoring and Screening http://www.cdc.gov/ncbddd/childdevelopment/screening.html

The increased rate of poverty has profound implications if this society believes that ALL children have the right to a good basic education. Moi blogs about education issues so the reader could be perplexed sometimes because moi often writes about other things like nutrition, families, and personal responsibility issues. Why? The reader might ask? Because children will have the most success in school, if they are ready to learn. Ready to learn includes proper nutrition for a healthy body and the optimum situation for children is a healthy family. Many of societies’ problems would be lessened if the goal was a healthy child in a healthy family. There is a lot of economic stress in the country now because of unemployment and underemployment. Children feel the stress of their parents and they worry about how stable their family and living situation is.

A healthy child in a healthy family who attends a healthy school in a healthy neighborhood ©

Related:

People MUST talk: AIDS epidemic in Black community
https://drwilda.wordpress.com/2012/08/02/people-must-talk-aids-epidemic-in-black-community/

Study: When teachers overcompensate for prejudice
https://drwilda.wordpress.com/2012/05/10/study-when-teachers-overcompensate-for-prejudice/

Location, location, location: Brookings study of education disparity based upon neighborhood https://drwilda.wordpress.com/2012/04/18/location-location-location-brookings-study-of-education-disparity-based-upon-neighborhood/

Jonathan Cohn’s ‘The Two Year Window’
https://drwilda.wordpress.com/2011/12/18/jonathan-cohns-the-two-year-window/

Hard times are disrupting families https://drwilda.com/2011/12/11/hard-times-are-disrupting-families/

3rd world America: The link between poverty and education
https://drwilda.com/2011/11/20/3rd-world-america-the-link-between-poverty-and-education/

3rd world America: Money changes everything https://drwilda.com/2012/02/11/3rd-world-america-money-changes-everything/

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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Tulane University Medical School study: Family violence affects the DNA of children

17 Jun

Moi reported about the effect stress has on genes in Penn State study: Stress alters children’s genomes https://drwilda.com/2014/04/08/penn-state-study-stress-alters-childrens-genomes/ A Tulane Medical School study finds that family violence or trauma alters a child’s genomes.

Science Daily reported in the article, Family violence leaves genetic imprint on children:

A new Tulane University School of Medicine study finds that the more fractured families are by domestic violence or trauma, the more likely that children will bear the scars down to their DNA.
Researchers discovered that children in homes affected by domestic violence, suicide or the incarceration of a family member have significantly shorter telomeres, which is a cellular marker of aging, than those in stable households. The findings are published online in the latest issue of the journal Pediatrics.
Telomeres are the caps at the end of chromosomes that keep them from shrinking when cells replicate. Shorter telomeres are linked to higher risks for heart disease, obesity, cognitive decline, diabetes, mental illness and poor health outcomes in adulthood. Researchers took genetic samples from 80 children ages 5 to 15 in New Orleans and interviewed parents about their home environments and exposures to adverse life events….
The study found that gender moderated the impact of family instability. Traumatic family events were more detrimental to young girls as they were more likely to have shortened telomeres. There was also a surprising protective effect for boys: mothers who had achieved a higher level of education had a positive association with telomere length, but only in boys under 10.
Ultimately, the study suggests that the home environment is an important intervention target to reduce the biological impacts of adversity in the lives of young children, Drury said. http://www.sciencedaily.com/releases/2014/06/140617102505.htm?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+sciencedaily%2Ftop_news%2Ftop_science+%28ScienceDaily%3A+Top+Science+News%29&utm_content=FaceBook

Citation:

Family violence leaves genetic imprint on children
Date: June 17, 2014
Source: Tulane University
Summary:
Children in homes affected by violence, suicide, or the incarceration of a family member have significantly shorter telomeres -— a cellular marker of aging — than those in stable households. The study suggests that the home environment is an important intervention target to reduce the biological impacts of adversity in the lives of young children.
Journal Reference:
1. S. S. Drury, E. Mabile, Z. H. Brett, K. Esteves, E. Jones, E. A. Shirtcliff, K. P. Theall. The Association of Telomere Length With Family Violence and Disruption. PEDIATRICS, 2014; 134 (1): e128 DOI: 10.1542/peds.2013-3415

Here is the press release from Tulane University:

Study: Family violence leaves genetic imprint on children
June 16, 2014
Keith Brannon
Phone: 504-862-8789

kbrannon@tulane.edu
A new Tulane University School of Medicine study finds that the more fractured families are by domestic violence or trauma, the more likely that children will bear the scars down to their DNA.
Researchers discovered that children in homes affected by domestic violence, suicide or the incarceration of a family member have significantly shorter telomeres, which is a cellular marker of aging, than those in stable households. The findings are published online in the latest issue of the journal Pediatrics.
Telomeres are the caps at the end of chromosomes that keep them from shrinking when cells replicate. Shorter telomeres are linked to higher risks for heart disease, obesity, cognitive decline, diabetes, mental illness and poor health outcomes in adulthood. Researchers took genetic samples from 80 children ages 5 to 15 in New Orleans and interviewed parents about their home environments and exposures to adverse life events.
“Family-level stressors, such as witnessing a family member get hurt, created an environment that affected the DNA within the cells of the children,” said lead author Dr. Stacy Drury, director of the Behavioral and Neurodevelopmental Genetics Laboratory at Tulane. “The greater the number of exposures these kids had in life, the shorter their telomeres were – and this was after controlling for many other factors, including socioeconomic status, maternal education, parental age and the child’s age.”
The study found that gender moderated the impact of family instability. Traumatic family events were more detrimental to young girls as they were more likely to have shortened telomeres. There was also a surprising protective effect for boys: mothers who had achieved a higher level of education had a positive association with telomere length, but only in boys under 10.
Ultimately, the study suggests that the home environment is an important intervention target to reduce the biological impacts of adversity in the lives of young children, Drury said.

See, School psychologists are needed to treat troubled children https://drwilda.com/2012/02/27/school-psychologists-are-needed-to-treat-troubled-children/

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

Related:

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

School psychologists are needed to treat troubled children https://drwilda.wordpress.com/2012/02/27/school-psychologists-are-needed-to-treat-troubled-children/

Battling teen addiction: ‘Recovery high schools’ https://drwilda.wordpress.com/2012/07/08/battling-teen-addiction-recovery-high-schools/

Resources:

About.Com’s Depression In Young Children http://depression.about.com/od/child/Young_Children.htm

Psych Central’s Depression In Young Children http://depression.about.com/od/child/Young_Children.htm

Psychiatric News’ Study Helps Pinpoint Children With Depression
http://psychnews.psychiatryonline.org/newsarticle.aspx?articleid=106034

Family Doctor’s What Is Depression? http://familydoctor.org/familydoctor/en/diseases-conditions/depression.html

WebMD’s Depression In Children http://www.webmd.com/depression/guide/depression-children

Healthline’s Is Your Child Depressed? http://www.healthline.com/hlvideo-5min/how-to-help-your-child-through-depression-517095449

Medicine.Net’s Depression In Children http://www.onhealth.com/depression_in_children/article.htm

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

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: , , , , , , , , , , , , , , , ,

Harvard study: High doses of antidepressants appear to increase risk of self-harm in children and young adults

29 Apr

People of all ages may have feelings of profound sadness, loss, and depression. There is no one on earth, despite what the ads attempt to portray, who lives a perfect life. Every life has flaws and blemishes, it is just that some cope better than others. For every person who lives to a ripe old age, during the course of that life they may encounter all types of loss from loss of a loved one through death, divorce or desertion, loss of job, financial reverses, illness, dealing with A-holes and twits, plagues, pestilence, and whatever curse can be thrown at a person. The key is that they lived THROUGH whatever challenges they faced AT THAT MOMENT IN TIME. Woody Allen said something like “90% of life is simply showing up.” Let moi add a corollary, one of the prime elements of a happy life is to realize that whatever moment you are now in, it will not last forever and that includes moments of great challenge. A person does not have to be religious to appreciate the story of Job. The end of the story is that Job is restored. He had to endure much before the final victory, though.

Medical Press reported in the article, High doses of antidepressants appear to increase risk of self-harm in children young adult:

Children and young adults who start antidepressant therapy at high doses, rather than the “modal” [average or typical] prescribed doses, appear to be at greater risk for suicidal behavior during the first 90 days of treatment.
A previous meta-analysis by the U.S. Food and Drug Administration (FDA) of antidepressant trials suggested that children who received antidepressants had twice the rate of suicidal ideation and behavior than children who were given a placebo. The authors of the current study sought to examine suicidal behavior and antidepressant dose, and whether risk depended on a patient’s age.
The study used data from 162,625 people (between the ages of 10 to 64 years) with depression who started antidepressant treatment with a selective serotonin reuptake inhibitor at modal (the most prescribed doses on average) or at higher than modal doses from 1998 through 2010.
The rate of suicidal behavior (deliberate self-harm or DSH) among children and adults (24 years or younger) who started antidepressant therapy at high doses was about twice as high compared with a matched group of patients who received generally prescribed doses. The authors suggest this corresponds to about one additional event of DSH for every 150 patients treated with high-dose therapy. For adults 25 to 64 years old, the difference in risk for suicidal behavior was null. The study does not address why higher doses might lead to higher suicide risk….
“Their findings suggest that higher than modal initial dosing leads to an increased risk for DSH and adds further support to current clinical recommendations to begin treatment with lower antidepressant doses. While initiation at higher than modal doses of antidepressants may be deleterious, this study does not address the effect of dose escalation,” they continue.
“Moreover, while definitive studies on the impact of dose escalation in the face of nonresponse remain to be done, there are promising studies that suggest in certain subgroups, dose escalation can be of benefit. Finally it should be noted that in this study, there was no pre-exposure to post-exposure increase in suicidal behavior after the initiation of antidepressants in youth treated at the modal dosage,” they conclude. http://medicalxpress.com/news/2014-04-high-doses-antidepressants-self-harm-children.html

Citation:

Online First >
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Original Investigation|April 28, 2014
Antidepressant Dose, Age, and the Risk of Deliberate Self-harm
ONLINE FIRST
Matthew Miller, MD, ScD1; Sonja A. Swanson, ScM2; Deborah Azrael, PhD1; Virginia Pate, PhD, PhD3; Til Stürmer, MD, ScD3
[+] Author Affiliations
JAMA Intern Med. Published online April 28, 2014. doi:10.1001/jamainternmed.2014.1053
Text Size: A A A
Article
Figures
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References
Comments
ABSTRACT
ABSTRACT | METHODS | RESULTS | DISCUSSION | CONCLUSIONS | ARTICLE INFORMATION | REFERENCES
Importance A comprehensive meta-analysis of randomized trial data suggests that suicidal behavior is twice as likely when children and young adults are randomized to antidepressants compared with when they are randomized to placebo. Drug-related risk was not elevated for adults older than 24 years. To our knowledge, no study to date has examined whether the risk of suicidal behavior is related to antidepressant dose, and if so, whether risk depends on a patient’s age.
Objective To assess the risk of deliberate self-harm by antidepressant dose, by age group.
Design, Setting, and Participants This was a propensity score–matched cohort study using population-based health care utilization data from 162 625 US residents with depression ages 10 to 64 years who initiated antidepressant therapy with selective serotonin reuptake inhibitors at modal or at higher than modal doses from January 1, 1998, through December 31, 2010.
Main Outcomes and Measures International Classification of Diseases, Ninth Revision (ICD-9) external cause of injury codes E950.x-E958.x (deliberate self-harm).
Results The rate of deliberate self-harm among children and adults 24 years of age or younger who initiated high-dose therapy was approximately twice as high as among matched patients initiating modal-dose therapy (hazard ratio [HR], 2.2 [95% CI, 1.6-3.0]), corresponding to approximately 1 additional event for every 150 such patients treated with high-dose (instead of modal-dose) therapy. For adults 25 to 64 years of age, the absolute risk of suicidal behavior was far lower and the effective risk difference null (HR, 1.2 [95% CI, 0.8-1.9]).
Conclusions and Relevance Children and young adults initiating therapy with antidepressants at high-therapeutic (rather than modal-therapeutic) doses seem to be at heightened risk of deliberate self-harm. Considered in light of recent meta-analyses concluding that the efficacy of antidepressant therapy for youth seems to be modest, and separate evidence that antidepressant dose is generally unrelated to therapeutic efficacy, our findings offer clinicians an additional incentive to avoid initiating pharmacotherapy at high-therapeutic doses and to closely monitor patients starting antidepressants, especially youth, for several months.

Here is the press release from Harvard:

PUBLIC RELEASE DATE:
28-Apr-2014

Contact: Marge Dwyer
mhdwyer@hsph.harvard.edu
617-432-8416
The JAMA Network Journals
High doses of antidepressants appear to increase risk of self-harm in children young adult
Bottom Line:
Children and young adults who start antidepressant therapy at high doses, rather than the “modal” [average or typical] prescribed doses, appear to be at greater risk for suicidal behavior during the first 90 days of treatment.
Author:
Matthew Miller, M.D., Sc.D., of the Harvard School of Public Health, Boston, and colleagues.
Background:
A previous meta-analysis by the U.S. Food and Drug Administration (FDA) of antidepressant trials suggested that children who received antidepressants had twice the rate of suicidal ideation and behavior than children who were given a placebo. The authors of the current study sought to examine suicidal behavior and antidepressant dose, and whether risk depended on a patient’s age.
How the Study Was Conducted:
The study used data from 162,625 people (between the ages of 10 to 64 years) with depression who started antidepressant treatment with a selective serotonin reuptake inhibitor at modal (the most prescribed doses on average) or at higher than modal doses from 1998 through 2010.
Results: The rate of suicidal behavior (deliberate self-harm or DSH) among children and adults (24 years or younger) who started antidepressant therapy at high doses was about twice as high compared with a matched group of patients who received generally prescribed doses. The authors suggest this corresponds to about one additional event of DSH for every 150 patients treated with high-dose therapy. For adults 25 to 64 years old, the difference in risk for suicidal behavior was null. The study does not address why higher doses might lead to higher suicide risk.
Discussion: “Considered in light of recent meta-analyses concluding that the efficacy of antidepressant therapy for youth seems to be modest, and separate evidence that dose is generally unrelated to the therapeutic efficacy of antidepressants, our findings offer clinicians an additional incentive to avoid initiating pharmacotherapy at high-therapeutic doses and to monitor all patients starting antidepressants, especially youth, for several months and regardless of history of DSH.”
(JAMA Intern Med. Published online April 28, 2014. doi:10.1001/jamainternmed.2014.1053. Available pre-embargo to the media at http://media.jamanetwork.com.)
Editor’s Note: Authors made a conflict of interest and funding disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Commentary: Initial Dose of Antidepressants, Suicidal Behavior in Youth
In a related commentary, David A. Brent, M.D., of the University of Pittsburgh, and Robert Gibbons, Ph.D., of the University of Chicago, write: “In summary Miller et al are to be commended on a thoughtful and careful analysis of the effects of initiating antidepressants at higher than modal doses.”
“Their findings suggest that higher than modal initial dosing leads to an increased risk for DSH and adds further support to current clinical recommendations to begin treatment with lower antidepressant doses. While initiation at higher than modal doses of antidepressants may be deleterious, this study does not address the effect of dose escalation,” they continue.
“Moreover, while definitive studies on the impact of dose escalation in the face of nonresponse remain to be done, there are promising studies that suggest in certain subgroups, dose escalation can be of benefit. Finally it should be noted that in this study, there was no pre-exposure to post-exposure increase in suicidal behavior after the initiation of antidepressants in youth treated at the modal dosage,” they conclude.
(JAMA Intern Med. Published online April 28, 2014. doi:10.1001/jamainternmed.2013.14016. Available pre-embargo to the media at http://media.jamanetwork.com.)
Editor’s Note: Authors made conflict of interest and funding disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
###
Media Advisory:
To contact author Matthew Miller, M.D., Sc.D., call Marge Dwyer at 617-432-8416 or email mhdwyer@hsph.harvard.edu. To contact commentary author David A. Brent, M.D., call Gloria Kreps at 412-586-9764 or email krepsga@upmc.edu.

What Should You Do if You Know Someone Who Thinking About Suicide?

If you are thinking of suicide or you know someone who is thinking about suicide, GET HELP, NOW!!!! The Suicide Prevention Resource Center http://www.sprc.org/basics/roles-suicide-prevention has some excellent advice about suicide prevention http://www.sprc.org/basics/roles-suicide-prevention

Resources:

Teen’s Health’s Suicide http://kidshealth.org/teen/your_mind/feeling_sad/suicide.html

American Academy of Adolescent Psychiatry http://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/Facts_for_Families_Pages/Teen_Suicide_10.aspx
Suicide Prevention Resource Center http://www.sprc.org/basics/roles-suicide-prevention

Teen Depression http://helpguide.org/mental/depression_teen.htm

Jared Story.Com http://www.jaredstory.com/teen_epidemic.html
CNN Report about suicide http://www.cnn.com/2009/LIVING/10/20/lia.latina.suicides/index.html
American Foundation for Suicide Prevention
http://www.afsp.org This group is dedicated to advancing the knowledge of suicide and the ability to prevent it.

SA\VE – Suicide Awareness\Voices of Education
http://www.save.org SA\VE offers information on suicide prevention. Call (800) SUICIDE

Youth Suicide Prevention
About.Com’s Depression In Young Children http://depression.about.com/od/child/Young_Children.htm

Psych Central’s Depression In Young Children http://depression.about.com/od/child/Young_Children.htm

Psychiatric News’ Study Helps Pinpoint Children With Depression
http://psychnews.psychiatryonline.org/newsarticle.aspx?articleid=106034

Family Doctor’s What Is Depression? http://familydoctor.org/familydoctor/en/diseases-conditions/depression.html

WebMD’s Depression In Children http://www.webmd.com/depression/guide/depression-children

Healthline’s Is Your Child Depressed? http://www.healthline.com/hlvideo-5min/how-to-help-your-child-through-depression-517095449

Medicine.Net’s Depression In Children http://www.onhealth.com/depression_in_children/article.htm

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

Related:
University of California, San Francisco study identifies most common reasons for children’s mental health hospitalizations https://drwilda.com/tag/depression/

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

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

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: , , , , , , , , , , , , , , , , , , , , , ,

‘Peer Counseling’ in schools

28 Apr

Moi wrote about a high school support program in Helping troubled children: The ‘Reconnecting Youth Program’:
Many children arrive at school with mental health and social issues. In School psychologists are needed to treat troubled children:

Mark Phillips, professor emeritus of secondary education at San Francisco State University wrote the article, School psychologists: Shortage amid increased need which discusses the need for psychological support in schools.
The adolescent suicide rate continues to rise, with each suicide a dramatic reminder that the lives of a significant number of adolescents are filled with anxiety and stress. Most schools have more than a handful of kids wrestling with significant emotional problems, and schools at all levels face an ongoing challenge related to school violence and bullying, both physical and emotional.
Yet in many schools there is inadequate professional psychological support for students.
Although statistics indicate that there is a significant variation from state to state (between 2005- and 2011 the ratio of students per school psychologist in New Mexico increased by 180%, while in the same period the ratio decreased in Utah by 34%), the overall ratio is 457:1. That is almost twice that recommended by the National Association of School Psychologists (NASP).
THE NASP noted a shortage of almost 9,000 school psychologists in 2010 and projected a cumulative shortage of close to 15,000 by 2020. Mental Health America estimates that only 1 in 5 children in need of mental health services actually receive the needed services. These gross statistics also omit the special need of under funded schools and the increased roles school psychologists are being asked to play….
Even with the psychological services that should be provided and often aren’t, schools can’t fully prevent suicides, acts of violence, bullying, or the daily stresses that weigh on kids shoulders. The malaise runs deeper and broader.
Still schools need more resources than they receive in order to provide more programs that actively identify and counsel those kids that need help. At the very least, they need to alleviate some of the stress these kids are experiencing and to help improve the quality of their daily lives. http://www.washingtonpost.com/blogs/answer-sheet/post/school-psychologists-shortage-amid-increased-need/2012/02/26/gIQAU7psdR_blog.html

It is important to deal with the psychological needs of children because untreated depression can lead to suicide. https://drwilda.com/2012/02/27/school-psychologists-are-needed-to-treat-troubled-children/ In addition to psychological programs, schools can offer other resources to help students succeed in school and in life.

Rebecca Jones of Ed News Colorado wrote about the Reconnecting Youth Program in the article, Reconnecting Youth program boosts teens.
http://www.ednewscolorado.org/2012/10/30/51106-reconnecting-youth-program-boosts-teens https://drwilda.com/2012/10/30/helping-troubled-children-the-reconnecting-youth-program/
Another model many schools are trying is peer counseling.

Evie Blad reported in the Education Week article, Schools Explore Benefits of Peer Counseling about peer counseling:

Schools in Baltimore, New York City, New Jersey, and North Carolina have used the program—created by the Princeton, N.J.-based Center for Supportive Schools—to boost attendance, academic persistence, and graduation rates.
At a time when schools are increasingly recognizing the important role social and emotional factors can play in academic success, leaders are wasting a valuable resource if they don’t enlist energetic students to help their peers, said Daniel F. Oscar, the president and chief executive officer of the Center for Supportive Schools.
“It becomes a very positive feedback loop where, by the act of helping the school out, that older student is in fact deepening his or her own education,” Mr. Oscar said. “Leadership is increasingly something that we don’t only expect from the person who has the top title in an organization. It’s something we expect from everyone.”
A study by researchers at Rutgers University in New Brunswick, N.J. published in the Journal of Educational Research found that Peer Group Connection had notable success raising graduation rates for Latino males.
Promising Signs
In a randomized control study, researchers tracked four-year graduation rates for 268 participating students at a high-poverty, mid-Atlantic, urban high school that is not named in the study. Of the program’s participants, 77 percent graduated high school in four years, compared with 68 percent of their nonparticipating peers. Latino males in the experimental group had an 81 percent graduation rate, compared to 63 percent in the control group.
Peer Group Connection is more successful than some other peer-mentoring efforts because it is integrated into the school day, incorporates several meetings with students’ families to reinforce lessons and supports, and requires buy-in from principals and teachers before a school implements the program, the researchers wrote.
The program employs a “train the trainer” model under which juniors and seniors complete a yearlong, credit-bearing leadership course where they practice group exercises and discussions. Older students also meet once a week with younger students to complete the exercises they practiced in class.
The class is led by teachers who received extensive training on the program, primarily through an 11-day course and a retreat with Center for Supportive Schools staff.
That training helps prepare teachers for a level of honesty they might not typically experience with students, said Sherry Barr, the vice president of the organization.
“When they go through it themselves and experience what it means to them to break down some of those barriers, that’s a very powerful experience,” Ms. Barr said. “They sort of leave transformed in the sense that they really want to have that experience with their students.”
As those teachers work with peer mentors in training, those discussions—often centered on experiences that can form hurdles for school completion and persistence—can be emotional.
On an April afternoon in Baltimore, peer leaders at the Academy for College and Career Exploration practiced how they would react to various text messages from peers, including nude photos and an angry message from a friend. Would they forward the photos to others? Would they respond to anger with anger?
“Keep it real,” teacher Candice Boone told senior Jada Davis, urging her to avoid simply telling adults in the room what she thought they’d want to hear about how she would respond to the hypothetical angry text message.
“You know I am,” Ms. Davis said, admitting that she “most likely would be going back and forth” with her friend if she got such a message.
Students also discussed the way girls are bullied and teased if they send a nude photo to a boyfriend, only to have it circulating on social media the next day. It’s a side of students teachers don’t always see, Ms. Boone said…. http://www.edweek.org/ew/articles/2014/04/23/29peerconnection.h33.html

The Center for Supportive Schools is one of the primary providers of training for peer counselors.

Here is what the Center for Supportive Schools says about Peer Counseling.

Peer Group Connection (PGC)
Through Peer Group Connection (PGC), CSS trains school faculty to teach leadership courses to select groups of older students, who in turn educate and support younger students. Our goal is to help schools enable and inspire young people to become engaged leaders who positively influence their peers. The CSS peer-to-peer student leadership model taps into schools’ most underutilized resources – students – and enlists them in strengthening the educational offerings of a school while simultaneously advancing their own learning, growth, and development.
Transition to High School
High School Juniors and Seniors Supporting Freshmen in Their Transition to High School
Peer Group Connection (PGC) for High Schools is an evidence-based program that supports and eases students’ successful transition from middle to high school. The program taps into the power of high school juniors and seniors to create a nurturing environment for incoming freshmen. Once per week, pairs of junior and senior peer leaders meet with groups of 10-14 freshmen in outreach sessions designed to strengthen relationships among students across grades. These peer leaders are simultaneously enrolled in a daily, for-credit, year-long leadership course taught by school faculty during regular school hours. PGC is CSS’s seminal peer leadership program, and has been implemented with a 70% sustainability rate in more than 175 high schools since 1979. A recently released, four-year longitudinal, randomized-control study conducted by Rutgers University and funded by the United States Department of Health and Human Services found that, among other major results, PGC improves the graduation rates of student participants in an inner city public school by ten percentage points and cuts by half the number of male students who would otherwise drop out.
http://supportiveschools.org/solutions/peer-group-connection/

Not all are supportive of peer counseling.

Andrew S. Latham wrote in the 1997 Education Leadership article, Research Link / Peer Counseling Proceed with Caution:

One of Lewis and Lewis’s concerns is that students serving as peer counselors are increasingly being asked to shoulder a burden that should be overseen only by trained, seasoned professionals. In a sobering study, the two researchers compared suicide rates among schools with no peer-led suicide-prevention program; schools with peer-led prevention programs overseen by a noncounselor (for example, a teacher or building administrator); and schools with peer-led prevention programs overseen by a certified counselor, psychologist, or social worker. Shockingly, the 38 schools with the noncounselor-led peer programs had the highest ratio of student suicides: Between 1991 and 1993, 11 of those 38 schools (29 percent) reported at least one suicide, as opposed to 7 of 55 schools (13 percent) with no prevention program at all, and just 5 of 65 schools (8 percent) with a counselor-led peer program….
Although Lewis and Lewis focus on suicide-prevention programs, we can extend this argument to other health and safety issues teens face, such as AIDS and drug and alcohol abuse. As teens confront the problems of the 1990s, they want concrete advice, not just an empathetic listener. Morey and colleagues (1993) confirmed this fact when they used a stepwise regression to identify factors that contribute to students’ satisfaction with peer counseling. Two such factors were “empathy and problem identification” and “empathy and problem solving,” indicating that students want help from peers who are willing to listen and understand their problems, and who can suggest ways to address those problems.
Professional Support Is Critical
These studies point to the need for students to receive extensive training and professional support both before and throughout their work with their peers. If such support is given, peer programs have tremendous potential.
A case in point: O’Hara and colleagues (1996) studied the effects of a student-led AIDS prevention program in an alternative school for at-risk youth. Following an initial interview, the peer counselors were trained over the course of eight weeks, including five classroom sessions, two retreats, and a trip to a local clinic for sexually transmitted diseases. Peer counselors with attendance problems were dropped from the program. Those who successfully completed the program then conducted two carefully structured large-group sessions with their peers, followed by two small-group sessions and various schoolwide activities. The results were impressive: pre- and post-intervention student surveys revealed that the number of students who intended to use condoms each time they had sex rose from 55 to 65 percent, while those reporting they had never used a condom dropped from 15 to 4 percent.
The lesson from these examples is that peer-led programs must be adopted carefully, particularly when dealing with the high-stakes problems that many teenagers face today. In fact, professional intervention may be preferable to peer support for potentially lethal issues, such as teen suicide…. http://www.ascd.org/publications/educational-leadership/oct97/vol55/num02/Peer-Counseling@-Proceed-with-Caution.aspx

For research on peer counseling programs, see http://www.cde.ca.gov/ls/cg/rh/counseffective.asp

Our goal as a society should be:

A healthy child in a healthy family who attends a healthy school in a healthy neighborhood ©

Related:

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

School psychologists are needed to treat troubled children
https://drwilda.wordpress.com/2012/02/27/school-psychologists-are-needed-to-treat-troubled-children/

Battling teen addiction: ‘Recovery high schools’
https://drwilda.wordpress.com/2012/07/08/battling-teen-addiction-recovery-high-schools/

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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Harvard Study: Television impairs kid’s sleep patterns

21 Apr

Moi wrote in Study: Blue light may affect the sleep habits of students:
The goal of this society should be to raise healthy and happy children who will grow into concerned and involved adults who care about their fellow citizens and environment. In order to accomplish this goal, all children must receive a good basic education and in order to achieve that goal, children must arrive at school, ready to learn. One of the mantras of this blog is there should not be a one size fits all approach to education and that there should be a variety of options to achieve the goal of a good basic education for all children.
The University of Illinois Extension has some good advice for helping children with study habits. In Study Habits and Homework he University of Illinois recommends:

Parents can certainly play a major role in providing the encouragement, environment, and materials necessary for successful studying to take place.
Some general things adults can do, include:
Establish a routine for meals, bedtime and study/homework
Provide books, supplies, and a special place for studying
Encourage the child to “ready” himself for studying (refocus attention and relax)
Offer to study with the child periodically (call out spelling words or do flash cards) http://urbanext.illinois.edu/succeed/habits.cfm

Some folks claim they need as few as four hours of sleep. For most folks, that is not healthy and it definitely isn’t healthy for children.

Sarah D. Sparks reported in the Education Week article, ‘Blue Light’ May Impair Students’ Sleep, Studies Say:

Schools may soon face an unintended consequence of more flexible technology and more energy-efficient buildings: sleepier students.
That’s because evidence is mounting that use of artificial light from energy-efficient lamps and computer and mobile-electronics screens later and later in the day can lead to significant sleep problems for adults and, particularly, children….
http://www.edweek.org/ew/articles/2013/12/11/14sleep_ep.h33.html?tkn=XYNFw7hK%2F8TdYrgvqxBY6H%2FjAT%2FMKwiy%2FAaU&cmp=clp-edweek

Technology may be interrupting children’s sleep patterns.
https://drwilda.com/tag/blue-light-may-impair-students-sleep-studies-say/

Tara Haelle reported in the Yahoo news post, More TV, Less Sleep for Kids:

A recent study found that children tended to get slightly less sleep with the more TV they watched. The most dramatic drop in daily sleep time, however, was linked to having a TV in the bedroom for minority children.
The authors suggested that reducing TV time and/or removing televisions from children’s bedrooms might help their sleep time.
The study, led by Elizabeth Cespedes, of the Obesity Prevention Program at Harvard Medical School, looked at the possible impact of television of children’s sleep.
The researchers collected daily average TV viewing information and sleep time from the parents of 1,864 children, starting at 6 months old and then once a year through age 7.
The researchers also gathered information on which children had a TV in their bedroom when they were aged 4 through 7.
Then the researchers analyzed the interaction of television viewing and sleep along with the children’s age, sex, race/ethnicity, income and mothers’ education level.
The group of children were diverse, including 35 percent who were racial/ethnic minorities and 37 percent who had family incomes of at least $70,000.
The children went from getting an average 12.2 hours of sleep each day at age 6 months old to an average of 9.8 hours a day at age 7.
During the same time span, the amount of TV the children watched increased from 0.9 hours a day to 1.6 hours a day.
About 17 percent of the children had a TV in their bedrooms when they were 4 years old, which increased to 23 percent by the time the children were 7 years old.
In comparing TV viewing time with sleep, the researchers found that each additional hour per day of watching TV was linked to seven fewer minutes of sleep each day.
Having a TV in children’s room also appeared to influence how much sleep the children got, but only for racial/ethnic minority children.
Among racial and ethnic minorities, children got an average 31 fewer minutes of sleep each day if they had a TV in their bedrooms than if they didn’t have a TV.
Among white, non-Hispanic children, however, a TV in the bedroom was only linked to eight fewer minutes of sleep each day, but this finding could have been the result of chance.
“Our study supports a negative influence of TV viewing and bedroom TV on children’s sleep,” the researchers wrote.
“TV viewing and the presence of a bedroom TV track over time,” they added. “Thus, modest decreases in sleep duration could form lasting habits leading to substantial sleep deficits as children age.”
The researchers suggested that making changes related to children’s TV viewing could have a positive impact on their sleep time.
http://health.yahoo.net/articles/parenting/more-tv-less-sleep-kids

Citation:

• Article
Television Viewing, Bedroom Television, and Sleep Duration From Infancy to Mid-Childhood
Authors
1. Elizabeth M. Cespedes, SMa,b,
2. Matthew W. Gillman, MD, SMa,b,
3. Ken Kleinman, ScDa,
4. Sheryl L. Rifas-Shiman, MPHa,
5. Susan Redline, MD, MPHc, and
6. Elsie M. Taveras, MD, MPHb,d
1. aObesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts;
2. bDepartment of Nutrition, Harvard School of Public Health, Boston, Massachusetts;
3. cBrigham and Women’s Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; and
4. dDivision of General Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, Massachusetts
Abstract
BACKGROUND: Television and insufficient sleep are associated with poor mental and physical health. This study assessed associations of TV viewing and bedroom TV with sleep duration from infancy to midchildhood.
METHOD: We studied 1864 children in Project Viva. Parents reported children’s average daily TV viewing and sleep (at 6 months and annually from 1–7 years) and the presence of a bedroom TV (annually 4–7 years). We used mixed effects models to assess associations of TV exposures with contemporaneous sleep, adjusting for child age, gender, race/ethnicity, maternal education, and income.
RESULTS: Six hundred forty-three children (35%) were racial/ethnic minorities; 37% of households had incomes ≤ $70 000. From 6 months to 7 years, mean (SD) sleep duration decreased from 12.2 (2.0) hours to 9.8 (0.9) hours per day; TV viewing increased from 0.9 (1.2) hours to 1.6 (1.0) hours per day. At 4 years, 17% had a bedroom TV, rising to 23% at 7 years. Each 1 hour per day increase in lifetime TV viewing was associated with 7 minutes per day (95% confidence interval [CI]: 4 to 10) shorter sleep. The association of bedroom TV varied by race/ethnicity; bedroom TV was associated with 31 minutes per day shorter sleep (95% CI: 16 to 45) among racial/ethnic minority children, but not among white, non-Hispanic children (8 fewer minutes per day [95% CI: −19 to 2]).
CONCLUSIONS: More TV viewing, and, among racial/ethnic minority children, the presence of a bedroom TV, were associated with shorter sleep from infancy to midchildhood.
Key Words:
• television
• sleep duration
• sleep hygiene
• childhood
• Accepted February 11, 2014.
• Copyright © 2014 by the American Academy of Pediatrics
1. Published online April 14, 2014

(doi: 10.1542/peds.2013-3998)
1. » AbstractFree
2. Full Text (PDF)Free

Education is a partnership between the student, parent(s) or guardian(s), teachers(s), and school. The students must arrive at school ready to learn and that includes being rested. Parent(s) and guardian(s) must ensure their child is properly nourished and rested as well as providing a home environment which is conducive to learning. Teachers must have strong subject matter knowledge and strong pedagogic skills. Schools must enforce discipline and provide safe places to learn. For more information on preparing your child for high school, see the U.S. Department of Education’s Tools for Success http://www2.ed.gov/parents/academic/help/tools-for-success/index.html

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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Penn State study: Stress alters children’s genomes

8 Apr

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

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

Schools are developing strategies to deal with troubled kids.

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

Growing up in a stressful social environment leaves lasting marks on young chromosomes, a study of African American boys has revealed. Telomeres, repetitive DNA sequences that protect the ends of chromosomes from fraying over time, are shorter in children from poor and unstable homes than in children from more nurturing families.
When researchers examined the DNA of 40 boys from major US cities at age 9, they found that the telomeres of children from harsh home environments were 19% shorter than those of children from advantaged backgrounds. The length of telomeres is often considered to be a biomarker of chronic stress.
The study, published today in the Proceedings of the National Academy of Sciences, brings researchers closer to understanding how social conditions in childhood can influence long-term health, says Elissa Epel, a health psychologist at the University of California, San Francisco, who was not involved in the research.
Participants’ DNA samples and socio-economic data were collected as part of the Fragile Families and Child Wellbeing Study, an effort funded by the National Institutes of Health to track nearly 5,000 children, the majority of whom were born to unmarried parents in large US cities in 1998–2000. Children’s environments were rated on the basis of their mother’s level of education; the ratio of a family’s income to needs; harsh parenting; and whether family structure was stable, says lead author Daniel Notterman, a molecular biologist at Pennsylvania State University in Hershey.
The telomeres of boys whose mothers had a high-school diploma were 32% longer compared with those of boys whose mothers had not finished high school. Children who came from stable families had telomeres that were 40% longer than those of children who had experienced many changes in family structure, such as a parent with multiple partners.
Genetic links
The link between stressful home environments and telomere length is moderated by genetic variants in pathways that process two chemical transmitters in the brain, serotonin and dopamine, the study found. Previous studies have correlated variants in some of the genes studied, such as TPH2, with depression, bipolar disorder and other mental-health issues. Variants of another gene, 5-HTT, reduce the amount of the protein that recycles serotonin in nerve synapses. Some alleles of these genes are thought to increase the sensitivity of carriers to external risks…. http://www.scientificamerican.com/article/stress-alters-childrens-genomes/?WT.mc_id=SA_Facebook

Citation:

Social disadvantage, genetic sensitivity, and children’s telomere length
1. Colter Mitchella,
2. John Hobcraftb,
3. Sara S. McLanahanc,1,
4. Susan Rutherford Siegeld,
5. Arthur Bergd,
6. Jeanne Brooks-Gunne,
7. Irwin Garfinkelf, and
8. Daniel Nottermand,g,1
Author Affiliations
Significance
This paper makes two contributions to research on the link between the social environment and health. Using data from a birth cohort study, we show that, among African American boys, those who grow up in highly disadvantaged environments have shorter telomeres (at age 9) than boys who grow up in highly advantaged environments. We also find that the association between the social environment and telomere length (TL) is moderated by genetic variation within the serotonin and dopamine pathways. Boys with the highest genetic sensitivity scores had the shortest TL when exposed to disadvantaged environments and the longest TL when exposed to advantaged environments. To our knowledge, this report is the first to document a gene–social environment interaction for TL, a biomarker of stress exposure.
Abstract
Disadvantaged social environments are associated with adverse health outcomes. This has been attributed, in part, to chronic stress. Telomere length (TL) has been used as a biomarker of chronic stress: TL is shorter in adults in a variety of contexts, including disadvantaged social standing and depression. We use data from 40, 9-y-old boys participating in the Fragile Families and Child Wellbeing Study to extend this observation to African American children. We report that exposure to disadvantaged environments is associated with reduced TL by age 9 y. We document significant associations between low income, low maternal education, unstable family structure, and harsh parenting and TL. These effects were moderated by genetic variants in serotonergic and dopaminergic pathways. Consistent with the differential susceptibility hypothesis, subjects with the highest genetic sensitivity scores had the shortest TL when exposed to disadvantaged social environments and the longest TL when exposed to advantaged environments.
gene–environment
adversity
senescence
Footnotes
↵1To whom correspondence may be addressed. E-mail: dan1@princeton.edu or mclanaha@princeton.edu.
Author contributions: C.M., J.H., S.S.M., J.B.-G., I.G., and D.N. designed research; C.M., J.H., S.S.M., J.B.-G., I.G., and D.N. performed research; S.R.S. and D.N. contributed new reagents/analytic tools; C.M., J.H., S.S.M., A.B., J.B.-G., I.G., and D.N. analyzed data; and C.M. and D.N. wrote the paper.
Reviewers: T.E.S., Geffen School of Medicine, University of California, Los Angeles; S.J.S., Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health.
The authors declare no conflict of interest.
This article contains supporting information online at http://www.pnas.org/lookup/suppl/doi:10.1073/pnas.1404293111/-/DCSupplemental.
Freely available online through the PNAS open access option.

Here is the press release from Penn State:

Disadvantaged environments affect genetic material, study finds
By Scott Gilbert
April 8, 2014
HERSHEY, Pa. — Children experiencing chronic stress from a disadvantaged life have shorter telomeres than their advantaged peers, according to a study led by Dr. Daniel Notterman, vice dean for research and graduate studies, and professor of pediatrics, and biochemistry and molecular biology at Penn State College of Medicine.
Telomeres are DNA sequences at the end of each chromosome that protect the ends of the chromosomes from damage. They vary in length per person and shrink as a person ages, a process that may be linked to health and disease.
The negative health effects of long-term chronic stress may be connected to the shortening of telomeres. Telomeres shorten faster in individuals experiencing chronic stress, such as that from living in a disadvantaged environment.
Notterman and colleagues studied genetic information from 40 9-year-old African-American boys.
Boys from disadvantaged environments had shorter telomeres than peers in the study who were not. In addition, the effect of environment on telomere length was mediated by genes involved with the function of two neurotransmitters, dopamine and serotonin. Neurotransmitters help transmit signals between brain cells and send information throughout the body.
For boys with genetic variants of dopamine or serotonin pathways that conferred greater sensitivity to environmental signals associated with stress, those from disadvantaged environments had the shortest telomeres, and those from advantaged environments had the longest.
The results suggest a link between genetic factors and social environment associated with changing telomere length and provides a biomarker for chronic stress exposure in children as young as 9, according to the authors.
Researchers also from Penn State College of Medicine are Arthur Berg, associate professor of biostatistics and bioinformatics, and Sue Siegel, assistant professor of biochemistry and molecular biology.
The study is published in Proceedings of the National Academy of Sciences (PNAS) and was supported by the National Institutes of Health-National Institute of Child Health and Human Development, and the Penn State Clinical and Translational Science Institute. For more information, visit PNAS’s Early Edition.
Sarah D. Sparks writes in the Education Week article, Research Traces Impacts of Childhood Adversity:
The stress of a spelling bee or a challenging science project can enhance a student’s focus and promote learning. But the stress of a dysfunctional or unstable home life can poison a child’s cognitive ability for a lifetime, according to new research.
While educators and psychologists have said for decades that the effects of poverty interfere with students’ academic achievement, new evidence from cognitive and neuroscience is showing exactly how adversity in childhood damages students’ long-term learning and health….
Good experiences, like nurturing parents and rich early-child-care environments, help build and reinforce neural connections in areas such as language development and self-control, while adversity weakens those connections.
Over time, the connections, good or bad, stabilize, “and you can’t go back and rewire; you have to adapt,” Dr. Shonkoff said. “If you’ve built on strong foundations, that’s good, and if you have weak foundations, the brain has to work harder, and it costs more to the brain and society…”
The Centers for Disease Control and Prevention provides access to the peer-reviewed publications resulting from The ACE Study. http://acestudy.org/

See, School psychologists are needed to treat troubled children https://drwilda.com/2012/02/27/school-psychologists-are-needed-to-treat-troubled-children/

Our goal as a society should be:

A healthy child in a healthy family who attends a healthy school in a healthy neighborhood ©

Related:

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

School psychologists are needed to treat troubled children
https://drwilda.wordpress.com/2012/02/27/school-psychologists-are-needed-to-treat-troubled-children/

Battling teen addiction: ‘Recovery high schools’
https://drwilda.wordpress.com/2012/07/08/battling-teen-addiction-recovery-high-schools/

Resources:
1. About.Com’s Depression In Young Children
http://depression.about.com/od/child/Young_Children.htm

2. Psych Central’s Depression In Young Children
http://depression.about.com/od/child/Young_Children.htm

3. Psychiatric News’ Study Helps Pinpoint Children With Depression http://psychnews.psychiatryonline.org/newsarticle.aspx?articleid=106034

4. Family Doctor’s What Is Depression?
http://familydoctor.org/familydoctor/en/diseases-conditions/depression.html

5. WebMD’s Depression In Children
http://www.webmd.com/depression/guide/depression-children

6. Healthline’s Is Your Child Depressed?
http://www.healthline.com/hlvideo-5min/how-to-help-your-child-through-depression-517095449

7. Medicine.Net’s Depression In Children
http://www.onhealth.com/depression_in_children/article.htm

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

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: , , , , , , , , , , , , , , ,

University of California, San Francisco study identifies most common reasons for children’s mental health hospitalizations

23 Mar

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

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

One strategy in helping children to succeed is to recognize and treat depression.

How Common Is Depression In Children?

According to Mary H. Sarafolean, PhD in the article, Depression In School Age Children and Adolescents

In general, depression affects a person’s physical, cognitive, emotional/affective, and motivational well-being, no matter their age. For example, a child with depression between the ages of 6 and 12 may exhibit fatigue, difficulty with schoolwork, apathy and/or a lack of motivation. An adolescent or teen may be oversleeping, socially isolated, acting out in self-destructive ways and/or have a sense of hopelessness.
Prevalence and Risk Factors
While only 2 percent of pre-teen school-age children and 3-5 percent of teenagers have clinical depression, it is the most common diagnosis of children in a clinical setting (40-50 percent of diagnoses). The lifetime risk of depression in females is 10-25 percent and in males, 5-12 percent. Children and teens who are considered at high risk for depression disorders include:
* children referred to a mental health provider for school problems
* children with medical problems
* gay and lesbian adolescents
* rural vs. urban adolescents
* incarcerated adolescents
* pregnant adolescents
* children with a family history of depression http://www.healthyplace.com/depression/children/recognizing-symptoms-of-depression-in-teens-and-children/

If you or your child has one or more of the risk factors and your child is exhibiting symptoms of prolonged sadness, it might be wise to have your child evaluated for depression.

How to Recognize Depression In Your Child?

MedNet has an excellent article about Depression In Children and how to recognize signs of depression in your child.
Signs and symptoms of depression in children include:

* Irritability or anger
* Continuous feelings of sadness, hopelessness
* Social withdrawal
* Increased sensitivity to rejection
* Changes in appetite — either increased or decreased
* Changes in sleep — sleeplessness or excessive sleep
* Vocal outbursts or crying
* Difficulty concentrating
* Fatigue and low energy
* Physical complaints (such as stomachaches, headaches) that do not respond to
treatment
* Reduced ability to function during events and activities at home or with friends, in school, extracurricular activities, and in other hobbies or interests
* Feelings of worthlessness or guilt
* Impaired thinking or concentration
* Thoughts of death or suicide
Not all children have all of these symptoms. In fact, most will display different symptoms at different times and in different settings. Although some children may continue to function reasonably well in structured environments, most kids with significant depression will suffer a noticeable change in social activities, loss of interest in school and poor academic performance, or a change in appearance. Children may also begin using drugs or alcohol,
especially if they are over the age of 12. http://www.onhealth.com/depression_in_children/article.htm

The best defense for parents is a good awareness of what is going on with their child. As a parent you need to know what is going on in your child’s world. https://drwilda.com/2011/11/15/schools-have-to-deal-with-depressed-and-troubled-children/

Science Daily reported in the article, Study identifies most common, costly reasons for mental health hospitalizations for kids:

Nearly one in 10 hospitalized children have a primary diagnosis of a mental health condition, and depression alone accounts for $1.33 billion in hospital charges annually, according to a new analysis led by UCSF Benioff Children’s Hospital.
The study is the first to examine frequency and costs associated with specific inpatient mental health diagnoses for children, and is a step towards creating meaningful measures of the quality of pediatric hospital care.
“This is the first paper to give a clear picture of the mental health reasons kids are admitted to hospitals nationally,” said Naomi Bardach, MD, an assistant professor of pediatrics at UCSF Benioff Children’s Hospital and lead author. “Mental health hospitalizations have been increasing in kids, up 24% from 2007-2010. Mental health is a priority topic for national quality measures, which are intended to help improve care for all kids.”
The study will be published in the April issue of the journal Pediatrics.
More than 14 million children and adolescents in the United States have a diagnosable mental health disorder, yet little is known about which specific mental health diagnoses are causing children to be hospitalized. In the study, researchers found that depression, bipolar disorder and psychosis are the most common and expensive primary diagnoses for pediatric admissions.
“We now know through our analysis of cost and frequency which diagnoses are the most relevant,” said Bardach. “Next, we need to define what the optimal care is for children with these conditions so that hospitals can consistently deliver the best care for every child, every time.”
Using two national databases — Kids’ Inpatient Database and Pediatric Health Information System — the researchers looked at all hospital discharges in 2009 for patients aged three to 20 years old to determine the frequency of hospitalizations for primary mental health diagnoses. They compared the mental health hospitalizations between free-standing children’s hospitals and hospitals that treat both adults and children, to assess if there was a difference in frequency of diagnoses.
The study found that hospitalizations for children with primary mental health diagnoses were more than three times more frequent at general hospitals than free standing children’s hospitals, which the researchers say could indicate that general hospitals have a greater capacity to deliver inpatient psychiatric care than free-standing children’s hospitals…. http://www.sciencedaily.com/releases/2014/03/140317084531.htm

Citation:

Study identifies most common, costly reasons for mental health hospitalization

Date: March 17, 2014

Source: University of California, San Francisco

Summary:
Nearly one in 10 hospitalized children have a primary diagnosis of a mental health condition, and depression alone accounts for $1.33 billion in hospital charges annually, according to a new analysis. The study is the first to examine frequency and costs associated with specific inpatient mental health diagnoses for children, and is a step towards creating meaningful measures of the quality of pediatric hospital care.
Journal Reference:
1.Naomi S. Bardach, Tumaini R. Coker, Bonnie T. Zima, J. Michael Murphy, Penelope Knapp, Laura P. Richardson, Glenace Edwall, and Rita Mangione-Smith. Common and Costly Hospitalizations for Pediatric Mental Health Disorders. Pediatrics, March 2014 DOI: 10.1542/peds.2013-3165

Here is the press release from the University of San Francisco:

Study Identifies Most Common, Costly Reasons for Mental Health Hospitalizations for Kids
By Juliana Bunim on March 13, 2014
Nearly one in 10 hospitalized children have a primary diagnosis of a mental health condition, and depression alone accounts for $1.33 billion in hospital charges annually, according to a new analysis led by UCSF Benioff Children’s Hospital.
The study is the first to examine frequency and costs associated with specific inpatient mental health diagnoses for children, and is a step towards creating meaningful measures of the quality of pediatric hospital care.
“This is the first paper to give a clear picture of the mental health reasons kids are admitted to hospitals nationally,” said Naomi Bardach, MD, an assistant professor of pediatrics at UCSF Benioff Children’s Hospital and lead author. “Mental health hospitalizations have been increasing in kids, up 24% from 2007-2010. Mental health is a priority topic for national quality measures, which are intended to help improve care for all kids.”
The study will be published in the April issue of the journal Pediatrics.
More than 4 million children and adolescents in the United States have a diagnosable mental health disorder, yet little is known about which specific mental health diagnoses are causing children to be hospitalized. In the study, researchers found that depression, bipolar disorder and psychosis are the most common and expensive primary diagnoses for pediatric admissions.
“We now know through our analysis of cost and frequency which diagnoses are the most relevant,” said Bardach. “Next, we need to define what the optimal care is for children with these conditions so that hospitals can consistently deliver the best care for every child, every time.”
Using two national databases – Kids’ Inpatient Database and Pediatric Health Information System – the researchers looked at all hospital discharges in 2009 for patients aged three to 20 years old to determine the frequency of hospitalizations for primary mental health diagnoses. They compared the mental health hospitalizations between free-standing children’s hospitals and hospitals that treat both adults and children, to assess if there was a difference in frequency of diagnoses.
The study found that hospitalizations for children with primary mental health diagnoses were more than three times more frequent at general hospitals than free standing children’s hospitals, which the researchers say could indicate that general hospitals have a greater capacity to deliver inpatient psychiatric care than free-standing children’s hospitals.
At both kinds of hospitals, the most common mental health diagnoses were similar (depression, bipolar disorder, and psychosis), which the researchers say supports the creation of diagnosis-specific quality measures for all hospitals that admit children.
Depression accounted for 44.1 percent of all pediatric primary mental health admissions, with charges of $1.33 billion dollars, based on the billing databases used in the study. Bipolar was the second most common diagnosis accounting for 18.1 percent and $702 million, followed by psychosis at 12.1 percent and $540 million.
“These are costly hospitalizations, and being hospitalized is a heavy burden for families and patients. Prevention and wellness is a huge part of the Affordable Care Act, along with controlling costs by delivering great care,” said Bardach. “This study helps us understand that mental health is a key priority. The long term goal is not only to improve hospital care for these kids, but also to understand how to effectively optimize mental health resources in the outpatient world.”
Co-authors include Tumaini Coker, MD, MBA and Bonnie Zima, MD, MPH, both of UCLA; J. Michael Murphy, EdD, Massachusetts General Hospital Boston; Penelope Knapp, MD, UC Davis; Laura Richardson, MD, MPH and Rita Mangione-Smith, MD, MPH, both of the University of Washington School of Medicine, Seattle; and Glenace Edwall, PsyD, PhD, MPP, Minnesota State Health Access Data Assistance Center.
The study was supported by the Agency for Healthcare Research and Quality and the National Institute for Children’s Health and Human Development.
UCSF Benioff Children’s Hospital creates an environment where children and their families find compassionate care at the forefront of scientific discovery, with more than 150 experts in 50 medical specialties serving patients throughout Northern California and beyond. The hospital admits about 5,000 children each year, including 2,000 babies born in the hospital.

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

Related:

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

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

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