Tag Archives: Science Daily

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

25 Dec

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

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

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

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

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

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

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

Citation

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

Date:       December 21, 2015

Source:   Yale University

Summary:

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

Journal Reference:

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

Here is the press release from Yale:

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

December 21, 2015

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

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

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

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

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

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

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

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

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

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

The program is called “Expect With Me.”

United Health Foundation describes the program:

Expect With Me

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

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

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

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

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

The key is regular prenatal care.

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

Prenatal Care

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

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

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

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

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

Learn more about prenatal and preconception care.

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

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

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

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

Where information leads to Hope. © Dr. Wilda.com

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

20 Dec

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

Definition and Facts for Appendicitis

What is appendicitis?

Appendicitis is inflammation of your appendix.

How common is appendicitis?

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

Who is more likely to develop appendicitis?

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

What are the complications of appendicitis?

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

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

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

Appendicitis can be a serious illness because of the complications.

Seattle Children’s Hospital describes appendicitis symptoms:

Symptoms of Appendicitis

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

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

Your child may also have these symptoms:

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

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

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

Appendicitis Diagnosis

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

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

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

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

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

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

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

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

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

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

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

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

Citation:

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

Date:      December 16, 2015

Source: Nationwide Children’s Hospital

Summary:

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

Journal Reference:

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

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

Jeff Armstrong,

Neil Merritt,

Sarah Jones,

Leslie Scott,

Andreana Bütter

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

Article Info

Publication History

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

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Abstract

Purpose

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

Methods

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

Results

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

Conclusion

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

Key words:

Appendicitis, Non-operative management, Antibiotics

 

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

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

Columbus, OH – 12/16/2015

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

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

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

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

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

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

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

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

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

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

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

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

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

Full citation:

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

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

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

Resources:

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

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

Where information leads to Hope. ©

Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

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

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

Dr. Wilda ©
https://drwilda.com/

 

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

3 Dec

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

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

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

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

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

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

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

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

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

Citation:

Income-based school assignment policy influences diversity, achievement

Date:      November 30, 2015

Source:   Duke University

Summary:

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

Journal Reference:

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

Here is the press release from Duke University:

Mixed Results for Income-based K-12 Assignment

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

November 30, 2015 |

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

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

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

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

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

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

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

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

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

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

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

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

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

—–

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

More Information

Contact: Karen Kemp

Phone: (919) 613-7315

Email: kkemp@duke.edu

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

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

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

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

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

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

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

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

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

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

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

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

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

Where information leads to Hope. © Dr. Wilda.com

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University of Wisconsin School of Medicine and Public Health study: Vitamin D does not reduce colds in asthma patients

26 Nov

The National Heart, Lung, and Blood Institute describe asthma:

What Is Asthma?

Asthma (AZ-ma) is a chronic (long-term) lung disease that inflames and narrows the airways. Asthma causes recurring periods of wheezing (a whistling sound when you breathe), chest tightness, shortness of breath, and coughing. The coughing often occurs at night or early in the morning.

Asthma affects people of all ages, but it most often starts during childhood. In the United States, more than 25 million people are known to have asthma. About 7 million of these people are children.

Overview

To understand asthma, it helps to know how the airways work. The airways are tubes that carry air into and out of your lungs. People who have asthma have inflamed airways. The inflammation makes the airways swollen and very sensitive. The airways tend to react strongly to certain inhaled substances.

When the airways react, the muscles around them tighten. This narrows the airways, causing less air to flow into the lungs. The swelling also can worsen, making the airways even narrower. Cells in the airways might make more mucus than usual. Mucus is a sticky, thick liquid that can further narrow the airways.

This chain reaction can result in asthma symptoms. Symptoms can happen each time the airways are inflamed….                                                                                                                                          http://www.nhlbi.nih.gov/health/health-topics/topics/asthma/

The Centers for Disease Control and Prevention describe how to tell if you have asthma:

How Can You Tell if You Have Asthma?

It can be hard to tell if someone has asthma, especially in children under age 5. Having a doctor check how well your lungs work and check for allergies can help you find out if you have asthma.

During a checkup, the doctor will ask if you cough a lot, especially at night, and whether your breathing problems are worse after physical activity or at certain times of year. The doctor will also ask about chest tightness, wheezing, and colds lasting more than 10 days. They will ask whether anyone in your family has or has had asthma, allergies, or other breathing problems, and they will ask questions about your home. The doctor will also ask if you have missed school or work and about any trouble you may have doing certain things.

The doctor will also do a breathing test, called spirometry, to find out how well your lungs are working. The doctor will use a computer with a mouthpiece to test how much air you can breathe out after taking a very deep breath. The spirometer can measure airflow before and after you use asthma medicine.

What Is an Asthma Attack?

An asthma attack may include coughing, chest tightness, wheezing, and trouble breathing. The attack happens in your body’s airways, which are the paths that carry air to your lungs. As the air moves through your lungs, the airways become smaller, like the branches of a tree are smaller than the tree trunk. During an asthma attack, the sides of the airways in your lungs swell and the airways shrink. Less air gets in and out of your lungs, and mucous that your body makes clogs up the airways even more.

You can control your asthma by knowing the warning signs of an asthma attack, staying away from things that cause an attack, and following your doctor’s advice. When you control your asthma:

  • you won’t have symptoms such as wheezing or coughing,
  • you’ll sleep better,
  • you won’t miss work or school,
  • you can take part in all physical activities, and
  • you won’t have to go to the hospital.

What Causes an Asthma Attack?

An asthma attack can happen when you are exposed to “asthma triggers”. Your triggers can be very different from those of someone else with asthma. Know your triggers and learn how to avoid them. Watch out for an attack when you can’t avoid the triggers. Some of the most common triggers are tobacco smoke, dust mites, outdoor air pollution, cockroach allergen, pets, mold, and smoke from burning wood or grass….                                                                                       http://www.cdc.gov/asthma/faqs.htm

A 2004 study by Bielory and Gandhi, Asthma and vitamin C examined “what role vitamin C may or may not play in the treatment of asthma.” They concluded:

Clearly from our review, the role of vitamin C in asthma and allergy is not well defined. The majority of the studies were short term and assessed immediate effects of vitamin C supplementation. Long term supplementation with vitamin C or delayed effects need to be studied. Although, the current literature does not support a definite indication for the use of vitamin C in asthma and allergy, the promising and positive studies revive curiosity and interest. With a large portion of health care dollars being spent on alternative medicine and vitamin C in particular, further studies are needed to define its role.

http://www.ncbi.nlm.nih.gov/pubmed/8067602

Some feel vitamin therapy is effective in treating asthma. Web MD lists studies in Vitamins & Supplements Search http://www.webmd.com/vitamins-supplements/condition-1007-Asthma.aspx?diseaseid=1007&diseasename=Asthma

Science Daily reported in Vitamin D does not reduce colds in asthma patients:

Vitamin D supplements do not reduce the number or severity of colds in asthma patients, according to a new study published online ahead of print publication in the American Thoracic Society’s American Journal of Respiratory and Critical Care Medicine.

Loren C. Denlinger, MD, PhD, associate professor of medicine at the University of Wisconsin, and colleagues conducted a randomized, controlled trial of adults with mild-to-moderate asthma. Among African Americans in the study, those receiving supplemental vitamin D, rather than a placebo, experienced more colds.

The findings surprised the researchers who had previously published research showing a 40 percent reduction in asthma exacerbations in patients with a vitamin D deficiency who achieved normal levels of the vitamin with supplements. Because colds often trigger exacerbations, they hypothesized that vitamin D supplementation would reduce colds and cold severity.

“Other studies of vitamin D and colds have produced mixed results,” Dr. Denlinger said. “Most of those studies were conducted among healthy patients. We wanted to ask the same question of a patient population in which the impact of a cold carries greater risk.”

The researchers followed asthma patients who were undergoing inhaled corticosteroid (ICS) tapering, Denlinger added, to test the hypothesis that vitamin D might bolster the potency of the ICS.

The multi-center AsthmaNet Vitamin D Add-on Therapy Enhances Corticosteroid Responsiveness (VIDA) trial enrolled 408 adults with mild-to-moderate asthma whose vitamin D levels were insufficient or deficient (25-OH-D3 < 30 ng/mL). Those enrolled had asthma symptoms despite low-dose ICS therapy. The patients were randomized to receive either vitamin D supplementation (100,000 IU once, then 4000 IU daily) or placebo for 28 weeks. Neither the patients nor their physicians knew whether they received vitamin D or the placebo.

During that time, about half the participants experienced at least one cold. The severity of their colds was measured by the Wisconsin Upper Respiratory Symptom Survey-21 (WURSS-21).

The researchers analyzed separately the results of the 82 percent of participants receiving supplements who achieved vitamin D sufficiency within 12 weeks. Achieving sufficiency made no difference in number of colds or their severity this group experienced.

The researchers wrote that one possible explanation for the unexpected finding: asthma patients with low vitamin D levels may be more likely to experience upper respiratory infections asymptomatically than those with normal levels of vitamin D, which is known to trigger an inflammatory response. This inflammatory response may, in turn, reduce the risk of lower airway infections, which are triggers for asthma exacerbations……                                                                     http://www.sciencedaily.com/releases/2015/11/151123103632.htm

Citation:

Vitamin D does not reduce colds in asthma patients

Date:         November 23, 2015

 

Source:     American Thoracic Society (ATS)

 

Summary:

Vitamin D supplements do not reduce the number or severity of colds in asthma patients, according to a new study. The findings surprised the researchers who had previously published research showing a 40 percent reduction in asthma exacerbations in patients with a vitamin D deficiency who achieved normal levels of the vitamin with supplements. Because colds often trigger exacerbations, they hypothesized that vitamin D supplementation would reduce colds and cold severity.

Journal Reference:

  1. Loren C. Denlinger, Tonya S King, Juan Carlos Cardet, Timothy Craig, Fernando Holguin, Daniel J Jackson, Monica Kraft, Stephen P Peters, Kristie Ross, Kaharu Sumino, Homer A. Boushey, Nizar N. Jarjour, Michael E Wechsler, Sally E. Wenzel, Mario Castro, Pedro C. Avila. Vitamin D Supplementation and the Risk of Colds in Patients with Asthma. American Journal of Respiratory and Critical Care Medicine, 2015; DOI: 10.1164/rccm.201506-1169OC

Send to:

Am J Respir Crit Care Med. 2015 Nov 5. [Epub ahead of print]

Vitamin D Supplementation and the Risk of Colds in Patients with Asthma.

Denlinger LC1, King TS2, Cardet JC3, Craig T4, Holguin F5, Jackson DJ6, Kraft M7, Peters SP8, Ross K9, Sumino K10, Boushey HA11, Jarjour NN12, Wechsler ME13, Wenzel SE14, Castro M15, Avila PC16; National Heart Lung and Blood Institute AsthmaNet Investigators.

Author information

Abstract

BACKGROUND:

Restoration of vitamin D sufficiency may reduce asthma exacerbations, events often associated with respiratory tract infections (RTIs) and cold symptoms.

OBJECTIVE:

To determine whether vitamin D supplementation reduces cold symptom occurrence and severity in adults with mild to moderate asthma and vitamin D insufficiency.

METHODS:

Colds were assessed in the AsthmaNet Vitamin D Add-on Therapy Enhances Corticosteroid Responsiveness (VIDA) trial, which randomized 408 adult patients to receive placebo or cholecalciferol (100,000 IU load plus 4,000 IU/day) for 28 weeks as add-on therapy. The primary outcome assessed cold symptom severity using daily Wisconsin Upper Respiratory Symptom Survey (WURSS)-21 scores.

RESULTS:

203 participants experienced at least one cold. Despite achieving 25-hydroxyvitamin D levels of 41.9 ng/mL (95%CI, 40.1-43.7 ng/mL) by 12 weeks, vitamin D supplementation had no effect on the primary outcome, the average peak WURSS-21 scores [62.0 (95% CI 55.1-68.9; placebo) and 58.7 (95% CI 52.4-65.0; vitamin D), p = 0.39]. The rate of colds did not differ between groups (rate ratio [RR] 1.2, 95% CI 0.9 to 1.5); however, among African-Americans those receiving vitamin D vs. placebo had an increased rate of colds (RR 1.7, 95% CI 1.1-2.7, p = 0.02). This was also observed in a responder analysis of all subjects achieving vitamin D sufficiency regardless of treatment assignment (RR 1.4, 95% CI 1.1-1.7, p = 0.009).

CONCLUSION:

In patients with mild-to-moderate asthma undergoing an ICS dose-reduction, these results do not support the use of vitamin D supplementation for the purpose of reducing cold severity or frequency. Clinical trial registration available at http://www.clinicaltrials.gov, ID NCT01248065.

KEYWORDS:

WURSS-21; asthma; upper respiratory tract infection; vitamin D

PMID:

26540136

[PubMed – as supplied by publisher]                                                                                                               http://www.ncbi.nlm.nih.gov/pubmed/26540136

The American Academy of Allergy, Asthma & Immunology (AAAAI) provides the following advice:

People with a family history of allergies or asthma are more prone to developing asthma. Many people with asthma also have allergies. This is called allergic asthma.
Occupational asthma is caused by inhaling fumes, gases, dust or other potentially harmful substances while on the job.

Childhood asthma impacts millions of children and their families. In fact, the majority of children who develop asthma do so before the age of five.

There is no cure for asthma, but once it is properly diagnosed and a treatment plan is in place you will be able to manage your condition, and your quality of life will improve.

An allergist / immunologist is the best qualified physician in diagnosing and treating asthma. With the help of your allergist, you can take control of your condition and participate in normal activities.

Keep pace with the latest information and connect with others. Join us on Facebook and Twitter.

http://www.aaaai.org/conditions-and-treatments/asthma.aspx

It is imperative to seek competent medical advice regarding individual treatment options.

Resources:

Asthma.com

http://www.asthma.com/additional-resources.html

Asthma Health Center

http://www.webmd.com/asthma/guide/asthma-support-resources

Asthma Resources

http://www.webmd.com/asthma/asthma-resources

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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Weizmann Institute of Science study: ‘Healthy’ foods differ by individual

22 Nov

Patti Neighmond reported in the NPR story, It Takes More Than A Produce Aisle To Refresh A Food Desert http://www.npr.org/blogs/thesalt/2014/02/10/273046077/takes-more-than-a-produce-aisle-to-refresh-a-food-desert In other words, much of the obesity problem is due to personal life style choices and the question is whether government can or should regulate those choices. The issue is helping folk to want to make healthier food choices even on a food stamp budget. See, Cheap Eats: Cookbook Shows How To Eat Well On A Food Stamp Budget http://www.npr.org/blogs/thesalt/2014/08/01/337141837/cheap-eats-cookbook-shows-how-to-eat-well-on-a-food-stamp-budget A University of Buffalo study reported that what a baby eats depends on the social class of the mother.

Roberto A. Ferdman of the Washington Post wrote in the article, The stark difference between what poor babies and rich babies eat:

The difference between what the rich and poor eat in America begins long before a baby can walk, or even crawl.
A team of researchers at the University at Buffalo School of Medicine and Biomedical Sciences found considerable differences in the solid foods babies from different socioeconomic classes were being fed. Specifically, diets high in sugar and fat were found to be associated with less educated mothers and poorer households, while diets that more closely followed infant feeding guidelines were linked to higher education and bigger bank accounts.

“We found that differences in dietary habits start very early,” said Xiaozhong Wen, the study’s lead author.
The researchers used data from the Infant Feeding Practices study, an in depth look at baby eating habits, which tracked the diets of more than 1,500 infants up until age one, and documented which of 18 different food types—including breast milk, formula, cow’s milk, other milk (like soy milk), other dairy foods (like yogurt), other soy foods (like tofu), 100 percent fruit or vegetable juice, and sweet drinks, among others – their mothers fed them. Wen’s team at the University at Buffalo focused on what the infants ate over the course of a week at both 6- and 12-months old.

In many cases, infants were fed foods that would surprise even the least stringent of mothers. Candy, ice cream, soda, and french fries, for instance, were among the foods some of the babies were being fed. Researchers divided the 18 different food types into four distinct categories, two of which were ideal for infant consumption—”formula” and “infant guideline solids”—two of which were not—”high/sugar/fat/protein” and “high/regular cereal.” It became clear which babies tended to be fed appropriately, and which did not….
http://www.washingtonpost.com/blogs/wonkblog/wp/2014/11/04/the-stark-difference-between-what-poor-babies-and-rich-babies-eat/

Science Daily reported in What do American babies eat? A lot depends on Mom’s socioeconomic background:

Dietary patterns of babies vary according to the racial, ethnic and educational backgrounds of their mothers, pediatrics researchers have found. For example, babies whose diet included more breastfeeding and solid foods that adhere to infant guidelines from international and pediatric organizations were associated with higher household income — generally above $60,000 per year — and mothers with higher educational levels ranging from some college to post-graduate education. http://www.sciencedaily.com/releases/2014/10/141030133532.htm

Cutting sugar in a child’s diet is important to improving the child’s health.

Science Daily reported in ‘Healthy’ foods differ by individual:

Ever wonder why that diet didn’t work? An Israeli study tracking the blood sugar levels of 800 people over a week suggests that even if we all ate the same meal, how it’s metabolized would differ from one person to another. The findings, published November 19 in Cell, demonstrate the power of personalized nutrition in helping people identify which foods can help or hinder their health goals.

Blood sugar has a close association with health problems such as diabetes and obesity, and it’s easy to measure using a continuous glucose monitor. A standard developed decades ago, called the glycemic index (GI), is used to rank foods based on how they affect blood sugar level and is a factor used by doctors and nutritionists to develop healthy diets. However, this system was based on studies that average how small groups of people responded to various foods.

The new study, led by Eran Segal and Eran Elinav of the Weizmann Institute of Science in Israel, found that the GI of any given food is not a set value, but depends on the individual. For all participants, they collected data through health questionnaires, body measurements, blood tests, glucose monitoring, stool samples, and a mobile-app used to report lifestyle and food intake (a total of 46,898 meals were measured). In addition, the volunteers received a few standardized/identical meals for their breakfasts.

As expected, age and body mass index (BMI) were found to be associated with blood glucose levels after meals. However, the data also revealed that different people show vastly different responses to the same food, even though their individual responses did not change from one day to another.

“Most dietary recommendations that one can think of are based on one of these grading systems; however, what people didn’t highlight, or maybe they didn’t fully appreciate, is that there are profound differences between individuals–in some cases, individuals have opposite response to one another, and this is really a big hole in the literature,” says Segal, of Weizmann’s Department of Computer Science and Applied Math….                                                                                               http://www.sciencedaily.com/releases/2015/11/151119133230.htm

Citation:

‘Healthy’ foods differ by individual

Date:           November 19, 2015

 

Source:       Cell Press

 

Summary:

Ever wonder why that diet didn’t work? An new study tracking the blood sugar levels of 800 people over a week suggests that even if we all ate the same meal, how it’s metabolized would differ from one person to another. The findings demonstrate the power of personalized nutrition in helping people identify which foods can help or hinder their health goals.

Journal Reference:

  1. David Zeevi, Tal Korem, Niv Zmora, David Israeli, Daphna Rothschild, Adina Weinberger, Orly Ben-Yacov, Dar Lador, Tali Avnit-Sagi, Maya Lotan-Pompan, Jotham Suez, Jemal Ali Mahdi, Elad Matot, Gal Malka, Noa Kosower, Michal Rein, Gili Zilberman-Schapira, Lenka Dohnalová, Meirav Pevsner-Fischer, Rony Bikovsky, Zamir Halpern, Eran Elinav, Eran Segal. Personalized Nutrition by Prediction of Glycemic Responses. Cell, 2015; 163 (5): 1079 DOI: 10.1016/j.cell.2015.11.001

Here is the press release from the Weizmann Institute of Science:

Blood Sugar Levels in Response to Foods Are Highly Individual

19 Nov
2015

Biomedical Biology

The largest study of its kind supports the need for personalized dietary recommendations

Embargoed until 12:00 PM Eastern time, US, November 19, 2015

Which is more likely to raise blood sugar levels: sushi or ice cream? According to a Weizmann Institute study reported in the November 19 issue of the journal Cell, the answer varies from one person to another. The study, which continuously monitored blood sugar levels in 800 people for a week, revealed that the bodily response to all foods was highly individual.

The study, called the Personalized Nutrition Project (www.personalnutrition.org), was conducted by the groups of Prof. Eran Segal of the Computer Science and Applied Mathematics Department and Dr. Eran Elinav of the Immunology Department. Segal said: “We chose to focus on blood sugar because elevated levels are a major risk factor for diabetes, obesity and metabolic syndrome. The huge differences that we found in the rise of blood sugar levels among different people who consumed identical meals highlights why personalized eating choices are more likely to help people stay healthy than universal dietary advice.”

Indeed, the scientists found that different people responded very differently to both simple and to complex meals. For example, a large number of the participants’ blood sugar levels rose sharply after they consumed a standardized glucose meal, but in many others, blood glucose levels rose sharply after they ate white bread, but not after glucose. Elinav: “Our aim in this study was to find factors that underlie personalized blood glucose responses to food. We used that information to develop personal dietary recommendations that can help prevent and treat obesity and diabetes, which are among the most severe epidemics in human history.”

David Zeevi and Tal Korem, PhD students in Segal’s lab, led the study. They collaborated with Dr. Niv Zmora, a physician conducting PhD studies in Elinav’s lab, and with PhD student Daphna Rothschild and research associate Dr. Adina Weinberger from Segal’s lab. The study was unique in its scale and in the inclusion of the analysis of gut microbes, collectively known as the microbiome, which had recently been shown to play an important role in human health and disease. Study participants were outfitted with small monitors that continuously measured their blood sugar levels. They were asked to record everything they ate, as well as such lifestyle factors as sleep and physical activity. Overall, the researchers assessed the response of different people to more than 46,000 meals.

Strikingly different responses to identical foods. In study participant 445 (top), blood sugar levels rose sharply after eating bananas but not after cookies of the same amount of calories. The opposite occurred in participant 644 (bottom)

Taking these multiple factors into account, the scientists generated an algorithm for predicting individualized response to food based on the person’s lifestyle, medical background, and the composition and function of his or her microbiome. In a follow-up study of another 100 volunteers, the algorithm successfully predicted the rise in blood sugar in response to different foods, demonstrating that it could be applied to new participants. The scientists were able to show that lifestyle also mattered. The same food affected blood sugar levels differently in the same person, depending, for example, on whether its consumption had been preceded by exercise or sleep.

In the final stage of the study, the scientists designed a dietary intervention based on their algorithm; this was a test of their ability to prescribe personal dietary recommendations for lowering blood glucose level responses to food. Volunteers were assigned a personalized “good” diet for one week, and a “bad” diet – also personalized – for another. Both good and bad diets were designed to have the same number of calories, but they differed between participants. Thus, certain foods in one person’s “good” diet were part of another’s “bad” diet. The “good” diets indeed helped to keep blood sugar at steadily healthy levels, whereas the “bad” diets often induced spikes in glucose levels —all within just one week of intervention. Moreover, as a result of the “good” diets, the volunteers experienced consistent changes in the composition of their gut microbes, suggesting that the microbiome may be influenced by the personalized diets while also playing a role in participants’ blood sugar responses.

The scientists are currently enrolling Israeli volunteers for a longer-term follow-up dietary intervention study that will focus on people with consistently high blood sugar levels, who are at risk of developing diabetes, with the aim of preventing or delaying this disease. To learn more, please visit http://www.personalnutrition.org.

Also participating in this research were Orly Ben-Yacov, Dar Lador, Dr. Tali Avnit-Sagi, Dr. Maya Lotan-Pompan, Elad Matot, Gal Malka, Noa Kosower, Michal Rein and Rony Bikovsky in Segal’s lab; Jotham Suez, Jemal Ali Mahdi, Gili Zilberman-Schapira, Lenka Dohnalova and Dr. Meirav Pevsner-Fischer in Elinav’s lab; Dr. David Israeli of the Jerusalem Center for Mental Health; and Prof. Zamir Halpern of the Tel Aviv Sourasky Medical Center.

Prof. Eran Segal’s research is supported by the Crown Human Genome Center, which he heads; the Adelis Foundation; the European Research Council; Mr. and Mrs. Donald L. Schwarz, Sherman Oaks, CA; Leesa Steinberg, Canada; and Jack N. Halpern, New York, NY.

Dr. Eran Elinav’s research is supported by the Abisch Frenkel Foundation for the Promotion of Life Sciences; the Gurwin Family Fund for Scientific Research; the Leona M. and Harry B. Helmsley Charitable Trust; the Crown Endowment Fund for Immunological Research; the Adelis Foundation; the Rising Tide Foundation; the Vera Rosenberg Schwartz Research Fellow Chair; Yael and Rami Ungar, Israel; John L. and Vera Schwartz, Pacific Palisades, CA; Alan Markovitz, Canada; Leesa Steinberg, Canada; Andrew and Cynthia Adelson, Canada; the estate of Jack Gitlitz; the estate of Lydia Hershkovich; Mr. and Mrs. Donald L. Schwarz, Sherman Oaks, CA; Jack N. Halpern, New York, NY; and Aaron Edelheit, Boca Raton, FL. Dr. Elinav is the Incumbent of the Rina Gudinski Career Development Chair.

http://wis-wander.weizmann.ac.il/blood-sugar-levels-in-response-to-foods-are-highly-individual#.VlI4gl4i1dh

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

Related:

Dr. Wilda Reviews Book: ‘Super Baby Food’ http://drwildareviews.wordpress.com/2013/09/11/dr-wilda-reviews-book-super-baby-food/

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

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 ©
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Cardiff University study: Significant positive associations between breakfast consumption, educational outcomes

17 Nov

The first thing I do when I get up, I have breakfast.

Karl Lagerfeld

Everyone from Mom to Grandma talks about the importance of breakfast. Nutrition provides the fuel for children to be ready to learn. Erica Lesperance, RD, LD of the Diet Channel wrote in 5 Important Reasons Your Child Should Eat Breakfast:

Benefits of breakfast

The following are key reasons why breakfast should be made a priority for every child:

Breakfast equals better behavior

Children who skip breakfast are more tired, irritable, or restless by late morning. These symptoms lead to aggressive behavior that causes children to get in trouble in school. Children who regularly eat a morning meal have more energy, are less likely to exhibit aggressive behavior, and have a better attitude toward school.

Breakfast leads to higher test scores

A study published in 1998 in the Archives of Pediatrics and Adolescent Medicine showed significantly higher math test scores after children ate breakfast. This and other research has clearly shown that children who consistently eat breakfast test higher in most academic areas. (See also Brain Food for Kids.)

Eating breakfast led to better class attendance

Children who eat breakfast are absent from school fewer days. They also spend less time in the nurse’s office complaining of stomach pains. Ironic as it may be, children who claim they don’t eat breakfast due to a lack of time in the morning are tardy more often than those who take time for a morning meal.

More nutritious intake by eating breakfast

Breakfast eaters generally meet vitamin and mineral requirements for prevention of deficiencies. They consume more fiber, vitamin C, calcium and folic acid. Unfortunately, children who miss breakfast do not make up for lost nutrients later in the day.

Eating breakfast helps weight control

Eating breakfast helps to establish a normal eating pattern. Eating regular meals and snacks is a key to maintaining a healthy weight throughout life. Increasing childhood obesity is in part attributed to the disappearance of normal eating patterns in many of today’s households.

Why do some children still resist breakfast?

Given the abundance of compelling information on the benefits of breakfast consumption, why does one out of eight school children start the day without eating breakfast? Some are not encouraged to do so by their parents, while others make arguments for avoiding breakfast. Some common arguments are lack of time, absence of hunger, and distaste for breakfast foods. No matter what the barrier, parents can and should find a way around them.

Creating healthy habits in your children

Here are some tips for parents on incorporating breakfast into their children’s before-school routines:

  • Prepare for school the night before by preparing the next day’s clothes, lunch and backpack.
  • Set the alarm for 15 minutes earlier to allow more time for breakfast.
  • Say no to TV, video games and computers in the morning.
  • Choose foods that require little preparation such as fresh and canned fruits, milk, yogurt, cheese, cottage cheese, hard-boiled eggs, whole grain cereals or instant oatmeal.
  • Eat on the run with celery stuffed with peanut butter or cream cheese, dried fruits, string cheese, juice boxes, milk cartons, or breakfast bars.
  • For those with little hunger in the morning, offer juice, milk or a fruit smoothie made with skim milk and fruit.
  • For those who dislike breakfast foods, offer something non-traditional like cold pizza or leftover chicken.

Set a good example to your children: eat breakfast yourself….                                                                       http://www.thedietchannel.com/5-Important-Reasons-Your-Child-Should-Eat-Breakfast.htm

A Cardiff University study links breakfast consumption to education outcomes.

Science Daily reported in Study provides strongest evidence yet of a link between breakfast quality and educational outcomes:

A direct and positive link between pupils’ breakfast quality and consumption, and their educational attainment, has for the first time been demonstrated in a ground-breaking new study carried out by public health experts at Cardiff University.

The study of 5000 9-11 year-olds from more than 100 primary schools sought to examine the link between breakfast consumption and quality and subsequent attainment in Key Stage 2 Teacher Assessments 6-18 months later.

The study — thought to be the largest to date looking at longitudinal effects on standardised school performance — found that children who ate breakfast, and who ate a better quality breakfast, achieved higher academic outcomes.

The research found that the odds of achieving an above average educational performance were up to twice as high for pupils who ate breakfast, compared with those who did not.

Eating unhealthy items like sweets and crisps for breakfast, which was reported by 1 in 5 children, had no positive impact on educational attainment.

Pupils were asked to list all food and drink consumed over a period of just over 24 hours (including two breakfasts), noting what they consumed at specific times throughout the previous day and for breakfast on the day of reporting.

Alongside number of healthy breakfast items consumed for breakfast, other dietary behaviours — including number of sweets and crisps and fruit and vegetable portions consumed throughout the rest of the day — were all significantly and positively associated with educational performance.

Social scientists say the research, published in the Public Health Nutrition journal, offers the strongest evidence yet of a meaningful link between dietary behaviours and concrete measures of academic attainment….                                                                                                                               http://www.sciencedaily.com/releases/2015/11/151116212635.htm?utm_source=dlvr.it&utm_medium=facebook

Citation:

Study provides strongest evidence yet of a link between breakfast quality and educational outcomes

New study of 5,000 9- to 11-year-olds demonstrates significant positive associations between breakfast consumption, educational outcomes

Date:       November 16, 2015

Source:   Cardiff University

Summary:

A new study of 5,000 9- to 11-year-olds demonstrates significant positive associations between breakfast consumption and educational outcomes.The research found that the odds of an above average Teacher Assessment score were up to twice as high for pupils who ate breakfast, compared with those who did not.

Journal Reference:

  1. Hannah J Littlecott, Graham F Moore, Laurence Moore, Ronan A Lyons, Simon Murphy. Association between breakfast consumption and educational outcomes in 9–11-year-old children. Public Health Nutrition, 2015; 1 DOI: 10.1017/S1368980015002669

Here is the press release from Cardiff University:

Good breakfast, good grades?

17 November 2015

A direct and positive link between pupils’ breakfast quality and consumption, and their educational attainment, has for the first time been demonstrated in a ground-breaking new study carried out by public health experts at Cardiff University.

The study of 5000 9-11 year-olds from more than 100 primary schools sought to examine the link between breakfast consumption and quality and subsequent attainment in Key Stage 2 Teacher Assessments* 6-18 months later.

The study – thought to be the largest to date looking at longitudinal effects on standardised school performance – found thatchildren who ate breakfast, and who ate a better quality breakfast, achieved higher academic outcomes.

The research found that the odds of achieving an above average educational performance were up to twice as high for pupils who ate breakfast, compared with those who did not.

Eating unhealthy items like sweets and crisps for breakfast, which was reported by 1 in 5 children, had no positive impact on educational attainment.

Pupils were asked to list all food and drink consumed over a period of just over 24 hours (including two breakfasts), noting what they consumed at specific times throughout the previous day and for breakfast on the day of reporting.

Alongside number of healthy breakfast items consumed for breakfast, other dietary behaviours – including number of sweets and crisps and fruit and vegetable portions consumed throughout the rest of the day – were all significantly and positively associated with educational performance.

Social scientists say the research, published in the Public Health Nutrition journal, offers the strongest evidence yet of a meaningful link between dietary behaviours and concrete measures of academic attainment.

Hannah Littlecott from Cardiff University’s Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPher), lead author of the study, said: “While breakfast consumption has been consistently associated with general health outcomes and acute measures of concentration and cognitive function, evidence regarding links to concrete educational outcomes has until now been unclear.

“This study therefore offers the strongest evidence yet of links between aspects of what pupils eat and how well they do at school, which has significant implications for education and public health policy – pertinent in light of rumours that free school meals may be scrapped following George Osborne’s November spending review.

“For schools, dedicating time and resource towards improving child health can be seen as an unwelcome diversion from their core business of educating pupils, in part due to pressures that place the focus on solely driving up educational attainment.

“But this resistance to delivery of health improvement interventions overlooks the clear synergy between health and education. Clearly, embedding health improvements into the core business of the school might also deliver educational improvements as well.”

Professor Chris Bonell, Professor of Sociology and Social Policy at the University College London Institute of Education, welcomed the study’s findings. He said: “This study adds to a growing body of international evidence indicating that investing resources in effective interventions to improve young people’s health is also likely to improve their educational performance. This further emphasises the need for schools to focus on the health and education of their pupils as complementary, rather than as competing priorities. Many schools throughout the UK now offer their pupils a breakfast. Ensuring that those young people most in need benefit from these schemes may represent an important mechanism for boosting the educational performance of young people throughout the UK”.

Dr Graham Moore, who also co-authored the report, added: “Most primary schools in Wales are now able to offer a free school breakfast, funded by Welsh Government. Our earlier papers from the trial of this scheme showed that it was effective in improving the quality of children’s breakfasts, although there is less clear evidence of its role in reducing breakfast skipping.

“Linking our data to real world educational performance data has allowed us to provide robust evidence of a link between eating breakfast and doing well at school. There is therefore good reason to believe that where schools are able to find ways of encouraging those young people who don’t eat breakfast at home to eat a school breakfast, they will reap significant educational benefits.”                                                                  http://www.cardiff.ac.uk/news/view/162112-good-breakfast,-good-grades?utm_source=cu-home&utm_medium=News_Feed&utm_campaign=news

Nutrition is one part of ensuring a child is ready to learn. See, Getting Young Children Ready to Learn http://www.classbrain.com/artread/publish/article_37.shtml   Education is a partnership between the student, the teacher(s) and parent(s). All parties in the partnership must share the load. The student has to arrive at school ready to learn. The parent has to set boundaries, encourage, and provide support. Teachers must be knowledgeable in their subject area and proficient in transmitting that knowledge to students. All must participate and fulfill their role in the education process.

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

Resources:

Importance of Breakfast

http://www.healthykids.nsw.gov.au/parents-carers/healthy-eating-and-drinking/importance-of-breakfast.aspx

Why is breakfast important for kids?                                                                                             http://sg.theasianparent.com/breakfast-for-kids-why-is-it-important/

Where information leads to Hope. ©

Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

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

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http://drwildareviews.wordpress.com/

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University of California Irvine study: One-step test for hepatitis C virus infection developed

16 Nov

The National Medical Association which an association of doctors of African descent reports the following hepatitis C facts:

Hepatitis C Statistics

General Statistics
• Hepatitis C virus commonly spread through sharing of needles, or other equipment to inject drugs. 1
• Risk of transmission occurs more if the person has a pre-existing virus such as HIV. 1
• 3.2 million persons in the United States have chronic Hepatitis C virus infection. 1
• Approximately 75%-85% of people infected with Hepatitis C virus develop chronic infection. 1
• After exposure, average time of symptoms is 6-7 weeks; however, most do not have any symptoms. 1
• Approximately 70-80% of people with acute Hepatitis C do not have symptoms. 1
• Of every 100 people infected with Hepatitis C about: 1
• 75-85 people will develop chronic Hepatitis C Virus infection; of those
o 60-70 people will go on to develop chronic liver disease
o 5-20 people will go on to develop cirrhosis over a period of 20-30 years
o 1-5 people will die from cirrhosis or liver failure.

African American Hepatitis C Statistics
• African American represents 13% of the U.S population, but make up about 22% of the chronic hepatitis C cases.1
• African Americans have significantly higher rates of chronic hepatitis C infections than do Caucasians and other ethnic groups. 1
• 4 of every 100 infant born to mothers with Hepatitis C become infected with the virus. 1
• Chronic liver disease, often Hepatitis C-related is the leading cause of death among people ages 45-64 among African Americans. 1
• Lack of testing for Hepatitis C among African Americans. 1
• There is no vaccine for Hepatitis C. 1
• 26 Americans die each day from Hepatitis C complications. 2
• Each year approximately 170,000 new cases of HCV occur in the United States of America. 2
Source: Centers for Disease Control and Prevention – http://www.cdc.gov/hepatitis/AfricanAmerica-HepC.htm

Hepatitis C Now Trumps HIV as Cause of Death in U.S.

More U.S. residents are now dying of hepatitis C complications than HIV-related illnesses, according to data summarized in the February 21 issue of Annals of Internal Medicine.
• The discovery that HCV infection is now responsible for more deaths than HIV infection is due, in large part, to the continued decline of AIDS-related deaths over the decade. Whereas HIV contributed to six per 100,000 deaths in 1999, the rate dropped to less than four per 100,000 deaths in 2007.
• Hepatitis C–related deaths have increased sharply.
• With respect to crude numbers, roughly 12,700 HIV-related deaths were reported to the National Center for Health Statistics in 2007. More than 15,000 HCV-related deaths were reported to the center that year.
• Co-infection with HIV nearly doubled the risk of death from HBV-related complications and quadrupled the risk of death from HCV-associated liver disease.
Source: Hep Smart + Strong – http://www.hepmag.com/articles/hiv_hcv_deaths_2501_21929.shtmlhttp://www.nmanet.org/index.php?option=com_content&view=article&id=291&Itemid=420

The World Health Organization (WHO) has a concise description of hepatitis C.

According to WHO:

Key facts

• Hepatitis C is a liver disease caused by the hepatitis C virus: the virus can cause both acute and chronic hepatitis infection, ranging in severity from a mild illness lasting a few weeks to a serious, lifelong illness.
• The hepatitis C virus is a bloodborne virus and the most common modes of infection are through unsafe injection practices; inadequate sterilization of medical equipment; and the transfusion of unscreened blood and blood products.
• 130–150 million people globally have chronic hepatitis C infection.
• A significant number of those who are chronically infected will develop liver cirrhosis or liver cancer.
• Approximately 500 000 people die each year from hepatitis C-related liver diseases1.
• Antiviral medicines can cure approximately 90% of persons with hepatitis C infection, thereby reducing the risk of death from liver cancer and cirrhosis, but access to diagnosis and treatment is low.
• There is currently no vaccine for hepatitis C; however research in this area is ongoing.
________________________________________
Hepatitis C virus (HCV) causes both acute and chronic infection. Acute HCV infection is usually asymptomatic, and is only very rarely associated with life-threatening disease. About 15–45% of infected persons spontaneously clear the virus within 6 months of infection without any treatment.
The remaining 55–85% of persons will develop chronic HCV infection. Of those with chronic HCV infection, the risk of cirrhosis of the liver is 15–30% within 20 years.

Geographical distribution
Hepatitis C is found worldwide. The most affected regions are Africa and Central and East Asia. Depending on the country, hepatitis C infection can be concentrated in certain populations (for example, among people who inject drugs); and/or in general populations. There are multiple strains (or genotypes) of the HCV virus and their distribution varies by region.

Transmission
The hepatitis C virus is a bloodborne virus. It is most commonly transmitted through:
• injecting drug use through the sharing of injection equipment;
• in health care settings due to the reuse or inadequate sterilization of medical equipment, especially syringes and needles;
• the transfusion of unscreened blood and blood products;
• HCV can also be transmitted sexually and can be passed from an infected mother to her baby; however these modes of transmission are much less common.
Hepatitis C is not spread through breast milk, food or water or by casual contact such as hugging, kissing and sharing food or drinks with an infected person.

Symptoms
The incubation period for hepatitis C is 2 weeks to 6 months. Following initial infection, approximately 80% of people do not exhibit any symptoms. Those who are acutely symptomatic may exhibit fever, fatigue, decreased appetite, nausea, vomiting, abdominal pain, dark urine, grey-coloured faeces, joint pain and jaundice (yellowing of skin and the whites of the eyes)…. http://www.who.int/mediacentre/factsheets/fs164/en/

A 2007 study, The costs and impacts of testing for hepatitis C virus antibody in public STD clinics estimated the test costs:

Abstract

OBJECTIVES:
To estimate the cost and cost-effectiveness of testing sexually transmitted disease (STD) clinic subgroups for antibodies to hepatitis C virus (HCV).

METHODS:
HCV counseling, testing, and referral (CTR) costs were estimated using data from two STD clinics and the literature, and are reported in 2006 dollars. Effectiveness of HCV CTR was defined as the estimated percentage of clinic clients in subgroups targeted for HCV antibody (anti-HCV) testing who had a true positive test and returned for their test results. We estimated the cost per true positive injection drug user (IDU) who returned for anti-HCV test results and the cost-effectiveness of expanding HCV CTR to non-IDU subgroups.

RESULTS:
The estimated cost per true positive IDU who returned for test results was $54. The cost-effectiveness of expanding HCV CTR to non-IDU subgroups ranged from $179 to $2,986. Our estimates were most sensitive to variations in HCV prevalence, the cost of testing, and the rate of client return.

CONCLUSIONS:
Based on national data, testing IDUs in the STD clinic setting is highly cost-effective. Some clinics may find that it is cost-effective to expand testing to non-IDU men older than 40 who report more than 100 lifetime sex partners. STD clinics can use study estimates to assess the feasibility and desirability of expanding HCV CTR beyond IDUs. http://www.ncbi.nlm.nih.gov/pubmed/17542455

University of California Irvine researchers may have developed a cheaper test.

Science Daily reported in One-step test for hepatitis C virus infection developed:
Related research shows blood or urine sample can be used:

UC Irvine Health researchers have developed a cost-effective one-step test that screens, detects and confirms hepatitis C virus (HCV) infections. Dr. Ke-Qin Hu, director of hepatology services, will present findings at the Annual Meeting of American Association for the Study of Liver Disease (AASLD) in San Francisco, Nov. 14-16. Current blood-based HCV testing requires two steps and can be expensive, inconvenient and is not widely available or affordable globally…. http://www.sciencedaily.com/releases/2015/11/151114185041.htm

Citation:

One-step test for hepatitis C virus infection developed
Related research shows blood or urine sample can be used
Date: November 14, 2015

Source: University of California – Irvine

Summary:
A cost-effective one-step test that screens, detects and confirms hepatitis C virus (HCV) infections has been developed by researchers. Current blood-based HCV testing requires two steps and can be expensive, inconvenient and is not widely available or affordable globally.

Medical Press reported the following information from the University of California Irvine:

One-step test for hepatitis C virus infection developed
November 14, 2015

UC Irvine Health researchers have developed a cost-effective one-step test that screens, detects and confirms hepatitis C virus (HCV) infections. Dr. Ke-Qin Hu, director of hepatology services, will present findings at the Annual Meeting of American Association for the Study of Liver Disease (AASLD) in San Francisco, Nov. 14-16. Current blood-based HCV testing requires two steps and can be expensive, inconvenient and is not widely available or affordable globally.

“Our novel HCV antigen test system has significantly improved sensitivity and specificity over current tests. Importantly, for the first time, we can use urine specimens for one-step screening and diagnosing of HCV infection,” said Hu, professor of gastroenterology and hepatology at UC Irvine School of Medicine. “Finding a more convenient, easy-to-use and cost-effective screening alternative is imperative, because HCV is significantly under-screened and under-diagnosed.”

Although the current HCV screening test is specific and sensitive, it cannot distinguish active infection from a previous infection. A blood sample is required, and two steps are required. First, virus-specific antibodies must be detected in the blood. Then, the sensitive HCV RNA PCR test must be administered to confirm whether or not the infection is active. Hu said many developing countries are not equipped to administer the two-step test, especially the HCV RNA PCR test. In the U.S., its cost is above $200. The novel HCV antigen test system developed by Hu’s UC Irvine lab could significantly reduce the cost, human resources and time required for the test results.

“The ability to detect infection using urine rather than blood avoids needle stick and blood sample collection, greatly reduces the cost and necessary clinical infrastructure for screening and diagnosis, helping to promote widespread adoption of the test on a global scale,” Hu said.

According to the Centers for Disease Control and Prevention, approximately 150 million people worldwide and 3.2 million people in the U.S. are infected with HCV. Effective screening and fast diagnosis are critical for treatment and controlling transmission.

“Those who are HCV infected can now be cured, before a further liver injury and complications develop, but only if they are diagnosed” Hu said.

People with an HCV infection do not usually experience symptoms until more serious liver injury develops, such as fibrosis, cirrhosis, or liver cancer. The CDC recommends screening tests for high-risk patients, including intravenous drug users, and individuals who had blood transfusions before 1992, as well as those born between 1945 and 1965.
In addition to Hu, researcher Wei Cui is also listed as an author of the AASLD abstract entitled A Highly Specific and Sensitive Hepatitis C Virus Angtigens Enzyme Immunoassay (HCV-Ags EIA) for One-step Diagnosis of Viremic HCV Infection.
Explore further: Only half newly reported HCV cases receiving follow-up test

Provided by: University of California, Irvine
http://medicalxpress.com/news/2015-11-one-step-hepatitis-virus-infection.html

A cheaper and simpler hepatitis C test could save lives as more of those at risk can be tested.

Resources:

Viral Hepatitis – Statistics & Surveillance

http://www.cdc.gov/hepatitis/Statistics/index.htm

Frequently Asked Questions About Hepatitis C

http://www.cpmc.org/learning/documents/hepatitisc-ws.html

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University of Georgia study: Kitchen utensils can spread bacteria between foods

12 Nov

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.

Science Daily reported in Kitchen utensils can spread bacteria between foods:

In a recent study funded by the U.S. Food and Drug Administration, University of Georgia researchers found that produce that contained bacteria would contaminate other produce items through the continued use of knives or graters–the bacteria would latch on to the utensils commonly found in consumers’ homes and spread to the next item.

Unfortunately, many consumers are unaware that utensils and other surfaces at home can contribute to the spread of bacteria, said the study’s lead author Marilyn Erickson, an associate professor in the College of Agricultural and Environmental Sciences’ department of food science and technology.

“Just knowing that utensils may lead to cross-contamination is important,” Erickson said. “With that knowledge, consumers are then more likely to make sure they wash them in between uses…”

This study, published in Food Microbiology, is similar in that it considers the influence that knives and graters have on the transfer of pathogenic bacteria to and from produce items. She urges consumers to realize that these germs can spread in their kitchens as well.

Researchers have known that poor hygiene and improper food preparation practices in a consumer’s home can lead to foodborne illnesses, but considering what practices in the kitchen are more likely to lead to contamination has not been examined extensively….

Using a knife, Erickson would cut into things like tomatoes or cantaloupe and other types of produce to see how easily the bacteria could spread when the knife was continuously used without being cleaned. Because they “were looking at what would be the worst-case scenario,” she said, Erickson and study co-authors did not wash between cutting these different produce items.

Researchers also grated produce, like carrots, to see how easily the pathogens spread to graters. They found that both knives and graters can cause additional cross-contamination in the kitchen and that the pathogens were spread from produce to produce if they hadn’t washed the utensils.

“A lot of the broken up material and particles from the contaminated produce remained on the graters,” said Erickson, who conducts her research at the UGA Center for Food Safety in Griffin. “Then if you were to shred another carrot or something else immediately after that, it gets contaminated, too.”

The study also found that certain fruits and vegetables spread pathogens to knives to different degrees.
“For items like tomatoes, we tended to have a higher contamination of the knives than when we cut strawberries,” Erickson said. “We don’t have a specific answer as to why there are differences between the different produce groups. But we do know that once a pathogen gets on the food, it’s difficult to remove.”

Knives and graters aren’t the only utensils in the kitchen consumers should be worried about. Erickson has also helped study the role brushes and peelers have on the transfer of dangerous kitchen bacteria.

In concurrent studies, Erickson found that scrubbing or peeling produce items–like melons, carrots and celery–did not eliminate contamination on the produce item but led to contamination of the brush or peeler. Even when placed under running water, the utensils still became contaminated; however, the ability to cross-contaminate later produce items depended on the brush type and the pathogenic agent.

These studies combined give researchers a better idea as to how common cross-contamination is in the kitchen–even when just using standard practices.

Erickson explained there is a small chance of buying fruits and vegetables contaminated with bacteria, but the problem can occur–whether the product is store-bought or locally grown. http://www.sciencedaily.com/releases/2015/11/151110134537.htm

Citation:

Kitchen utensils can spread bacteria between foods

Date: November 10, 2015

Source: University of Georgia

Summary:

Researchers have found that produce that contained bacteria would contaminate other produce items through the continued use of knives or graters — the bacteria would latch on to the utensils commonly found in consumers’ homes and spread. Unfortunately, many consumers are unaware utensils and other surfaces at home can contribute to the spread of bacteria, say the authors of a new report.

Journal Reference:

1. Marilyn C. Erickson, Jean Liao, Jennifer L. Cannon, Ynes R. Ortega. Contamination of knives and graters by bacterial foodborne pathogens during slicing and grating of produce. Food Microbiology, 2015; 52: 138 DOI: 10.1016/j.fm.2015.07.008

Here is the press release from the University of Georgia:

Kitchen utensils can spread bacteria between foods, UGA study finds

November 6, 2015
Sydney Devine

Contact:
Marilyn Erickson

Griffin, Ga. – In a recent study funded by the U.S. Food and Drug Administration, University of Georgia researchers found that produce that contained bacteria would contaminate other produce items through the continued use of knives or graters—the bacteria would latch on to the utensils commonly found in consumers’ homes and spread to the next item.
Unfortunately, many consumers are unaware that utensils and other surfaces at home can contribute to the spread of bacteria, said the study’s lead author Marilyn Erickson, an associate professor in the College of Agricultural and Environmental Sciences’ department of food science and technology.

“Just knowing that utensils may lead to cross-contamination is important,” Erickson said. “With that knowledge, consumers are then more likely to make sure they wash them in between uses.”

Erickson has been researching produce for the past 10 years. Her past work has mainly focused on the fate of bacteria on produce when it’s introduced to plants in the field during farming.

In 2013, she was co-author on a study looking at the transfer of norovirus and hepatitis A between produce and common kitchen utensils—finding that cutting and grating increased the number of contaminated produce items when that utensil had first been used to process a contaminated item.

This study, published in Food Microbiology, is similar in that it considers the influence that knives and graters have on the transfer of pathogenic bacteria to and from produce items. She urges consumers to realize that these germs can spread in their kitchens as well.

Researchers have known that poor hygiene and improper food preparation practices in a consumer’s home can lead to foodborne illnesses, but considering what practices in the kitchen are more likely to lead to contamination has not been examined extensively.

“The FDA was interested in getting more accurate numbers as to what level of cross-contamination could occur in the kitchen using standard practices,” Erickson said.

In her recent study, Erickson contaminated many types of fruits and vegetables in her lab—adding certain pathogens that often can be found on these foods, such as salmonella and E. coli.

Using a knife, Erickson would cut into things like tomatoes or cantaloupe and other types of produce to see how easily the bacteria could spread when the knife was continuously used without being cleaned. Because they “were looking at what would be the worst-case scenario,” she said, Erickson and study co-authors did not wash between cutting these different produce items.

Researchers also grated produce, like carrots, to see how easily the pathogens spread to graters. They found that both knives and graters can cause additional cross-contamination in the kitchen and that the pathogens were spread from produce to produce if they hadn’t washed the utensils.

“A lot of the broken up material and particles from the contaminated produce remained on the graters,” said Erickson, who conducts her research at the UGA Center for Food Safety in Griffin. “Then if you were to shred another carrot or something else immediately after that, it gets contaminated, too.”

The study also found that certain fruits and vegetables spread pathogens to knives to different degrees.
“For items like tomatoes, we tended to have a higher contamination of the knives than when we cut strawberries,” Erickson said. “We don’t have a specific answer as to why there are differences between the different produce groups. But we do know that once a pathogen gets on the food, it’s difficult to remove.”

Knives and graters aren’t the only utensils in the kitchen consumers should be worried about. Erickson has also helped study the role brushes and peelers have on the transfer of dangerous kitchen bacteria.

In concurrent studies, Erickson found that scrubbing or peeling produce items—like melons, carrots and celery—did not eliminate contamination on the produce item but led to contamination of the brush or peeler. Even when placed under running water, the utensils still became contaminated; however, the ability to cross-contaminate later produce items depended on the brush type and the pathogenic agent.

These studies combined give researchers a better idea as to how common cross-contamination is in the kitchen—even when just using standard practices.

Erickson explained there is a small chance of buying fruits and vegetables contaminated with bacteria, but the problem can occur-whether the product is store-bought or locally grown.

Additional study co-authors were Qing Wang, a doctoral student at the University of Delaware, and Jean Liao, a research professional; and associate professors Jennifer Cannon and Ynes Ortega with UGA’s Center for Food Safety.

The study, “Contamination of knives and graters by bacterial foodborne pathogens during slicing and grating of produce,” is available at http://www.sciencedirect.com/science/article/pii/S0740002015001306.

Filed under: Culture / Living, Nutrition, Diet, and Health, Environment, Food Science and Safety
http://news.uga.edu/releases/article/kitchen-utensils-can-spread-bacteria-between-foods-1115/

Obviously, more research must be completed, but moderate exposure to a variety of germs maybe helpful to developing immune systems.

Resources:

Common Childhood Infections
http://pediatrics.about.com/od/childhoodinfections/

Infections
http://kidshealth.org/parent/infections/

Overview of Bacterial Infections in Childhood
http://www.merckmanuals.com/home/childrens_health_issues/bacterial_infections_in_infants_and_children/overview_of_bacterial_infections_in_childhood.html

9 Childhood Illnesses: Get the Facts
http://www.webmd.com/children/features/childhood-illnesses-get-the-facts

Where information leads to Hope. © Dr. Wilda.com

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Ohio State University study: Why four-year-olds don’t thrive in head start classes

11 Nov

One of the mantras of this blog is that education is a partnership between the student, parent(s) or guardian(s), teacher(s), and the school. All parts of the partnership must be involved. Many educators have long recognized that the impact of social class affects both education achievement and life chances after completion of education. There are two impacts from diversity; one is to broaden the life experience of the privileged and to raise the expectations of the disadvantaged. Social class matters in not only other societies, but this one as well. A few years back, the New York Times did a series about social class in America. That series is still relevant. Janny Scott and David Leonhardt’s overview, Shadowy Lines That Still Divide describes the challenges faced by schools trying to overcome the disparity in education. The complete series can be found at Class Matters

Teachers and administrators as well as many politicians if they are honest know that children arrive at school at various points on the ready to learn continuum. Teachers have to teach children at whatever point on the continuum the children are. Jay Matthews reports in the Washington Post article, Try parent visits, not parent takeovers of schools. http://www.washingtonpost.com/local/education/try-parent-visits-not-parent-takeovers-of-schools/2012/05/30/gJQAlDDz2U_story.html

The key ingredient is parental involvement. The Wisconsin Council on Children and Families (Council) has a great policy brief on parental involvement.http://www.wccf.org/pdf/parentsaspartners_ece-series.pd

Science Daily reported in Study shows why four-year-olds don’t thrive in head start classes:

Most Head Start classrooms serve children of mixed ages and that hurts the academic growth of older children, a new national study suggests.

Researchers found that 4-year-olds in Head Start classrooms that included higher concentrations of 3-year-olds were up to five months behind in academic development compared with their peers in classrooms with fewer younger children.
That’s a problem because, as of 2009, about 75 percent of all Head Start classrooms were mixed-age. Head Start is a federal preschool program that promotes the school readiness of children in low-income families from age 3 to age 5.
“While there has been some enthusiasm for mixed-age classrooms, our results suggest there may be a significant downside for older children,” said Kelly Purtell, co-author of the study and assistant professor of human sciences at The Ohio State University.

“Four-year-olds are often enrolled in classrooms that are less supportive of their academic learning.”
The results may also help explain why a 2010 national evaluation of the Head Start program found that it was only modestly effective in helping the academic achievement of 4-year-olds.

“Mixed-age classrooms may be one reason that older children don’t seem to benefit as much from Head Start as do younger children,” said Arya Ansari, lead author of the study and a graduate student in human development and family sciences at the University of Texas at Austin….

The researchers used data from the Family and Child Experiences Survey, which is a nationally representative sample of 3- and 4-year-old Head Start attendees across 486 classrooms nationwide.

This study included 2,829 children who were tested in fall 2009 and spring 2010 to determine how much they progressed during that time on assessments of language and literary skills, math skills, social skills and behavior.

Findings showed that a higher proportion of 3-year-olds in the classroom was linked to lower gains in math and in language and literacy skills among 4-year-olds.

It didn’t take many 3-year-olds in the classroom to hurt the academic growth of the older children. Even when 3-year-olds composed just 20 percent of a class, the older children lost nearly two months of academic achievement in the school year.

But when the younger children made up nearly half the class, the 4-year-olds lost roughly four to five months of academic development….

There was no effect on social or behavioral skills for either age group in mixed-age classes.

This study didn’t look at why mixed-age classrooms hurt older children’s academic gains. But other research suggests two possibilities. One is that interacting with younger peers does not provide as much gain for older children as interacting with peers at the same or higher skill levels in math and language…. http://www.sciencedaily.com/releases/2015/11/151110094407.htm

Citation:

Study shows why four-year-olds don’t thrive in head start classes
Date: November 10, 2015

Source: Ohio State University

Summary:

Most Head Start classrooms serve children of mixed ages and that hurts the academic growth of older children, a new national study suggests.

Here is the press release from Ohio State University:

Study shows why 4-year-olds don’t thrive in Head Start classes

Mixed-age classrooms hurt academic progress of older children

By: Jeff Grabmeier

Published on November 10, 2015

COLUMBUS, Ohio – Most Head Start classrooms serve children of mixed ages and that hurts the academic growth of older children, a new national study suggests.

Researchers found that 4-year-olds in Head Start classrooms that included higher concentrations of 3-year-olds were up to five months behind in academic development compared with their peers in classrooms with fewer younger children.
That’s a problem because, as of 2009, about 75 percent of all Head Start classrooms were mixed-age. Head Start is a federal preschool program that promotes the school readiness of children in low-income families from age 3 to age 5.

“While there has been some enthusiasm for mixed-age classrooms, our results suggest there may be a significant downside for older children,” said Kelly Purtell, co-author of the study and assistant professor of human sciences at The Ohio State University.

“Four-year-olds are often enrolled in classrooms that are less supportive of their academic learning.”
The results may also help explain why a 2010 national evaluation of the Head Start program found that it was only modestly effective in helping the academic achievement of 4-year-olds.

“Mixed-age classrooms may be one reason that older children don’t seem to benefit as much from Head Start as do younger children,” said Arya Ansari, lead author of the study and a graduate student in human development and family sciences at the University of Texas at Austin.

Purtell and Ansari conducted the study with Elizabeth Gershoff, an associate professor at UT-Austin.
Their results appear online in the journal Psychological Science.

The researchers used data from the Family and Child Experiences Survey, which is a nationally representative sample of 3- and 4-year-old Head Start attendees across 486 classrooms nationwide.

This study included 2,829 children who were tested in fall 2009 and spring 2010 to determine how much they progressed during that time on assessments of language and literary skills, math skills, social skills and behavior.

Findings showed that a higher proportion of 3-year-olds in the classroom was linked to lower gains in math and in language and literacy skills among 4-year-olds.

It didn’t take many 3-year-olds in the classroom to hurt the academic growth of the older children. Even when 3-year-olds composed just 20 percent of a class, the older children lost nearly two months of academic achievement in the school year.

But when the younger children made up nearly half the class, the 4-year-olds lost roughly four to five months of academic development.

“Not only did we see limits in academic growth in 4-year-olds, but we also didn’t see any academic gains for 3-year-olds who were in these mixed-age classrooms,” Purtell said. “So there was no real benefit for the younger children.”
There was no effect on social or behavioral skills for either age group in mixed-age classes.

This study didn’t look at why mixed-age classrooms hurt older children’s academic gains. But other research suggests two possibilities. One is that interacting with younger peers does not provide as much gain for older children as interacting with peers at the same or higher skill levels in math and language.

Another is that teachers modify their classroom practices to accommodate a wider range of skill levels, which leads to older children hearing content they’ve already been exposed to and feeling disengaged.
It is likely that both factors play a role, Purtell said.

Ansari said that it may not be feasible for many Head Start programs to separate children by age.
“That means we need to figure out what teachers and programs can do to foster a more cognitively stimulating environment for the older children,” he said. https://news.osu.edu/news/2015/11/10/mixed-age-class/

Teachers and schools have been made TOTALLY responsible for the education outcome of the children, many of whom come to school not ready to learn and who reside in families that for a variety of reasons cannot support their education. All children are capable of learning, but a one-size-fits-all approach does not serve all children well. Different populations of children will require different strategies and some children will require remedial help, early intervention, and family support to achieve their education goals.

Richard D. Kahlenberg, , a senior fellow at The Century Foundation wrote the informative Washington Post article, How to attack the growing educational gap between rich and poor. http://www.washingtonpost.com/blogs/answer-sheet/post/how-to-attack-the-growing-educational-gap-between-rich-and-poor/2012/02/10/gIQArDOg4Q_blog.html

There is no magic bullet or “Holy Grail” in education. There is only what works to produce academic achievement in each population of children. That is why school choice is so important. https://drwilda.wordpress.com/2012/02/11/3rd-world-america-money-changes-everything/

Study: Poverty affects education attainment

Related:

Tips for parent and teacher conferences

Tips for parent and teacher conferences

Common Sense Media report: Media choices at home affect school performance

Common Sense Media report: Media choices at home affect school performance

Making time for family dinner

Making time for family dinner

Policy brief: The fiscal and educational benefits of universal universal preschool https://drwilda.com/2012/11/25/policy-brief-the-fiscal-and-educational-benefits-of-universal-universal-preschool/

Studies: Lack of support and early parenthood cause kids to dropout

Studies: Lack of support and early parenthood cause kids to dropout

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