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New report: NC kids' health shows good progress

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A report on the health of North Carolina's children has encouraging news, but warns that the future will likely be more challenging. Action for Children North Carolina and the North Carolina Institute of Medicine released on Thursday its annual report card ranking kids' health using 13 categories.

The state gets especially high marks for early intervention, environmental health and the low number of communicable disease cases. The report didn't assign a grade of 'F' in any of the categories. But the report says the data, taken from 2010, will likely get worse in the future as a long-term consequence of the sluggish economy. The groups warn that budget cuts to education and other child-focused programs could come back to haunt the state years from now.

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Keeping Your Kids Healthy This Winter

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As the cold weather starts, we begin to face the inevitable illnesses that go hand-in-hand with winter.  Luckily, there are measures that you can take to keep your kids healthy all year long.

1.  Keep them safe in the car.

Although this may seem like an odd recommendation to lead the list of ways to your child healthy this winter, accidents are the number one cause of death among children, with motor vehicle accidents being the most common.  Following child passenger safety guidelines is the single most important way to keep your child healthy.  According to the Centers for Disease Control, following guidelines for child passenger safety can reduce the risk of death by at least half.  Children under 13 years of age should be in the back seat, or have the air bag turned off in the front seat.  Even with airbags turned off, the back seat is 26 percent safer for children.  Using safety belts and, when recommended, booster seats or car seats, is a great way to keep your kids healthy.  Details of NJ State guidelines for Child Passenger Safety can be found at http://www.nj.gov/oag/hts/childseats

2.  Have your child wash their hands.

Washing hands is the one of the easiest ways to keep your child healthy throughout the year.  According to the CDC, hand washing is considered the single most important means of preventing the spread of infection. Diseases are caused by germs and germs are carried on your hands. Proper hand washing is an easy and effective way to reduce the transmission of disease. Hand washing works - the result is fewer sick days and fewer visits to the doctor.  When a sink is not available, waterless hand sanitizer is a great way to keep hands germ free.

3.  Keep children up to date on their vaccines.

Vaccines are among the most successful and cost-effective public health tools for preventing disease and death of the 20th century.  Vaccines help protect not only your child, but also the children around them, from serious illness.  As a result of vaccines, death rates for 13 diseases that can be prevented by childhood vaccinations were found to be at all-time lows in the United States in 2007.  A schedule of recommended vaccines can be found at www.cdc.gov/vaccines/recs/schedules/default.htm.

4. Encourage physical activity.

Increased physical activity leads to a longer and healthier life.  Physically inactive children become physically inactive adults, and are increased risk for cardiovascular disease, obesity and diabetes. Physical inactivity has contributed to the 100 percent increase in the prevalence of childhood obesity in the U.S. since 1980, as found by the CDC. The World Health Organization recommend that children should get at least 60 minutes of moderate to vigorous intensity physical activity daily.  

5. Encourage healthy food choices.

Along with encouraging physical activity among our children, a key step to good health is a healthy diet. These choices begin by providing your child with a hearty breakfast every day; continue into their school day with a healthy lunch; and at home with a nutritious dinner. Teach children to choose brightly colored fruits and vegetables, whole grain foods, low fat or fat free milk and cheese and lean meats, beans and other proteins. By involving children in the choosing and preparing of food, it encourages them to make healthy food choices.  Eating meals as a family is also a key ingredient to children developing good nutrition.  Children who eat dinner with their parents are more likely to eat fruit and vegetables, more likely to eat dairy products, and less likely to skip breakfast.

6.  Make sure your child gets enough sleep.

Children need about 10 hours of sleep per night. Children who do not get adequate sleep are more likely to have difficulty in school, to have behavioral difficulties and to be overweight. Healthy sleep habits begin early in life, and children reap the benefits of these habits throughout their life.

7. Keep them home when they are sick.

When your child has a fever, a cold, vomiting or diarrhea, it is always a good idea to keep them home from school. Keeping them home will not only help them recover faster, but will also prevent the illness from spreading.

8.  Don’t smoke.

Children who grow up with one or both parents smoking are more likely to develop asthma and are nearly twice as likely to start smoking when they are adolescents. If you are a smoker, quitting the habit is not only a healthy choice for yourself, but for your child, as well.

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ADHD Drugs Do Not Increase Heart Problems in Kids

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Stimulants used to treat attention deficit hyperactivity disorder do not increase the risk of heart attacks, strokes or sudden death, U.S. researchers said on Monday, in a finding that should reassure millions of parents whose children take the drugs.

Researchers studied the medical records of more than 1 million children and young adults aged 2 to 24 who were taking or had taken stimulants such as Ritalin or Adderall and found no sign of increased risk of heart problems.

"We don't see any evidence of increased risk," said Dr. William Cooper of Vanderbilt University, whose study was published in the New England Journal of Medicine.

The study in children is the first of three commissioned by the U.S. Food and Drug Administration to understand the potential heart risks of the drugs after U.S. and Canadian regulators received a number of reports in 2006 of heart attacks, strokes and sudden cardiac arrest in children taking the medications.

The reports prompted several FDA advisory committee hearings on heart problems, and Health Canada temporarily suspended marketing of ADHD drugs.

The concerns also prompted the American Heart Association to issue guidelines suggesting that children who were just starting to take the drugs should be tested for potential underlying heart problems.

"There was a lot of concern and confusion among families and providers about what the best approach would be to treating kids who had ADHD and who might benefit from these medicines," Cooper said by phone.

Common Child Disorder

ADHD is one of the most common child mental disorders, affecting around 3 to 5 percent of children globally. Children with ADHD are excessively restless, impulsive and easily distracted, and often have trouble at home and in school. There is no cure, but the symptoms can be kept in check by a combination of behavioral therapy and medication.

In the United States, some 2.7 million people have prescriptions for ADHD drugs including Novartis' Ritalin, known generically as methylphenidate, Johnson & Johnson's Concerta, Shire's Adderall and Vyvanse and Eli Lilly's Strattera.

For the study, Cooper's team used prescription data from four large, geographically and demographically diverse health plans on 1,200,438 children and youth, including both current and past users of the drugs. They checked health records for evidence of heart problems, including heart attacks, strokes and sudden cardiac deaths, in children who were currently taking the drugs or who had taken them.

The team found no increased risk of heart problems for either current or past users of the drugs. Yet because there were so few cases of serious heart problems -- just 81 -- the study may not have been large enough to detect it.

But even if there were a risk of heart problems, it is extremely slight, Cooper said. FDA spokeswoman Sandy Walsh said in an e-mail the FDA continues to recommend that the drugs not be used in patients with serious heart problems. The agency is expected to release fuller guidance later on Tuesday.

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Children’s mental health program expands

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Point in Time is continuing to help deal with children's mental health issues with an expansion of programming. The child and youth services provider rolled out a program called Working Together for Kids' Mental Health last year and funding from the province is helping to grow the program and make dealing with kids' mental health a more collaborative process.

A tri-ministerial program – involving the health, education and child and youth services ministries – aimed at child and youth mental health and providing $297 million in funding over three years was announced in the spring.

"I'm very pleased to say that today, some of that money has made its way to Haliburton County," said Point in Time executive director Marg Cox, explaining that Haliburton County is one of just a few communities in the province that will act has a demonstration site for the new, collaborative programming.

The organization has received funding to attain three more full-time mental health workers, which it is currently in the process of hiring. Those employees will be working closely with the school board since, as Cox explained, part of the program is to get the school board more involved in children's mental health.

"In society in general, teachers are trained to teach," she said, but added that members of the Trillium Lakelands District School Board would be undergoing training in mental health literacy. "It will help them understand what different mental health challenges might look like . . . what depression might look like . . . when somebody might be at risk, or need a referral."

The aim of the program is to get children and youth services, schools and health care institutions working together on children's mental health issues, since, as Cox said, "they're all dealing with the same kids."

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No anthrax vaccine testing on children for now

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Should the anthrax vaccine be tested in children? It will be a while longer before the government decides. An advisory board said Friday that ethical issues need to be resolved — but if that can be accomplished the vaccine can be tested in children to be sure it's safe and to learn the proper dose in case it's needed in a terrorist attack.

Because of concerns that terrorists might use the potentially deadly bacteria, the government has stockpiled the vaccine. It has been widely tested on adults but never on children. The question is whether to do tests so doctors will know if children's immune systems respond to the shots well enough to signal protection. The children would not be exposed to anthrax.

The National Biodefense Science Board said Friday a separate review board should look into the ethical issues of doing such tests in children. If that is completed successfully, the panel, said, the Department of Health and Human Services should develop a plan for a study of the vaccine in children.

How to protect young people after an anthrax attack is a challenging issue, said Dr. Nicole Lurie, a member of the board and assistant secretary for preparedness and response at the Public Health Service. "Protecting children still stands, for me, among the most important responsibilities that we have as a nation."

The board gives advice to the Department of Health and Human Services on preparations for chemical, biological and nuclear events. Its vote was 12-1. There is no deadline for the government to decide whether to go along. And if it does agree, it's not clear how much time it would take to find money for such research and get clearance from review boards at medical centers that would conduct studies.

Another big question is whether parents would sign up their children to test a vaccine when there is no immediate threat. It's not possible to get anthrax from the vaccine, but there are side effects. In adults, shot-site soreness, muscle aches, fatigue and headache are the main ones, and rare but serious allergic reactions have been reported.

Anthrax is among several potential bioterror weapons and is of special interest because it was used in letters sent to the media and others in 2001, claiming five lives and sickening 17. That prompted extensive screening of mail and better ventilation and testing at postal facilities and government agencies.

The FBI has blamed the attacks-by-mail on Bruce Ivins, a scientist at an Army biodefense laboratory, who committed suicide before he could be charged. Anthrax can be difficult to treat, especially if someone has breathed anthrax spores. Millions of doses of antibiotics have been stockpiled since the 2001 episode, and two experimental toxin-clearing treatments also are being stored.

U.S. troops deploying to Iraq, Afghanistan and some other countries are required to get anthrax shots. Since 1998, more than 1 million have been vaccinated. After lawsuits objecting to the requirement, a federal judge suspended the program in 2004, finding fault in the Food and Drug Administration's process for approving the drug. The next year, the FDA reaffirmed its finding that the vaccine was safe.

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Tobacco Money to keep Kids Healthy: Has some of it gone up in smoke?

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"Up in Smoke"  That's what anti-smoking advocates say has happened to a significant amount of money spent every year to spread smoking prevention messages to your children. The money doesn't come from taxpayers. It comes from tobacco companies.  

The companies pay the state roughly $120 million every year as part of the huge settlement, known as the master tobacco settlement,  reached in the late 1990's.  Each state then decides how to spend it.   

Most years roughly $12 million has gone to reach your kids with anti-smoking, anti-drug and anti-obesity messages and education. Now a big portion of that money has been diverted.  It's down to roughly $9 million a year. That's a 25% decline in funding and anti smoking advocates want that funding brought back.

The funding is used in part to bring a message to Virginia's children over the air through a series of advertisements and also in the classroom through prevention programs. At Wasena Elementary School in Roanoke a prevention specialist from Blue Ridge Prevention Council is seated on a chair surrounded by young students.  "What would a consequence be if you started smoking cigarettes," J.D. Carlin askes the students.

Several answers come from the children.  One child says aloud "It could make you die."  The teacher responds "It could even make you die, right."In an eighth grade class at Auburn Middle School in Riner, students are also hearing an anti-tobacco message. A prevention specialist splits the class into two teams and a contest is on.  Each team answers questions about the dangers of cigarettes and the diseases linked to tobacco use.

These types of programs at Wasena Elementary and Auburn Middle School are  replicated at schools and community centers around the Commonwealth. "The programs reach 60 thousand kids every single day with a tobacco prevention message," said Jenny Martin, with the Virginia Foundation for Healthy Youth.

"I think it's pivotal," said J.D. Carlin who teaches classes. "The reason I think it's pivotal is very simply that it's a message they need to hear."It's these types of education programs along with advertising that, according to advocates, are working to get the message across.

In eight years spanning 2001 to 2009 smoking among Virginia High school students has dropped about a third from 28.6% to 19.7%, according to a Virginia Youth Tobacco Survey.  Smoking among middle school students in Virginia dropped 65 percent, from 10.6% in 2001 to 3.6% in 2009, according to the survey.

We asked one child what would you do if you were offered a cigarette? "I know I will not take it and say no," said eighth grade student Cameron Bissell.

Other eighth graders offered their thoughts on tobacco use. "It's disgusting and it makes me cough," said Bissell. "The gum disease, the rotting teeth, the lip infections, ugh," said classmate Andrea Tiller. "It kind of sends a chill down my spine."

"I know I'm never going to smoke just probably because of this class," said Brendan Collett. "I don't want to end up having lung surgery and lung cancer."Dr. Colleen Kraft is a pediatrician and faculty member at the Virginia Tech Carilion School of Medicine who vocally supports prevention programs and wants all the funding brought back.

"We have an unsustainable health care cost trajectory in this country," said Dr. Kraft. "We need to be looking at long term investments, because the return on investment in tobacco prevention and obesity prevention is over a generation."

Jenny Martin with the Virginia Foundation for Healthy Youth put it simply. "We can invest now in prevention programs and in helping kids make healthy choices or we'll pay for it later."

Schools and community centers apply for these educational programs through a grant process. With less money fewer grants can be awarded. So where does the rest of that $120 million in tobacco money go? It's up to lawmakers.

Half has been going to help with economic development in areas that relied on the tobacco industry. Forty percent of the pie goes to help the state with Medicaid health care costs for tobacco related illnesses.

While Virginia's Healthy Youth foundation used to get 10 percent, lawmakers cut that to 8 and half percent moving the extra money over to help Medicaid costs.

Virginia is supposed to get that money from the tobacco companies for the next ten years or more. Tobacco companies continue to fight the settlement in court, arguing in part that their market share is down and therefore they can't afford to keep paying.

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Two grants issued to improve children’s health

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Two projects in the Central Valley aimed at protecting children from environment health hazards were awarded $198,000 of grants on Wednesday. “Safeguarding the health of children is one of our most important responsibilities, and an issue that is very dear to me,” said Jared Blumenfeld, the Environmental Protection Agency’s Regional Administrator for the Pacific Southwest, in a release. “This funding will provide critical tools such as information, training and education to communities that are most in need.”

The Building Community Capacity to Monitor, Track, and Address Environmental Health Hazards and Improve Children’s Health Outcomes in California’s San Joaquin Valley project in Kern and Tulare counties is conducted by the Pesticide Action Network of North America. The project received $98,000 to assist with its work to “monitor, track, and address environmental health issues that impact children.”

Farmworker Justice’s Healthy Fields, Healthy Kids in the Central Valley, central Florida and areas along the U.S.-Mexico border in Yuma County of Arizona received $100,000. A total of $357,999 was granted to four projects.

The other two projects were Expansion of Outreach under Center for the Health Assessment of the Mothers and Children of Salinas with the UC Berkeley—Center for Environmental Research and Children’s Health and the Community-Based Healthy Child Care Program put on by Sonora Environmental Research Institute.

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Risk kids now or later? Ethical dilemma: Should feds test anthrax vaccine on children?

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Children would be largely unprotected in the event of an anthrax bioterrorism attack because no studies have been done on vaccine risk, benefits and effectiveness in a young population. On the other hand, subjecting children to vaccine injections when there's no imminent or credibly identified risk "just in case" is problematic, especially since no one knows what will happen.

What to do is a question dividing experts across America. And it's about to be decided. Friday, members of the National Biodefense Science Board will decide whether anthrax vaccine testing should take place in children, something that a working group has recommended, after much debate. Experts agree that neither option is great: They can either test now in some healthy children and see if it is safe or wait until there's a real attack and then try to gather the data.

In April, Dr. Nicole Lurie, assistant secretary for preparedness and response in the Department of Health and Human Services, wrote the board asking it to decide. She noted the government has stockpiled a lot of anthrax vaccine to be used post-exposure. Periodically the government runs exercises to practice for a mass vaccination effort, including one recently that highlighted, she said, the policy and response challenges with vaccine use in special populations such as children.

"We have no safety, immunogenicity or efficacy data in pediatric populations that would permit the U.S. Food and Drug Administration to evaluate the product for use under an Emergency Use Authorization," she wrote. Gathering that data would appear to be the answer, she said, but "there are legitimate countervailing concerns regarding subjecting children to risk with no clear benefit at the time of the study."

What to do about testing a vaccine against that threat in kids is a question with both practical and ethical implications, experts agree. Children usually are study subjects only when they will reap direct or indirect benefit and there is minimal potential for harm. That's not clear with the anthrax vaccine.

The Centers for Disease Control and Preparedness has categorized anthrax as having "category A" or most dangerous bioterrorism potential, because it can be deadly, may spread across a large area and requires a lot of planning to protect public health. The anthrax spores are formed by the bacterium Bacillus anthracis and take three forms. They can infect through the skin, lungs or the digestive tract.

CDC notes that 80 percent of people infected through skin don't die, even without treatment. In the gastro-intestinal form, between one quarter and one half of cases result in death. And inhalation anthrax is very severe. In 2001, when anthrax was sent through the U.S. mail system, about half of those who inhaled it died.

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Good dental health starts even before birth

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When babies begin getting teeth around 6 months of age, it’s a sign that they are growing up. It’s also the moment when parents may begin thinking about their child’s oral health. However, you can start making a difference in the overall health of you and your child before they are born.

Studies have shown that an expecting mother’s poor oral health may lead to an increased risk for having preterm labor, premature delivery, low birth weight babies and twice the chance of developing preeclampsia.

As parents, our goal is to raise our children to be as healthy and productive as they can be. Simple preventive measures or early routine treatment will make a difference in your child’s oral health.

Bacteria make acid in our mouth from our food and drinks — even breast milk. It slowly eats away at our teeth, eventually making cavities. These bacteria make acid for about 45 minutes every time we eat or drink something with sugar, starch or carbohydrates (not just candy).

In the worst-case scenario, neglecting oral health can result in death. In February 2007, an article in The Washington Post highlighted an 8-year-old boy who died from a tooth infection that spread to his brain.

Most kids have 20 baby teeth by the time they are 3, and they won’t lose all of them until they are 11 to 13 years old. Some parents wonder why dentists care so much about teeth that are going to be lost anyway. Here are some reasons:

To prevent toothaches, the second-leading cause of children missing school. To hold space for permanent teeth to come in properly. Tooth infections can spread to other parts of the body, causing stomachaches, heart disease, even death. Establish healthy habits while children are young, which is much easier than when they are older.

What can parents do?

Take care of yourself: Children acquire bacteria in the mouth in the first 18 months of life, usually from the parents. Maintain your oral health by brushing and flossing daily, scheduling regular dental visits and using things such as mouth rinses or chewing gum containing xylitol (a natural sugar that limits bad bacteria ).

Good hygiene, good diet: Cavities can start as soon as you can see your baby’s teeth. Even before the teeth come in, it is helpful to clean your baby’s gums with a clean, moist cloth after feeding. This limits bacteria and trains the child for future dental care. As the teeth erupt, use a soft child’s toothbrush with a tiny smear of fluoride toothpaste, which helps make teeth more resistant to getting cavities. Children generally don’t develop proper coordination to brush well until they are about 7, so help them until then. Establishing healthy eating schedules when young will help prevent cavities by limiting the amount of time the bacteria have to make the acid. Fewer snacks equals fewer cavities.

First birthday, first visit: Take your child to a dentist within six months of their first teeth coming in. This allows the dentist to help prevent cavities, to find cavities while they are small and easier to fix, and helps your child become more comfortable at the dentist as they grow. Find a dentist who works with young children and an office that caters to them .

With healthy hygiene practices, parents can have a profound influence on both the oral health and overall health of their children.

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BPA in pregnant women might affect kids` behaviour

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Exposure to BPA before birth could affect girls` behavior at age 3, according to the latest study on potential health effects of the widespread chemical.

Preschool-aged girls whose mothers had relatively high urine levels of bisphenol-A during pregnancy scored worse but still within a normal range on behavior measures including anxiety and hyperactivity than other young girls.

The results are not conclusive and experts not involved in the study said factors other than BPA might explain the results. The researchers acknowledge that "considerable debate" remains about whether BPA is harmful, but say their findings should prompt additional research.

The researchers measured BPA in 244 Cincinnati-area mothers` urine twice during pregnancy and at childbirth. The women evaluated their children at age 3 using standard behavior questionnaires.

Nearly all women had measurable BPA levels, like most Americans. But increasingly high urine levels during pregnancy were linked with increasingly worse behavior in their daughters. Boys` behavior did not seem to be affected.

The researchers said if BPA can cause behavior changes that could pose academic and social problems for girls already at risk for those difficulties. "These subtle shifts can actually have very dramatic implications at the population level," said Joe Braun, the lead author and a research fellow at Harvard`s School of Public Health. For every 10-fold increase in mothers` BPA levels, girls scored at least six points worse on the questionnaires. The study was released online Monday in Pediatrics.

Linda Birnbaum, director of the National Institute of Environmental Health Sciences and the National Toxicology Program, said the study contributes important new evidence to "a growing database which suggests that BPA exposure can be associated with effects on human health."

Grants from that federal agency helped pay for the study. The Food and Drug Administration has said that low-level BPA exposure appears to be safe. But the agency also says that because of recent scientific evidence, it has some concern about potential effects of BPA on the brain and behavior in fetuses, infants and small children. The FDA is continuing to study BPA exposure and supports efforts to minimize use in food containers.

BPA has many uses, and is found in some plastic bottles and coatings in metal food cans. It was widely used in plastic baby bottles and sippy cups but industry phased out that use.

Braun said it`s possible that exposure to BPA during pregnancy interferes with fetal brain development, a theory suggested in other studies, and that could explain the behavior differences in his study. Why boys` behavior wasn`t affected isn`t clear. But BPA is thought to mimic the effects of estrogen, a female hormone.

The researchers evaluated other possible influences on children`s behavior, including family income, education level and whether mothers were married, and still found an apparent link to BPA.

But Dr. Charles McKay, a BPA researcher and toxicologist with the Connecticut Poison Control Center, said the researchers failed to adequately measure factors other than BPA that could explain the results.

For example, there`s no information on mothers` eating habits. That matters because mothers` higher BPA levels could have come from eating lots of canned foods instead of healthier less processed foods, which might have affected fetal brain development.

The American Chemistry Council, a trade group whose members include companies that use BPA, said the research "has significant shortcomings ... and the conclusions are of unknown relevance to public health."

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