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Sleep Apnea in Children

Doctors Should Screen Kids for Snoring and Sleep Apnea Mon Apr 1,11:48 AM ET By Melissa Schorr NEW YORK (Reuters Health) – For the first time, the American Academy of Pediatrics (AAP) is recommending that doctors screen all children for snoring to determine if they might be at risk of obstructive sleep apnea, a temporary collapse of the upper airway that occurs during sleep. Symptoms of the condition include snoring, often with pauses, snorts or gasps as breathing temporarily stops and restarts. “Our hope is this will raise awareness of this condition among pediatricians so more children will be diagnosed,” AAP committee chair Dr. Carole L. Marcus, director of the pediatric sleep center at Johns Hopkins University in Baltimore, Maryland, told Reuters Health. During the past 3 years, the committee conducted a review of more than 2,000 medical journal articles to develop the first-of-their-kind guidelines on sleep apnea among children. While about 3% to 12% of youngsters snore, about 2% are thought to have obstructive sleep apnea syndrome. If left untreated, sleep apnea can cause significant health problems such as poor growth, neurological or behavioral problems, and in the most severe cases, heart problems. “People are familiar with this for adults, but don’t realize this is common in children because they look fine when they are awake,” Marcus noted. “People don’t think to bring up the condition of snoring.” However, the guidelines recommend that pediatricians should ask all children and their parents whether or not the child snores. Those who do snore should be further questioned on whether the snoring is continuous, causes the child to choke or gasp,...

To snoop or not to snoop in a child’s bedroom?

Sunday Patriot-News Front Page Story December 19, 1999 (Harrisburg, PA)– Parents must weigh issues of trust, curiosity, concern before searching, experts say. “Trust has everything to do with your child’s success and safety.” says Dr. Chris Petersen, a psychiatrist and assistant professor of psychiatry at Pennsylvania State University’s College of Medicine at the Hershey Medical Center.  “If you initiate damage of the trust by intruding into their life without reason, then that is a mistake.  If they’ve earned the trust and respect because of a level of responsibility, that should be respected, he says.   WARNING SIGNS Dr. Chris Petersen, a psychiatrist at Hershey Medical Center, cites these symptoms of teen depression: •Social withdrawal: A desire to remain isolated or restricted to a narrow peer group for weeks or months. •Isolation from peer group: Diminishing time and interaction with a previously close group of friends. •Symptoms of depression: ‘Irritability, anger and sadness, as well as boredom in situations they would not normally consider boring. •Deteriorating grades and work habits. •Frequent fighting, becoming abusive. • Maintaining poor personal hygiene. • Abusing alcohol or drugs. •Changing sleep habits and appetite. PARENTING ADVICE •The National, Parenting Center at www.tnpc.com. RECOMMENDED READING From George Schmidt, psychologist with the East Pennsboro Area School District. Both are by Anthony Wolf: •”Get Out of My Life … but first could you drive me and Cheryl to the Mall- Parent’s Guide to the Teenager.” • “It’s Not fair, Jeremy Spencer’s Parents Let Him Stay Up All...

Majority of children don’t get appropriate health care

Up to three-quarters of children and adolescents don’t get appropriate care Washington, D.C., April 15, 2004—Despite a number of noted successes, American children largely don’t get the quality of health care they should, with up to three-quarters of children and adolescents not receiving care scientifically proven or recommended, according to a new overview of children’s health care released today by The Commonwealth Fund. The review, Quality of Health Care for Children and Adolescents: A Chartbook, shows a number of clear advances in children’s health care and improved outcomes on a series of measures. But it also notes that one-third of children with asthma don’t get appropriate controller medications and three-fourths of children with severe mental health problems don’t get evaluation or treatment. In addition, it illustrates ongoing racial disparities in care and inadequate attention to widely effective preventive measures. Distilled from a review of 500 studies, the report illustrates through 40 charts and commentary the quality of care children receive in numerous categories, such as preventive care and treatment of chronic conditions. The chartbook was produced by Sheila Leatherman, research professor at the University of North Carolina School of Public Health, and Douglas McCarthy, president of Issues Research, Inc., based in Durango, CO, in consultation with national experts in child and adolescent care quality. “Given the fact that we spend far more on health care than other countries, we should be doing better for our children,” Leatherman said. “The report shows dangerous lapses in patient safety, substantial shortcomings in providing effective and recommended care, persistent racial and ethnic disparities in care, and widespread failure to provide needed preventive services...

Penn State Sex Abuse Scandal

Published Online Wed, 11 Nov 2011 22:46:00 Tonight Penn State Board of Trustees made a “rush to judgment“ according to some media sources regarding the ongoing sex abuse scandal at the university.  Coach Paterno was removed and dismissed as athletic director due to a reported moral lapse of judgment in not pursuing the suspected child abuse reporting himself despite his reports to his superiors of what he knew of the alleged sex abuse of a child by his former assistant coach Jerry Sandusky.  According to many students and faculty, the Board of Trustees appears to be using this opportunity to “scapegoat” Coach Paterno while apparently taking the focus off of those who legally failed to report the alleged child abuse perpetrated by Jerry Sandusky to the police. A report of a KDKA-TV News Poll Conducted By Survey USA of a survey of Penn State alumni is consistent with the recent Grand Jury findings in not condemning or invoking consequences for Coach Paterno.  Consequences are apparently due with the lack of action by Penn State University and administrators in not reporting the alleged abuse of children by Jerry Sandusky. The same survey placed the responsibility with President Spanier and his lack of action in not having reported the child sexual abuse to the police as mandated by Pennsylvania law for professionals such as teachers and faculty.  See Pennsylvania’s legal reporting laws:...

Overdose: A Review of 100 Consecutive Cases

1. Evaluate and treat patients with significant overdose. 2. Understand risk factors for significant overdose. Patients who overdose represent a significant challenge(1) for consultation-liaison psychiatrists. Methods: A retrospective chart review of 100 patients over 18 consecutively admitted from July through December, 1998 by the toxicology service following overdose warranting hospitalization was performed. Diagnoses were based on DSM-IV criteria. Results: Seventy-eight percent of the 100 toxicology cases reported suicidal intent. The age range was 18 to 79; the mean was 34.8. Fifty-five percent were female. The primary psychiatric diagnoses are as follows: 64% mood disorder, 16% substance related disorder, 8% adjustment disorder, 7% psychotic disorder, 2% anxiety disorder, 3% other. Sixty-eight percent had a prior Axis I diagnosis other than substance abuse. Forty-one percent were currently receiving psychiatric treatment. Sixty-four percent had co-existing substance abuse. Twenty-nine percent ingested at least one substance of abuse as part of the overdose. Forty-six percent had previously attempted suicide. Seventy-five percent identified a stressful life event. Conclusion: Adult overdose patients share risk factors(1,2) for suicidal behavior including the presence of an Axis I diagnosis, particularly a mood disorder; lack of current psychiatric treatment; history of prior suicide attempt; and significant life stressors. Substance abuse represents a significant independent and comorbid risk factor for overdose.   Klerman GL. Clinical epidemiology of suicide. Journal of Clinical Psychiatry, 1987;48:33-8. Beaumont G, Hertzel W. Patients at risk of suicide and overdose. Psychopharmacology,...

Orphanages are an ‘option’

Posted 12/18/2009 1:09 AMBy Wendy Koch, USA TODAY“Children who live in orphanages fare as well or better than those in family homes, reports a Duke University study that tracked more than 3,000 children in five Asian and African countries. The study is touted as one of the most comprehensive ever done on orphans. Orphaned and abandoned children ages 6-12 were evaluated over a three-year period in 83 institutions and 311 families in Cambodia, Ethiopia, India, Kenya and Tanzania. Those in institutions had significantly better health scores, lower prevalence of recent sickness and fewer emotional problems.“ The findings were reported in USA...

Obama Supports Early Education

Obama Supports Early Education as Ultimately Cost Saving CHICAGO, Dec 16 (New York Times) — “Mr. Obama’s platform, which Mr. Duncan helped write, emphasizes extending care to infants and toddlers as well, and it makes helping poor children a priority. It would also provide new federal financing for states rolling out programs to serve young children of all incomes.“ Mr. Obama’s platform accepts the broad logic of the Ypsilanti study. “For every one dollar invested in high-quality, comprehensive programs supporting children and families from birth,” the platform says, “there is a $7-$10 return to society in decreased need for special education services, higher graduation and employment rates, less crime, less use of the public welfare system and better health.” The report was published in the New York...

Study: Mom’s nurturing can stimulate intelligence

July 19, 2000 Web posted at: 9:16 AM EDT (1316 GMT) (AP) — Be grateful for the times Mom cooed over you and rocked you to sleep. All of that fussing, it appears, may have made you smarter. Experiments on rats by Canadian researchers suggest that mothers’ nurturing stimulates neural connections in their babies’ brains and enhances learning. Those offspring subsequently scored higher in intelligence and memory tests. The researchers said the results, which appear in the August issue of Nature Neuroscience, are broadly applicable to humans, too. “It’s never nature vs. nurture. The influences are inseparable,” said Michael Meaney, a neuroendocrinologist at McGill University who led the study. “Activity of the genes is always influenced by the environment. And the most important feature of the environment for an infant is mother.” Other researchers described the findings as impressive. “The stimulation provided by these mothers is certainly a large part of what causes the brain to develop more extensively,” said neuroendocrinologist Bruce McEwen of Rockefeller University in New York City. However, some scientists cautioned against comparing rat and humans mothers too closely, or attributing infants’ intelligence to relatively small differences in parenting styles. “I don’t want to put any more pressure on mothers,” said Rebecca Burwell, a psychologist at Brown University. “The rat mothers showed differences in skills, but they all were in the normal range. So it doesn’t really speak to parental abuse. Some individuals may be very sensitive to subtle variations in parenting.” In the experiment, the McGill team divided 32 female rats into two groups. One group provided a high level of care to their offspring,...

Millions of children are not receiving health benefits

WASHINGTON | Wed Sep 8, 2010 Joanne Allen, editing by Anthony Boadle, report for Reuters that “An estimated five million uninsured children in the United States were eligible for Medicaid or the Children’s Health Insurance Program (CHIP) but were not enrolled in either plan, according to a new report.  The study published on Friday in the journal “Health Affairs” recommended policy reforms and broader efforts to get uninsured children into government medical programs, including the use of income tax data for automatic enrollment.”  These findings were reported on http://www.reuters.com. Every state is effected by the budget issues.  Children’s health insurance is just one of the under funded areas that affect children and families.  A combination of State and Federal funds are involved with this process. Benjamin D. Sommers reports that “Keeping children who are eligible for Medicaid and the Children’s Health Insurance Program (CHIP) enrolled in these programs remains an important policy challenge.“  See Health...

Prescriptions for Stimulants, Antidepressants on the Rise for Preschoolers

February 22, 2000 JAMA/MedscapeWire The amount of prescriptions being written for preschoolers for stimulants and antidepressants is on the rise, suggesting increased unapproved use of these medications, according to an article in the February 23 issue of The Journal of the American Medical Association. Julie Magno Zito, PhD, from the University of Maryland, Baltimore, and colleagues studied the prescription records of children aged 2 to 4 years enrolled in 2 Medicaid programs (Midwestern state Medicaid program and Mid-Atlantic state Medicaid program) and 1 health maintenance organization (HMO, in the Northwest United States) to determine the prevalence of psychotropic medication use in preschoolers. Psychotropic medications are drugs such as stimulants, antidepressants, sedatives, and antipsychotic drugs that have an effect on the mind. The researchers analyzed data from 1991, 1993, and 1995 from more than 200,000 patients. “Several prominent trends characterized the use of psychotropic medications in preschoolers during the early to mid 1990s,” the authors explain. “Overall, there were large increases for all study medications (except neuroleptics) and considerable variation according to gender, age, geographic region, and health care system. These findings are remarkable in light of the limited knowledge base that underlies psychotropic medication use in very young children.” In 1995, the prevalence rates per 1,000 2- through 4-year-old children in the Midwestern state Medicaid program were 12.3 for stimulants, 3.2 for antidepressants, and 2.3 for clonidine; in the mid-Atlantic state Medicaid program prevalence rates were 8.9 for stimulants, 1.6 for antidepressants, and 1.4 for clonidine; and in the HMO program prevalence rates were 5.1 for stimulants, 0.7 for antidepressants, and 1.9 for clonidine. Increases in prevalences were noted...
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