Friday, January 30, 2009

Obama hails passage of children's health insurance

Date: 1/30/2009

WASHINGTON (AP) — The White House says President Barack Obama could sign a bill providing government-sponsored health care to roughly 4 million uninsured children as soon as next week.

Obama released a statement Friday, the day after the Senate approved the bill 66-32, calling the vote, in his words, "a down payment on my commitment to ensure that every American has access to quality, affordable health care."

The House plans to take up the bill next week.

The measure authorizes an additional $32.8 billion over the next 4 1/2 years for the State Children's Health Insurance Program.

White House press secretary Robert Gibbs said Friday that Obama looks forward to inviting lawmakers to a bill signing as early next week.

Copyright 2009 The Associated Press.

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Friday, January 23, 2009

Minn. illnesses worry CDC officials

Date: 1/23/2009

ATLANTA (AP) — Five Minnesota children have grown sick — and one of them died — from a germ that can cause meningitis, causing U.S. health officials to warn of the importance of a common childhood vaccine.

The Hib vaccine, which is given to babies, has succeeded in reducing U.S. cases of the bacterial illness to about only 20 a year in children younger than 5. But a cluster of five cases occurred in central Minnesota last year in young children. One child, who was 7 months old, died of meningitis in November.

No other states have reported such an increase. But Minnesota's disease surveillance is unusually good, so problems in other states could be developing, said Dr. Anne Schuchat of the U.S. Centers for Disease Control and Prevention.

Three of the five children — including the dead child — had not received any vaccine, due to a decision by their parents. But a shortage of Hib vaccine may also have contributed, CDC officials said.

Haemophilus influenzae Serotype b (Hib) can cause meningitis, pneumonia and other dangers. Because of a Hib vaccine shortage that started in 2007, CDC officials say doctors should defer for most children a booster dose given at 12 to 15 months. But they say there's enough for children to get necessary doses at ages 2, 4 and 6 months.

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On the Net:

CDC information on Hib: http://www.cdc.gov/ncidod/dbmd/diseaseinfo/haeminfluserob_t.htm

Copyright 2009 The Associated Press.

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Tuesday, January 20, 2009

Texas girl gets new heart; sis awaiting transplant

Date: 1/20/2009

By JAMIE STENGLE
Associated Press Writer

DALLAS (AP) — A 7-year-old girl received a new heart Monday, more than eight months after she and her older sister were put on the transplant list because of the same rare ailment.

Their mother said Shayde Smith is relieved now that her sister Emily has received a transplant. "She's still nervous about it, but she said that now that Emily's made it through, she knows she will," Natalie Van Noy said.

The girls have restrictive cardiomyopathy, which means the heart doesn't relax between pumps and doesn't fill properly with blood. The condition can cause blood clots or death.

Emily was a higher priority for transplant than 9-year-old Shayde because she had more symptoms, including wheezing spells and her lips, toes and fingertips turning blue when she got cold.

Van Noy said Emily's hands and feet are now warm. "She looks awesome," her mother said.

The girls' condition is rare, with less than one-in-a-million children diagnosed, said Dr. Kristine Guleserian, the pediatric cardiothoracic surgeon who led the team operating on Emily at Children's Medical Center Dallas. Without a transplant, the chance of survival is 40 to 50 percent one to two years after diagnosis.

Restrictive cardiomyopathy doesn't have a known cause. It seems to run in families, but the condition hasn't yet been proven to be genetic.

While it isn't rare for siblings to need transplants, it is rare that they would need them at the same time, said Pam Silvestri, a spokeswoman for Southwest Transplant Alliance, one of the organ donation agencies across the country that provides organs to transplant hospitals.

The girls are from the Boyd area, about 30 miles northwest of Fort Worth.

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Children's Medical Center Dallas: www.childrens.com

Donate Life America: www.donatelife.net

Copyright 2009 The Associated Press.

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Monday, January 19, 2009

MRSA rising in kids' ear, nose, throat infections

Date: 1/19/2009

By LINDSEY TANNER
AP Medical Writer

CHICAGO (AP) — Researchers say they found an "alarming" increase in children's ear, nose and throat infections nationwide caused by dangerous drug-resistant staph germs.

Other studies have shown rising numbers of skin infections in adults and children caused by these germs, nicknamed MRSA, but this is the first nationwide report on how common they are in deeper tissue infections in the head and neck, the study authors said. These include certain ear and sinus infections, and abcesses that can form in the tonsils and throat.

The study found a total of 21,009 pediatric head and neck infections caused by staph germs from 2001 through 2006. The percentage caused by hard-to-treat MRSA bacteria more than doubled during that time from almost 12 percent to 28 percent.

"In most parts of the United States, there's been an alarming rise," said study author Dr. Steven Sobol, a children's head and neck specialist at Emory University.

The study appears in January's Archives of Otolaryngology, released Monday.

It is based on nationally representative information from an electronic database that collects lab results from more than 300 hospitals nationwide.

MRSA, or methicillin-resistant Staphylococcus aureus, can cause dangerous, life-threatening invasive infections and doctors believe inappropriate use of antibiotics has contributed to its rise.

The study didn't look at the severity of MRSA illness in affected children.

Almost 60 percent of the MRSA infections found in the study were thought to have been contracted outside a hospital setting.

Dr. Robert Daum, a University of Chicago expert in community-acquired MRSA, said the study should serve as an alert to agencies that fund U.S. research "that this is a major public health problem."

MRSA involvement in adult head and neck infections has been reported although data on prevalence is scarce.

MRSA infections were once limited mostly to hospitals, nursing homes and other health-care settings but other studies have shown they are increasingly picked up in the community, in otherwise healthy people. This can happen through direct skin-to-skin contact or contact with surfaces contaminated with germs from cuts and other open wounds.

But staph germs also normally live or "colonize" on the skin and in other tissues including inside the nose and throat, without causing symptoms. And other studies have shown that for poorly understood reasons, the number of people who carry MRSA germs is also on the rise.

Sobol said MRSA head and neck infections most likely develop in MRSA carriers, who become susceptible because of ear, nose or throat infections caused by some other bug. Symptoms that it could be MRSA include ear infections that drain pus, or swollen neck lymph nodes caused by pus draining from a throat or nose abcess.

Unlike cold and flu bugs, MRSA germs aren't airborne and don't spread through sneezing.

MRSA does not respond to penicillin-based antibiotics and doctors are concerned that it is becoming resistant to others.

The study authors said a worrisome 46 percent of MRSA infections studied were resistant to the antibiotic clindamycin, one of the non-penicillin drugs doctors often rely on to treat community-acquired MRSA. However, other doctors said it's more likely that at least some of infections thought to be community-acquired had actually originated in a hospital or other health-care setting, where MRSA resistance to clindamycin is common.

Dr. Buddy Creech, an infectious disease specialist at Vanderbilt University Medical Center, said the research "fits nicely" with smaller studies reporting local increases in MRSA head and neck infections.

"Every time someone looks, the rates of MRSA are going up and that's certainly concerning because it's a bug that can cause dramatic disease," Creech said.

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On the Net:

Archives: http://www.archoto.com

CDC: http://www.cdc.gov/ncidod/dhqp/ar_mrsa.html

Copyright 2009 The Associated Press.

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Sunday, January 18, 2009

Caution: Students soaring ahead

Date: 1/18/2009

By DORIE TURNER
Associated Press Writer

ATLANTA (AP) — The seventh-grade students are playing a round-robin trivia game, excitedly naming the countries on a blank map showing on their classroom's overhead projector. Burkina Faso. Cote d'Ivoire.

Justyn McGowan does a dance each time he gets an answer right and remains standing as one-by-one his classmates sit down, disappointed.

Ghana. Togo. Benin.

Faster and faster, the teacher goes around the room until it's just Justyn and another boy.

The tallest mountain in Africa? Mount Kilimanjaro. The tallest mountain range in South America? The Andes.

And then it's over. Justyn doesn't win the game but he's still smiling, showing off the deep dimples in his cheeks. His 25 classmates erupt into cheers, applauding both students.

This is how it works at the extraordinary Ron Clark Academy, a private middle school tucked among boarded-up houses and graffiti-peppered walls in Lakewood, one of Atlanta's poorest neighborhoods.

Ron Clark isn't just the name behind the school — he teaches mathematics and global politics, plays basketball and spends many evenings on the phone with boys and girls who need help with homework.

Going over a test, the lanky 37-year-old quickly covers members of the U.S. Supreme Court and the presidential line of succession. Amid the questions, Clark utters the magic words that send his students into musical overdrive.

"It's easy," he says.

"It's so easy, easy," the students sing in unison, swaying their hands back and forth, ending with a "Bom, bom."

These children know a collection of songs written by Clark, ditties that help them remember everything from algebra to political platforms. He wrote many of them while teaching in New York City schools, a unique strategy that helped him win the Disney American Teacher of the Year title in 2000 and inspired a TNT movie, "The Ron Clark Story."

Seventh-grader Ajee Jenkins says music helps her connect with what she's learning in a way she's never experienced.

Indeed, music has made the children overnight stars. Last fall they scored millions of views of their YouTube video featuring an infectious election rap called "Vote However U Like," which led to Justyn and his classmates performing on "Good Morning America," CNN and BET.

Each appearance, the children discussed political platforms for Republicans and Democrats, talking about capital gains taxes and the war in Iraq with the composure and maturity of grown-ups.

They've written a follow-up song called "Dear Obama" that some students will perform at the inaugural celebration for the new president.

On the way to class each morning, Justyn passes a sign in the lobby at the foot of a blue plastic slide that curls from the second floor down to the first.

"Caution: People flying!" it warns.

It's not merely a warning that students might come shooting out the mouth of the slide. The sign is the unspoken mantra in the halls of this unique school, where students say "yes, ma'am" and "no, sir" and look you in the eye while giving a firm handshake.

They wear their uniforms with pride: khaki pants, light blue shirts and navy blue blazers — girls have the option of wearing skirts. Their navy blue ties are trimmed with the colors and crests reflecting which of the four houses they belong to: Isibindi (Zulu for "courage"), Reveur (French for "dreamer"), Amistad (Spanish for "friendship") or Altruismo (Portuguese for "altruism").

From fundamental discipline to essential courtesy, these children are learning what it takes to succeed, and they're soaring.

"I don't care if you have a problem with your parents, your brother, your cousin. I don't care if things are tough at home," says Clark, a white man looking at a sea of black faces in his global politics class. "You have no excuse. You have got to find a way to rise above that and be successful."

Debate is a key to what the students learn here, and it spills over into their personal conversations.

At lunch, Justyn and his friend Willie Thornton are deep in a discussion over which kind of pilot is more important to his country. Justyn dreams of flying for a commercial airline, Willie wants to be an Air Force fighter pilot. The 12-year-olds volley back and forth like seasoned politicians on the stump.

"People are depending on us to take them from one country to another country. They need us," Justyn says.

"We have missiles, we have guns, but all Boeings have are peanuts and crackers," Willie retorts.

Just one day at Ron Clark Academy reveals how these boys and girls from mostly working-class families in Atlanta are changing perceptions — and beating the odds. They come from some of the city's toughest neighborhoods. They could be joining gangs, failing out of school. They could easily become tragic statistics.

Instead, the 80 students who attend this academy in a renovated 100-year-old warehouse have gotten a chance at something most urban students can only dream about. They are attending a private school carrying a price tag of $14,000 a year per student, a bill paid almost entirely by donors.

Oprah Winfrey's foundation sent the school a $365,000 check for Christmas, a gift that can pay for 26 students to attend the academy for a year. She calls Clark a role model and applauds the "profound difference you're making with your passion for teaching."

The children each have their own donated Dell laptop and sit in classrooms decorated with colorful mosaics painted by Atlanta graffiti artist Totem. Instead of chalkboards, teachers use interactive projection screens that respond to touch like an iPhone.

The bathrooms feature flat screen TVs broadcasting CNN, a strategy Clark says keeps students preoccupied in the place where most school fights break out. They take trips abroad thanks to Delta Air Lines, traveling to countries most of their parents couldn't afford to take them — the Netherlands, England, France and Australia. It's part of the school's curriculum to escort students to six of the seven continents by the time they finish the eighth grade.

"We're not just teaching math and reading for a test. We're teaching life," says Clark. "We want kids to have appreciation of other countries and religions."

Many days, teachers from school districts across the globe visit the academy, observing classes and learning techniques to take back to their schools. About 3,000 teachers visit each year, a way for Clark to reach beyond the students he teaches.

The school was founded on one basic principle — any child can learn. Clark was tired of the excuses he was hearing for children he taught in his home state of North Carolina and in a Harlem public school.

They're too unruly. They have a hard home life. They're a lost cause.

He created a set of rules called "The Essential 55," which became the title of his best-selling book, aimed at creating a structure that promotes a mix of creativity and discipline. He teaches classes with animation, doing impressions of presidents Richard Nixon and John F. Kennedy.

He marches around on the desktops, crouching down to make eye contact with each child as he lectures on Supreme Court cases and sings about algebraic equations. Students must sit up straight, pay close attention and answer "yes, sir" or they could face detention.

"If there's no structure, you end up with chaos. That's how creativity gets a bad name," said Kim Bearden, an English teacher who co-founded the school with Clark in 2007. "We teach them how to have organized creativity."

For students like Justyn, who lives with his mother, her boyfriend and his 6-year-old half-sister, Taylor, in a Habitat for Humanity house not far from a federal prison, the school is a lifeline. He likes school now, has fewer discipline problems and is more respectful, his mother, Shaewana Johnson, said.

He likes to wear his glasses in class, something that might have gotten him picked on at his old school. He doesn't talk back to adults. He stopped mentioning wanting to be a basketball player when he grows up, shifting his focus to becoming an airline pilot so he can see more of the world.

"He would have fallen into that peer pressure trap. I can't afford to supply him with the shoes these students have," said Johnson, 32, who works full-time at a daycare center and takes college classes in hopes of becoming a school counselor. "He would try to fit in and he would be an angry child."

Justyn has a daily checklist he must complete, with tasks for the morning and evening.

Wash face. Brush hair. Iron clothes. Put book bag by door. Make up bed. Organize desk.

School is his magnet now, a place where students aren't allowed to tease each other.

"I want to get up in the morning and go," he said as he stood in his bedroom, which was recently redecorated courtesy of Delta after he won a school essay contest. "It's just something in me. I want to go to school."

In each classroom, around every corner, along the corridors countless surprises emerge.

Life-sized cardboard cutouts of the students hang from windows, hover over door frames and smile down from the upper balcony. Walls are decorated with brightly colored graffiti murals of city skylines, football games and the Seven Wonders of the World.

In the student garden, they're helping to grow carrots, potatoes and spinach for the school cafeteria. The stairwell is lined with coins from every country in the world — among them the Japanese yen and Italian lira (now defunct).

One classroom is dedicated to The Gauntlet, an academic obstacle course where children are tested on what they learn during the year. Students run from station to station, only moving on once they've answered the math problem or geography trivia question correctly.

Classrooms burst with song, drumming and dancing. Cheers of students applauding each other's correct answers echo in the hallways.

"We teach them how to represent themselves in society, how to be articulate," Clark said. "We still are struggling with prejudices in our country. I never want to give anyone an opportunity to deny my students a chance because they don't know how to present themselves or act in a certain situation. We're taking away excuses from people."

The 2-year-old school serves fifth- through eighth-graders, though the first class of eighth-graders won't start until next year. Once the children graduate, Clark and Bearden hope to get them into some of Atlanta's private high schools.

In math class, Justyn's worst subject, he is using Life Savers, mints and licorice to graph out the concepts of greater than, less than and equal to. He gets the first few wrong but doesn't give up.

"I'm gonna get this one," he says under his breath, determination in his eyes.

He does, and the dimples sink even deeper into his cheeks as a grin lights up his face. The next problem proves even tougher than the last, and just when hope seems lost, his buddy Jalen Tyler pipes up.

"You got it, Justyn!"

Even the crowd at the football game painted on the classroom walls seems to cheer him on.

Copyright 2009 The Associated Press.

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Monday, January 12, 2009

Nutrient diligence needed for vegetarian kids

Date: 1/11/2009

By MIKE STOBBE
AP Medical Writer


Children who want to be vegetarians need to "fill in the blanks" of their low-protein diets by eating alternatives to red meat, fish and poultry, experts say.

Good examples are soybeans, fortified soy milk and nuts. Those are important sources of the protein, iron, zinc, calcium and vitamin D that most kids get from meat.

Nutritional yeast — which has a cheesy flavor — has the much-needed vitamin B-12. And flaxseed is good for linolenic acid.

Vegetarian children who eat eggs and dairy products will most likely get all the nutrition they need. But those who become vegan — abstaining from dairy — need to be more diligent, said Dr. David Ludwig of Children's Hospital Boston, a specialist in pediatric nutrition.

"It really requires much more attention to avoid nutrient deficiencies," Ludwig said.

Children can start on a vegetarian diet from birth, said Sarah Krieger, a spokeswoman for the American Dietetic Association who is a registered dietitian at All Children's Hospital in St. Petersburg, Fla.

Breast milk or an iron-fortified formula are necessary in the first six months, she said, adding that soy-based formula is an option.

Copyright 2009 The Associated Press.

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Thursday, January 8, 2009

Search abandoned for NJ baby's body, lost in trash

Date: 1/8/2009

JERSEY CITY, N.J. (AP) — Police who searched dumps in three states for the remains of a baby thrown out in a Jersey City hospital's trash gave up Thursday, saying they had little chance of success.

"We have come to the harsh reality that efforts to locate the remains of Bashere Davon Moyd Jr. would be a Herculean undertaking with little probability of a successful conclusion," Jersey City police Chief Thomas Comey said in a statement posted on the department's Web site.

Authorities had been looking for the baby's body since Jan. 2, when it was discovered missing from the morgue at Christ Hospital. The remains apparently were thrown away with the hospital's trash sometime between Dec. 21 and Jan. 2, police said.

They searched dumps in New Jersey and Pennsylvania before focusing on a landfill in Ashland, Ky., where the waste may have been transferred. On Wednesday, Comey said he feared the waste was sent elsewhere and may have been incinerated.

Hospital officials and police have declined to say exactly how the baby ended up in the trash.

"The investigation failed to uncover any evidence of criminal conduct, but rather indicated this unfortunate incident was the result of procedural deficiencies and human error," Comey said.

The baby was delivered Dec. 21. Hospital officials say it was stillborn, but the mother, 26-year-old Kalynn Moore, said her son was born alive with a weak heartbeat and died about 20 minutes later as doctors tried to save him.

Whether the child was stillborn is an important legal distinction because New Jersey law does not recognize stillborn babies as human.

Moore's lawyer, Michael Anise, has said that a lawsuit is likely. He maintains there is no reason for the body of a fetus to have been thrown into the trash.

Copyright 2009 The Associated Press.

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Monday, January 5, 2009

Shaping good health as teens outgrow pediatrician

Date: 1/5/2009

AP Medical Writer

WASHINGTON (AP) — Ever watched a teen skulk in the corner of a toddler-packed pediatrician's waiting room, obviously wishing to be anywhere else?

Adolescents aren't just big kids, and too many start falling through cracks in the health care system when they pass the stage of preschool shots and summer camp checkups — what a major new report calls missed opportunities to shape the next generation's well-being.

The period between ages 10 and 19 is unique, bringing more rapid biological changes than perhaps any age other than infancy. Even though most of the nation's 42 million adolescents seem to be thriving, it is a time of risk-taking and pushing boundaries in ways that can mean immediate consequences: Car crashes, experimenting with alcohol or drugs, teen pregnancy, sexually transmitted disease.

And it's also an age when many of the habits that determine good health during adulthood are set, or not.

"They are quite literally our future. If we don't take good care of them, there's a strong likelihood when they're running the ship they're not going to have a good time running the ship," said Dr. Frank Biro of Cincinnati Children's Hospital's long-running adolescent medicine program.

Yet the system of care for tweens and teens is fragmented and poorly designed. Few doctors specialize in adolescents' complex needs, or provide comprehensive care that earns their trust, concludes a recent probe by the National Research Council and Institute of Medicine. Most at risk are the poor.

The result: The past decade has brought declines in teen pregnancy and smoking but little other overarching progress. Tweens and teens increasingly are overweight; physical activity's dropping; chronic diseases like asthma and diabetes are on the rise; and injuries, chiefly from car crashes, remain this age's leading cause of death.

While 20-somethings tend to see primary-care doctors the least, a gradual falloff begins in adolescence. Only a fraction of tweens and teens have been screened for risky behavior so doctors can intervene before a problem arises, the report found. Between 10 percent and 20 percent of adolescents annually experience a mental health disorder, such as depression or anxiety, with less access to that specialty care. Five million are uninsured, too often even left out of federal-state programs designed to provide health coverage to children.

Yet half of deaths among adults are due to health-related behaviors that often start during adolescence.

"A 10-year-old is probably the healthiest person in America," notes Dr. Frederick Rivara of the University of Washington, a co-author of the new report. "Something happens between age 10 and age 25."

Teens do tend to see a doctor, clinic or school-based care program somewhat regularly, if not because parents demand it, then for vaccinations or the 15-minute physical required by sports teams. But the report notes it can take at least 40 minutes to do a thorough adolescent checkup, including screening and counseling for risky behaviors — the kind that may prompt enough trust for the teen to return with a problem he or she doesn't want Mom to know about.

But with fewer than 500 doctors certified as adolescent medicine specialists between 1996 and 2005 — some states have none — most families will need to hunt a pediatrician or family physician with the communication and social skills and, perhaps more importantly, the true interest to engage a teen.

"Adolescents have so much energy. They see the world so differently than you or I," says Biro, Cincinnati's adolescent medicine chief, who wasn't part of the report and says society's stereotype of sex and drugs isn't the typical teen.

The relationship starts with the doctor making clear that the adolescent has a right to patient confidentiality that grows with age, although he or she must work with the parents, too.

As Biro describes the balancing act: "As long as you're not hurting yourself, another person or getting hurt by another person, I will hold that information confidential. ... If there's a direct health risk that could involve their life, then I will share that."

Then comes recognizing that the early teen years are when kids move from concrete thinking to more abstract thought — they begin to connect the dots, Biro explains. They may assume the doctor connected the dots the same way, meaning a girl who complains of stomach pain may not volunteer that she's fears pregnancy.

"It's not that they're withholding information. They figure they've just told you everything you need to know because the rest of it you should be able to figure out," Biro says. "I prove to them I am indeed about as smart as mud and I have to ask them more probing questions."

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EDITOR's NOTE — Lauran Neergaard covers health and medical issues for The Associated Press in Washington.

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On the Net:

Society for Adolescent Medicine: http://www.adolescenthealth.org

Adolescent medicine report: http://www.iom.edu

Copyright 2009 The Associated Press.

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