Medical Health Center

Young People Divided On Housework And Abortion

Young people from 10 countries around the world have shared their views on housework and abortion issues in a new study from the University of Adelaide, Australia.

The research, conducted by Professor Chilla Bulbeck in the University’s Discipline of Gender, Work and Social Inquiry, looked at the attitudes of young men and women to a number of gender equality issues.

Small surveys were conducted at high schools and universities in the United States, Canada, Australia, Korea, China, Japan, Vietnam, Thailand, India and Indonesia.

“Apart from Australia and Japan, my samples were small and confined to young, middle-class urbanites. Nevertheless, this study is unusual because it covers so many nations, and the comparisons offer some interesting food for thought,” Professor Bulbeck says.

“Overall, the results show that young men and women are divided on the issues of sharing housework and a woman’s right to have an abortion. It should come as no surprise that young women are more in favor of domestic democracy than the young men, while also being more supportive of a woman’s right to have an abortion,” she says.

“It is interesting to note that those in western countries tend to see sharing housework and ‘role reversal’ as similar ideas, whereas most of those from Asian countries who are also supportive of sharing housework were quite opposed to role reversal. While this might indicate to some people that greater equality exists in the western countries, another interpretation is that it demonstrates the greater commitment to the fathers’ bread-winning role in the Asian countries.”

Professor Bulbeck says the young men surveyed were more likely to want to have their say on abortion than they were on sharing housework.

“While performing housework and childcare was seen as nothing short of emasculation for many of the young men in my study, this does not prevent them from claiming their rights in relation to abortion decisions,” she says.

“The Chinese people surveyed were the most accepting of a woman’s right to have an abortion, with both males and females seeing this as her decision. In some cases, the Chinese responses asserted that both parents had responsibilities in relation to the child, but it was the woman’s right alone to choose an abortion.”

Infant sensitivity to negative emotional expressions develops at around 6 months

Scientists working in the Academy-funded Research Programme on Neuroscience (NEURO) have discovered important changes in the way that infants react to another person’s face at age 5 to 7 months.

Infants aged 5 months react very differently to a fearful face than those aged 7 months. “At the age of 7 months babies will watch a fearful face for longer than a happy face, and their attentiveness level as measured by EEG is higher after seeing a fearful than a happy face. By contrast, infants aged 5 months watch both faces, when they are shown side by side, for just as long, and there is no difference in the intensity of attention in favour of the fearful face,” said Mikko Peltola, researcher at the University of Tampere, at the Academy’s Science Breakfast this week.

It seems that at age 6 months, important developmental changes take place in the way that infants process significant emotional expressions. A fearful face attracts intense attention by the age of 7 months. In addition, it takes longer for infants to shift their attention away from fearful than from happy and neutral faces.

“Our interpretation of this is to suggest that the brain mechanisms that specialise in emotional response and especially in processing threatening stimuli regulate and intensify the processing of facial expressions by age 7 months,” Peltola said.

The emotions conveyed by facial expressions are an important part of infant-parent interaction from childbirth onwards. Another area of interest in the Neuroscience Research Programme is how inherited differences impact the development of perceptual functions in infants. Likewise, scientists in the programme are interested in interindividual variation in mother-child interaction.

The results of the project shed useful new light on emotional reactions related to the perception of human faces and how they develop. Furthermore, the project will help to increase understanding of the development of perceptual functions that are crucial to normal social interaction.

Make Sure Kids Get Required Vaccinations Before School Starts

As the first day of school approaches, the Health Department is reminding parents to get their kids the required vaccinations. City public schools open on September 2 this year, leaving only three more weeks to get your child to the doctor. Vaccines can prevent many serious illnesses, such as diphtheria, measles, and whooping cough. Children who do not meet the City’s immunization requirements can be excluded from daycare, pre-kindergarten and kindergarten-through-12th-grade schools.

Vaccination is the surest way to protect your child from contagious diseases that still cause outbreaks. This year alone, New York City experienced two dozen cases of measles – two-thirds of them among children.

New Vaccination Requirements for 2008-2009 School Year

Vaccines work best when they are given at certain ages. New York State law requires that children be immunized if they attend a childcare facility and when they enter school. School vaccine requirements are structured to ensure that children get vaccinated at the best times. See new requirements below:

* The vaccine against tetanus, diphtheria and pertussis (Tdap) is now required for students entering either 6th or 7th grade if they are at least 11 years old. The 7th grade requirement is new this year.

* The chicken pox (varicella) vaccine is now required for all children from pre-K through 9th grade. (Fifth graders were still exempt last year, after 4th and 8th graders were added to the required list.) Two doses are recommended.

“To avoid any hold ups on the first day of school, parents should make sure their kids have their vaccinations,” said Dr. Jane R. Zucker, Assistant Commissioner for the Health Department’s Bureau of Immunization. “These shots are required for good reason: they protect your child from serious diseases. If you have questions about where to get free or low-cost shots, call 311.”

All children entering school must also show proof that they received a complete medical evaluation. For a full list of required immunizations, see the nyc.gov/health (under “School Health”) or call 311.

Vaccines to Protect People of All Ages

Vaccines are not just for kids. All New Yorkers should mark National Immunization Awareness Month by checking their immunization status in August. Here are some of the vaccines recommended for people of various ages:

* Rotavirus vaccine to protect infants against a severe type of diarrhea

* HPV (human papillomavirus) vaccine to protect girls and women (ages 9-26 only) from the virus that can cause cervical cancer

* Hepatitis A vaccine to protect children against this food-borne infection.

* Meningococcal vaccine, to prevent meningitis, for adolescents

* Zoster vaccine to help adults 60 and over prevent shingles

* Tetanus vaccine boosters are due every 10 years to maintain immunity. If you have not had a tetanus booster already, you should get a Tdap (which prevents pertussis as well) when your next booster is due. This is especially important for adults who have contact with young children.

* Children born on or after January 1, 2008 now have a pneumococcal vaccine to attend daycare if they are at least 9 months old.

As always, an annual flu shot is recommended for groups at high risk including people over 50, children between 6 months and 18 years of age, pregnant women, people with chronic medical conditions and all health care workers.

Vaccines against other infections, such as hepatitis (A and B) and pneumococcal infection, may be needed depending on your job, medical condition or age. And before you travel abroad, remember that you may need certain vaccines before you take off.

Protecting Most Vulnerable From Flu Pandemic

Current estimates show that as many as 105 million people in the U.S. may be infected during the next influenza pandemic and nearly 2 million may die from flu-associated illness. At the same time, current vaccine and antiviral resources will be available to less than half the population when an outbreak occurs. A critical question: What happens to the infirm elderly, the most vulnerable among us?

The answer may be found in nonpharmaceutical interventions, or NPIs.

In a study published in the current online edition of Proceedings of the National Academy of Sciences, Miriam Nuno, a postdoctoral researcher at the UCLA School of Public Health, and colleagues found that preventing the introduction of pandemic influenza at nursing homes is possible by using only nonpharmaceutical interventions — wearing masks, isolating the sickest people, modifying staff work schedules and limiting group activities and outside visitors.

The researchers used a mathematical model to look at how to best protect the estimated 2.5 million residents of U.S. nursing homes. Their findings are the first to show that containment of influenza is achievable with the use of NPIs, which are likely to be the only resources readily available during a pandemic outbreak.

“In a pandemic, making enough vaccine to protect everyone will take months,” Nuno said. “So we focused our research on protecting this vulnerable group, because vaccination levels in these facilities among both residents and staff will be low. And unlike acute-care hospitals, where people constantly come and go, nursing homes have a real chance at controlling access and can thereby potentially prevent a virus introduction.”

Specifically, the researchers had three goals in the study:

* To determine whether an intrinsic ability to control access to these facilities provided a basis for protection.

* To identify specific NPIs and combinations of NPIs that could achieve community access control.

* To develop practical combinations of these NPIs that could be sufficiently implemented for protection over the full range of projected pandemic categories.

“On the face of it, it seems implausible that nonpharmaceutical measures alone would help contain a pandemic influenza,” Nuno said. “And in acute-care hospitals, it probably isn’t.”

But in the more controllable environment of a nursing home, Nuno said, NPIs may really work.

The researchers evaluated five levels of nonpharmaceutical interventions, which varied according to the severity of the pandemic. They included screening visitors and staff who come and go, and placing restrictions on visits by family and friends; isolating those residents who show symptoms; modifying staff work schedules — such as working four days on and four off, with a period of isolation from the community for a portion of the time off; and evaluating precautions taken by staff and visitors to reduce their risk of infection, such as wearing protective masks and frequently washing hands.

“Overall, we found that conventional NPIs are sufficient to curtail mild outbreaks, and that higher levels of NPIs requiring greater social restrictions and higher levels of cooperation were needed to manage more severe outbreaks,” said Gerardo Chowell-Puente, a co-author of the study from Arizona State University.

But the biggest surprise, Nuno said, was “identifying the critical role that staff plays in controlling the spread and preventing the introduction of disease in these facilities.”

“Staff members are highly overworked and underpaid and very frequently work multiple jobs to make ends meet,” Nuno said. “They are continuously challenged with the decision of going to work even when sick or losing wages by staying at home.”

They are also the ones who most frequently come and go. That leads to a critical NPI need: paid sick days for staff.

“Our work shows that isolation periods are essential to control the introduction of the virus and thereby prevent a pandemic,” Nuno said. “In our view, the only feasible way to implement isolation periods is if staff receive paid sick days.”

The research, Nuno said, provides a road map for flu prevention and protection of residents in these facilities. Currently, the majority of nursing care facilities do not have a ready-to-execute plan in the event of a pandemic.

“Our work details a set of simple interventions that seem workable and that may be easily implemented by current staff members,” Nuno said.

New School Year: Starting And Staying Healthy

School’s about to start and schedules will soon be filled with extra-curricular activities. That makes it hard to keep health top-of-mind. Here, experts at Duke University Medical Center advise how to ensure your child stays healthy throughout the year:

Wash Your Hands

Viral infections run rampant in classrooms, which may be why most children under six have eight to 12 respiratory infections per year.

“They play closely together, mouth their toys and touch one another,” explains Coleen Cunningham, MD, chief of pediatric infectious diseases at Duke. “Frequent handwashing is the best form of infection control out there.”

Teach children to keep fingers, toys, and anything else out of their mouths. Use anti-bacterial wipes and cleansers to rid skin of germs.

If your child gets sick, don’t despair. Most viral infections aren’t serious. “They stimulate the immune system and can even teach kids a lesson or two in empathy,” says Dr. Cunningham.

Play It Safe

More than 3.5 million children age 14 and under are injured playing sports or participating in recreational activities annually.

Remind children to wear helmets when wheels are under their feet. Insist that they wear protective equipment made for their sport, including mouth guards, which can protect against injuries that harm children’s teeth, lips, cheeks, and tongues.

Keep Obesity at Bay

The CDC recommends children get at least 60 minutes of physical activity a day, but fewer than three percent of 15 year olds do. Encourage kids to be active daily, whether it’s playing neighborhood games, through a community league, school activity, or other opportunities.

“Encourage them to stay active, and be a role model by showing them you enjoy an active, healthy lifestyle, too,” says Sarah Armstrong, MD, a pediatric obesity specialist at Duke. “Suggest they try new things. Support their interests. That’s how they will develop a lifelong habit of activity.”

Get Enough Sleep

If you’re having a hard time getting your child up each morning, join the club. As kids grow, they get sleepy later in the evening. But busy family schedules, little to no bedtime supervision and today’s technology aren’t helping.

“Too little sleep can negatively impact children’s health and learning potential,” says Michelle Bailey, MD, a pediatrician with Duke Integrative Medicine. “Lack of sleep interferes with a child’s ability to concentrate, and may lead to school difficulties, behavior problems, and even misdiagnosis of attention deficit performance.”

To ensure your child gets the recommended 10 hours of sleep each day, establish uniform bedtimes, avoid letting children eat late or drink caffeine in the evening, and reinstate bedtime rituals.

Keep Vaccines Up to Date

New vaccine recommendations aim to lower kids’ risk for contracting whooping cough, which is occurring more frequently. Also known as pertussis, the bacterial infection is contagious and can be deadly if transmitted to infants. Children ages 10-13 now need a booster to protect them against diphtheria and tetanus, and a new Tdap vaccine offers protection against those infections as well as pertussis.

Doctors now recommend children get vaccinated against meningitis starting at ages 11 and 12. About 20 percent of people who contract the disease die, and approximately 50 percent of survivors suffer permanent damage. The new vaccine immunizes children against four of the five types of meningococcus bacteria and is more effective than the shot previously available.

Gardasil is a relatively new vaccine that targets four strains of the human papillomavirus (HPV), a common sexually transmitted virus that causes genital warts and most cases of cervical cancer. “Since these viral infections are rapidly acquired with sexual debut, it’s recommended that girls receive this protection between the ages of 11 and 18, before embarking on sexual activities,” says Samuel Katz, MD, chairman emeritus of pediatrics at Duke. “It will be many years before we can state with certainty that they will protect against cervical cancer, but the evidence is highly convincing that it does protect against the viruses that are responsible.”

Do a Mental Health Check

By the time kids reach high school, their risk for starting bad habits such as smoking, drugs, and drinking rises dramatically. That’s also the time when kids may engage in high-risk sexual behavior. Keeping the lines of communication open with your children is smart, and eating as a family is a good place to start.

According to Nancy Zucker, director of the Duke Eating Disorders Program, female teens with families who ate together were less likely to engage in substance abuse and disordered eating behavior. “So much happens at family meals,” Dr. Zucker says. “Parents get the opportunity to prepare and observe healthy eating behaviors, teach family teamwork and communication skills. And adolescents can trust that there is a certain time each day when they have their parents’ undivided attention to share the events of the day.”

Safety City USA Offers Free Car Seat Safety Checks

On Thursday, Aug. 14, Safety City U.S.A. is offering Beaumont area residents “Car Seat Safety Checks.” Certified child passenger safety technicians will check and teach parents how to properly install car seats at no charge. The event begins at 11 a.m. and ends at 3 p.m. Safety City U.S.A. is in the Northwood Shopping Center, 30955 N. Woodward Ave. (at 13 Mile Road), Royal Oak.

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Study Outlines Effective Partnerships On Mental Health Of Urban Students

Addressing and improving mental health outcomes for students is a particularly complex issue in urban public schools. Proposed solutions to critical situations are usually prepackaged suggestions from research conducted outside of the communities seeking help.

A new study approaches community partnerships and their ability to problem-solve in-depth right in their own backyards. In an article published this month in the Journal of Community Psychology, a community-based research group composed of a child psychiatrist, two researchers, and a school principal analyze the key principles to establish successful partnerships and build an alliance for educational systemic change.

Three guidelines - attachment theory, use of authentic self, and learned optimism - were derived from the authors’ work over four years with an urban public school system focused on improving the behavioral and academic functioning of immigrant students.

The researchers were driven to action by the significant learning gaps seen in immigrant students. Frustrated by the lack of services available to address the achievement gap, the researchers worked to define problems in collaboration with school staff. Interventions were piloted, school resources were reviewed, and many project participants were interviewed at length to identify the barriers in serving these students.

“Community-based partnerships are often touted as encouraging collective problem-solving while capturing the complexity of educational settings, yet we found challenges when engaging in such research,” said Nancy Rappaport, MD, the study’s lead author and director of school-based programs at Cambridge Health Alliance. “It became clear that participants held different pictures of how the group should address the immigrant students’ achievement gap.”

Co-author and school principal Barbara Boyle discussed the dynamic between teachers and researchers: “The pot boiled in our meetings. All these ideas, solutions, and strategies were talked about and this provided a catalyst for us to take it another step. The think-tank approach allowed us to develop trust, listen to each other and no one was the ‘authority with the answer.’ But the thoughtful reflection affected how we made decisions.”

The researchers found the management of expectations, particularly maintaining optimism in the face of negative experiences, to be a key component of successful community-based partnerships. Learned optimism is a concept that helps to counteract feelings of despair by challenging the belief that a situation is permanent and pervasive. By reframing disappointments and identifying incremental positive change, this allows progress on seemingly large and entrenched problems.

Evaluating Children In Preschools Programs

Growing interest in publicly funded programs for young children has drawn attention to whether and how Head Start and other early childhood programs should be asked to prove their worth. Congress asked the National Research Council for guidance on how to identify important outcomes for children from birth to age 5 and how best to assess them in preschools, child care, and other early childhood programs.

The Research Council’s new report concludes that well-planned assessments can inform teaching and efforts to improve programs and can contribute to better outcomes for children, but poor assessments or misuse of the results can harm both children and programs. The report offers principles to guide the design, implementation, and use of assessments in early childhood settings.

Federal agencies, states, school systems, and other organizations that evaluate early childhood programs or the children they serve should make the purpose of any assessment explicit and public in advance, the report says. For example, a state should specify whether an assessment will be used to help teachers gauge the progress of individual children or to help public agencies decide whether to continue a program’s funding.

“The goal of the assessment should guide the choice of the assessment tools used, and assessments that will have widespread effects should meet high standards of rigor and validity,” said Catherine Snow, a professor at the Graduate School of Education at Harvard University and chair of the committee that wrote the report. “For example, using a standardized test with a sample of children in a program would be suitable if the goal was to determine whether the program is bringing children closer to national norms, but if the purpose is to guide instruction within a specific classroom, a nonstandardized assessment linked to the curriculum would be appropriate.”

Effective assessment must be part of a larger system with a strong infrastructure to support children’s care and education, the report says. Facets of this system should include clearly articulated standards for what children should learn and what constitutes a quality program. Other aspects include professional development opportunities, training to familiarize policymakers, teachers, and administrators with standards and assessments, and continuous monitoring to ensure that all elements of the system are working together to serve the interests of the children.

The report urges extreme caution in basing high-stakes decisions — such as determining whether a program will receive continued funding or whether a child is eligible for services because of an identified disability — on assessments of young children. Models such as those set forth in the No Child Left Behind Act strive to link yearly progress assessments to explicitly defined academic content areas for children in grades three through 12. It would be inappropriate to borrow this model unchanged and apply it to early childhood settings, the committee said, because well-defined academic content areas are not characteristic of excellent care and education for younger children.

Cutting a program’s funding or imposing other negative consequences based on assessments of the participating children should happen only under certain conditions — if the program has been given enough resources to meet expectations, for example, and if the level of children’s development when they entered the program has been taken into account. Child assessment results should never be the only information considered. And a program should not be closed or restructured if doing so would have worse consequences for children than leaving it open, the report adds.

Likewise, decisions to penalize a teacher should never rest solely on findings from assessments of students in his or her classroom, without considering children’s starting points, how the test is related to the curriculum, and whether the teacher has adequate support, professional development, and other resources.

Programs’ quality should be evaluated based not only on how they affect children’s academic skills such as language and mathematics, but also on whether they improve other important aspects of child development, such as social and emotional skills, the report says. While good measures of certain outcomes — such as literacy and language development — currently exist, tools to assess other abilities such as problem-solving and creativity remain underdeveloped, and more effort will be required to improve their quality.

In addition, the report notes, some assessment measures have only been tested with populations that do not represent the diversity of children enrolled in today’s early childhood programs. Care should be used in assessing the status or progress of young children with special needs and those for whom English is a second language, because many existing instruments have not demonstrated their validity for these groups.

Health and marriage: The times they are a changing

The health of people who never marry is improving, narrowing the gap with their wedded counterparts, according to new research that suggests the practice of encouraging marriage to promote health may be misguided.

Hui Liu, assistant professor of sociology at Michigan State University and lead researcher on the project, said sociologists since the 1970s have emphasized that marriage benefits health more so for men than for women.

“Married people are still healthier than unmarried people,” Liu said, “but the gap between the married and never-married is closing, especially for men.”

The findings of Liu and fellow researcher Debra Umberson of the University of Texas at Austin will appear in the September issue of the Journal of Health and Social Behavior. The article is called “The Times They Are a Changin’: Marital Status and Health Differentials from 1972 to 2003.”

The researchers analyzed National Health Interview Survey data from that period and found that while the self-reported health of married people is still better than that of the never-married, the gap has closed considerably.

The trend is due almost exclusively to a marked improvement in the self-reported health of never-married men. Liu said that may be partly because never-married men have greater access to social resources and support that historically were found in a spouse.

Further, the research shows that the health status of the never-married has improved for all race and gender groups examined: men, women, blacks and whites. (The health of married women also improved, while the health of married men remained stable.)

“Politicians and scholars continue to debate the value of marriage for Americans,” the researchers write in the study, “with some going so far as to establish social programs and policies to encourage marriage among those socials groups less inclined to marry, particularly the poor and minorities.”

But the research findings “highlight the complexity of this issue” and suggest that “encouraging marriage in order to promote health may be misguided.”

In contrast, the self-reported health for the widowed, divorced and separated worsened from 1972 to 2003 relative to their married peers. This held true for both men and women, although the widening gaps between the married and the previously married groups are more pronounced for women than for men.

Immigrant Children Less Active Than US Born

Immigrant children are less likely than U.S.-born children to exercise regularly or participate in sports and other physical activities, according to a study published on Monday in the Archives of Pediatrics and Adolescent Medicine, the AP/Washington Times reports. For the study, lead researcher Gopal Singh and colleagues at HHS’ Maternal and Child Health Bureau conducted telephone interviews between 2003 and 2004 with the parents of nearly 70,000 white, black, Hispanic and Asian immigrant children ages six to 17.

The study — considered to be the largest on the issue — found that nearly 18% of foreign-born children with immigrant parents did not get any vigorous exercise each week and 56% did not take part in any team sports or games. By comparison, 11% of U.S.-born children with U.S.-born parents did not exercise regularly and 41% did not participate in organized sports. When the researchers combined the data for all the immigrant children, they found that 65% were physically active, compared with 75% of the U.S.-born children.

The study also found that the inactivity rate for Hispanic children was 23%; 13% for black children; 10% for whites; and 7% for Asian children. The rate of children who did not participate in organized sports was about 66% for Hispanic children; 49% for blacks; 38% for Asians; and 32% for whites. The researchers noted that the parents often are not well-informed about their children’s activity levels. The researchers said additional studies will be required to verify the findings of Asian children because there were comparatively fewer Asians involved in the survey.

Reasons

According to the AP/Times, the researchers explained the results by noting that immigrant families generally lived in low-income areas and less-safe neighborhoods, leading to less time and fewer outlets to pursue exercise and sports. In addition, the researchers noted that many immigrant parents place greater emphasis on reading, language lessons, studying and other sedentary pursuits. The study also found that immigrant children were not regular television viewers (Tanner, AP/Washington Times, 8/5).

Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Weekly Health Disparities Report, search the archives, and sign up for email delivery at kaisernetwork.org/email . The Kaiser Weekly Health Disparities Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. ? 2007 Advisory Board Company and Kaiser Family Foundation. All rights reserved.