KIDS MAY NOT BE RECOMMENDED FOR COVID-19 VACCINATION INITIALLY, U.S. CDS SAYS

(Reuters) - The U.S. Centers for Disease Control and Prevention (CDC) said on 10/14 that COVID-19 vaccines may not be initially recommended for children, when they become available.

Children, who rarely have severe COVID-19 symptoms, have not yet been tested for any experimental coronavirus vaccine. The CDC said so far early clinical trials have only included non-pregnant adults, noting the recommended groups could change in the future as clinical trials expand to recruit more people.

Pfizer Inc PFE.N has said it will enroll children, who are capable of passing on the virus to high-risk groups, as young as 12 in its large, late-stage COVID-19 vaccine trial, while AstraZeneca AZN.L has said a sub-group of patients in a large trial will test children between five to 12.

There is no vaccine for COVID-19 yet, but a handful of companies such as Pfizer and Moderna Inc MRNA.O are in final-stage trials of their experimental vaccines.

The CDC also said that any coronavirus vaccine would, at least at first, be used under the Food and Drug Administration's emergency use authorization, and that there could be a limited supply of vaccines before the end of 2020.

In case of limited supply, some groups may be recommended to get a COVID-19 vaccine first, the CDC said.

Coronavirus vaccines should be rolled out in four phases, with initial supply going to front-line health workers and first responders, an independent expert panel tapped by top U.S. health officials recommended earlier this month.
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WE ALL WANT THE ANSWERS!

LATEST INTERVIEW WITH DR. FAUCI

Here is a brief summary:

- There is a development of rapid $1 pocket test or COVID-19.
This will be a solution for reopening of schools and other businesses. This is an only way to ease the anxiety among people.
The sensitivity of this test will be less than the PCR-test, but high enough to be safely used.

- There is an evidence that COVID-19 causes the systemic infection and virus might be found in different organs. we do not have enough data yet.

- Rough estimate of mortality rate is 1%. Can not be accurately determined because asymptomatic and mild cases are not being tested. If a lot of people get infected, still a lot will die.

- Herd immunity in NYC is about 22%. In US in average, only 4-5%, very far from the level to stop the pandemic.

- Herd immunity most likely won't be achieved without vaccine. Or if achieved naturally, will take a lot of lives and long period of time.

- Natural and vaccine immunity most likely will wean. How fast? We do not know. Will reinfection cause lighter or more severe symptoms? We do not know.... Hoping for immunity to last at least a season. Booster doses might be required
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STUDY LINKS ZINC LEVELS TO COVID-19 OUTCOMES
Lower levels of zinc were associated with greater inflammation and poorer outcomes in hospitalized COVID-19 patients, compared with more healthful levels, researchers reported at the European Society of Clinical Microbiology and Infectious Disease's Conference on Coronavirus Disease. Pulmonologist Dr. Len Horovitz of Lenox Hill Hospital in New York City commented that one potential explanation is that zinc may have a protective anti-inflammatory effect. HealthDay News
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CHILDREN ACCOUNT FOR 10% OF US COVID-19 CASES
The US recorded more than 34,000 new COVID-19 cases and 422 fatalities on Tuesday, bringing the total number of infections to more than 6.5 million and deaths to 194,500. Nearly 550,000 children have tested positive for COVID-19 since the pandemic started, accounting for about 10% of all US cases, according to a report from the Children's Hospital Association and the American Academy of Pediatrics.
And please keep in mind that testing rate among kids is significantly lower than in adults. Which means that kids do get infected fairly frequently, but because they are often asymptomatic or with minimal symptoms, they mostly are not being tested, but nevertheless spreading the virus.
Scientists say 121 COVID-19 patients aged 21 and younger have died of COVID-19. Three-quarters of those deaths involved at least one comorbidity, with the most common underlying medical conditions linked to COVID-19 mortality being chronic lung disease, obesity, neurological or developmental disorders, cardiovascular disease, cancer and diabetes
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HOT TOPIC: SCHOOL REOPENING
www.nbclosangeles.com/news/local/calabasas-mayor-wants-to-open-schools-as-la-county-hits-breaks-o...
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CHECK YOUR VITAMIN D LEVEL
Vitamin D deficiency linked to increased COVID-19 risk
A study in JAMA Network Open found vitamin D deficiency was associated with a 77% increased risk of being infected with COVID-19. Researchers tracked the health of 489 patients whose vitamin D status was included in their EHRs before the pandemic started, and they found 22% of 124 patients with insufficient vitamin D levels tested positive for COVID-19, compared with 12% of those with sufficient levels.
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5 COMMON MISCONCEPTIONS ABOUT KIDS & CLOTH FACE COVERINGS
​​​​​By: Kimberly M. Dickinson, MD, MPH​ & Theresa W. Guilbert, MD, MS, FAAP​​

Along with physically distancing and good hand washing, masks or cloth face coverings are an effective way to help prevent the spread of COVID-19. Some parents may have questions and concerns about cloth face coverings, and we're here to help.

Here are 5 common questions about kids and masks, along with evidence-based information that will put your mind at ease:

1. Can wearing a mask make it harder​ for my child to breathe?
There have been concerns that cloth face coverings can reduce oxygen intake, and can lead to low blood oxygen levels, known as hypoxemia. However, cloth masks are made from breathable materials that will not block the oxygen your child needs. Masks will not affect your child's ability to focus or learn in school. The vast majority of children age 2 or older can safely wear a cloth face covering for extended periods of time, such as the school day or at child care. This includes children with many medical conditions.

2. Can masks interfere with a child's lun​​g development?
No, wearing a cloth face covering will not affect your child's lungs from developing normally. This is because oxygen flows through and around the mask, while blocking the spray of spit and respiratory droplets that may contain the virus. Keeping your child's lungs healthy is important, which includes preventing infections like COVID-19.

3. Do masks trap the carbon dioxide ​that we normally breathe out?
No. There have been false reports that cloth face coverings can lead to carbon dioxide poisoning (known as hypercapnia) from re-breathing the air we normally breathe out. But this is not true. Carbon dioxide molecules are very tiny, even smaller than respiratory droplets. They cannot be trapped by breathable materials like cloth masks. In fact, surgeons wear tight fitting masks all day as part of their jobs, without any harm.

However, children under 2 years of age should not wear masks since they may not be able to remove them without help. Children with severe breathing problems or cognitive impairments may also have a hard time tolerating a face mask and extra precautions may be needed.

4. Can masks lead to a weaker immune​ system by putting the body under stress?
No. Wearing a cloth face covering does not weaken your immune system or increase your chances of getting sick if exposed to the COVID-19 virus. Wearing a cloth face covering, even if you do not have symptoms of COVID-19, helps prevent the virus from spreading.

5. How do masks prevent the ​​spread of COVID-19?
When worn correctly, cloth masks create a barrier that reduces the spray of a person's spit and respiratory droplets. These droplets play a key role in the spread of COVID-19 because they can carry SARS-CoV-2, the virus that causes COVID-19. Masks also can protect you from others who may have coronavirus but are not showing symptoms and who could come within 6 feet of you, which is how far respiratory droplets can travel when people sneeze or cough or raise their voices.

​In order to be effective, masks should:

Cover both the nose and mouth​​

Fit snugly but comfortably against the sides of the face

Be secured with ear loops or ties

Have multiple layers of fabric

Allow for unrestricted breathing

​Be washed and dried carefully after use​

Another benefit of wearing masks is that they may keep people from touching their mouths and faces, which is another way COVID-19 can be spread. There are many types of masks, but cloths masks are best choice for the general public and families should choose a mask that is most comfortable while still providing a secure fit.

Remem​​ber
Cloth face coverings are an important tool in preventing the spread of COVID-19. They are safe and effective for children over the age of 2 years and adults. Cloth face coverings are especially important when social distancing, or keeping 6 feet away from others, is hard to do. Washing hands, staying home and physical distancing are still the best ways to keep your family safe from COVID-19. But when you go outside your home, wearing a cloth face covering will help keep you and others safe.

Don't hesitate to talk with your child's pediatrician if you have any questions about your child wearing cloth face coverings.
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MANY AMERICANS MAY NOT COMPREHEND COVID-19 INFORMATION AS AGENCIES FAIL TO MEET HEALTH LITERACY GUIDELINES, STUDY SAYS:

The U.S. Centers for Disease Control and Prevention, the White House and state health departments failed to meet guidelines when communicating vital information about COVID-19 to the public, according to a study released Tuesday.

The CDC, the American Medical Association and the National Institutes of Health all recommend that medical information for the public be written at no higher than an eighth-grade reading level.

But after studying 137 federal and state web pages, Dartmouth College researchers found that public information about the coronavirus averaged just over an 11th-grade reading level.

The study worries public health experts, who reference previous research highlighting health inequities among vulnerable communities impacted most by the coronavirus pandemic. 😂
USA Today
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DEALING WITH SCHOOL AND CHILDCARE CLOSINGS
To help contain COVID-19, many schools moved children to online learning at home. In addition, many parents are being asked to work from home. These forms of social distancing help slow the spread of the virus and prevent overloading the health care system.

But many families now face new challenges: how do we care for our children while working and schooling at home, and not panic during this unprecedented outbreak? The first step: take a deep breath. Know that we are all in this together. And together we will get through it.

Here are some other tips from the American Academy of Pediatrics to help you cope with this “new normal" until the virus is under control.

Slow the spread
It may be tempting to get kids together for play dates or sleepovers, but this should be avoided. Social distancing only works if we all participate. And slowing down or preventing the spread of the virus will save lives.

Protect grandparents. This is also not the time to visit grandparents or ask them to help out with child care duties. People who are over age 60 are at higher risk of severe illness with COVID-19 and should not increase that risk by being around children who may be ill with mild symptoms. However, they may feel alone or disconnected during social distancing, so keep up communications through phone calls, texting, or video chats.

Keep a routine
Since changes in routine can be stressful, it will be helpful to talk with your kids about why they are staying home and what your daily structure will be during this time. Let them help create a daily schedule that can hang on the refrigerator or somewhere they can see it each day. Be sure to include breaks from tele-work or schoolwork to relax and connect with each other.

Here are some ideas to help you create a daily schedule:

Wake up, get dressed and have breakfast at the normal time.

Decide where everyone can do their work most effectively and without distractions.

List the times for learning, exercise and breaks.

For younger children, 20 minutes of class assignments followed by 10 minutes of physical activity might work well.

Older children and teens may be able to focus on assignments for longer stretches, taking breaks between subjects.

Include your hours as well, so your children know when the work day is done.

Schedule time for nutritious lunches and snacks. Many schools are providing take-home school meal packages for students who need them.

Don't forget afternoon breaks as well!

Have dinner together as a family and discuss the day.

Enjoy more family time in the evenings, playing, reading, watching a movie or exercising together.

Stick with normal bedtime routines as much as possible during the week to make sure everyone gets enough sleep.

Try not to have the news on all day. It is best not to have the news on while kids are in the room as it can increase their fear and anxiety (and yours!). If they do listen to the news, talk together about what they are hearing and correct any misinformation or rumors you may hear.

Should I worry about extra screen time right now?
While limits are still important, it's understandable that under these stressful circumstances, kids' screen media use will likely increase. Here are some ways to help keep media use positive and helpful:

Contact teachers about educational online and offline activities your children should do. Preschool teachers may not have an online curriculum to share, but good options include PBS Kids, which is sending out a daily newsletter with show and activity ideas.

Use social media for good. Check in with your neighbors, friends and loved ones. If schools are closed, find out if there are ways to help students who need meals or internet access for at-home learning.

Use media for social connection. Social distancing can be isolating. If your kids are missing their school friends or other family, try video chats or social media to stay in touch.

Choose quality content and use trusted sources to find it. Common Sense Media, for example, suggests 25 dance games and other active apps, websites, and video games​ for families hunkering down right now.

Use media together. This is a great opportunity to monitor what your older children are seeing online and follow what your children are learning. Even watching a family movie together can help everyone relax while you appreciate the storytelling and meaning that movies can bring.

Take your child (virtually) to work. Working from home? Use this time as a chance to show your kids a part of your world. Encouraging imaginative “work" play may be a way to apply “take your child to work day" without ever leaving home!

Limits are still important. As always, technology use should not push out time needed for needed sleep, physical activity, reading, or family connection. Make a plan about how much time kids can play video games online with friends, and where their devices will charge at night.

Remember
Staying at home and other social distancing recommendations may feel like an inconvenience, but it's the best way right now to protect our family, friends, and neighbors who may be vulnerable.

If anyone in your home starts showing symptoms of COVID-19, call your doctor to discuss what to do.
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HIGH VIRUS LEVELS FOUND IN YOUNG CHILDREN WITH COVID-19
A 145-person study in JAMA Pediatrics found that children younger than 5 with mild-to-moderate COVID-19 infections had more viral RNA in the nasopharynx than adults and older children. "Thus, young children can potentially be important drivers of SARS-CoV-2 spread in the general population, as has been demonstrated with respiratory syncytial virus," the study team wrote. Physician's Briefing/HealthDay News (7/30)
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SURVEY ON SCHOOL RE-OPENING:
Survey Says Only 8% Of Americans Want Schools To Reopen Without Restrictions
Newsweek (7/23) reports 8% of Americans “believe daycare centers, preschools or K-12 schools should open this fall without restrictions, a new poll says.” In the same survey, 46% of respondents “said they thought major adjustments were needed if schools reopen in a few weeks, amid rising coronavirus cases in the U.S.”
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AVOCADOS AND BRAIN HEALTH AT EVERY AGE
Brain Health is important at every age and research supports the link between eating certain foods with keeping the brain healthy. Latest research is showing how avocados may support cognition.
A recent clinical study found that 84 overweight and obese adults performed better on a cognitive test when consuming fresh avocado daily for 12 weeks.
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WHAT TYPE OF CORONAVIRUS TEST SHOULD MY CHILD GET?
Families across the U.S. are talking about whether their children should be tested for COVID-19.

The American Academy of Pediatrics (AAP) encourages parents to talk to their child’s pediatrician about testing.

There are two types of COVID-19 tests: diagnostic tests and antibody tests. It is important to know what each test can and cannot do.

A diagnostic test can show if your child has COVID-19 infection now.

One kind of diagnostic test is a molecular test. It uses a nasal or throat swab or sometimes saliva. You might get results the same day or up to a week later. The molecular test is very accurate and tells you if your child has SARS-CoV-2, the virus that causes COVID-19. It will not tell if your child had COVID-19 in the past. It also will not tell you that your child will not become infected in the future.

Another kind of diagnostic test is an antigen test. It uses a nasal or throat swab. Results take an hour or less. Positive test results are very accurate. But if the test result is negative, a molecular test might be needed so you know for sure that your child does not have the virus that causes COVID-19.

An antibody test looks for antibodies in your child’s blood. The body makes antibodies to fight off viruses like SARS-CoV-2. An antibody test uses a sample of blood. It shows if your child was infected by coronavirus in the past. It cannot detect current COVID-19 infection. This is because it can take up to three weeks after your child first shows symptoms of being sick before the test can find antibodies in the blood sample. Many test locations can give you results the same day or within one to three days. Sometimes, a second antibody test is needed.

The AAP does not recommend testing every child. It is important to talk with your pediatrician about whether testing is necessary and if so, what option is best. Testing might be recommended for a child who currently has symptoms of COVID-19 or who was in close contact with someone with COVID-19. After testing, it is important to follow up with your pediatrician. She or he can explain positive or negative test results and answer questions. It is not known if people who had COVID-19 can catch it again.

If you have any concerns about your child’s health, call your pediatrician. Pediatricians are open for business and ready to care for your children.
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BATHING BABIES MORE THAN ONCE A WEEK NEARLY DOUBLES ECZEMA RISK

Bathing an infant more than once a week nearly doubles the risk for eczema, and each additional bath increases the risk for skin-barrier dysfunction, according to new research.

Previous studies have looked at bathing frequency in infants with eczema, but this is the first time investigators have looked at bathing in a general population of infants at a time when eczema typically develops, he said.

"Different professionals advise differently. Wash less? Wash more? There's a wide range of difference in awareness of the importance of this," he said. And although this is an observational study, it "tells us there is a relationship between bathing and skin dryness."

"In the first few months of life, there's a pride in routine, in bath, story, bed," Marrs said. However, "I would caution against a daily bathing routine; once a week is enough for a young baby, particularly if they have risk factors for developing eczema."
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REPORT FINDS OVER $1B WAS SPENT ON ADVERTISEMENTS IN 2018 ENCOURAGING PEOPLE TO DRINK SUGARY BEVERAGES
(6/23) reports people are faced with a “barrage of ads on television and social media designed to entice them to drink sugary beverages, a leading cause of obesity, type 2 diabetes and heart and kidney disease.” The “amount of money spent on such advertising exceeded a billion dollars in 2018, according a new report released Tuesday from the Rudd Center for Food Policy & Obesity at the University of Connecticut entitled Sugary Drinks FACTS 2020.” Dr. Natalie Muth, an AAP spokesperson and “lead author of the AAP’s policy statement on sugary drinks,” said, “The fact that so much money is spent to get minority teens hooked on these drinks is reprehensible and more needs to be done to stop it.” Muth added that “AAP recommends an ‘excise tax should be placed on these drinks and the proceeds committed to efforts to improve health equity and reduce disparities.’”
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HIGHER COVID-19 VIRAL LOAD, LESS SEVERE DISEASE REPORTED IN SYMPTOMATIC INFANTS

Infants were found to have higher SARS-CoV-2 nasopharyngeal viral loads at presentation but developed less severe disease compared with older children and adolescents, according to the results from a report published as a letter to the editor in Clinical Infectious Diseases.
The relative contribution of infants and children to virus transmission is unknown, but most likely does exist and should be kept in mind even with mild cases.
More testing among kids is required to have a better answers, and to develop research based policies for school return.
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COVID-19 CONTAINMENT MEASURES MAY IMPACT MENTAL HEALTH OF CHILDREN AND TEENS
(6/2) reports researchers have “established how loneliness and disease containment measures” in place due to the COVID-19 pandemic “could impact the mental health of both children and adolescents.” For “the rapid review, the investigators examined articles published between 1946-2020, with 20% of articles double screened using a predefined criteria and 20% of data double extracted for quality assurance.” The review revealed that “social isolation and loneliness increased the risk of depression, as well as the possibility of anxiety at the time of loneliness, which was measured between 0.25-9 years later.” What’s more, the review found that “young people were as much as three times more likely to develop depression in the future due to social isolation, with the impact of loneliness on mental health lasting up to nine years later.” The findings were published online in the Journal of the American Academy of Child and Adolescent Psychiatry.
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CDC REPORTS RECORD-LOW BIRTH RATE IN THE US
Preliminary data from the CDC's Vital Statistics Rapid Release show that the general fertility rate among US women ages 15 to 44 fell by 2% between 2018 and 2019, dropping to a record low of 58.2 births per 1,000 women, while the teen birth rate decreased by 5% also to a record-low level. The report found that the percentage of preterm births rose to 10.23% in 2019, while cesarean deliveries fell to 31.7%.
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TO MASK OR NOT TO MASK CHILDREN TO OVERCOME COVID-19?
It has been reported that asymptomatic people can transmit the new coronavirus disease 2019 (COVID-19) and become important sources of COVID-19. To reduce the role of asymptomatic or poorly symptomatic people in COVID-19, universal use of face masks in addition to hand hygiene and safety distance seems extremely useful. Consequently, preparing the healthy child to use face masks is strongly needed. To obtain maximal compliance, reasons for mask wearing without attempts of removing must be clearly explained. Moreover, child’s will must not be forced.

On the basis of clinical findings, we think that the universal use of facial masks seems necessary when people have to go out in their everyday lives. In addition to the availability of masks of different sizes capable of adapting perfectly to the face, it is necessary that the use of masks in children is preceded by a strong parental work and school lessons on this issue and other hygiene topics with the main aim to obtain child cooperation.
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CONDITION AFFECTING KIDS WITH COVID-19 REMAINS VERY RARE

Amid recent warnings about a possible link between COVID-19 in children and an inflammatory condition called Kawasaki disease that can harm the heart and other organs, heart experts stress that such cases seem to be rare.
As of past Friday, there were only 85 cases nationwide and only 3 at Children's Hospital Los Angeles

Most kids with COVID-19 have mild symptoms or none at all, but a small number have developed Kawasaki disease, often requiring hospitalization and occasionally, intensive care.

Features of Kawasaki disease include fever above 102 to 104 degrees Fahrenheit for at least five days, swelling of the neck glands and rash.
Other symptoms include redness and swelling of the palms of the hands and soles of the feet, bloodshot eyes, irritation and inflammation of the mouth, lips and throat, according to the American Heart Association (AHA). Patients may also develop heart, kidney, gastrointestinal or neurological disorders.

"We want to reassure parents -- this appears to be uncommon," said Dr. Jane Newburger of AHA's Council on Lifelong Congenital Heart Disease and Heart Health in the Young. "While Kawasaki disease can damage the heart or blood vessels, the heart problems usually go away in five or six weeks, and most children fully recover."

The American Academy of Pediatrics has more on Kawasaki disease.

SOURCE: American Heart Association, news release, May 6, 2020
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CDC and AMERICAN ACADEMY OF PEDIATRICS RECOMMENDATIONS ON IMMUNIZATIONS DURING COVID-19 PANDEMIC:

- Prioritize newborn care and vaccination of infants and young children (through 24 months of age) when possible
- Schedule well visits in the morning and sick visits in the afternoon
- Separate patients spatially, such as by placing patients with sick visits in different areas of the clinic or another location from patients with well visits.

For more information:

American Academy of Pediatrics (AAP): COVID-19 Clinical Guidance Q & A
CDC Pediatric Guidance: Maintaining Childhood Immunizations During COVID-19 Pandemic
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AND AGAIN MULTIPLE UNKNOWNS

Among the guidelines for "Opening Up America Again," states shouldn't start to reopen until they have a downward trajectory of documented cases in a 14-day period or a downward trajectory of positive tests as a percent of total tests in a 14-day period.

The select criteria were adequate hospitalization, testing capacity and an increasing contact-tracing capacity

As more governors start reopening their states and others set the date, they're pushing to get a better idea of how hard their state has been hit through antibody testing.

Experts warn there's still a lot researchers don't know about the accuracy of the tests, and the World Health Organization has cautioned that no evidence exists yet that antibodies prevent a second infection.
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RESEARCHERS SUGGEST PANDEMIC MAY WORSEN CHILDHOOD OBESITY EPIDEMIC IN US
Medscape (4/15, Subscription Publication) reports, “Although priority number one lies in controlling the spread of” coronavirus, “public health researchers are calling attention to the long-term repercussions of the pandemic on children’s health.” In a perspective piece in Obesity, researchers say the epidemic of childhood obesity may be noticeably worsened by school closures in the United States. The researchers “estimate that time spent out of school will double this year because of school closures due to” the pandemic, and “that, along with shelter-in-place orders, will pose challenges both for physical activity and healthy eating among children.”
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TEENS & COVID-19: CHALLENGES AND OPPORTUNITIES

Social distancing to slow the spread of COVID-19 can be especially hard for teens, who may feel cut off from their friends. Many also face big letdowns as graduations, proms, sports seasons, college visits and other long-planned events are cancelled or postponed.

Here are a few ways you can help your teen through this difficult time.

Work together to create a new normal
Help your teen create a healthy and productive routine:

Stick to a schedule that works with online learning. Set a time to wake up, exercise, shower, get dressed, have breakfast, or whatever they need to start the “school day." If it helps, allow your teen to sleep in a little later than normal. Like they would be in class, phones should be off while doing schoolwork. Keep the TV off during school hours, too, and limit time watching the news. Plan mini breaks and a 1-hour lunch break.

Make dinner a transition time between the "school day" and the evening. Dinner is a great time to gather the whole family together to talk and share a meal. Try fun conversation starters, such as, “My favorite part of today was…" or "Today I am grateful for...". This may be the time your family may choose to observe a quiet moment together. Help them keep their usual sleep time routine so they are ready for learning each day.

Allow "down time." It's normal for teens to crave more privacy from their family. Give them space for some quiet time, creative time, music time, or to virtually hang out with friends. This can help ease any feelings of being isolated from their friends or difficulties with routine-change.

Communicate honestly & openly
Share information about what is happening in a calm and factual way to help ease their concerns about the virus. Discuss facts about COVID-19 and correct misinformation when you hear it. Reinforce the basics, like the importance of frequent hand washing and avoiding touching their face.

Stress that staying home saves lives. Talk about how social distancing is an important way they are helping slow the spread of the virus and protecting those most at risk. Have a strict “no cheating" rule and stress that it is NOT okay to hang out with friends in person or play outdoor sports like basketball and softball.

Help your teen look forward by helping them shift away from what was lost and identify ways to move on with plans and goals.

​​​​Watch for signs your teen ma​y need more support
Teens who feel sad, depressed, hopeless, nervous or angry, during the COVID-19 pandemic may need more support. Ask your pediatrician if your teen's social and emotional health can be screened in an e-visit. During the visit, the doctor will ask whether your teen has been​​ bothered by problems such as feeling down, depressed or hopeless in the past two weeks. The doctor also might ask if your teen has lost interest or in pleasure in doing things. ​

Be aware of the signs of mental health problems in teens such as frequent irritability, changes in weight or sleep habits, repeated thoughts about an unpleasant event and conflicts with friends and family.​

Stay safely connected
Reach out virtually. Allow your teen to stay connected to friends and loved ones during social distancing by phone, text, video chat, or social media. (Remind them to check their privacy settings so they are not posting too much personal information online.) Playing games online with friends can also be relaxing and enjoyable for your teen. But be sure to agree on screen time during school days.

Help others connect. Many teens have expertise in using technology and can teach parents or grandparents how to video chat or use social media. This is also an opportunity for them to bring you into their virtual world.

What about media use?
While limits are still important, it's understandable that under these unusual circumstances, your teen's screen time will li​kely increase. Work together to come up with a plan that includes both online and offline time. Our Family Media Plan tool can help. Allowing your teen to be a part of making a media plan can help them stick to it.​

Support family & community
New responsibilities. Routines have changed, and your family may need extra help in caring for younger children or keeping the house clean. Talk to your teen about ways they can play a bigger role. For example, can they help plan or cook dinner? How about teaching their siblings a new dance or fun game?

Virtual guests. Ask your teen to help you come up with creative ways to stay connected with family and friends on a regular basis. Try hosting a "virtual dinner" by setting up a laptop or iPad at the table with the invited guests. Or use a video conferencing platform like Zoom to have an online party where everyone can see each other.

Family projects. Suggest your teen take the lead in projects that involve the entire family, like organizing family photos or recreating the family's history. This is a great topic for calls to grandparents, who may be able to describe challenging times in the past, and how the family coped with stress.

Declutter and donate. Encourage them to clean out their room, the basement, or declutter the garage and prepare items to donate to charity.

Volunteer within the community. Following social distancing and local regulations, suggest your teen look online for local opportunities to serve. Show acts of kindness by making someone's day better with a phone call, text, or social media post. Volunteer to help tutor children of neighbors or friends online.

Risky times for risky be​haviors
As schools move t​o online learning, teens may have more unscheduled time. This can leave them more likely to experiment with risky behaviors. Be sure to talk with your teen about how this is an especially important time to avoid vaping and smoking, for example. Experts warn these habits may harm lung health and immune function, potentially increasing COVID-19 risk. ​

​Mind and body he​alth
Help your teen find ways to keep their mind and body healthy, such as:

Go for a walk or a run outside, either by themselves or as a family. Remind them of the social distancing rules and to stay 6 feet away from others.

Read a book or visit the library online where there are thousands of e-books, audiobooks, and musical recordings. Research new hobbies or skills to learn.

Do video workouts. Many can be found online, and some park districts are offering access to virtual exercise classes, too.

Watch movies or TV shows together as a family or virtually with friends.

Create a video blog of life during the COVID-19 outbreak.

Start a scrapbook showing what it was like to be a teenager during the outbreak, or a family journal where each family member can take turns describing the day's happenings.

Take a virtual tour of a museum, or walk through the Grand Canyon with Google Earth. Challenge your teen to research 10 places they might like to visit someday and show you why.

Get plenty of sleep!

Source: American Academy of Pediatrics
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POSITIVE PARENTING & COVID-19:
10 TIPS TO HELP KEEP THE CALM AT HOME

​​Calmly teaching your child good behavior can become more difficult, though no less important, during stressful times. The American Academy of Pediatrics (AAP) offers these tips for families facing long periods of time isolated at home during the COVID-19​ outbreak.

With schools closing and many parents working at home or facing job uncertainty, it's more important than ever to use positive parenting and healthy approaches to discipline. Some examples:

1. Prevent boredom. Bored or frustrated children are more likely to act out. Many U.S. children have had their lives disrupted--they are out of school, and they can't play with their friends. Try to keep kids busy with a healthy and productive schedule at home.

2. Address fears. Children who are ​old enough to follow the news may be afraid, for example, that they or their parents are going to die. The medical research about COVID-19 shows that healthy people under 60 are unlikely to get very sick or die. Talk with children about any frightening news they hear.

3. Use time-outs. This discipline tool works best by warning children they will get a time-out if they don't stop. Remind them what they did wrong in as few words―and with as little emotion―as possible. Then, remove them from the situation for a pre-set length of time (1 minute per year of age is a good guide).

4. Redirect bad behavior. Sometimes children misbehave because they don't know any better and need some guidance. Find something else for your child to do.

5. Know when not to respond. As long as your child isn't doing something dangerous and gets plenty of attention for good behavior, ignoring bad behavior can be an effective way of stopping it. Ignoring bad behavior also can teach children natural consequences of their actions. For example, if your child keeps dropping food on purpose, there will be nothing left to eat.

6. Praise success. Children need to know when they do something bad—and when they do something good. Notice good behavior and point it out, praising success and good tries. This is particularly important in these difficult times, when children are separated from their friends and usual routines.

7. Allow time for attention. The most powerful tool for effective discipline is attention—to reinforce good behaviors and discourage others. When parents are trying to work at home with children who are out of school or child care, this can be tough. Clear communication and setting up expectations, particularly with older children, can help with this.

8. Avoid physical punishment. The Academy reminds parents that spanking, hitting, and other forms of physical or “corporal" punishment risks injury and isn't effective. Physical punishment can increase aggression in children long-term, and fails to teach children to behave or practice self-control. In fact, research shows it may harm the child and inhibit normal brain development. Corporal punishment may take away a child's sense of of safety and security at home, which are especially needed now.

​​​The Academy reminds parents and caregivers never to shake or jerk a child, which could cause permanent injuries and disabilities and even result in death. Tips for calming a fussy baby and advice for caregivers who have reached a breaking point can be found here. If you have a friend relative or neighbor with the new baby at home, think of ways you can ​​reach out to provide support during the ​isolation period.

9. Take care of yourself. Caregivers also should be sure to take care of themselves physically: eat healthy, exercise and get enough sleep. Find ways to decompress and take breaks. If more than one parent is home, take turns watching the children if possible.

10. Remember to take a breath. In addition to reaching out to others for help, the AAP recommends parents feeling overwhelmed or especially stressed try to take just a few seconds to ask themselves:

Does the problem represent an immediate danger?

How will I feel about this problem tomorrow?

Is this situation permanent?

In many cases, the answers will deflate the panic and the impulse to lash out physically or verbally at children.

American Academy of Pediatrics/ April, 2020
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Hi everybody,
Let me summarize general recommendations for self care:

As everyone takes action to reduce the spread of COVID-19, I want to remind you of the importance of taking care of your immune system.

Physical distancing and washing your hands are important, but let’s not forget that a strong immune system is critical for protecting your body from infection. We all need to focus on proper nutrition, sleep, stress management, and gut health to maintain our health.

Eat Right.
If the gut is healthy, the immune system will be healthy. During a time when grocery stores are facing shortages you want to make food choices that are as nutrient dense as possible, as opposed to foods with empty calories and high carbohydrates.

Avoid foods that come in a box and reduce your sugar and alcohol consumption. If selection is limited, look to canned foods like beans, vegetables, meats, fish (sardines are a great source of Omega-3 fatty acids), chicken/beef broths, and rice. Foods that are high in antioxidants are a great choice.

Take Supplements.
Multi-vitamins and fish oil are good for foundational health, but for immune support I recommend Vitamins A, C, and D, as well as Zinc and DMG. Maitake mushroom extract is also known for containing beta-glucans, which increase immune defense.

Lastly, quality probiotics are essential for promoting natural antibodies and keeping harmful bacteria at bay. Use these supplements to help bridge nutritional gaps in your diet and support stronger immune system function.

Stay Active.
Staying home doesn’t mean forgetting your exercise routine. Keeping active reduces stress hormones and stimulates endorphins, so make time for working out indoors or taking a walk outside. Natural sunlight will also help regulate your circadian rhythm and promote a good night’s rest.

Sleep Well.
Turn off your devices at least an hour before bed, and maybe read a book instead. Blue light from laptops and phones suppress melatonin and mess with your sleep. Listening to relaxing music and taking a warm bath are other good ways to “wind down” and help you relax.

Manage Stress.
High cortisol and increased stress weaken the immune system. This is a pervasive problem among adults, and recent events are not helping.

Meditation and breathing exercises are the best approaches to lowering cortisol, and there are several apps and methods out there to help. The 4-7-8 breathing technique is a great way to immediately lower stress. Remind yourself to focus on the things you can control right now — how you react to situations and the actions you can take.

Most importantly, remember you are not alone. We are all facing similar challenges right now, and we will get through them together. I am confident our community will emerge from this predicament stronger than ever. Until then, please know my team and I are here to support you on your wellness journey.

Stay safe and be well.

Sincerely,
Marina Burstein, MD
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Please watch, very smart and instructive video!

youtu.be/sjDuwc9KBps
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Just off topic, but informative:

CDC REPORTS 38M FLU CASES, AND 23K FLU DEATH

CDC officials estimated that the number of flu cases in the US reached 38 million and flu-related hospitalizations reached 390,000 during the week ending March 14. There have been 23,000 flu-related deaths this season, including 149 pediatric deaths, recording the highest mortality rate among people ages 18 and younger since the 2009 flu season.
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ANOTHER WEEK.... WHAT DO WE KNOW AND WHAT WE DO NOT HAVE?

COVID-19 infection in the majority of cases is mild-moderate self-limited respiratory infection

Kids are not frequently being affected

Is quite deadly to older population

Our hospitals, mainly ICU's may get overwhelmed with number of sick patients. Outbreak only in one nursing home will saturate local hospital ICU

We do not have enough tests, medical equipment, protective gear. Our Health Care system is not capable of meeting Community needs as of now

Lack of testing is affecting our statistics, increasing panic in population

In a state of crisis a lot of people are showing not their best

Vaccine development is on the way, but may take up to another year

Data from another countries is very promising in regards to Hydroxy-Chloroquin use for treatment and prophylaxis with great safety profile

Few antiviral agents are being tested and already used in other countries, and have shown excellent results

Hopefully we will have several medications approved for use in USA very soon

Our office is open. We are canceling all Preventive Visits; seeing only emergencies; practicing telemedicine where it is appropriate; accommodating our patients with minimal time in the waiting room
Call us if you need anything, or even if you need just to talk..

Stay safe and well, enjoy your time with your family
And bad times will pass

Sincerely
MB
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UPDATES!
Situation is changing rapidly, so this update is for today 3/10/2020
We do believe that Corona virus is a real threat, especially to older people 60+, and is much worse than Influenza Virus.

Only 2% of severe cases were under age of 20 y.o.Pediatric population seems to be safe.

There are probably a lot of mild cases which are not being tested , because of shortage of tests.

So, we do not know exact numbers to calculate the mortality overall.

The fact that outbreak is now almost contained in China and Korea, is telling us, that large population was infected , with mild symptoms and now most of them are immune.

More tests are available at Public Health labs, but patients are required to have Influenza and common Respiratory viruses be ruled out first.

There are new developments in testing of some antimalarial medications, possibly be effective against Corona virus.

Measures we are taking in the office which are recommended by Academy of Pediatrics:

- Minimizing Well Child appointments
- Carefully triaging sick patients through separate waiting room
- Diligently sanitizing office space 3 times a day
- Encouraging patients with appointments to check in by
phone and wait in the car until they are ready to be seen
- Personnel to wear masks and wash hands with every patient
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A QUOTE FROM AN EXPERT:

James Robb, MD FCAP, UCSD

"Dear Colleagues, as some of you may recall, when I was a professor of pathology at the University of California San Diego, I was one of the first molecular virologists in the world to work on coronaviruses (the 1970s). I was the first to demonstrate the number of genes the virus contained. Since then, I have kept up with the coronavirus field and its multiple clinical transfers into the human population (e.g., SARS, MERS), from different animal sources.
>
> The current projections for its expansion in the US are only probable, due to continued insufficient worldwide data, but it is most likely to be widespread in the US by mid to late March and April.
>
> Here is what I have done and the precautions that I take and will take. These are the same precautions I currently use during our influenza seasons, except for the mask and gloves.:
>
> 1) NO HANDSHAKING! Use a fist bump, slight bow, elbow bump, etc.
>
> 2) Use ONLY your knuckle to touch light switches. elevator buttons, etc.. Lift the gasoline dispenser with a paper towel or use a disposable glove.
>
> 3) Open doors with your closed fist or hip - do not grasp the handle with your hand, unless there is no other way to open the door. Especially important on bathroom and post office/commercial doors.
>
> 4) Use disinfectant wipes at the stores when they are available, including wiping the handle and child seat in grocery carts.
>
> 5) Wash your hands with soap for 10-20 seconds and/or use a greater than 60% alcohol-based hand sanitizer whenever you return home from ANY activity that involves locations where other people have been.
>
> 6) Keep a bottle of sanitizer available at each of your home's entrances. AND in your car for use after getting gas or touching other contaminated objects when you can't immediately wash your hands.
>
> 7) If possible, cough or sneeze into a disposable tissue and discard. Use your elbow only if you have to. The clothing on your elbow will contain infectious virus that can be passed on for up to a week or more!
>
> What I have stocked in preparation for the pandemic spread to the US:
>
> 1) Latex or nitrile latex disposable gloves for use when going shopping, using the gasoline pump, and all other outside activity when you come in contact with contaminated areas.
>
> Note: This virus is spread in large droplets by coughing and sneezing. This means that the air will not infect you! BUT all the surfaces where these droplets land are infectious for about a week on average - everything that is associated with infected people will be contaminated and potentially infectious. The virus is on surfaces and you will not be infected unless your unprotected face is directly coughed or sneezed upon. This virus only has cell receptors for lung cells (it only infects your lungs) The only way for the virus to infect you is through your nose or mouth via your hands or an infected cough or sneeze onto or into your nose or mouth.
>
> 2) Stock up now with disposable surgical masks and use them to prevent you from touching your nose and/or mouth (We touch our nose/mouth 90X/day without knowing it!). This is the only way this virus can infect you - it is lung-specific. The mask will not prevent the virus in a direct sneeze from getting into your nose or mouth - it is only to keep you from touching your nose or mouth.
>
> 3) Stock up now with hand sanitizers and latex/nitrile gloves (get the appropriate sizes for your family). The hand sanitizers must be alcohol-based and greater than 60% alcohol to be effective.
>
> 4) Stock up now with zinc lozenges. These lozenges have been proven to be effective in blocking coronavirus (and most other viruses) from multiplying in your throat and nasopharynx. Use as directed several times each day when you begin to feel ANY "cold-like" symptoms beginning. It is best to lie down and let the lozenge dissolve in the back of your throat and nasopharynx. Cold-Eeze lozenges is one brand available, but there are other brands available.
>
> I, as many others do, hope that this pandemic will be reasonably contained, BUT I personally do not think it will be. Humans have never seen this snake-associated virus before and have no internal defense against it. Tremendous worldwide efforts are being made to understand the molecular and clinical virology of this virus. Unbelievable molecular knowledge about the genomics, structure, and virulence of this virus has already been achieved. BUT, there will be NO drugs or vaccines available this year to protect us or limit the infection within us. Only symptomatic support is available.
>
> I hope these personal thoughts will be helpful during this potentially catastrophic pandemic. You are welcome to share this email. Good luck to all of us! Jim"
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LATER BEDTIME IS LINKED TO HIGHER BMI IN KIDS, STUDY SUGGESTS
CNN (2/18) reports that research “found that children who habitually went to sleep late – defined by the researchers as past 9 p.m. – had a wider waist and higher BMI...by the end of the study.” The findings were published in Pediatrics.
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PEDIATRIC CASES OF CORONAVIRUS WITH SEVERE SYMPTOMS SEEM RARE

The New York Times (2/5) reports “relatively few children appear to have developed severe symptoms” from coronavirus “so far, according to the available data.” A report published in JAMA said, “The median age of patients is between 49 and 56 years. Cases in children have been rare.” The article quotes several experts discussing this trend. For example, Dr. Malik Peiris, chief of virology at the University of Hong Kong who developed a diagnostic test for the virus, said, “My strong, educated guess is that younger people are getting infected, but they get the relatively milder disease.”
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NO PLANS TO DECLARE PUBLIC HEALTH EMERGENCY OVER CORONAVIRUS
HHS Secretary Alex Azar said the novel coronavirus spreading in China does not constitute a public health emergency at present because although suspected cases are being monitored in about 30 states, all confirmed infections are travel-related. The CDC and National Institute of Allergy and Infectious Diseases are working on potential vaccines, and airport screenings are being expanded to 20 airports.
The Hill (1/28), United Press International (1/28)
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WHAT DO YOU THINK?
DO WE NEED TO START SCREENING DADS FOR PERINATAL DEPRESSION?
Perinatal depression screenings for fathers urged.
Fathers should also be screened for perinatal depression during well-child visits "It is time for the focus on perinatal depression within pediatrics to include fathers, too," said lead author Tova Walsh. Reuters
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AT LEAST 1.3 K PEOPLE DIED FROM FLU THIS SEASON, CDC SAYS
The CDC estimates there have been at least 2.6 million flu cases, 23,000 flu-related hospitalizations and 1,300 flu-related deaths so far this season, according to the CDC. As of the week ending Dec. 29, the illness has spread significantly in all states except Alaska, and widespread flu activity was reported in 23 states.

Full Story:CNN
www.lavalleypediatrics.com
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Happy holidays! This is WOODLAND HILLS-CALABASAS PEDIATRICS last publication for 2019. To close out the year, I have selected the most-read news/ topics that have caught readers' attention past week . Hope you enjoy this special edition, and I look forward to keeping you smart in 2020!

-Essential oils may cause abnormal breast growth in young girls, boys, tea tree and lavender specifically

-At least 1.3K people died from flu this season, CDC says
The CDC estimates that there have been at least 3.7 million flu cases, 32,000 flu-related hospitalizations and 1,800 flu-related fatalities, including 19 pediatric deaths, so far this season, and the majority of laboratory-confirmed flu cases were caused by influenza B/Victoria viruses.

-Study links antibiotic use in infancy to higher risk of allergies

-Marijuana vaping becomes more prevalent among US teens

-Report ranks Boston Children's as No. 1 pediatric hospital

-Minn. ranked No. 1 state for physicians to practice
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CDC RECOMMENDATION OF FLU SHOTS FOR MIGRANTS REJECTED BY BORDER PATROL
The US Customs and Border Protection dismissed the CDC's recommendation that detained migrant families and their children be given flu vaccinations, according to a letter sent by CDC Director Dr. Robert Redfield to Rep. Rosa DeLauro, D-Conn. The current administration's policies prolonging migrant detainment have prompted flu outbreaks at detention facilities and Boarder Patrol's persistent refusal to vaccinate detainees against the flu is "unconscionable," DeLauro said.
The Washington Post (tiered subscription model)
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OBESITY MAY AFFECT PEDIATRIC BRAIN DEVELOPMENT
Researchers who scanned the brains of children using MRI found that those with the highest body mass index had slightly smaller cortical volumes, particularly in the prefrontal region, which is involved in executive functioning, compared with those with normal weight. The findings in JAMA Pediatrics also found higher BMI was associated with slightly reduced scores on tests of executive functiond.
The Associated Press (12/9), HealthDay News (12/9)
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REPORT SHOWS GROWING NUMBER OF UNINSURED CHILDREN IN THE US

The number of US children without insurance rose from 3.6 million in 2016 to 4.1 million in 2018, amid delayed Children's Health Insurance Plan funding, efforts to unravel the Affordable Care Act and changes to Medicaid, according to a report from the Georgetown University Center for Children and Families. "For children who are uninsured, I worry about the critical services they are missing out on and what it will mean for their short- and long-term health," said American Academy of Pediatrics spokesperson Lanre Falusi. CNN (10/30),
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MATERNAL GASTRIC BYPASS INCREASES RISK OF PEDIATRIC BIRTH DEFECTS

Swedish researchers found that 3.4% of babies born to mothers who underwent BARIATRIC surgery developed major birth defects, compared with 4.9% of those whose mothers didn't receive gastric bypass surgery. The findings in the Journal of the American Medical Association also showed that 60% of birth defects among those born after surgery were major heart defects, while none of those in the surgery group developed neural tube defects, compared with 0.07% of controls. Physician's Briefing/HealthDay News
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CDC REPORTS RECORD HIGH STD PREVALENCE IN THE US IN 2018

A CDC report showed that new cases of sexually transmitted diseases such as chlamydia, gonorrhea and syphilis reached a record high of 2.4 million in 2018, nearly 1.8 million of which were from chlamydia. Researchers also found that 1,306 infants had congenital syphilis last year, including 94 deaths, and Texas had the most cases of congenital syphilis. CNN (10/8), Los Angeles Times
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PUBLIC HEALTH EMERGENCY DECLARED AND E-CIGARETTES BANNED

Mass. governor seeks temporary ban on e-cigarette, vaping product sales. The outbreak of vaping-related lung injuries across the US has prompted Massachusetts Gov. Charlie Baker to declare a public health emergency and call on the state's public health council to prohibit all e-cigarette and vaping product sales for four months, effective immediately. "We as a Commonwealth need to pause sales in order for our medical experts to collect more information about what is driving these life-threatening vaping-related illnesses," Baker said.CNN (9/24)
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PROBIOTIC SUPPLEMENTS MAY BENEFIT YOUTH WITH OBESITY

Researchers found that children with obesity who received probiotic supplements had significantly greater weight reduction and improved metabolic health, compared with those who weren't given probiotics. The findings, presented at the European Society for Pediatric Endocrinology's annual meeting, suggest the viability of probiotic supplementation in preventing and treating pediatric obesity but more studies are still needed, said researcher Rui-Min Chen. The Independent (London) (tiered subscription model) (9/20)
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PRENATAL WELL BEING MAY AFFECT CHILDHOOD BEHAVIOR

Children whose mothers had stress or anxiety during pregnancy had increased odds of developing behavioral problems, such as restlessness, spitefulness and temper tantrums, at age 2, compared with those whose mothers didn't have stress or anxiety during gestation, according to a study in the journal Development and Psychopathology. Researchers also found increased odds of emotional problems among those whose parents had relationship problems early after childbirth.
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That's what I am hearing from my anti-vaxers daily:

Очень забавно!

"Почему я не делаю прививок, почему я не обращаюсь к врачам, почему мои дети веганы...
Ну или почему я не пользуюсь пешеходными переходами...
Почему я не пользуюсь пешеходным переходом и разрешающим сигналом светофора. Все мои знакомые им пользуются, они не задумываются о пользе и вреде пешеходного перехода и просто тупо шпарят по нему через дорогу.
Я тоже была такой. Совсем недавно. Как же я ошибалась! Когда я готовилась стать мамой, я впервые задумалась о том, так ли необходимы в нашей жизни переходы? И так ли опасны машины?... Я изучила статистику дорожных происшествий, море альтернативной информации и вот, что я вам скажу: я больше не пользуюсь переходами! Моему ребёнку год , и мы ни разу не переходили дорогу по зебре!
И мы живы!! Более того, я хочу сказать, мы точно опережаем по развитию наших сверстников, пользующихся зеброй: у нас крепкие ноги, ведь мы постоянно перебегаем перед носом машин, у нас крепкие нервы, по этой же причине, и главное!!! Мы не прикармливаем ГИБДД! Мы не спонсируем производителей светофоров и краски для полос разметки! Мы вступили в клуб ненавистников пешеходных переходов и будем отстаивать наши права. А вы...вы!! несчастные добропорядочные бараны!! Давайте, водите детей по этим губителям детского здоровья! соблюдайте правила и скоростной режим - нам же безопаснее!! Ведь, если подумать, а так ли опасны машины? Ну даже если вы попадёте под машину, скорее всего вы отделаетесь ссадинами и ушибами, а сколько плюсов! Вы точно больше никогда не будете так беспечны, вы станете поклонниками ЗОЖ и будете вихрем проноситься перед носом у водителей, потренируете регенерацию организма и прочее. Подумайте! Вы словно стадо баранов прётесь по этим жалким переходам, когда мир , вот он! рядом! Поверьте, если вы будете поклонником ЗОЖ, любая машина обогнёт вас, не причинив вреда! Любая! Что касается многотонных фур, которые, якобы, не могут затормозить сразу,
то я вообще сомневаюсь в их существовании.
У нас в центре города они не ездят, т.к. проезд запрещен! А значит, вы с ними никогда не встретитесь, ими лишь пугают доверчивых дурочек. Даже если предположить, что они существуют, и вы их даже встретите в центре города (это миф, поверьте!), но вдруг...- то они все равно не причинят вреда, т.к. на дороге в 98% случаев они просто стоят, ну не ездят они, а значит, вы можете только сами о них удариться и всё. Всё!! Все эти правила созданы для того, чтобы погубить наших детей, нашу свободу, наше национальное самосознание, а этим гаишникам только бы запретить переходить дорогу не по зебре. Бре-е-ед... Мамы, помните! Это нарушение наших прав и свободы. А потом, не зря же говорят продвинутые люди, в полосках зебры зашифровано число зверя 666... Девочки, как страшно! Берегите детей, не пользуйтесь зебрами и обязательно распространите эту информацию!!!"

Лидия Станкевич
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We are hiring, please email me
Bursteinmarina@gmail.com
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TOP RANKING OF BEST STATES FOR HEALTHCARE

WalletHub ranked Minnesota, Massachusetts, Rhode Island, Washington, D.C., and Vermont as tops for health care, based on factors such as health care costs, accessibility and outcomes. Rounding out the top 10 were New Hampshire, Hawaii, Maine, North Dakota and Iowa, while Arkansas, South Carolina, Mississippi, North Carolina and Alaska were at the bottom of the list.
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INCREASE IN PRETERM BIRTH IS SEEN AMONG HISPANICS AFTER TRUMP'S ELECTION

There were 2,337 additional preterm births to Hispanic mothers during the nine months after the election of President Donald Trump in November 2016, compared with the expected number of premature births during that time, researchers reported in JAMA Network . CNN (7/19),
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DRUG USE IS ON THE RISE. FOSTER CARE ENTRIES STATISTICS

A study in JAMA Pediatrics showed that the rate of children entering the foster care system because of parental drug use rose from 14.53% of entries in 2000 to 36.26% in 2017. Researchers also found increased odds of parental drug-use-related foster care placements among those ages 5 and younger and among whites. WBUR-FM (Boston) (7/15)
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MORE US AND CANADIAN TEENS ARE VAPING, STUDY SHOWS

Researchers found that the rate of US and Canadian adolescents ages 16 to 19 who reported vaping during the past month increased by nearly 50% and almost twofold, respectively, from 2017 to 2018. The findings also showed that teen Juul e-cigarette use became more prevalent in all countries, with the rate of US youths with Juul as their preferred brand rising from 1% to 4.5% during the study period. Reuters (6/28)
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BRAIN CHANGES FOUND IN YOUTH WITH REGULAR CANNABIS USE

Teens and young adults with frequent cannabis use who underwent a cognitive control task had reduced brain activity in the frontostriatal circuits involved in conflict resolution and cognitive control, compared with those who didn't use cannabis, with elevated and more persistent changes among those with earlier cannabis initiation, researchers reported in the Journal of the American Academy of Child & Adolescent Psychiatry. The findings were based on functional MRI scans from 60 youths ages 14 to 23. Psych Central (6/22)
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Study looks at motorized scooter-related craniofacial injuries
The annual incidence of motorized scooter-related head and facial injuries rose by threefold from 2008 to 2017, and young children ages 6 to 12 and teens ages 13 to 18 accounted for 33.3% and 16.1% of the injuries, respectively, according to a study in the American Journal of Otolaryngology. The findings should prompt standardization of electric scooter policies and license requirements to curb risky behaviors, said researcher Dr. Amishav Bresler.
Physician's Briefing/HealthDay News (6/14)
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TEENS MAY BENEFIT FROM LATER SCHOOL START TIMES

A study in the journal Sleep showed that middle- and high-school students had 31 minutes and 48 minutes longer sleep on school nights a year after their school start times were delayed by 50 minutes and 70 minutes, respectively. The findings, to be presented at the annual meeting of the Associated Professional Sleep Societies, also associated later school start times to reduced rates of homework sleepiness, as well as significantly increased academic engagement among youths. Psych Central (6/8)
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CHILDREN ARE EATING LESS FISH

Children have consumed less seafood each year since 2007, and eat less fish than meat, researchers wrote in an American Academy of Pediatrics report published in Pediatrics that examined the benefits and risks associated with fish consumption. Registered dietitian Maria Romo-Palafox said fish has a specific taste, so children should learn to like it early, because by age 5 they have most of their eating habits and preferences in place.
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MOST AMERICANS SUPPORT MEASLES VACCINATION

Seventy-seven percent of US adults said that measles vaccinations should be given to children despite the objection of their parents, while only 4% believed that vaccines were unsafe, according to a Reuters/Ipsos survey. The poll also found that 22% of adults were either unvaccinated against measles or were unsure if they had received the vaccine in childhood.Medscape/Reuters
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HERE'S WHERE MEASLES OUTBREAKS ARE MOST LIKELY

A study published in The Lancet Infectious Diseases ranked the top 50 US counties at greatest risk of measles outbreaks based on four factors: population, international air travel volume, nonmedical vaccine exemptions and measles incidence in countries people visit. The top five counties are Cook County, Ill.; Los Angeles County; Miami-Dade County, Fla.; Queens County, N.Y.; and King County, Wash.CNN (5/11)
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CDC: MORE US YOUTHS DEVELOPING AUTISM SPECTRUM DISORDER (ASD). OVERLY DIAGNOSED?

CDC researchers reported that the rate of autism spectrum disorder among 4-year-olds in the US rose from 13.4 per 1,000 children in 2010 to 17 per 1,000 in 2014. The findings in the agency's Morbidity and Mortality Weekly Report also showed significantly higher ASD rates among boys. Physician's Briefing/HealthDay News (4/11)
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CDC: 314 MEASLES CASES CONFIRMED IN 15 STATES

CDC officials reported that 314 measles cases in 15 states have been confirmed this year as of March 21, compared with 372 confirmed cases for all of 2018. An outbreak in Rockland County, New York, has prompted an emergency declaration that prohibits unvaccinated people younger than 18 from public places.
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CATCH UP SLEEP ON WEEKENDS MAY HAVE NEGATIVE EFFECT ON METABOLISM

The findings, based on 36 healthy young adults, showed that those who had catch-up sleep on the weekend had reduced insulin sensitivity in the muscles and liver, which could lead to type 2 diabetes, compared with those who did not sleep in on the weekend. Most likely due to nighttime overeating on the weekdays, which also is strongly correlating with weekend sleeping in. HealthDay News (2/28)
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NEW RECOMMENDATIONS TO CURB PEDIATRIC ALLERGIES
The American Academy of Pediatrics issued an updated clinical report in Pediatrics stating that there is strong evidence linking peanut introduction at age 4 months to peanut allergy prevention among high-risk infants. The report also showed eczema protection among those exclusively breastfed among until ages 3 months to 4 months, and any further breastfeeding provided wheezing protection until age 2 and asthma protections until ages 5 and older, but maternal avoidance of allergenic foods during gestation and breastfeeding and special hydrolyzed formulas didn't have a protective effect against pediatric allergic conditions.
CNN (3/18)
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LARGE STUDY CONFIRMS THAT MMR VACCINATION IS NOT TIED TO HIGHER AUTISM RISK

Children who received the measles, mumps and rubella vaccine didn't have higher odds of developing autism compared with those who weren't given the MMR vaccine, according to a Danish study in the Annals of Internal Medicine. The findings, based on data involving 657,461 Danish children born from 1999 to 2010, also showed no association between MMR vaccination and increased autism risk among those who had siblings with autism and other risk factors. CNN (3/5), Reuters (3/4)
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CHILDHOOD GREEN SPACE EXPOSURE MAY BENEFIT LATER MENTAL HEALTH

A Danish study in the Proceedings of the National Academy of Sciences showed that adults who lived near parks or forests in childhood had a 52% lower risk of developing substance abuse disorders, including a 55% and 44% reduced risk of alcohol and cannabis abuse, respectively, as well as a 40% reduced likelihood of developing stress-related or neurotic disorders. Researchers also found reduced odds of schizophrenia, personality disorders, and bipolar and mood disorders among those who lived near green spaces as children.
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CDC REPORTS WIDESPREAD FLU ACTIVITY IN 48 STATES

CDC officials reported that 48 states had widespread flu activity during the week ending Feb. 9, while 26 states and New York City had high levels of activity. Six additional pediatric deaths were documented, bringing the season total to 34, according to the CDC.
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MORE BENEFITS OF REPEATED FLU VACCINE

Repeated flu vaccines may protect against pediatric respiratory illness
Dutch researchers looked at 4,183 youths with pre-existing medical conditions and found that repeated annual inactivated influenza vaccination was tied to lower odds of respiratory illness. The findings were published in the Annals of Family Medicine.
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US FLU ACTIVITY WORSENING, CDC SAYS

CDC officials report that US flu activity has worsened over the past week, with the hospitalization rate reaching 14.8 per 100,000 people for the week ending Jan. 19. A total of 18 states plus New York City reported high influenza-like illness activity, up from nine states in the week ending Jan. 12, while the number of states reporting widespread flu activity increased from 30 to 36. CNN (1/25)
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EVEN SMALL AMOUNT OF MARIJUANA USE IS TIED TO BRAIN CHANGES IN TEENS. ANOTHER PERFORMANCE TEST IS REQUIRED TO DETERMINE BENEFIT VS.HARM

Adolescents who used marijuana once or twice had significantly increased gray matter volume in some brain regions, especially in the hippocampus, which is involved in reasoning and memory, and the amygdala, which is involved in emotion processing, compared with those who never tried marijuana, Australian researchers reported in the Journal of Neuroscience. The findings were based on brain imaging data from 46 14-year-olds in England, France, Germany and Ireland.
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NEUROLOGIC SYMPTOMS SEEN IN SOME YOUTH WITH FLU

VACCINATE YOUR KIDS! In Colorado, 18% of children with influenza who presented at a hospital during the 2017-2018 flu season had neurological symptoms of influenza, such as encephalopathy or seizures. The study in the Journal of the Pediatric Infectious Diseases found that 85% of children who had neurologic manifestations of influenza had the H3N2 strain./Infectious Diseases in Children (1/3)
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