Child Health News Round-up (June 9 – July 2, 2010)
Contents
* Gaza siege damages Palestinians’ health: study
* UK doctors: fetus can’t feel pain before 24 weeks
* Study finds welfare cuts can cost lives
* Scientists find gene links to vitamin D deficiency
* Violent videogames harmless for most kids
* Moms’ full-time work tied to childhood obesity
* Birth impact on learning problems
Gaza siege damages Palestinians’ health: study
LONDON | Fri Jul 2, 2010
(Reuters) – Palestinian health experts studying the impact of Israel’s blockade of the Gaza Strip say it threatens to cause long-term damage to Palestinians’ health, with many children at risk of stunted growth or malnutrition.
In a series of studies published in the Lancet medical journal on Friday, researchers also said Israel’s attack on the region in early 2009 had a devastating effect, causing injury, displacement and social suffering, particularly among children.
Stress levels are also high, with women describing the terror of giving birth under siege. “I cannot believe that I did not die,” said one woman cited in the research.
Around 1,400 people were estimated to have died and many more injured during the Israeli attack on the occupied Palestinian territory of the Gaza Strip between December 2008 and January 2009. The health experts described the destruction of infrastructure, including homes, as “unprecedented.”
Israel has slightly eased the blockade it imposed on the region soon after Islamist group Hamas, which rejects Western calls to recognize Israel’s right to exist, won a Palestinian election in 2006. Restrictions were tightened after Hamas seized power in Gaza the following year.
“The siege of this region continues to be the main obstacle for improvement of the living conditions and the quality of life of the population,” said Niveen Abu-Rmeileh of Birzeit University’s institute of community and public health in the West Bank.
Despite its blockade, Israel allows medical and humanitarian aid into Gaza and the Israeli military says 7,000 Palestinians visit Israel from Gaza each month for medical treatment for serious conditions.
CHILDBIRTH
In a study looking at some of the health consequences of the attack itself and conducted before the embargo easing, Abu-Rmeileh’s team analysed health-related quality of life using data from a random survey of about 3,000 Palestinian households.
Almost a third of the sample population was displaced during the war, while 39 percent of their homes were either completely or partly destroyed. By the end of the study in August 2009, three quarters of the damaged homes had yet to be repaired.
The study also found that more than 70 percent of households were reliant on food aid, and 57 percent of respondents whose families received food aid rated quality of life as “less than good” compared with 30 percent of respondents who did not.
A second study looking at childbirth under siege interviewed five midwives and 11 women about their experiences during the bombings. They described how they coped with fear, violence and uncertainty around them as they waited for labor to begin.
One woman quoted in the study said the worst time was when darkness fell: “I was not thinking like other people in face of death or shelling, but was only thinking of my case. What would happen if I had labor pains at night? How will I manage? They were shelling even ambulances. Nights were like nightmares. Each morning I breathed a sigh of relief that daylight had appeared.”
Kholoud Nasser from the Ministry of Education in Ramallah, looked at Palestinian children’s diets and the knock-on effects for their health and education.
In a study of around 2,000 children and adolescents, she found that one in four misses breakfast – the main indicator of healthy eating habits – while one in 10 is anemic, and one in 17 is stunted. Around 2 percent are underweight and 15 percent are either overweight or obese.
“Comprehensive and effective school nutrition programs that are targeted at all age groups, with special attention to adolescents and girls, are needed because the data for overweight and iron-deficiency anemia are alarming,” Nasser wrote in the study.
SOURCE: link.reuters.com/kas55m The Lancet, July 2, 2010
UK doctors: fetus can’t feel pain before 24 weeks
Jun 25, 2010
LONDON (AP) – British health experts say the human fetus cannot feel pain before the age of 24 weeks, so there is no reason to change the country’s abortion laws.
The government-commissioned study is a setback for anti-abortion activists, who want the country’s current 24-week time limit for terminations reduced.
The study says that nerve connections in the brain are not sufficiently formed to allow pain perception before 24 weeks.
The study by the Royal College of Obstetricians and Gynecologists, published Friday, was recommended by lawmakers who are considering lowering the abortion limit.
The doctors say there is increasing evidence that even after 24 weeks the fetus is in a state of “continuous sleep-like unconsciousness or sedation.”
Study finds welfare cuts can cost lives
By Kate Kelland
LONDON | Fri Jun 25, 2010 12:03am BST
(Reuters) – Radical cuts in social welfare spending by governments intent on reducing budget deficits can cost lives as well as cause economic pain, according to a study published on Friday.
British researchers found that levels of social spending in Europe are strongly associated with risks of premature death, particularly from diseases linked to wealth and social circumstances such as heart attacks and alcohol-related illness.
In a study published in the British Medical Journal, the researchers calculated that for approximately every 80 euros ($107) cut from social welfare spending per person, alcohol-related deaths would rise by about 2.8 percent and heart disease deaths by around 1.2 percent.
The global recession and financial crisis have driven many governments in Europe to make drastic budget cuts to try to reduce ballooning deficits.
Some, like Britain, have ring-fenced health spending with a view to keeping voters on their side. But the study suggested that while such governments may think they are safeguarding the population’s health by protecting healthcare budgets, they may be ignoring the health dangers implicit in welfare cuts.
“This report reveals that ordinary people may be paying the ultimate price for budget cuts — potentially costing them their lives,” the authors, led by sociologist David Stuckler from the Oxford University, wrote in the study.
Heart disease is already the number one killer in Europe, the United States and other wealthy nations, while alcohol-related illnesses rank at number eight in the World Health Organization’s top 10 leading causes of death worldwide.
Previous studies have found that in developed nations, both heart disease and alcohol-related health problems are more prevalent among people in deprived communities.
Stuckler’s team looked at Organization for Economic Cooperation and Development (OECD) data on welfare spending in 15 European countries between 1980 to 2005.
These included programs to provide support to families and children, to help the unemployed get jobs, and support for people with disabilities — all of which could plausibly affect health, the researchers explained.
Analyzing trends in the data, they found that when social spending was high, death rates fell, but when they were low, death rates rose substantially.
“Health and social welfare programs appear to be a key determinant of future population health that should be taken into account in ongoing economic debates,” Stuckler wrote.
(Editing by Noah Barkin)
Scientists find gene links to vitamin D deficiency
By Kate Kelland
LONDON | Thu Jun 10, 2010 12:06am BST
(Reuters) – Scientists have found three genetic differences that affect a person’s risk of being deficient in the “sunshine” vitamin D and say their work helps explain why sunlight and a good diet aren’t always enough.
British and American researchers studied the genes of almost 34,000 white Europeans and found that variants of three genes involved in cholesterol synthesis, vitamin D metabolism and vitamin D transport may increase the risk of deficiency.
“Our findings establish a role for common genetic variants in regulation of circulating vitamin D concentrations,” said Elina Hypponen of the University College London Institute of Child Health, who worked on the study.
She said the presence of the variants at the three specific genes more than doubled the risk of vitamin D insufficiency.
Most vitamin D is made by the body as a natural by-product of the skin’s exposure to sunlight. It is vital for health, as it helps cells absorb calcium and is key for bone strength.
Some recent studies have also suggested vitamin D may protect against cancer, artery disease and tuberculosis.
A normal level of vitamin D is defined as a concentration greater than 30 nanograms per millilitre (ng/ml), while vitamin D insufficiency is 20 to 30 ng/ml and vitamin D deficiency is less than 20 ng/ml.
Almost half of the world’s population has lower than optimal levels of vitamin D and scientists say the problem is getting worse as people spend more time indoors or cover up too quickly and completely when they are exposed to sunshine.
Non-white populations in less sunny climates are at higher risk since dark skin can make it harder for the body to absorb ultraviolet light.
Hypponen said there was no doubt that sunshine and a good diet were still the most important factors for vitamin D levels, but the study helped explain why some people who should get enough from these sources still appear to be deficient.
“Sometimes when we look at geographical variations in vitamin D deficiency, they do not always go logically in the way we would expect, for example, on the basis of sunlight,” she said in a telephone interview. “So this study raises the possibility that that is down to genetic influences.”
Besides the sunlight source, vitamin D can also be found in fish liver oil, eggs and fatty fish such as salmon, herring and mackerel, or taken as a supplement.
There are no definitive studies on the optimal daily vitamin D dose but some experts recommend 25 to 50 micrograms.
A study published in March found that vitamin D is important in activating the immune system’s killer cells, known as T cells, which remain dormant and unaware of threats from infections if vitamin D is lacking in the blood.
(Editing by Mark Trevelyan)
Violent videogames harmless for most kids
NEW YORK | Thu Jun 10, 2010
(Reuters) – Violent videogames can increase aggression and hostility in some players but they can also benefit others by honing their visual/spatial skills and improving social networking ability, scientists said.
In a special issue of the journal Review of General Psychology published by the American Psychological Association, researchers said the games can also help to control diabetes and pain and work as a tool to complement psychotherapy.
“Violent video games are like peanut butter,” said Christopher J. Ferguson, of Texas A&M International University. “They are harmless for the vast majority of kids but are harmful to a small minority with pre-existing personality or mental health problems.”
He added that studies have revealed that violent games have not created a generation of problem youngsters.
“Recent research has shown that as video games have become more popular, children in the United States and Europe are having fewer behavior problems, are less violent and score better on standardized tests,” Ferguson, a guest editor for the journal, explained.
Patrick Markey, of Villanova University in Pennsylvania, found in a study of 118 teenagers that certain personality traits can predict which children will be negatively influenced by videogame.
If someone is easily upset, depressed and emotional or is indifferent to the feelings of other people, breaks rules and fails to keep promises, they may be more likely to be hostile after playing violent videogames.
“These results suggest that it is the simultaneous combination of these personality traits which yield a more powerful predictor of violent video games,” Markey said. “Those who are negatively affected have pre-existing dispositions, which make them susceptible to such violent media.”
But on a more positive note Pamela Kato, of University Medical Center in Utrecht in the Netherlands, showed in her research that specially tailored games can help to prevent asthma attacks, and ease pain management and diabetes treatment.
T. Atilla Ceranoglu, of Massachusetts General Hospital in Boston, discovered in a research review that videogames can also be used in psychological assessment of children and teenagers.
(Reporting by Patricia Reaney; Editing by Paul Casciato)
Moms’ full-time work tied to childhood obesity
NEW YORK | Thu Jun 10, 2010 9:17pm BST
(Reuters Health) – The growing number of full-time working moms in the past few decades could be one of the factors contributing to the concurrent rise in childhood obesity, new research hints.
In a study of more than 8,500 UK adults followed since their birth in 1958, researchers found that the study participants’ young children were 50 percent more likely to be overweight or obese than they themselves had been back in the 1960s.
When the researchers looked at factors that could be associated with the trend, they found that mothers’ full-time employment, which was more common in the younger generation, appeared to be one.
The findings, published in the American Journal of Epidemiology, do not prove that moms’ full-time work, per se, contributes to the risk of childhood obesity.
One possibility, according to the researchers, is that children of full-time working moms have fewer family meals or less-healthy diets in general.
So the trend in mothers’ employment over the past few decades may be one of the variables contributing to a general erosion in children’s diets; the explosion in sugary junk foods on the market, food advertising aimed at kids, and the increasing availability of high- fat, high-sugar fare in schools are among the other factors that have been blamed.
The current study lacked information on the children’s diets and exercise habits, so it is not known whether kids of working moms did in fact have poorer-quality diets or were less active.
For the study, Dr. Leah Li and colleagues at the University College London analyzed data from a project that has followed a large group of Britons since their birth in 1958. They focused on 8,552 participants who, in 1991, had a total of 1,889 children between the ages of 4 and 9.
Overall, the children were more likely to be overweight or obese than their parents had been back in 1965: 12 percent of boys were overweight or obese, versus 8 percent of their fathers in childhood; and 18 percent of girls were heavy, versus of 11 percent in their mothers’ generation.
Li’s team found that both parents’ current weight and mothers’ employment status were associated with the risk of their children being overweight.
Children of mothers who worked full-time were 48 percent more likely to be overweight or obese than children of non-working mothers. That was with factors such as socioeconomics, parents’ weight and breastfeeding (which some studies have linked to a lower risk of childhood obesity) taken into account.
When parents were obese, the odds of the child being overweight were three to six times greater than when parents were normal-weight.
Rates of both parental obesity and full-time work among mothers increased between the two generations. In 1991, 60 percent of mothers worked, including 15 percent who were full-time; that compared with 45 percent and 10 percent, respectively, in 1965.
Similarly, about 12 percent of parents were obese in 1991, versus 5 to 7 percent of the first generation’s parents in 1965.
So it’s possible, according to Li and her colleagues, that both factors (parents’ weight, in particular) contributed to the intergeneration increase in childhood weight.
However, even if mothers’ employment is a factor in the rise of childhood obesity, it would only account for a small portion of that increase, the current findings suggest.
Based on their data, the researchers estimate that in 1991, less than 8 percent of cases of childhood overweight or obesity could be attributable to mothers’ employment.
In general, experts believe that a complex mix of societal factors — from shifts in eating habits, to greater reliance on cars and increasing hours logged in front of the TV or computer — has been behind the rise in childhood weight problems in recent decades.
SOURCE: link.reuters.com/heh49k
American Journal of Epidemiology, online May 20, 2010.
Birth impact on learning problems
BBC 9 June 2010
Babies born slightly early or two weeks late have a marginally raised risk of learning difficulties – from poor vision to autism, research suggests.
The Glasgow University study of 400,000 schoolchildren found those born between 37 to 39 weeks were 16% more likely to develop problems than those born at 40.
But the overall risk was still relatively low, at 5% of all children.
Elective Caesareans are now commonly carried out at 39 weeks.
Writing in the Public Library of Science Medicine journal, the Scottish-led team suggested their findings should inform the debate on whether and when to undergo a Caesarean.
But the Royal College of Obstetricians and Gynaecologists (RCOG) said very few women opted for a surgical birth without reason, and that to delay the operation could put the health of mother and baby at risk.
Intervening
It has long been established that babies born prematurely – at 24 weeks – are significantly more likely to suffer learning difficulties and disabilities. It has also been recognised that those born a few weeks early may have respiratory difficulties among other immediate problems.
But this is the largest study of its kind to track the impact these slightly early births may have on development later on, analysing data on Special Educational Needs (SEN) – a broad spectrum which can include minor learning delays, dyspraxia and attention deficit disorder.
In total, nearly 5% of the children studied were recorded as having SEN.
The likelihood of their having such a diagnosis decreased the longer their mother’s pregnancy had lasted, up until 42 weeks – when it rose sharply.
This means that for every 100 babies born between 37 and 39 weeks, there may be one more diagnosis of SEN than among 40-week contemporaries.
Health reasons may explain why some babies are born spontaneously slightly before term, and this in turn could be behind later development problems. While these early births are not preventable, the research team suggested some elective Caesareans could be reconsidered.
“Early term births – between 37 and 39 weeks gestation – are becoming more common, because more mothers are electing to be delivered early for non-medical reasons – so-called birth scheduling,” lead author Jill Pell, an expert in public health and health policy at Glasgow University, wrote.
“These findings have implications for clinical practice in relation to undertake elective delivery and the timing of elective deliveries.”
Balancing act
But Professor James Walker, a consultant and spokesperson from the RCOG said very few Caesareans were now carried out before 39 weeks and the vast majority of elective operations were for good medical reasons.
“The findings of this study do seem credible, but the risk they highlight has to be balanced against the risk of waiting for a mother to reach term. If she then goes into labour at night, or ends up having an emergency Caesarean, these present much greater risks.
“But we do all have to be aware of the consequences of medical intervention, as well as the consequences of not intervening, and make decisions accordingly. This study adds to the body of what we know.”
Cathy Warwick, general secretary of the Royal College of Midwives, said: “This new research highlights another reason for women and professionals to think carefully about the necessity for each elective caesarean section.
“There is a real need to encourage more normal births and midwives are doing this. Midwives need to have the time to spend with women to discuss all the birth options available to them, and to offer them help and advice. There are many examples of this happening across the country, and I would like to see many more.”
Latest figures show a quarter of all births in the UK are carried out by Caesarean. Some 15% of these are emergency operations, and 10% are planned. About 7% of these elective operations are thought to be due to the mother’s wish rather than medical grounds.