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• Past Factoids (all volumes)

• More than 50% of extremely low birth weight (ELBW) or very preterm children born in the 1990s display clinically significant neurobehavioral impairment at school age. Even so, most of these children do not have educational problems, do not repeat grades and do not require additional educational assistance. Even though ELBW or very preterm children had lower mean test scores for reading, spelling and arithmetic than the NBW controls, they may have improved compared with children born before surfactant therapy became routinely available in 1989. There are trials designed to improve the rate of survival free of impairments and disabilities. Such trials include "nutritional interventions, different techniques for supporting breathing, and early intervention programs in the nursery and after birth, among others."  JAMA 2003;289;3264-3272.
• Around 16% of US adults will develop depression over their lifetimes, but only one-fifth of those who report recent episodes receive adequate treatment. Depression is a common and disruptive condition, and many people need more help than they are getting. More than half (52%) of those who were depressed in the last year sought help for their condition, and this percentage is an increase over previous years. However, treatment was adequate only 42% of cases, meaning that only 22% of people with recent depression receive adequate treatment. Approximately 16% of U.S. adults--equivalent to between 32.6 and 35.1 million people--will experience an episode of major depressive disorder during their lifetimes. And almost 7%--or between 13.1 and 14.2 million people--experience major depressive disorder within the course of one year. JAMA 2003;289:3095-3105.
• "More than a quarter of adolescents surveyed in the Belgian province of Limburg considered suicide in the past year. The study found that 27 percent of young people in the 14-16 year age group thought about suicide in the previous year, and nine percent had attempted suicide at least once in their life. The numbers were even higher for students in vocational and trade schools where 31 percent thought about suicide and 13 percent had attempted it. So far, no conclusions had been drawn about the reasons for such high numbers, she said. The results from study are to be combined later this year with similar studies being done in several other regions of Belgium, the Netherlands, and Germany. Attempts will be made to draw conclusions from the figures and determine if the best policies are being used by authorities in each area once the data have been combined."
• Many parents of pediatric transplant patients have posttraumatic stress disorder (PTSD). Researchers found that 27.1% of parents could be classified as having PTSD and 44.6% of these parents had symptoms that interfered with their daily life. The prevalence of PTSD in these parents is similar to that seen in parents of children with cancer. By comparison, PTSD affects about 8% of the general population. The risk and severity of PTSD symptoms was directly related to how dangerous parents perceived transplantation to be. Other predictors of symptom severity included how the parents perceived the impact of transplantation on their family. For example, concern about not being able to travel and visit family was tied to greater severity. Pediatrics 2003;111:725-731
• UK researchers have found that middle-aged smokers show a faster decline in scores on tests of word memory, relative to non-smokers. Furthermore, people who smoked in their 40s did worse on tests that measure how fast they could pick out certain letters from a page full of different letters, the authors write in the June issue of the American Journal of Public Health. The relationship between smoking and cognitive decline appeared strongest in people who smoked more than 20 cigarettes each day, and persisted even when controlled for socioeconomic status, gender and a range of medical conditions.Smoking could have been causing changes in the brain's blood supply that we were not able to measure. the findings also suggest that quitting may help, for the researchers discovered that people who stopped smoking before age 53, and especially those who stopped before age 43, tended to exhibit a slower decline in cognitive function. Am J Public Health 2003;93.
• One in five pregnant women may show signs of depression, but many do not talk about the problem. Women are known to be twice as likely as men to experience depression, and symptoms usually appear during the childbearing years. One previously published report found that women are more likely to be depressed during their pregnancy than after the child is born. Yet most women anticipate that they will feel good during pregnancy, she noted.Women who rated themselves as having poorer overall health, those with high-risk drinking behaviors and those who smoked more cigarettes per day while pregnant were also more likely than their peers to have symptoms of depression. The women's risk of depression was not associated with age, race or ethnicity. J Women Health 2003;12:000-000.
• Autism cases in California nearly doubled over the past 4 years to more than 20,000--a phenomenon whose cause may be difficult to pinpoint because it is does not appear to be related to population increases or changes in reporting criteria. The report showed that the agency's caseload increased 97%--from 10,360 in December 1998 to 20,337 four years later. The spectacular increase in autism cases dwarfs rises of 35% to 49% seen for new cases of mental retardation, cerebral palsy and epilepsy. The study was a follow-up to an earlier report ordered by California lawmakers that showed a 273% rise in autism cases statewide between 1987 and 1998. Preliminary results of a study commissioned by the Department of Developmental Services found high levels of a naturally occurring protein in the blood of newborns who later developed autism.
• Increased prescribing of selective serotonin reuptake inhibitors (SSRIs) is significantly associated with decreased rates of suicide. In the early 1990s, selective serotonin reuptake inhibitors (SSRIs) were first introduced. During the study period, the overall rate of suicide did not change. In terms of specific age groups, suicide rates fell dramatically among older men and women--subjects with higher antidepressant prescription rates, but increased among younger adults--subjects with lower prescription rates. Across all age groups, the suicide rate was inversely related to the antidepressant prescription rate.  BMJ 2003;326:1008-1011.
• People who have been drinking--be they passenger or driver--are more likely to be severely injured in a car accident than people without alcohol in their system who are in a similar crash. The findings have important implications for injury prevention, treatment and research the researchers say. Even after adjusting for crash severity, whether or not the patients wore a seatbelt and whether they had a high alcohol tolerance, the researchers found an association between blood alcohol and injury severity. The authors report that the findings were statistically significant only when head injuries were involved. As a result, they could not determine if the alcohol-related severity of injury relates to all body parts. In addition, the researchers are not able to pinpoint the exact biological mechanism that would explain their findings. However, they do note that findings from animal studies suggest that alcohol may alter cell membranes, making them more vulnerable to rupture during a crash. Alcohol Clin Exp Res 2003;27:000-000.
• Highly educated workers may be more likely to have mental health problems in comparison to the general public, according to a report published in the March/April issue of the American Journal of Health Promotion. The respondents completed a five-item mental health assessment. Possible scores ranged from 0 to 100, with higher scores indicating better mental health. The respondents' average mental health score was 70, lower than what has previously been reported for the general US population.The report also showed that 10% of workers said they used antidepressants at least every week, or more frequently in some cases, and 5% of the workers had symptoms indicative of problem drinking. Mental health scores were lowest among those individuals who showed signs of problem drinking or who took antidepressants, as well as among younger respondents, those who reported higher levels of stress at home or work and those who used avoidance as a coping strategy, study findings indicate. Higher educational levels were associated with poorer mental health, but only among men. Among women, advanced degrees were associated with higher mental health scores.Am J Health Promot 2003;17.
• One in 4 children and teenagers has a psychosocial problem that affects their functioning at home or school. This incidence is believed to be underestimated due, in large part, to inadequate screening by primary care providers. The KYSS Campaign is designed to change that. KYSS stands for "Keep Your Children/Yourself Safe and Secure.
  1. How to cope with stressful things in their lives.
  2. Depression.
  3. Anxiety.
  4. Self-esteem.
  5. Parent-child relationships.

  In fact, about 25% of kids worried about how to cope with stressful things often to nearly always. Another important finding from the study is that despite the fact that so many children and parents have these worries.

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• Healthcare practitioners cannot expect to understand every culture, but remembering some key points will lead to more culturally sensitive care:
• Keep medical explanations simple and avoid jargon.
• Make sure translators are available and avoid using family members, especially children, as translators.
• Ask patients how they deal with stressful situations ("What gets you through it? How can I provide support?").
• Ask if they want their family involved in their care or when learning about a diagnosis, for example ("How would you like me to handle this? Who would you like me to talk to?").
• Be thoughtful about end-of-life issues. Some cultures have strict taboos about an individual dying at home.
• Treatment with sustained-release bupropion did not reduce or delay relapse to smoking in smokers who quit while on nicotine patch therapy, according to the results of a new study. The 194 of those still smoking after completing the nicotine patch therapy were randomly assigned to 8 weeks of bupropion or placebo, after which abstinence rates were 3.1% and 0%, respectively, a nonsignificant difference. There were fewer and less frequent follow-up visits in the current study, and behavioral counseling was less intensive, thus more closely resembling current clinical practice. J Clin Oncol 2003;21:914-920