DiversityNursing Blog

Source: www.rntobsnonlineprogram.com

By Michelle Healy

Nearly one-third of U.S. children and adolescents are obese or overweight, but many don't realize that they fall into that category.

According to new government statistics, approximately 30% of children and adolescents ages 8-15 years (32% of boys and 28% of girls) — an estimated 9.1 million young people — don't have an accurate read on their own weight.

About 33% of kids (ages 8–11) and 27% of teens (ages 12–15) misperceive their weight status, says the report from the National Center for Health Statistics.

Based on data collected between 2005 and 2012 from more than 6,100 kids and teens for the National Health and Nutrition Examination Survey (NHANES), the report also finds:

• 42% of those classified as obese (48% of boys; 36% of girls) considered themselves to be about the right weight.

• 76% of those classified as overweight (81% of boys; 71% of girls) believed they were about the right weight.

• 13% of those classified as being at a healthy weight considered themselves too thin (9%) or too fat (4%).

Studies have shown that recognizing obesity can be an important step in reversing what is a major health problem for U.S. children and adolescents, and it can be an important predictor of later weight-control behaviors, says Neda Sarafrazi, a nutritional epidemiologist at NCHS and lead author of the report.

"When overweight kids underestimate their weight, they are less likely to take steps to reduce their weight or do additional things to control their weight, like adopt healthier eating habits or exercise regularly," Sarafrazi says.

"On the other hand, when normal weight or underweight kids overestimate their weight, they might have unhealthy weight-control behaviors," she says.

Weight misperception varied by race and Hispanic origin, according to the report. Black and Mexican-American youths were more likely to misperceive their weight than white children. It also varied by income level and was significantly less common among higher-income families compared with lower-income families.

The report's findings are not a surprise, says Timothy Nelson, an assistant professor of psychology at the University of Nebraska-Lincoln. He was not involved in the study.

"In general, children and adolescents have a tendency to underestimate their health risks, and this certainly appears to be the case with obesity," says Nelson, who studies pediatric health behaviors. "We see a similar pattern of misperception when parents are asked about their children's weight. Parents are often unaware of the problem."

With obesity so prevalent today, it's understandable that many kids might have a skewed take on their weight, he says. "If they are surrounded by people who are overweight, they may be less likely to label their own weight as a problem."

The findings highlight the need for health professionals "to communicate with families about the child's weight," Nelson says. "This can be a tough conversation when the child is overweight, but it is critical that pediatricians help parents understand where their child stands and what steps need to be taken to get the child on a healthier track."

Source: http://www.usatoday.com

By: Healthday

Odds are small, but family, doctors should keep possibility in mind, researchers say.

Babies born prematurely appear to have a slightly increased risk of potentially fatal blood clots that they will carry into adulthood, Swedish researchers report.

Doctors have previously suspected that babies born earlier than 37 weeks' gestation have a raised risk of deep vein thrombosis and pulmonary embolism, two serious conditions caused by blood clotting in the veins, the researchers noted in background information.

This new study confirms that link, and takes it even further. Premature birth appears to be linked to an increased chance of blood clots in the veins in childhood and early adulthood, according to findings published online July 28 in the journal Pediatrics.

The researchers also reported that a baby's chances of blood clot-related illnesses are directly related to the degree of prematurity. "The more premature, the higher the risk," said Dr. Edward McCabe, chief medical officer of the March of Dimes. A full-term pregnancy lasts from 39 to 40 weeks.

While parents and doctors should keep this risk in mind, they should also be aware that the risk is not huge, said Dr. Kristi Watterberg, chair of the American Academy of Pediatrics' committee on the fetus and newborn. Watterberg and McCabe were not involved with the study.

The association between premature birth and clot risk seen in the study does not prove a cause-and-effect relationship.

The study involved 3.5 million babies born in Sweden between 1973 and 2008, including almost 207,000 born preterm. Out of all the births, only about 7,500 children -- 0.2 percent -- suffered either deep vein thrombosis or pulmonary embolism later in life.

"I think it's important scientifically to know, but it's such a low incidence phenomenon that there are a lot of things to think about before that," said Watterberg, a professor of pediatrics and neonatology at the University of New Mexico School of Medicine.

Deep vein thrombosis involves blood clots that form in a vein deep in the body. If these clots aren't treated and dissolved, they can break off and travel through the bloodstream to the lungs, causing a blockage called a pulmonary embolism. Such a blockage can be deadly.

For the study, Dr. Bengt Zoller, of the Center for Primary Health Care Research at Lund University in Malmo, Sweden, and colleagues used records from the Swedish Birth Registry to track the babies' health. The researchers found that premature babies had an increased risk of blood clots in their veins in infancy, but also from ages 1 to 5 and from 18 to 38.

Very preterm births -- before 34 weeks of gestation -- also had a risk of blood clot-related illness in adolescence, from age 13 to 17.

Boys had an increased risk of blood clots in infancy, while girls were more likely to carry the risk into adolescence and adulthood, the study authors reported.

No one knows why this increased risk exists, but it could be due to genetic factors that caused the mother to deliver prematurely in the first place, Watterberg and McCabe said.

Diseases such as diabetes, thyroid problems and obesity are genetic in nature and can cause preterm delivery, McCabe said.

Also, some mothers who suffer a genetic deficiency in a key protein that controls blood clotting may be predisposed to give birth prematurely, Watterberg said.

"It may be that maternal genetics are a setup for preterm delivery, and those problems are passed along to the infant," she said.

The mother's wellness and lifestyle also play a role in a baby's lifelong health, and could influence their risk of blood clots, McCabe said.

Finally, this link might arise because the babies are born prematurely, and are robbed of maternal hormones and nutrition in the womb that could have decreased their future risk of blood clots.

"We are not as good at getting nutrition into those babies as the mother and placenta are, and we do know that hormones have something to do with the predisposition to clotting," Watterberg said. "It makes sense to me you'd have changes in those long-term outcomes as well."

In any case, it is something for the family and doctor of a person born prematurely to keep in mind, McCabe said.

"If a patient has a history of preterm birth, and the more preterm, the more attention it needs to have," he said. "It helps us be better prepared. If a patient comes in with unusual findings, this provides us some clue."

Source: http://healthfinder.gov

By SYDNEY LUPKIN

Wyatt Scott turned a year old earlier this summer, but he ate his birthday dinner through a tube in his tummy.

It’s been more than four months since the Scott family launched WhatsWrongWithWyatt.com to find out why their baby boy can’t open his mouth, and though they’ve been flooded with emails, their little boy’s condition remains a mystery.

Wyatt’s lockjaw has baffled doctors since he was born in June 2013 in Ottawa, Canada, and though the Scott family has taken him to every specialist imaginable, they can’t figure out the root of the problem, Andrew Scott said. Wyatt spent the first three months of his life in the hospital, and his parents have had to call 911 several times because he's been choking and unable to open his mouth.

So Wyatt's mother, Amy, decided to create a website, WhatsWrongWithWyatt.com last spring in the hopes that someone would recognize the condition and offer a solution.

Wyatt's doctor, Dr. J. P. Vaccani, told ABC News in April that the condition, congenital trismus, is rare and usually the result of a fused joint or extra band of tissue. But Wyatt’s CT and MRI scans appear to be normal.

"It's an unusual situation where he can’t open his mouth, and there’s no kind of obvious reason for it,” Vaccani, a pediatric otolaryngologist at Children’s Hospital of Eastern Ontario told ABC News. “Otherwise, he’s a healthy boy."

Andrew Scott said he’s sifted through 500 emails submitted to WhatsWrongWithWyatt.com over the last several months, and compiled a list of the most important ideas to give to Wyatt’s doctors. One letter-writer from Virginia told the Scotts that Wyatt’s story made her cry because her now-14-year-old had similar mysterious symptoms.

“She could have written it herself,” Andrew Scott recalled her saying.

Though the Virginia 14-year-old underwent surgery and therapy, Andrew Scott said Wyatt seems to have something different.

“It’s not just that his mouth doesn’t open,” he said.

Wyatt underwent a study in which doctors X-rayed him while he was feeding to see how the muscles in his mouth and throat worked. They found that he has problems with motor function and swallowing in addition to the lockjaw.

“His blinking is erratic,” Andrew Scott added. “He’ll wink on one side a bunch, then the other side and back and forth.”

Their quest for answers has been slow. A recent muscle biopsy came back negative, and Wyatt is awaiting results of his third genetic test.

Since the website launched, Wyatt had a major health scare: he stole a piece of chicken off his mother’s plate and put it in his mouth, Andrew Scott said. His lips were parted just enough to get it in, but neither of his parents could get it out, so they pulled it out in pieces. They thought it was all gone when Wyatt fell asleep.

Then, Wyatt started choking.

“He almost died,” Andrew Scott said. “I ended up just giving him breath.”

Wyatt “came back” just as ambulances and fire trucks arrived, Andrew Scott said. At the hospital, doctors scoped Wyatt’s lungs, but he was still coughing up chicken pieces several days later.

The emergency forced doctors to use anesthesia to put Wyatt to sleep, which they were too afraid to do before because they feared he would stop breathing. While he was out for the lung scope, the also did a muscle biopsy and put in a G-tube. Now, instead of being fed through a tube in his nose that leads to his stomach, Wyatt can “eat” through a tube in his belly.

Wyatt’s birthday party at the end of June was a pig roast that drew 50 people and included a piñata, goats and a trampoline. Though Wyatt didn’t get any mashed-up pig in his G-tube, Andrew Scott said “maybe next time.” By the end of the party, Wyatt was sound asleep in the grass.

“He is a very happy baby,” he said.

Source: http://abcnews.go.com

By Kim Painter

A nice firm handshake has long been a mark of good manners and elevated social skills.

It is also a very germy way to greet your fellow humans, much worse than a couple of more casual alternatives, a new study shows.

"A short, sweet fist bump will transmit the least bacteria," and even a high-five is better than a traditional shake, says David Whitworth, a senior lecturer in biochemistry at Aberystwyth University-Ceredigion in the United Kingdom.

Whitworth and a colleague systematically tested the three greetings for a study published Monday in the American Journal of Infection Control.

For the experiment, one of them repeatedly dipped a gloved hand into a container loaded with a not-too-dangerous strain of E. coli bacteria. The dirty-gloved scientist let the film dry, then shook, fist-bumped or high-fived the other person's clean, gloved hand. Finally, the receiving gloves were tested for bacteria.

Result: The shakes transmitted about 10 times more bacteria than the fist bumps and about two times more than the high fives. The longest, firmest shakes transmitted the most.

In a separate round in which the gloves were dipped in paint rather than bacteria, the researchers found one rather obvious explanation: Bigger areas of the hands touched during the shakes. Handshakes also tended to last longer, but the researchers found more clinging germs even when they compared shakes to fist bumps and high-fives of the same duration.

Since we don't go around dipping our hands in vats of bacteria, the experiment does not perfectly mimic real life – in which different areas of the hand carry different amounts of bacteria, for one thing. It does provide some new ammunition for those who would like to ban handshaking in hospitals and other places where germs are a particular concern.

Whitworth says it also provides an especially good alternative, the fist bump. "You can't really imagine a world where people don't greet each other physically," he says. "It seems to be a basic human need."

Whitworth's findings "are not surprising," says Mary Lou Manning, an associate professor in the school of nursing at Thomas Jefferson University in Philadelphia and president-elect of the Association for Professionals in Infection Control and Epidemiology.

She is not enthusiastic about replacing handshakes with fist bumps in hospitals. The better, more hygienic idea, she says, is to promote rigorous hand-washing and ban hand-to-hand greetings altogether. "That's already starting to happen" in a lot of places, she says.

She says she "can't even imagine" health workers and patients greeting one another with a casual fist bump. A nod or slight bow might be nicer, she says.

Whitworth concedes that the perceived informality of fist bumps and high fives might be a problem. Figures as august as President Obama and the Dalai Lama have used them, he notes – "but I couldn't imagine the British prime minister doing that."

Source: www.usatoday.com

 By Carly Ledbetter

An 11-year-old's wish to give the gift of life to others came true on the last day of his life. The photograph below shows doctors bowing to Liang Yaoyi, a gifted student from Shenzhen, China, who died from a brain tumor in June. His mother can be seen crying in the background.

Liang was diagnosed with the tumor at the age of 9, just after he moved to Shenzhen to join his brother and sister, and to attend primary school, Shanghai Daily reports. One day, Liang felt dizzy and the next day had trouble walking, so his sister took him to a hospital where he learned he had a brain tumor.

Before passing away on June 6, Liang told his mother, Li Qun, that he wanted to donate his organs.

"There are many people doing great things in the world," he said according to China Daily. "They are great, and I want to be a great kid too."

CCTV News reported that Liang also said it was also a chance for him to be "alive in another way."

Liang's teacher said he may have learned of organ donation by reading stories in a school textbook. Liang's mother honored his wishes and doctors were able to save his kidneys and liver for donation, according to China Daily.

The picture has created a firestorm within Chinese media outlets and on Reddit, where users commented on the beauty of the photo, the strength of Liang and the importance of organ donation.

If you would like to learn more about how you can become an organ donor, contact Donate Life.

Source: www.huffingtonpost.com

By Joe Sutton and Holly Yan

A second American aid worker in Liberia has tested positive for Ebola, according to the Christian humanitarian group she works for.

Nancy Writebol is employed by Serving in Mission, or SIM, in Liberia and was helping the joint SIM/Samaritan's Purse team that is treating Ebola patients in Monrovia, according to a Samaritan's Purse statement.

Writebol, who serves as SIM's personnel coordinator, has been living in Monrovia with her husband, David, according to SIM's website. The Charlotte, North Carolina, residents have been in Liberia since August 2013, according to the blog Writebols2Liberia. They have two adult children.

On Saturday, Samaritan's Purse announced that American doctor Kent Brantly had become infected. The 33-year-old former Indianapolis resident had been treating Ebola patients in Monrovia and started feeling ill, spokeswoman Melissa Strickland said. Once he started noticing the symptoms last week, Brantly isolated himself.

Brantly, the medical director for Samaritan Purse's Ebola Consolidated Case Management Center in Monrovia, has been in the country since October, Strickland said.

"When the Ebola outbreak hit, he took on responsibilities with our Ebola direct clinical treatment response, but he was serving in a missionary hospital in Liberia prior to his work with Ebola patients," she said.

Deadliest Ebola outbreak

Health officials say the Ebola outbreak, centered in West Africa, is the deadliest ever.

As of July 20, some 1,093 people in Guinea, Sierra Leone and Liberia are thought to have been infected by Ebola since its symptoms were first observed four months ago, according to the World Health Organization.

Testing confirmed the Ebola virus in 786 of those cases; 442 of those people died.

Of the 1,093 confirmed, probable and suspected cases, 660 people have died.

There also are fears the virus could spread to Africa's most populous country, Nigeria.

Last week, a Liberian man hospitalized with Ebola in Lagos died, Nigerian Health Minister Onyebuchi Chukwu said.

Lagos, the largest city in Nigeria, has a population of more than 20 million.

The man arrived at Lagos airport on July 20 and was isolated in a local hospital after showing symptoms associated with the virus. He told officials he had no direct contact with anyone with the virus nor had he attended the burial of anyone who died of Ebola.

Another doctor infected

Confirmation of the death in Lagos came after news that a doctor who has played a key role in fighting the Ebola outbreak in Sierra Leone is infected with the disease, according to that country's Ministry of Health.

Dr. Sheik Humarr Khan is being treated by the French aid group Medecins Sans Frontieres -- also known as Doctors Without Borders -- in Kailahun, Sierra Leone, agency spokesman Tim Shenk said.

Before falling ill, Khan had been overseeing Ebola treatment and isolation units at Kenema Government Hospital, about 185 miles east of the capital, Freetown.

Ebola typically kills 90% of those infected, but the death rate in this outbreak has dropped to roughly 60% because of early treatment.

Spread by bodily fluids

Officials believe the Ebola outbreak has taken such a strong hold in West Africa because of the proximity of the jungle -- where the virus originated -- to Conakry, Guinea, which has a population of 2 million.

Because symptoms don't immediately appear, the virus can easily spread as people travel around the region. Once infected with the virus, many people die in an average of 10 days as the blood fails to clot and hemorrhaging occurs.

The disease isn't contagious until symptoms appear. Symptoms include fever, headache and fatigue. At that point, the Ebola virus is spread via bodily fluids.

Health workers are at especially high risk, because they are in close contact with infected people and their bodily fluids. Adding to the danger, doctors may mistake the initial stages of an Ebola infection for another, milder illness.

Source: www.cnn.com

By Kim Painter

Music has an unmatched power to bring back our pasts. But what if our memories have been lost to Alzheimer's or some other condition? Can music still work its magic?

A new film, Alive Inside, says yes. The film, opening Friday in New York, features the work of Dan Cohen, a New York social worker who started taking personalized iPods to people with dementia in nursing homes several years ago. Cohen's non-profit Music & Memory got a huge boost in 2012 when an early clip from the film, featuring a gentleman named Henry, became an online sensation. It has been viewed more than 10 million times at various websites, filmmaker Michael Rossato-Bennett says.

In the clip, Henry, then 94, is shown slumped and unresponsive in a wheelchair – until a nursing home worker places a set of headphones over his ears. Henry comes alive. He scats along with Cab Calloway and sings a soulful I'll Be Home for Christmas. The music "gives me the feeling of love, romance," he says.

Henry has since passed away, but that clip is one big reason that the Music & Memory program is in 640 nursing homes and assisted-living facilities, Cohen says. He says he won't be satisfied until personalized iPods – loaded with music especially chosen for each participant – are in all 16,000 U.S. nursing homes, available to all 1.6 million residents.

"Ninety-nine percent of these people are still sitting around and doing nothing all day when they could be rocking to their music," he says.

The reasons for Cohen's passion become clear in what Rossato-Bennett dubs "the only good-news film ever made about Alzheimer's." In segment after segment, people with Alzheimer's and other conditions don the headphones, hear the music of their youths and light up. A World War II veteran named John dances in his chair as the Andrews Sisters sing Oh Johnny, Oh Johnny, Oh! Another man holds his wife's hands and sings a duet of Can't Take My Eyes Off of You. An agitated woman becomes serene as she dances to strains of Schubert.

Such scenes are interspersed with comments from doctors, including the neurologist Oliver Sacks, who says, "Music has more ability to activate more parts of the brain than any other stimulus." Others talk about the need to reconnect with lonely, inactive and neglected elders, in and out of nursing homes.

Viewers might come away with the idea that a skillfully loaded iPod is a proven and universally effective cure for all that. In fact, the first big study of Music & Memory is just getting underway in Wisconsin, as part of a state-funded rollout in 200 nursing homes. Researchers will look at whether the approach improves social engagement and reduces agitation, anxiety and depression, say University of Wisconsin-Milwaukee researchers Jung Kwak and Michael Brondino. The study won't focus on memory but will look at overall effects on dementia, Brondino says. One thing they know, he says, is that staffs and patients "absolutely love this program."

The program, which relies on families and aides to work with patients, should not be confused with formal music therapy delivered by professionals trained in that discipline, says Alicia Clair, professor of music education and therapy at the University of Kansas.

Still, she says, "it's a wonderful thing" for many people. Caregivers need to know, she says, that not everyone will respond and that some people can even respond negatively. A song that stirs up sadness or anger might do more harm than good, she says.

Cohen says, "This is not a cure for Alzheimer's, and this does not work for everybody." But, he says, it is something just about anyone can try – something that might open up a whole lost world.

Cohen's tips for setting up an individualized music program and for donating used iPods to the program are at musicandmemory.org.

Alive Inside will open in theaters and be shown in film festivals around the country through mid-September.

Source: http://www.usatoday.com

By Robert Preidt

Surviving a life-threatening illness or injury may be more likely if you're treated at a busy emergency department instead of one that handles fewer patients, a new study finds.

Researchers analyzed data on 17.5 million emergency patients treated at nearly 3,000 hospitals across the United States. The overall risk of death in the hospital was 10 percent lower among those who initially went to the busiest emergency departments rather than to the least busy ones, the study found.

"It's too early to say that based on these results, patients and first responders should change their decision about which hospital to choose in an emergency," said the study's lead author, Dr. Keith Kocher, an assistant professor of emergency medicine at the University of Michigan Medical School.

"But the bottom line is that emergency departments and hospitals perform differently, there really are differences in care and they matter," he added.

The survival difference was even greater for patients with serious, time-sensitive conditions. Death rates were 26 percent lower for sepsis patients and 22 percent lower for lung failure patients who went to the busiest emergency departments, compared to those who went to the least busy ones.

Heart attack patients were also more likely to survive if they went to the busiest emergency departments, according to the study published July 17 in the journal Annals of Emergency Medicine.

If all emergency patients received the kind of care provided at the busiest emergency departments, 24,000 fewer patients would die each year, the researchers said.

The finding held even when the researchers accounted for differences in the patients' health, income level, hospital location and technology, they said.

But the study wasn't designed to look into the reasons for the finding; it only found an association between better survival rates and busier ERs.

"The take-home message for patients is that you should still call 911 or seek the closest emergency care, because you don't know exactly what you're experiencing. What makes one hospital better than another is still a black box, and emergency medicine is still in its infancy in terms of figuring that out," Kocher said in a university news release.

"For those who study and want to improve emergency care and post-emergency care, we hope these findings will inform the way we identify conditions in the pre-hospital setting, where we send patients, and what we do once they arrive at the emergency department and we admit them to an inpatient bed," he added.

Source: http://www.medicinenet.com