DiversityNursing Blog

Wolters Kluwer Health

Concerted effort is needed to reverse the ongoing rise in pertussis cases and deaths, especially among children and young people, according to the article in the Journal of Christian Nursing by Emily Peake, APRN, MSN, FNP-C, CLC, and Lisa K. McGuire, MSN, MBA-HCM, RN. "This effort begins with nurses and nurse practitioners and other primary care providers who educate patients and the public," they write. "The battle of pertussis is winnable through education, awareness, and vaccination."

Caused by infection with Bordetella pertussis  bacteria, pertussis has been increasing in recent years. In the United States, average annual pertussis cases increased from less than 3,000 cases per year during the 1980s to 48,000 in 2012, including 20 deaths. Worldwide, there are an estimated 50 million cases of pertussis and 300,000 deaths. Pertussis is a major cause of death in infants worldwide.

Why is pertussis on the rise? "Ambivalence toward precautionary childhood vaccinations" is a key reason, along with the lack of well-child visits and appropriate boosters. The arrival of non-vaccinated immigrants may also be linked to new clusters of pertussis outbreaks, according to Peake and McGuire. They write, "Nurses should educate patients and the public that follow-up booster vaccinations at all ages are critical to maintain immunity to pertussis and other vaccine-preventable diseases."

Issues including vaccine availability and cost, literacy and language barriers, and lack of information all contribute to the lack of recommended vaccinations. Fear of vaccination and religious objections also play a role. Most states allow exemptions from vaccination based on religious reasons, and there's evidence that even non-religious parents are using these exemptions to avoid vaccinating their children.

Nurses should reassure parents that that recommended vaccines are safe. Current diphtheria-tetanus-pertussis vaccines do not contain the mercury-containing preservative thimerosal. Adverse events occur in only a small fraction of vaccinated children, and most of these are mild local reactions.

"Practitioners must build a trusting relationship with patients and reinforce the need for vaccinations through face-to-face contact, engaging parents to discuss concerns, and provide evidence-based research to guide recommendations and reassure patients of the safety of vaccines," Peake and McGuire write. Waiting rooms provide a good opportunity to present videos and other educational materials.

The World Health Organization is working to increase the percentage of infants who receive at least three doses of pertussis vaccine to 90 percent or higher, especially in developing countries. Closer to home, partnerships should be formed with service organizations, food banks, churches, hospitals and schools. "These groups can help identify those most likely not to be vaccinated and help them find free or low cost immunizations," the authors write. "Faith community nurses are in an ideal role to create and lead these partnerships."

Nurses can also advocate for policies aimed at making universal vaccinations available for adolescents and adults. Peake and McGuire conclude, "By using our resources and uniting, a global battle will be waged and won against pertussis and the children of tomorrow can breathe easier for a lifetime."

Source: infectioncontroltoday.com

By Jeffrey S. Solochek

TRINITY, Fla. (AP) — Evan Wolin sat patiently in his slightly oversized cap and knee-length black gown, waiting his turn.

One by one, the teacher called his classmates to the stage. Then, finally, she read his name.

Evan burst from his seat, sped to the front and grabbed his diploma, a huge smile eclipsing his face. He thrust the paper into the air with an extra arm pump, as his mom, Jessica, tried not to cry while she captured it all on her phone.

He was so ready for kindergarten.

____

Nearly three years ago, when Evan first entered Longleaf Elementary's preschool program for children with developmental delays, few predicted that this day would come.

At 2 1/2 years old, he had barely begun walking, hadn't started talking and coped daily with many medical problems stemming from being born a micropreemie.

"On paper, his medical diagnosis had us thinking, 'Oh, my,' " recalled school speech pathologist Janice Whittaker.

Since he still sometimes used a feeding tube, some of the staff at Longleaf thought Evan might be better suited for a program at Cotee River Elementary, which had dedicated nurses on staff. But his mom, a special-education teacher, and dad, a school administrator, did not want their son in a medical unit.

"I knew developmentally I wanted him in the area school. I knew that he had more in him," Jessica Wolin said. "Although he wasn't speaking, although he wasn't eating, I knew he was very bright. . I always wanted him to be challenged."

Teacher Heather Goldstein, also a neighbor of the Wolins who remembered seeing Evan come home as an infant "with every tube connected to him," committed to making her classroom work for his needs.

"As soon as they told me, I went right online to research everything," she said. "I thought, if he is coming I want to make sure I have everything in place."

Before he arrived, Goldstein reorganized the furniture in her book- and toy-filled classroom to make it easier for Evan to navigate. She continued to learn about his medical demands and prepare for his academic requirements, communicating with his family to keep them informed on daily activities.

Jessica Wolin praised Goldstein's dedication, saying the teacher went above and beyond to make Evan feel at home in school and to help ensure his success. District special-education prekindergarten coordinator Kelli Boles never doubted it.

Goldstein, Boles said, exemplifies what the school district wants from its teachers in the program, which is federally funded and guaranteed to all eligible children with special needs ages 3 to 5. When other educators need training or classroom ideas, Boles sends them to Goldstein.

"She knows where the kids are, what they need to work on," Boles said. "She's the model of what I would like to see for all classrooms."

Goldstein's overriding philosophy is simple: Treat all kids like typical kids, set high expectations and then help them get there. She's taught her special-needs preschoolers to read and write that way, not to mention how to speak and socialize.

____

During a recent class day, Goldstein had Evan working with pattern blocks, where he would match colored plastic shapes to a design on a paper. She had him count yellow hexagons to figure out how many he needed to complete the pattern. Then she turned to another set of pieces.

"What do we call the blue?" she asked. "We used to call them diamonds, but now that you're going to kindergarten we have to call them ..."

"Rom," Evan said, looking up at Goldstein for affirmation.

"Rhombus," she said, completing the word.

"I love rhombus," Evan said cheerfully, placing them on the pattern and then sweeping them all away to start again. "I did it!"

"What do you get to do now?" Goldstein asked.

"Build a tower!" Evan shouted. He started to stack pieces, knock them down and repeat.

____

Goldstein refuses to take full credit for Evan's progress. Parents must participate actively, she said, and the child must be determined, too, in order for them all to find success.

That collaboration shone through for Evan, she said. "He amazes me every year."

His mom feels much the same.

When he was born at 24 weeks weighing 1.5 pounds, some people wondered whether he would even survive. She kept the faith through illnesses and surgeries for short-bowel syndrome, months in the hospital, feeding tubes, therapists.

Would he walk? Would he talk? Would he eat?

Now he races around at breakneck speed, bouncing from his pet hamster to his stash of toy cars, climbing on furniture and jabbering nonstop. He loves bacon and pancakes (and syrup and eggs), and though he's still small for his age, he loves to play with as much abandon as any 5-year-old.

In April, he was named Longleaf's pre-K student of the month.

Program coordinator Boles had nothing but good to say about Evan's progress, which includes his move to a traditional kindergarten class in the fall.

"He is like the poster child of why we do this, because early intervention works," she said, expressing hope that more families would enroll their eligible children in the classes.

Jessica Wolin, meanwhile, looks forward to Evan's next adventure. Sure, she's nervous about kindergarten, just like she was about so many other steps in her son's life.

But "he's done all those things. I want to be surprised by him. I want to see the next surprise."

Source: ksl.com

By MICHELLE ANDREWS

School nurses today do a lot more than bandage skinned knees. They administer vaccines and medications, help diabetic students monitor their blood sugar, and prepare teachers to handle a student's seizure or asthma attack, among many other things.

And though school nurses see many students regularly, they don't always have the most up-to-date information about the students' health. School nurses must get permission from parents to communicate with a child's doctor. Once the doctor gives them a care plan for the child, they generally rely on the doctor and/or parents for updates and changes.

"When things change, we don't always get told in a timely manner," says Nina Fekaris, a school nurse in the Beaverton, Ore., school district. "It works, but it takes a lot of coordination."

At the same time, school-based health care is unfamiliar territory to many medical professionals, who operate in a health care universe largely separate from school clinics and other community-based medical services.

In Delaware, "lots of nurses expressed that they had difficulty communicating with providers" at Nemours Health System, which serves children around the state, according to Claudia Kane, program manager of the Student Health Collaboration at Nemours.

In 2011, Nemours got together with the Delaware School Nurses Association and the state Department of Education to develop a program that, with parental approval, gives school nurses read-only access to the electronic health records of more than 1,500 students who have complex medical conditions or special needs. That includes conditions such as diabetes, asthma, attention deficit hyperactivity disorder, seizure disorders or gastrointestinal problems.

Beth Mattey, a school nurse in Wilmington, says that now that she has access to the Nemours system, she can check the recent lab test results of a student who has diabetes. "It's helpful for me to monitor his [blood sugar levels] and work with him to make sure he's in better control," says Mattey, who is president-elect of the National Association of School Nurses.

When a student put a staple through his finger, Mattey was able to check to make sure he went to the doctor and got treatment. "Checking with him directly involves calling him out of class," she says.

Eventually, school nurses will be able to put information into the Nemours electronic records system as well, says Kane.

In the meantime, Nemours doctors, some of whom were initially skeptical about allowing school nurses access to health system medical records, are warming up to the arrangement. Kane says it encourages communication between physicians and school nurses, and eases the burden of routine tasks because Nemours doctors no longer have to fax over care plans or instructions to the school nurse every few months for students who are part of the program.

The Nemours Student Health Collaboration project is operating in all Delaware public school districts as well as half of charter schools and about one-third of private schools. Kane says Nemours plans to extend the program to school-based health centers next.

Source: npr.org

Do you think they should have access to medical records?

By Alexandra Sifferlin

After six years of trying, scientists have discovered a way to genetically modify mosquitoes so they produce sperm that will only conceive male offspring.

Female mosquitoes are the ones who bite people and pass along malaria, so scientists think if they can significantly lower the number of female mosquitoes the rate of malaria will also go down. In their researchpublished in the journal Nature Communications, the researchers created a modified strain of mosquitoes that produced 95% male offspring.

When they introduced the strain to a five caged wild mosquito populations, the modified pests eradicated entire mosquito populations in four of them. There were too few females for the populations to survive. The researchers hope that this same scenario could happen in the wild, and malaria-carrying mosquitoes could die off.

Their findings are important because the scientists are the first to interfere in the sex ratios of mosquitoes, and their strategy could be successful in eliminating malaria, which remains a fatal disease in some sub-Saharan regions in Africa. Malaria prevention methods worldwide have brought down malaria mortality rates by 42%, but scientists are concerned over insecticide-resistant mosquitoes that pass along drug resistant malaria.

“The research is still in its early days, but I am really hopeful that this new approach could ultimately lead to a cheap and effective way to eliminate malaria from entire regions. Our goal is to enable people to live freely without the threat of this deadly disease,” said study author Roberto Galizi from the Department of Life Sciences at Imperial College London in a statement.

Source: time.com

By Karen Weintraub

The parents of children with autism often have to cut back on or quit work, and once they reach adulthood, people on the autism spectrum have limited earning potential.

Those income losses, plus the price of services make autism one of the costliest disabilities – adding $2.4 million across the lifespan if the person has intellectual disabilities and $1.4 million if they don't, according to a new study published in the journal JAMA Pediatrics.

"We've known for a long time autism is expensive, but we've really never had data like this to show us the full magnitude of the issue," said Michael Rosanoff, associate director of public health research for the advocacy group Autism Speaks, which funded the research. "These are on top of the costs to care for a typically developing individual."

Jackie Marks knows the problem firsthand. The Staten Island, N.Y., mom has 13-year-old triplets, all on the spectrum and all with intellectual deficits.

Everything about their care costs more money, she says, from the diapers and wipes she still has to buy to the specially trained babysitters she has to hire every time she wants to go out. For karate classes, she has to pay for one-on-one lessons; the therapist helping with social skills costs $150 an hour per child.

"I enjoy my children immensely," Marks said. "I have a wonderful husband. That, at the end of the day makes it all worth it. But is it like a typical experience? No."

Marks quit her job with the state as a bank auditor to care for Tyler, Dylan, and Jacob. Her husband's job not only has to cover day-to-day needs, but he has to put away enough money to pay for both her and the boys after he retires. She hopes the boys will be able to work someday, but they'll never have the kind of earnings that will sustain them, she said, and will probably receive modest Social Security benefits once they turn 18.

Four things need to change to bring down the cost of autism for families and society, according to David Mandell, director of research for the Center for Mental Health Policy and Services at the University of Pennsylvania.

Adults on the spectrum need more job opportunities. There are many small success stories of individuals or small groups of people with autism who are employed, but "we need to be more creative about thinking about employment on a large scale," Mandell said.

Adult care must be improved so only people who really need expensive residential care get it, and everyone else can find support in their own community, he said. "I think in too many cases, these residential settings represent a failure of our society to provide community-based, cheaper options," he said. "More flexible, cheaper options would be a way to bring these costs down."

Families with autism need more opportunities to stay in the workplace. "Issues that face autism ultimately face all families," Mandell said. "If we had more family-friendly workplace policies, we might see substantial change in the way families were able to manage the work-life balance when they had children with (all kinds of) disabilities."

Society needs to take the long view, he said. Spending money diagnosing and helping young children on the spectrum will probably save money when they are older, by reducing disability and improving employability. "We often talk about the cost of care, and we don't spend much time talking about the cost of not caring," he said.

NUMBERS:

•Cost of supporting someone with an autism spectrum disorder plus intellectual disability: $2.4 million in the USA and 1.5 million pounds in the United Kingdom ($2.2 million in U.S. dollars)

•Cost of supporting someone with an autism spectrum disorder but no intellectual disability: $1.4 million in the USA and .92 million pounds in the United Kingdom ($1.4 million)

Source: usatoday.com

By KAREN KAPLAN

Another influenza season is in the books, and overall it caused less sickness and death than flu seasons in the recent past, according to a new report from the Centers for Disease Control and Prevention.

Between Sept. 29, 2013, and May 17, 2014, a total of 53,471 specimens sent to U.S. labs tested positive for a flu virus. Among them, 87% were influenza A viruses, and the most common of these were versions of the H1N1 virus that prompted the swine flu epidemic in 2009. The other 13% of the confirmed specimens were influenza B viruses.

The CDC findings, which were published Thursday in the Morbidity and Mortality Weekly Report, did not estimate a total number of flu deaths for the 2013-14 flu season. But based on records kept by doctors and hospitals, researchers concluded that flu activity in the last year resulted in “lower levels of outpatient illness and mortality” compared with years when the predominant strains were versions of the H3N2 virus.

At least 96 children died of the flu in the last year, laboratory tests confirmed. Those deaths were reported in 30 states, New York City and Chicago. In about half of these cases, the patients had at least one preexisting condition, such as a neurologic disorder or a pulmonary disease, that may have made them more vulnerable to the flu.

The most striking statistic in the report is the rate of hospitalization among people between the ages of 50 and 64. Over the course of the entire flu season, the cumulative hospitalization rate for these adults was 54.3 per 100,000 people. In the previous four years, that figure has been as low as 8.1 and it never topped 40.6.

The report noted one human case of a H3N2 virus that was first spotted in pigs in 2010 and was identified in a dozen people the following year. The new case was a child from Iowa who had direct contact with pigs. The patient fully recovered, apparently without spreading it to relatives or anyone else, according to the CDC.

The vaccine for the 2014-15 flu season will be based on the same four viruses, the CDC said.

Source: latimes.com

By KATE MURPHY

PITTSBURGH — Trauma patients arriving at an emergency room here after sustaining a gunshot or knife wound may find themselves enrolled in a startling medical experiment.

Surgeons will drain their blood and replace it with freezing saltwater. Without heartbeat and brain activity, the patients will be clinically dead.

And then the surgeons will try to save their lives.

Researchers at the University of Pittsburgh Medical Center have begun a clinical trial that pushes the boundaries of conventional surgery — and, some say, medical ethics.

By inducing hypothermia and slowing metabolism in dying patients, doctors hope to buy valuable time in which to mend the victims’ wounds.

But scientists have never tried anything like this in humans, and the unconscious patients will not be able to consent to the procedure. Indeed, the medical center has been providing free bracelets to be worn by skittish citizens here who do not want to participate should they somehow wind up in the E.R.

“This is ‘Star Wars’ stuff,” said Dr. Thomas M. Scalea, a trauma specialist at the University of Maryland. “If you told people we would be doing this a few years ago, they’d tell you to stop smoking whatever you’re smoking, because you’ve clearly lost your mind.”

At normal body temperatures, surgeons have less than five minutes to restore blood flow before brain damage occurs. CreditUniversity of Pittsburgh Medical Center

Submerged in a frozen lake or stowed away in the wheel well of a jumbo jet at 38,000 feet, people can survive for hours with little or no oxygen if their bodies are kept cold. In the 1960s, surgeons in Siberia began putting babies in snow banks before heart surgery to improve their chances of survival.

Patients are routinely cooled before surgical procedures that involve stopping the heart. But so-called therapeutic hypothermia has never been tried in patients in which a penetrative wound has already occurred, and until now doctors have never tried to replace a patient’s blood entirely with cold saltwater.

In their trial, funded by the Department of Defense, doctors at the University of Pittsburgh Medical Center will be performing the procedure only on patients who arrive at the E.R. with “catastrophic penetrating trauma” and who have lost so much blood that they have gone into cardiac arrest.

At normal body temperatures, surgeons typically have less than five minutes to restore blood flow before brain damage occurs.

“In these situations, less than one in 10 survive,” said Dr. Samuel A. Tisherman, the lead researcher of the study. “We want to give people better odds.”

Dr. Tisherman and his team will insert a tube called a cannula into the patient’s aorta, flushing the circulatory system with a cold saline solution until body temperature falls to 50 degrees Fahrenheit. As the patient enters a sort of suspended animation, without vital signs, the surgeons will have perhaps one hour to repair the injuries before brain damage occurs.

After the operation, the team will use a heart-lung bypass machine with a heat exchanger to return blood to the patient. The blood will warm the body gradually, which should circumvent injuries that can happen when tissue is suddenly subjected to oxygen after a period of deprivation.

Dr. Tisherman and his colleagues plan to try the technique on 10 subjects, then review the data, consider changes in their approach, and enroll another 10. For every patient who has the operation, there will be a control subject for comparison.

The experiment officially began in April and the surgeons predict they will see about one qualifying patient a month.

It may take a couple of years to complete the study. Citing the preliminary nature of the research, Dr. Tisherman declined to say whether he and his colleagues had already operated on a patient.

Each time they do, they will be stepping into a scientific void. Ethicists say it’s reasonable to presume most people would want to undergo the experimental procedure when the alternative is almost certain death. But no one can be sure of the outcome.

“If this works, what they’ve done is suspended people when they are dead and then brought them back to life,” said Dr. Arthur L. Caplan, a medical ethicist at New York University. “There’s a grave risk that they won’t bring the person back to cognitive life but in a vegetative state.”

But researchers at a number of institutions say they have perfected the technique, known as Emergency Preservation and Resuscitation, or E.P.R., in experimental surgeries on hundreds of dogs and pigs over the last decade.

As many as 90 percent of the animals have survived in recent studies, most without discernible cognitive impairment — after the procedure, the dogs and pigs remembered old tricks and were able to learn new ones.

“From a scientific standpoint, we now know the nuts and bolts and that it works,” said Dr. Hasan B. Alam, chief of general surgery at the University of Michigan Medical Center, who has helped perfect the technique in pigs.

“It’s a little unsettling if you think of all the what ifs, but it’s the same every time you push into new frontiers,” he added. “You have to look at risk and balance it against benefits.”

Trauma accounts for more years of life lost than cancer and heart disease combined, and it is the leading cause of death in people up to age 44, according to the Centers for Disease Control and Prevention. Surgeons are eager for new techniques that would help better the odds in emergency situations. Black males are disproportionately victims of homicide, especially gun violence, and most of the patients likely to fit the study criteria in Pittsburgh are African-American males, according to officials at the medical center.

In order to obtain an exemption to federal informed consent rules, the hospital held two town hall meetings on the university campus, placed advertisements on buses, and made sure the news got in newspapers catering to minority readers.

Officials posted information about the study on a website,acutecareresearch.org, and conducted a phone survey in the neighborhoods most at risk for “involuntary enrollment” in the trial. Still, a taxi driver, grocery clerk and security guard — all African-American men approached at random — said they had never heard of the trial, though they work within a couple of miles of the hospital.

They also did not object. “I don’t have a problem with it, if it saves lives,” said Charles Miller, a 52-year-old security guard.

Just 14 people have so far requested “No E.P.R.” bracelets, according to the medical center.

Nearly a half-dozen trauma hospitals may join the trial and begin testing the hypothermia procedure on dying patients, including the University of Maryland Medical Center in Baltimore.

Dr. Scalea, who will head the effort there, said he hoped to receive final regulatory approval by the end of the year.

He recalled a recent stabbing victim who died on his operating table.

“He might have lived if we could have cooled him down,” Dr. Scalea said.

Source: nytimes.com

By LAUREN SILVERMAN

In the emergency department at Children's Medical Center in Dallas, pharmacists who specialize in emergency medicine review each medication to make sure it's the right one in the right dose.

It's part of the hospital's efforts to cut down on medication errors and dangerous drug interactions, which contribute to more than 7,000 deaths across the country each year.

At Children's in Dallas, there are 10 full-time emergency pharmacists, more than anywhere else in the country, and they are on call 24 hours a day. The pharmacists provide a vital safety net, according to Dr. Rustin Morse, chief quality officer and a pediatric ER physician.

"Every single order I put in," Morse says, "is reviewed in real time by a pharmacist in the emergency department prior to dispensing and administering the medication."

That may sound obvious, but Morse says doctors like him, are used to jotting down a type and quantity of drugs and moving on. If there's a problem, a pharmacist will hopefully catch it and get in touch later. But later won't work in the emergency room.

The extra review is particularly important at Children's because medication errors are three times more likely to occur with children than with adults. That's because kids are not "just little adults," says Dr. Brenda Darling, the clinical pharmacy manager for Children's Medical Center.

"They have completely different metabolic rates that you have to look at," Darling says, "so you have to know your patients."

On any given week, pharmacists at Children's review nearly 20,000 prescriptions and medication orders, looking at things like the child's weight, allergies, medications and health insurance.

There are also automatic reviews by an electronic medical record system designed to essentially "spell check" orders to prevent errors. You need both, says Dr. James Svenson, associate professor of emergency medicine at the University of Wisconsin, because the electronic medical record doesn't catch all errors.

Svenson co-authored a study in the Annals of Emergency Medicine that found that even with an electronic medical record, 25 percent of children's prescriptions had errors, as did 10 percent of adults'. Now his hospital also has a pharmacist in the emergency department 24 hours a day.

So why doesn't every hospital do this? The main reason, Svenson says, is money.

"If you're in a small ER, it's hard enough just to have adequate staffing for your patients in terms of nursing and techs, let alone to have a pharmacist sitting down. If the volume isn't there, it's hard to justify."

Hiring pharmacists is expensive, but Morse points to research showing prescription review can reduce the number of hospital readmissions, thereby saving money and lives.

"People do make mistakes," Morse says, and you need to make sure "a patient doesn't get a drug that could potentially stop them breathing because it's the wrong dose."

Source: npr.org

BY LINDA CARROLL

Want a healthy baby? You may want to roll her around in dirt.

For decades, parents have shielded infants from bacteria and other possible triggers for illness, allergies and asthma.

Interestingly, contact with bacteria and dander after age 1 was not protective — it actually increased the risk.

“It was the opposite of what we expected,” said Dr. Robert Wood, chief of the division of allergy and immunology at the Johns Hopkins Children’s Center and co-author of the study in the Journal of Allergy and Clinical Immunology. “We’re not promoting bringing rodents and cockroaches into the home, but this data does suggest that being too clean may not be good.”

 The new findings may help explain some contradictions in research on the so-called hygiene hypothesis, which suggested that kids growing up in a super clean environment were more likely to develop allergies.

“This doesn't completely resolve the controversy, but it does add a big piece of the puzzle,” said Dr. Jonathan Spergel, a professor of pediatrics and chief of allergy at the Children’s Hospital of Philadelphia.

“We’re not promoting bringing rodents and cockroaches into the home, but this data does suggest that being too clean may not be good.”

The theory “is that as we clean up our environment, our immune system moves away from being geared toward fighting bacteria and parasites,” said Dr. Maria Garcia Lloret, an assistant clinical professor of pediatric allergy and immunology at the Mattel Children’s Hospital at the University of California, Los Angeles. “It then has nothing to do and starts to react against things that are normally not harmful, like dust mites, or cat dander or cockroaches or peanuts.”

A chink in the hygiene hypothesis seemed to be the high rates of allergy and asthma in inner-city environments. But the new study may help explain the contradictions by showing that early exposure is crucial.

“It’s all about being exposed to the right bacteria at the right time,” Spergel said.

Wood and his colleagues followed 467 newborns for three years, screening them for allergies annually and testing the dust in the houses where they lived for allergens and bacteria. To the researchers’ surprise, kids who were exposed before their first birthday to mouse and cat dander along with cockroach droppings had lower rates of allergies and wheezing by age 3, compared to those who were not exposed so early on.

 In fact, wheezing was three times as common among children who had less exposure to those allergens early in life.

The protective effect of early exposure to allergens was amplified if the home also contained a wide variety of bacteria.

The reason may be that “a lot of immune system development that may lead someone down the path to allergies and asthma may be set down early in life,” Wood said.

Researchers aren’t ready to try to translate the new findings into practical advice for parents. But, Lloret said, we now know that “strict avoidance of allergens from the beginning does not protect you, and early exposure in the right context may make the difference between disease and tolerance. You could say that this is the downside of cleanliness.”

The new findings may upend advice experts have been giving to parents on the topic of pets and newborns.

“Twenty years ago we used to tell parents to get the cats and dogs out of the house,” Wood said. “This shows that the younger the child is when you get a pet, the better.”

Source: nbcnews.com

By AGATA BLASZCZAK-BOXE

Do men and women feel pain differently? A new study finds an unexpected gender divide.

Researchers found that men tend to report feeling more pain after major surgeries than women, whereas women tend to report experiencing more pain after minor surgical procedures than men.

In the study, researchers found that men were 27 percent more likely to report higher pain ratings after a major surgery such as a knee replacement, while women were 34 percent more likely to report experiencing more pain after procedures that the researchers labeled as minor, such as biopsies. (The researchers differentiated between "major" and "minor" procedures depending on the intensity of pain that people typically expect to feel after a particular procedure.)

To conduct the study, the researchers interviewed 10,200 patients from the University Hospitals of the Ruhr University of Bochum, Germany, following an operation, over more than four years. About 42 percent of the patients were male and 58 percent were female.

Initially, the study authors didn't find significant differences between the genders in people's overall experience of postoperative pain. However, that changed when the researchers distinguished between different kinds of surgeries.

The researchers are not sure where these differences stem from; however, they speculate that a lot may depend on the kind of surgery a person is undergoing. For instance, procedures such as cancer-related biopsies or an abortion may take a particularly serious emotional toll on women, and therefore exacerbate their individual perceptions of pain.

"It could be anxiety," study author Dr. Andreas Sandner-Kiesling of Medical University of Graz, Austria, told CBS News.

"This is a very interesting study," Dr. M. Fahad Khan, an assistant professor in the Department of Anesthesiology at NYU Langone Medical Center, told CBS News. "Ten thousand patients in any type of study is a huge number, and it is really great to see studies on that number of patients because it can limit a lot of the bias that some studies have."

Khan noted he found it interesting that in women, even smaller procedures "can be fraught with the development of pain problems after the procedure," which many people may not expect when they go to the hospital for a simple biopsy, he said.

Sandner-Kiesling said he did not think the findings should change the way men and women are treated for pain. "Clinically, there is no relevance," he said.

According to certain popular cultural stereotypes, women are often considered to be tougher about dealing with pain than men, but is this really the case?

"Anecdotally, people will say that women have a higher threshold for pain and they are more tolerant to pain, just because of their life experience. And perhaps, emotionally, maybe they are stronger than men," Khan said. "However, medically, in my experience, we haven't really noticed much of a difference with regard to men and women in the development of problems with dealing with severe and chronic pain."

The new study is presented at this year's Euroanaesthesia meeting in Stockholm.

Source:cbsnews.com