July/August 2008

Guns and Health (PDF)
This July 2008 New England Journal of Medicine article discusses the recent U.S. Supreme Court's 5-4 decision on the second amendment of the Constitution—the right to bear arms and for States to maintain a "well-regulated militia." The piece explores the public health evidence on effects of guns and health as well as examines the implications on intentional and unintentional injury to individuals and populations when guns are in the home. Finally, the article explains evidence over many years of research, which demonstrates an increase in the death and injury rate, both accidental and intentional due to fun possession.

Health Care Reform in Massachusetts—Expanding Coverage, Escalating Costs(PDF)
This article from the July 2008 New England Journal of Medicine examines the effects of a Massachusetts health care reform program. Early data suggests that access to care has improved, especially among low income individuals as well as there have been decreases in out-of-pocket spending on health insurance. Overall, about 350,000 additional people have been enrolled as of May 2008.

School Food Environments and Policies in US Public Schools
Featured in the July 2008 edition of Pediatrics, the journal published by the American Academy of Pediatrics, this article asserts that the higher the grade level—from elementary through secondary schools—the lower the food's nutritional value and the more likely that the food items were high in fat and sugar. The authors also concluded that this is a major factor in the increasing obesity of the child and youth population.

The School Health Index
The Center for Disease Control and Prevention's (CDC) online tool, The School Health Index, sets standards related to health including, nutrition, physical activity, physical education, and social and psychological services that should be available at all secondary schools. It can be used by faculty, administration, and parents to assess the status of services, including psychological, which is considered to be the "gold standard" for schools. Users must create a free account to view the assessment tool online.

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June 2008

Health Insurance Coverage of Young Adults: Issues and Broader Considerations(PDF)
This study, funded by the Robert Wood Johnson Foundation, discusses the statistics and the incumbent problems of youth, aged 19-26 who are uninsured in the United States. This age group has the highest rate of being uninsured in the US. The reasons for this include higher levels of poverty than the rest of the population and lack of health insurance coverage for entry level jobs, which youth are more likely to have. Also, many State Medicaid and SCHIP programs only cover youth through 18 years of age. This has immense implications for access to mental and physical health care.

The Building Blocks of Health Reform: Achieving Universal Coverage and Health System Savings(PDF)
There has been focused and recent attention in the media and elsewhere on the need for health system reform and universal coverage. This article by the Commonwealth Fund offers a number of options that include provider payment, expansion of prevention services, and improvement of quality and access. It includes mental health services in the overall package. One of the major options is to expand Medicaid and SCHIP as to enable coverage for low income adults, children and youth at or below 150% of the Federal Poverty Level, or $33,300 per year for a family of four. Medicaid has broader coverage for community-based mental health services than most private insurance and could potentially expand these services under this option.

Medications and Choices: The Perspective of Families and Youth(PDF)
A groundbreaking study from the Institute for Community Health examines the decision making process that families and youth use when they choose to take psychotropic medications. The data comes from a survey of 274 parents and 80 youth and provides details about their experiences, which included a search for reliable information, trials of alternative treatments, and concerns about the financial costs.

The Center for Adolescent Health and the Law
The Center for Adolescent Health and the Law's Web site contains information of interest to youth, families, and health care professionals. It includes discussions on confidentiality, health care insurance for youth, juvenile and adult justice, and many others. It contains data on State-by-State minor consent laws that are kept up-to-date. There are also opportunities for internships in the Chapel Hill, North Carolina area.

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May 2008

Medicaid and SCHIP Programs Given the Economic Downturn (PDF)
The Kaiser Commission on Medicaid and the Uninsured issued an updated report on the status of the Medicaid and SCHIP programs given the economic downturn. Noted as a point of concern in the report are the increasing numbers of families who are losing health insurance as a result of job loss. In the previous report (October 2007), the Medicaid directors were reasonably hopeful about expanding Medicaid and SCHIP eligibility and services. There now may be retrenchment, as additional factors include changes in the regulations such as those in the targeted case management and the rehabilitation services option. These last two regulatory changes coupled with the economic downturn, the report states, can have major impact on the delivery of mental health services as well as all necessary preventive and/or therapeutic services.

Integrating Publicly Funded Physical and Behavioral Health Services: A Description of Selected Initiatives (PDF)
On behalf of the Robert Wood Johnson Foundation, Health Management Associates reviewed 13 programs in 13 States that were integrating primary care and mental health. Seven of the programs involved children and youth. The report highlights commonalities across the thirteen initiatives, including the use of communication processes, the consistent use of screening tools, collaboration in the use of identified clinical approaches, the identification of funding mechanisms, and the need for sustainability planning. It also identifies considerations for future planning. The report also includes the development of sufficient funding, identifying training resources to support implementation of promising practices and engaging payers in dialogues about integration expectations.

Public Opinion and Health Care (PDF)
This article published in the New England Journal of Medicine discusses the similarities between 1994 and 2008 with regard to health care reform, including the possibility of universal health insurance coverage. Between the 1990s through today, 90% of Americans agree that the U.S. health care system needs complete redesign or major changes. How it will achieve these changes remains a matter of debate. The author discusses the possibilities and the chances for reform with the next Presidential administration.

Book Review: Public Health Behind Bars: From Prisons to Communities
This book describes the difficulties of providing care in correctional facilities and addressing issues such as HIV/AIDS, sexually transmitted infections, and mental illness. It describes how health care professionals and the correctional staff have different missions and outlooks towards health and health care. It also discusses the challenges faced by individuals who are discharged from these facilities in getting the care they need. More information about this book is available from Amazon.

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April 2008

Guns, Fear, the Constitution, and the Public's Health
This article from the April 2008 New England Journal of Medicine details the risk of gun ownership and having a gun in the household. It documents that gun ownership does not increase safety but rather increases the risk of homicide and suicide. In 2005 there were 30,594 deaths due to gunshot wounds in the US, of which 55% were due to suicide and 40% due to homicide. The report states that, "Living in a home where there are guns increases the risk of homicide by 40% and the risk of suicide by 90%.” It goes on to state that young people who commit suicide with a gun usually use a weapon kept at home, and that among women in shelters for victims of domestic violence, two thirds of those who come from homes with guns have had those guns used against them.

IMPACT Spotlights the National Federation of Families (PDF)
The American Academy of Pediatrics publishes a monthly E-News brief entitled Improving Mental Health in Primary Care through Access, Collaboration and Training (IMPACT). IMPACT E-News contains practical applications and information for primary care pediatricians on children and youth mental health and the role of primary care. The April 2008 IMPACT E-News features an article on the National Federation of Families. The article encompasses a discussion on the history, vision, mission and goals of the Federation. It also provides the Web site where the reader can find out more about the organization and how to work with the Federation.

National Expenditures for Mental Health and Substance Abuse Treatment (PDF)
This report from the Substance Abuse and Mental Health Services Administration (SAMSHA) details mental health and substance abuse treatment expenditures for adults and children from 1993-2003. It also tracks trends including the increasing importance of Medicaid, especially for children and youth. The estimates in this latest report include data for years that are revised from earlier reports to take advantage of better data sources and improved methodologies.

New Foundation-Supported Campaign to Help Smokers Quit
According to the Robert Wood Johnson Foundation (RWJF), smoking is one of the most dangerous and hard to overcome behaviors. It not only affects those smoking but also causes health problems for family members who are subject to second hand smoke. It increases sudden infant deaths, asthma and growth retardation in children and youth, and many other health problems. Therefore, RWJF in partnership with the National Alliance for Tobacco Cessation announced the results of a nationwide study on improving smoking cessation for youth and adults. Successful methods detailed in the report include relearning the behavioral aspects of smoking and the triggers that cause smoking as well as working with family member to stop smoking.

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March 2008

History of Bright Futures (paid subscription required)
In the latest issue of Pediatrics Annals online, Dr. Judith Palfrey discusses the history of supporting healthy growth and development of children and youth that began in the 1920's with some of the first pediatricians like Dr. Abraham Jacobi. It was a partnership between health care and preventive public health. Over the years there is a growing emphasis on children and youth developmental and mental health. The new Bright Futures published in 2008, emphasizes prevention in all aspects of care, family partnerships with providers, advocacy for children and youth and developing full partnerships with youth.

Bright Futures: The Screening Table Recommendations (paid subscription required)
The new Bright Futures recommends a variety of screening tests beginning at birth and throughout adolescence. The include screening for metabolic disorders that can cause mental retardation if not addressed early. Also recommended are screening for blood disorders like Sickle Cell Anemia. In addition, newborn screening should be done for vision and hearing. Screening for autism should occur at 12-18 months. Children should also be screened at 18 months fro Body Mass Index to have an early warning on obesity and overweight. Adolescents should be screened for sexually transmitted infection, alcohol, drug and tobacco use and mental health issues.

Practice Improvement: Child Healthcare Quality and Bright Futures (paid subscription required)
This article, also included in the March 2008 edition of Pediatrics Annals online, discusses methods for improving the quality of care provided to children and youth using Bright Futures. An emphasis on prevention, early detection and intervention including mental health and substance use is reiterated. Practitioners should be encouraged to improve performance by encouraging systems changes and rewarded for innovation.

Care for Children and Evidence-based Medicine (PDF)
The article discusses the evidence-base for preventive pediatric care including psychosocial development of children and youth, partnering with families and partnering with youth.

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February 2008

New Medicaid Rule Would Leave Schools without Needed Funds
A new rule has been projected by the Bush administration that will prohibit schools from billing Medicaid for busing special education students to and from school and for particular administrative expenses, including enrolling children in Medicaid and coordinating and scheduling services. The proposed Targeted Case Management proposed regulations would make it difficult or impossible for schools to bill Medicaid for any activities for children and youth with special health needs including those with mental health concerns. This potentially could result in a loss of funding for those children and youth who are most vulnerable and most in need of services.

Howard University Department of Pediatrics and Child Health Receives Research Grant (PDF)
The Howard University Department of Pediatrics and Child Health received a grant from the American Legacy Foundation to train health care professionals on the clinical and public health approach to working with African American to either not start using tobacco products or quit using them. It is a culturally competent approach and developmentally appropriate. The training curriculum works not only for health professionals including mental health professionals but also gives ideas about talking with youth and provides the history and current public health activities including regulation of tobacco products, public education and counter advertising.

Health in Action Toolkit Sample (PDF)
This sample of the Health in Action, Food, Fitness and Fun curriculum for elementary aged school children contains tips and learning modules for children to be taught in after school programs. It is highly interactive and discusses healthy eating and physical activity. There are also homework exercises for the children and the families. These modules have been tested and evaluated in the District of Columbia and Maryland. It has also been evaluated and demonstrated to increase knowledge and change lifestyles. One of the major concerns of youth in Systems of Care has been obesity prevention.

Summary Guidelines for the Management and Treatment of Asthma (PDF)
The National Heart, Lung and Blood Institute of the National Institutes of Health published the evidence-based guidelines on the diagnosis and treatment of asthma in December 2007. The guidelines contain updates and expansion of the child and youth section. It includes self management of the asthma beginning at the age of 10 years, if not sooner. It has a self management plan for children and youth. In addition, there is a discussion on the risks and outcomes in people with other health problems including mental health issues. The discussion focuses on the fact that children, youth and adults with depression and other mental health problems are at high risk for being hospitalized, receiving care in emergency departments and of death.

 

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Resources from 2007

December 2007/January 2008

Best Practices in State Medicaid and Mental Health Program Collaboration
In the past several years, Medicaid has become a prominent and invaluable funding source for public mental health services. In 1997, Medicaid paid for half of State and local mental health services, whereas it paid for only one-third of these services in 1987. A new report asserts that the increasing reliance on Medicaid has led to a corresponding increase in the influence of Medicaid policies and rules on the operation of the public mental health system. The report's authors claim States and localities have few policies and procedures to address the growing importance of Medicaid as a payer of these services. Therefore, they conclude it can be of tremendous benefit if State Medicaid agencies and Mental Health agencies effectively work together to assure a sound and cohesive system within each state.
Access this report (PDF).

Medicaid Support of Evidence-Based Practices in Mental Health Programs
Over the past five years, The President's New Freedom Commission have identified several key principles for enabling adults with serious mental illness and children with serious emotional disturbances to live, work, learn, and participate in their communities. One principle in particular calls for an increase in the quality of services delivered, including consideration of how mental health research findings can be used most effectively to influence the delivery of services. For a program to be rated as having a strong or very strong evidence-base, it must have demonstrated positive outcomes both in carefully controlled research and in “real-world” settings. In support of this principle, the Centers for Medicare and Medicaid Services (CMS) has assembled from the professional literature in the field the following descriptions of six evidence-based practices (EBPs) shown to be effective for individuals with mental illness.
Access this report (PDF).

The Uninsured, A Primer: Key Facts About Americans Without Health Insurance
A new resource published by the Kaiser Commission on Medicaid and the Uninsured indicates that nearly 47 million Americans were uninsured in 2006, an increase of 2.1 million from 2005. Of the 47 million, approximately 9 million are children and youth under the age of 18 years. Children and youth who are uninsured represent approximately 20% of the uninsured population. The purpose of this primer is to present basic information about the uninsured—who they are and why they do not have health coverage. It also provides a necessary understanding of the difference health insurance makes in people's lives. Beyond this, the primer also explains how and why the problem is growing and concludes with an overview of currently proposed solutions.
Access the primer (PDF).

Robert Wood Johnson Foundation Toolkit
The Robert Wood Johnson Foundation in partnership with the Campaign for Tobacco-Free Kids has developed a toolkit on how to pass and implement smoke free policies in their States and communities. It includes tip on how to reach out to the media, develop advertising materials, and more.
Access the toolkit.

 

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November 2007

Bright Futures: Guidelines for Health Supervision of Infants, Children and Adolescents
This is the third edition of Bright Futures and was published in October 2007. Originally published in 1994, Bright Futures provided a standardized, well researched way in which everyone who cares for children can help assure a “bright future” for all children and adolescents. This new edition includes special emphasis on mental health and healthy weight. Also intertwined are cultural competence, family-led care and partnerships. The publication asserts that youth involvement evolves from age 11 to 21 years and that health care professionals should form partnerships with youth so that the youth may take responsibility and the lead in their health care and healthy outcomes. For more information and to order this publication, visit http://www.aap.org/bst/showdetl.cfm?&DID=15&Product_ID=4367&CatID=132.

Attention Deficit and Hyperactivity Disorder and Your School-Aged Child
This one-page document from the American Academy of Pediatrics discusses:

• What is Attention Deficit and Hyperactivity Disorder (ADHD)
• How a parent can tell if their child has ADHD
• Treatment options

To access this document, visit http://www.aap.org/policy/adhd.pdf (PDF).

On the Web: Children's Health Topics - ADHD
This Web page is part of the American Academy of Pediatrics Web site and discusses a wide variety of child and youth health issues for parents and youth. This particular web site includes a discussion on ADHD. It includes family and community resources and how to find them, publications and brief (usually one minute) videos discussing the issues. To access this Web site, visit http://www.aap.org/healthtopics/adhd.cfm.

A Consensus Statement on Health Care Transitions for Young Adults With Special Health Care Needs
This is a consensus policy statement endorsed by the AAP, the American Academy of Family Physicians and the American College of Physicians-American Society of Internal Medicine discusses the critical first steps that the health care profession needs to take to realize the vision of family-centered, continuous, community-based, comprehensive, coordinated, compassionate, and culturally competent care. It addresses transitions in the health care system for young people with physical, emotional and behavioral health concerns. For more information, visit http://aappolicy.aappublications.org/policy_statement/index.dtl.

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October 2007

Mental Health United States, 2004
This publication introduces the quality improvement model and its application to the mental health field. It includes discussions on:

• measures of quality including a brief overview of those measures,
• quality tools available including consumer and provider surveys and
• vehicles for entering, processing and bench-marking quality measures.

It also contains highlights the fast-growing role of mental health care provided in primary care settings. Another section contains data derived from population-based surveys on the prevalence of the behavioral health disorders. It also addresses national and state mental health trends including availability of services.

Managed Mental Health Care, Findings from the Literature, 1990-2005
The goal of this report is to provide public and private sector stakeholders with reliable information derived from the literature regarding the organization, design, delivery and financing of managed care health benefits and to guide stakeholders on the best way to apply managed care techniques.

Administration of Mental Health Services by Medicaid Agencies
State Medicaid agencies are playing an increasing role in funding, managing and monitoring public mental health services in States. This reflects the steady growth over the last three decades in the share of public mental health services funded by Medicaid. However, relatively little is known on a State-by State basis about how Medicaid agencies are exercising thse responsibilities. The report was the result of an hour-long survey with State Mediciad Directors in all 50 States and the District of Columbia. It addresses how States are addressing organizational, funding, policy, management, shared responsibilities and data issues.

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April/May 2007

1. Report: Health Care in America: Understanding the Issues and Proposed Solutions

Prepared for the Cover the Uninsured by the Alliance for Health Reform, Washington, DC, www.allhealth.org

This 24-page guide, updated for Cover the Uninsured Week 2007, provides a readable overview to how Americans get health coverage, why so many of us don't have coverage and what could be done to ease the problem. Includes many graphs, a glossary of health coverage terms and links to sources of additional information. Topics include:

• Why is health coverage so important
• Who is uninsured
• How do American get coverage
• Approaches to covering the uninsured
• Questions to ask about any health insurance proposal and
• Some specific proposals.

It includes statistics about the affect on access to care including primary preventive care, mental health, diabetes, cancer and HIV/AIDS diagnosis, treatment and outcomes. It is a user-friendly document that can be used to educate youth, families, and legislators about the importance of this issue.

Supported by the Robert Wood Johnson Foundation.

2. Resource List: Public Programs and Insurance Information
The Parent Advocacy Coalition for Educational Rights (PACER) Center hosts this list of resources on medical assistance, home and community-based waiver programs, and other health information and advocacy fact sheets.

To access this information, visit
http://www.pacer.org/health/insurance.htm

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March 2007

1. Report: The State Children's Health Insurance Program: Past, Present, and Future

The Commonwealth Fund recently published a report on the State Children's Health Insurance Program (SCHIP) and its upcoming reauthorization. Take a look at a brief overview of the report on the Commonwealth Fund's Web site, which includes information on:

• history and design of the program
• challenges and success
• Reauthorization issues

To view this report, visit:
http://www.cmwf.org/publications/publications_show.htm?doc_id=449518

2. News: Governors, Worried about SCHIP Funding, Clash with Bush
CovertheUninsured.org, a Web site hosted by the Robert Wood Johnson foundation, reports on recent controversy within the National Governor's Association and Congress regarding use of health care funds and SCHIP reauthorization.

To view this article, visit:
http://covertheuninsured.org/news/index.php?NewsID=1807

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Resources from 2006

November 2006

Presentations:

State Children's Health Insurance Plan Reauthorization (SCHIP)

Confused about State Children's Health Insurance Plan (SCHIP) eligibility or about new reauthorization implications? Take a look at the PowerPoint presentation Dr. Mary Tierney's presented to the George Washington School of Public Health on SCHIP history, benefits, and possible changes resulting from the 2007 reauthorization.

The presentation includes such information as:

What is SCHIP?

• The purpose of SCHIP is to help states pay for health insurance for children in families whose income exceeds the State's Medicaid eligibility standards as of March 31, 1997.

What are the differences between SCHIP and Medicaid? For example, SCHIP:

• Has more flexible eligibility standards than Medicaid;
• Permits cost sharing for all children and youth (except under Medicaid expansion), unlike Medicaid; and
• Permits enrollment caps, unlike Medicaid.

How are SCHIP funds generated?

• Annual allotments are based upon a formula: 50% on the number of low-income children under age 19 with incomes at or below 200% of the Federal Poverty Line (FPL) and 50% on the number of children without health insurance.
• A State's allotment for one year is available for use for 3 years (i.e. carry it forward).
• After 3 years the money can be redistributed to other States that have spent their allotment and after 1 year the money must be spent or revert to the US Treasury.

What are the implications of the reauthorization?

• President's budget calls for reducing the period of availability of the 2005 allotment from 3 to 2 years, after which the money would go to states that exceeded their allotments from previous years.
• Given the current baseline funding at the FY 2007 level in out years, the reauthorization could cause a 25% cutback in payment for services.

To download this presentation, click here.

Web Tutorial: Children's Health Insurance Coverage

Take a look at Kaiser's 15-minute Web based tutorial, where you can listen to David Rousseau, Senior Policy Analyst for the Kaiser Family Foundation, talk about the basic financial and programmatic features of children's health insurance. The audio presentation is supplemented by PowerPoint visuals, including graphs depicting variations in coverage, eligibility, and cost. Viewing this tutorial does not require any specialized software.

To view this resources, visit
http://www.kaiseredu.org/tutorials/childrenscoverage/childrenscoverage.html

Reports:

Fact Sheet:State Children's Health Insurance Plan Reauthorization (SCHIP) 101

Need a basic overview of what SCHIP is and how it works? Take a look at this fact sheet, created by the National Association of Children's Hospitals and Related Institutions. It briefly covers the origin and purposes of SCHIP, and reviews key issues such waiver, redistribution, and outreach.

To view this resource, click here.

 

September 2006

Reports:

Study Indicates Rising Health Care Costs and Lower Coverage for Working Adults
The Commonwealth Fund recently released a new report, Squeezed: Why Rising Exposure to Health Care Costs Threatens the Health and Financial Well-Being of American Families. This report analyzes results from a 2005 national survey on individual and employee-provided health care costs and coverage for “working-age” adults. “As health care costs continue to rise, there has been steady erosion in the proportion of workers covered under employer-based plans, as well as in the adequacy of such coverage,” write study authors. The survey indicates that 89% of adults age 19-64 who were not covered by employee packages and sought individual coverage ultimately failed to buy a plan.

To view this report, visit http://www.cmwf.org/publications/publications_show.htm?doc_id=402531&#doc402531

News:

Legislative Brief : New Kaiser Commission Brief on Deficit Reduction Act's Impact on Medicaid
In February, 2006, the Kaiser Commission on Medicaid and the Uninsured released a brief on the 2005 Deficit Reduction Act's implications for Medicaid. This six-page brief presents an overview of the impact on premiums, benefits and asset transfer. It also includes information on proposed changes to reduce spending, such as documentation requirements and narrowing the definition of targeted case management. The document focuses primarily on reporting the different Medicaid benefits and services that would be affected, but also includes brief recommendations for monitoring the effects of this legislation on beneficiaries.

To view this brief, visit http://www.kff.org/medicaid/upload/7465.pdf

Legislative Brief: New Kaiser Commission Brief on Medicaid Documentation Requirements
In July, 2006, The Kaiser Commission on Medicaid Facts released a fact sheet on the new Federal requirements regarding demonstration of citizenship status when applying for or renewing Medicaid coverage. The sheet outlines eligibility under the law, and reviews exemptions and acceptable documentation. Also discussed are the impacts of new requirements on beneficiaries, providers, and States. The brief concludes with implementation recommendations, citing key elements such as “significant flexibility in administering the requirement, extensive outreach, and state financial resources.”

To view this resource, visit http://www.kff.org/medicaid/upload/7533.pdf

July 2006

Reports:

Study Finds Correlation between Mental Health Problems and Risk for HIV
A new study released by Bradley Hasbro Children's Research Center and Brown Medical School indicates that young men with mental health issues are among those with the highest risk for HIV infection. According the Child Development Web site, “the authors found that there are subgroups within a high-risk population in which patterns of risks like unprotected sex, mental health crises and substance abuse exist at the same time, and also vary by gender.” To view a summary of the report, visit the Child Development Web site.

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News:

“New Medicaid Law Is Called a Threat”*
Take a look at the Chicago Tribune's article on the impact that the Deficit Reduction Act will have on Medicaid laws. The Casey Journalism Center Daily Summary gives the following overview: “As a result of a new law -- an effort to keep illegal immigrants from finding their way onto the Medicaid rolls -- consumer advocates warn that many vulnerable Americans could lose or be denied Medicaid coverage. Come Saturday, a controversial law goes into effect that requires as many as 50 million Medicaid recipients to prove they are U.S. citizens by providing passports, birth certificates, driver's licenses or other documents to authorities. All new applicants also have to provide proof of citizenship before their request to join Medicaid is considered. Especially at risk, experts say, are seniors in nursing homes, the severely disabled, children in foster care, the homeless, African Americans and Native Americans born outside of hospitals and Hurricane Katrina evacuees who have lost personal records.”
View this article. (Readers must register on the site before viewing the article, but registration is free. )

* This resource is from the Casey Journalism Center Daily Summary. The CJC Summary is produced by David C. Morrison and edited by Carolyn Ruff Spellman. The CJC Summary is made possible with the generous support of the Annie E. Casey Foundation. Visit the Annie E. Casey Web site at: http://www.aecf.org/

 

May 2006

New Legislation to Expand Health Care Coverage in Vermont
CoverTheUninsured.org Weekly News Digest, an electronic news digest published by the Robert Wood Johnson Foundation, reported on the new Vermont health care reform bill in their May 15 issue. The bill has been passed by the Vermont legislature, and if signed by Governor Jim Douglas will “expand insurance coverage to about 30,000 uninsured Vermonters.” Under the bill, insurance companies will offer a specialized health plan, Catamount Health, to state residents who are uninsured and are not eligible to be covered under other public programs. To read the summary from CoverTheUninsured.org, visit:
http://covertheuninsured.org/news/index.php?NewsID=1547

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Michigan Governor Plans Increased Health Care Coverage
Also in their May 15 issue, CoverTheUninsured.org Weekly News Digest reported on the Michigan Governor's plan to extend coverage to currently uninsured Michigan residents. According to the Michigan Office of the Governor's Web site, extending health care coverage is one of the four key pillars in Governor Jennifer M. Granholm's plan for 2006. The Michigan Web site reports, “The Michigan First Health Care Plan will make affordable private health plans available to small business employees, the self-employed, and the working poor without access to traditional employer-based health insurance or government-run programs. The Governor noted that cutting the state's uninsured population by half will create significant savings for businesses and citizens who subsidize uninsured health care.” To read the summary from CoverTheUninsured.org, visit:
http://covertheuninsured.org/news/index.php?NewsID=1548
To visit the Michigan Office of the Governor's Web site, take a look at: http://www.michigan.gov/gov/0,1607,7-168--134988--,00.html

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Insuring America's Health: Principles and Recommendations
Insuring America's Health: Principles and Recommendations is a series of 6 reports by the Institute of Medicine and its Committee on the Consequences of Uninsurance. Published sequentially between the 2001 and 2004, these reports review and analyze the effects of current national health insurance standards. The series takes a look at the social, political, and economic repercussions of uninsurance, and concludes with strategies and recommended policy changes on the National level. To read a summary of findings and recommendations, visit: http://www.iom.edu/Object.File/Master/17/732/Uninsured6-EnglishFINAL.pdf
For information on how to purchase this resource, visit: http://www.iom.edu/?id=19175

 

March 2006

Recent Advances in Medicare and Medicaid
Take a look at Dr. Mary Tierney's April, 2006 keynote presentation to the International Society of Psychiatric-Mental Health Nurses in Denver, Colorado. This presentation offers a comprehensive overview of Medicaid and Medicaid, including:

• Eligibility requirements
• Mandatory vs optional coverage
• Services and benefits
• Early and Periodic Screening Diagnosis and Treatment (EPSDT)
• Waivers
• Historical funding and enrollment trends
• Recent trends and changes

To download this presentation for viewing, click here.

 

January 2006

The TA Partnership Primary Care Resources for January include a series of CMS-sponsored papers co-authored by Primary Care Resource Specialist Mary Tierney. These papers discuss a range of Medicaid programs and waiver options for supporting or expanding community-based mental health services.

Medicaid Support of Evidence-Based Practices in Mental Health Programs
This paper reviews available Medicaid programs that can be used to pay for evidence-based mental health services under the present statute and regulations. It begins with an overview of basic mandatory and optional State Medicaid and waiver program services, including discussion of the rehabilitation, clinical, and targeted case management options, among others. Continuing with a description of required elements for approval of a Medicaid State plan amendment that supports evidence-based practices, the paper also covers compliance, eligible services, third party liability, and reimbursement methodology. To view this resource, visit: http://www.cms.hhs.gov/PromisingPractices/Downloads/EBP_Basics.pdf

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Best Practices in State Medicaid and Mental Health Program Collaboration
As the importance of Medicaid funding increases, successful collaboration between State Medicaid agencies and Mental Health programs is becoming even more essential for sustaining adequate mental health services. This paper reviews ways in which States can build infrastructure to facilitate working relationships between Medicaid and Mental Health. Highlighting programs in Maryland and New Jersey, the paper also discusses options for covering child-only or mixed child/adult populations. To view this resource, visit: http://www.cms.hhs.gov/PromisingPractices/Downloads/tabestpractices.pdf

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Utilizing the Section 1115 HIFA Waiver Option to Improve Services for Persons with Mental Illness
This paper covers the expanded services under the 1115 HIFA waiver. The 1115 HIFA waiver, a relatively new initiative under the Federal Medicaid program, can be used to expand Medicaid eligibility and mental health services for people who might not normally be able to utilize Medicaid and SCHIP. The paper covers the background of the initiative as well as the waiver's programmatic and fiscal requirements. The paper also includes brief descriptions of the programs implemented by the 10 States approved to utilize the HIFA waiver as of February 2005. To view this resource, visit:http://www.cms.hhs.gov/PromisingPractices/Downloads/tahifa.pd

March 2005

NBC Autism Series
"Autism: The Hidden Epidemic?" is a compilation of NBC News special reports on the subject of America 's fastest growing serious developmental disability. Included on the DVD are an 11-part "Today" show series, a four-part series from CNBC, extensive reporting from "Nightly News with Brian Williams," as well as comprehensive coverage on autism. Visit MSNBC's website to access information and resources about autism as well as information on how to get a free copy of "Autism: the Hidden Epidemic?" on DVD. Although the DVD may be currently sold out, they intend to keep restocking until all orders are filled, courtesy of MSNBC's partnership with the advocacy group, Autism Speaks. To find out more, visit: http://www.msnbc.msn.com/id/6844737/

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Autism Rates Rise After MMR Vaccine Eliminated in Japan

A study of more than 30,000 children in Japan provides evidence that autism is not linked to expose to the measles, mumps and rubella (MMR) vaccine. According to the study, autism rates continued to rise even after the measles, mumps and rubella vaccine was replaced with single vaccines. These findings contradict the findings of a 1998 study, which indicated that a link between autism and the MMR vaccine might exist. This article, posted on NewScientist.com, outlines study findings and provides information on the study report. To view this article, visit:
http://www.newscientist.com/article.ns?id=dn7076

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Online Autism Chat Forum
Written by individuals with autism and their families, ChatAutism.com is a source for information about autism and Asperger's syndrome. It provides links to online resources, but is primarily a forum for exchanging experiences and resources pertaining to autistic spectrum disorders. Site creators state that their mission was to create a place where both family members and autistic individuals could share their perspectives; "we hope to give parents of children on the autistic spectrum a view of the autistic perspective in order to aid understanding of autistics." The site offers support to parents of children with autism and Asperger's, and also has a chat room for autistic individuals and families to discuss related issues. To view this resource, visit:
http://www.chatautism.com/

 

January 2005

Childhood Malnutrition Linked to Behavior Problems
A study conducted by researchers from the University of Southern California indicates that malnourished children are more likely to develop behavior problems as teenagers. Both increased aggressive behavior and decreased IQs were more common among teenagers who had not received proper nutrition as children. This brief from the online resource "Well Rounded Kids" outlines the study's findings. To view this resource, visit: http://www.wellroundedkids.com/articles/News/2004/12/malnutrition.htm

***

New Journal on Primary Care and Mental Health
Primary Care Mental Health is a new journal covering research and practice in the field of mental health delivery in primary care. It is aimed at practitioners, medical and mental health professionals, teachers, and researchers. Radcliff Publishing allows access to full text articles from number of journal issues, covering topics such as staff views on mental healthcare in primary care settings and training programs specializing in primary/mental health integration. The journal also publishes reviews of books and websites relevant to the field. To view the full text of the June 2004 issue, visit: http://titania.ingentaselect.com/vl=2513099/cl=56/nw=1/rpsv/ cw/rmp/14764717/v2n2/contp1-1.htm

To find out how to order this journal, visit: http://www.radcliffe-oxford.com/journals/J14_Primary_Care_Mental_Health/default.htm

***

Telemedicine and Mental Health
This article, from Medscape General Medicine, reviews a variety of telemedicine strategies for providing psychiatric care in difficult-to-access areas. The review includes the results of a study showing a relatively high patient preference for, and satisfaction with, alternatives to in-person care. It also includes a discussion of areas for further research and technological expansion. To view this resource, visit:http://www.medscape.com/viewarticle/430544_2

***

Long-Term Health Effects of Childhood Abuse
"The Legacy of Maltreatment: Long-Term Health Consequences for Women," from the Journal for Women's Mental Health , discusses the results of a study suggesting that physical, sexual, or psychological childhood abuse affects the physical and mental health of women throughout their lifetime. The study concludes that childhood maltreatment can have serious direct and indirect negative impact on a woman's overall wellbeing, including increasing the tendency for such a woman to be "victimized" as an adult. The article suggests that early interventions in abusive situations may be crucial to helping prevent long-term health problems. To view this resource, visit: http://www.medscape.com/viewarticle/482931?src=search

 

November 2004

Study Finds Teens with Asthma At-Risk for Emotional Problems
A new study shows that teens requiring frequent treatment for asthma are at increased risk of depression and anxiety. Researchers from the Johns Hopkins University administered surveys to 185 adolescents with moderate to severe asthma, asking the youth about the logistical and emotional impact of asthma on their lives. Results indicate that increased emotional discomfort is correlated to increased asthmatic symptoms. The article recommends addressing both physical and emotional needs of teens with asthma to improve overall health. To view this article, visit http://www.kidshealth.org/research/emotional_asthma.html

***

New Medicaid/SCHIP Mental Health Coverage
At least 10 percent of low-income children have serious emotional and behavioral problems. States have adopted a variety of methods for financing and delivering children's mental health services. Access to Children's Mental Health Services under Medicaid and SCHIP provides new information on Medicaid and SCHIP coverage of mental health services and on the prevalence of mental health problems among children according to income and health insurance coverage. To view this guide, visit http://www.urban.org/UploadedPDF/311053_B-60.pdf

***

Diagnosing ADHD in Primary Care
This recent study by the American Academy of Pediatrics (AAP) evaluated the effectiveness of the AAP attention-deficit/hyperactivity disorder (ADHD) diagnostic guidelines. This two-year study examined the diagnoses of 159 children in San Diego evaluated for school or behavioral problems. The study concluded that barriers such as 1) physician's limited information about rating scales, 2) lack of information given to families about ADHD supports, 3) physicians' lack of information on mental/physical health plans that restricted care for ADHD, and 4) lack of knowledge of community resources prevented full implementation of AAP guidelines. To view a summary of the article, visit http://pediatrics.aappublications.org/cgi/content/abstract/114/1/129

 

July 2004

Physical Activity and Weight Control

This fact sheet from the National Institutes of Health (NIH) gives the reader tips on how to be physically active. It describes the health benefits of physical activity and gives suggestions for how to work physical activity into your daily routine. In addition, the fact sheet provides additional reading from the Weight-Control Information Network and a list of national organizations.

To view this fact sheet, visit http://www.niddk.nih.gov/health/nutrit/pubs/physact.htm.

***

Weight-Loss and Nutrition Myths: How Much Do You Really Know?

This fact sheet reveals some of the common myths associated with weight loss and nutrition and is a guide for making smart decisions about one's health. It also offers tips and additional resources. Some of the myths uncovered include the following:

• Skipping meals is a good way to lose weight.
• Natural or herbal weight-loss products are safe and effective.
• Nuts are fattening and you shouldn't eat them if you want to lose weight.
• Eating red meat is bad for your health and will make it harder to lose weight.

To view this fact sheet and to uncover these myths, visit http://www.niddk.nih.gov/health/nutrit/pubs/myths/index.htm.

***

TV Watching and Childhood Development

A new article in the journal Pediatrics , "Early Television Exposure and Subsequent Attentional Problems in Children," examines the first-ever study linking early television watching with later attention and concentration problems. Researchers from the University of Washington found that for children age 3 and younger, every hour of television they watched led to a 10% increase in the likelihood of attention problems at age 7.

To view the summary of this article, visit http://pediatrics.aappublications.org/cgi/content/abstract/113/4/708.

***

Behavior Problems Precede Asthma Symptoms

A British study of more than 700 young children has reported that badly behaved 3-year-olds were more likely to develop late-onset wheezing by the time they were 5 years old. Analysis revealed three risk factors for late-onset wheezing: maternal asthma; maternal smoking; and high-intensity scores on the Eyberg Child Behavior Inventory, a 36-question survey completed by the children's parents. Problem ratings that distinguished the badly behaved children included destroying toys and other objects, teasing or provoking other children, arguing with peers, having a short attention span, failing to complete tasks, and having difficulty concentrating.

To view the full article, visit http://www.medscape.com/viewarticle/478864?src=mp .

(Medscape is a free service provided by WebMD;registration is required.)

 

June 2004

 

Disorders of Pubertal Development: Precocious Puberty

Puberty is a complex developmental process culminating in sexual maturity. This transitional period begins in late childhood and is characterized by the maturation of the hypothalamic-pituitary-gonadal axis, the appearance of secondary sexual characteristics, the acceleration of growth, and, ultimately, the capacity for fertility. Significant endocrinologic changes accompany these developmental events. Disorders of pubertal development may occur at any of the steps of the maturational process and may lead to either precocious or delayed puberty. A thorough understanding of the normal pubertal process is important to the accurate diagnosis and treatment of pubertal disorders.

To view this abstract and the complete article, visit http://www.medscape.com/viewarticle/468259?mpid=25909.

(Medscape is a free service provided by WebMD; registration is required.)

***

 

Soft Drinks, Schools, and Obesity

The American Academy of Pediatrics issued a major policy statement in January urging the restriction of soft drinks in the nation's schools. This article discusses obesity in children and the steps that pediatricians have taken over the years to address the issue.

To view this article, visit http://www.medscape.com/viewarticle/470344?mpid=25909.

(Medscape is a free service provided by WebMD; registration is required.)

***

Violence in Teen-Rated Video Games

Content analysis suggests a significant amount of violence, injury, and death in T-rated (rated "T" for teen) video games. Given the large amount of violence involving guns and knives, the relative lack of blood suggests that many T-rated video games do not realistically portray the consequences of violence. Physicians and parents should appreciate that T-rated video games may be a source of exposure to violence and some unexpected content for children and adolescents and that the majority of T-rated video games provide incentives to the players to commit simulated acts of violence.

To view the complete article, visit http://www.medscape.com/viewarticle/468087?mpid=25909.

(Medscape is a free service provided by WebMD; registration is required.)

***

Americans Concerned About Teenage and Underage Drinking

According to a national survey on alcohol taxes released by the American Medical Association's Office of Alcohol and Other Drug Abuse, 90% of Americans are concerned about teenage and underage drinking. Voters, by a margin of two to one, favor a tax increase on alcohol in their states to help fund prevention programs. This article describes what several states are doing to reduce the drinking problems among teenagers.

To view this article, visit http://www.amaassn.org/ama/pub/article/1616-8551.html.

 

 

May 2004

Overweight in Children and Adolescents

This fact sheet from the Surgeon General's Call to Action to Prevent and Decrease Overweight and Obesity provides a statement on the problem of overweight in children and adolescents. In addition, it presents information about the causes and determination of overweight and suggestions for physical activity and healthy eating.

To view this fact sheet, visit http://www.surgeongeneral.gov/topics/obesity/calltoaction/fact_adolescents.htm.

***

Psychiatric Aspects of Child and Adolescent Obesity: A Review of the Past 10 Years

Childhood obesity is currently a national epidemic with numerous pediatric and public health initiatives focused on diagnosis, prevention, and treatment. The authors of this review summarize the current research findings on the psychiatric aspects of obesity in children and adolescents. The review cites numerous causes for obesity, including possible neurobiological and neuroendrocrine dysregulations, genetics, decreased physical activity, increased fat intake, and social factors such as neglect, abuse, and environmental deprivation. The review concludes with guidelines for medical and psychiatric assessment.

To view this summary of the review and the abstract, visit http://www.medscape.com/viewarticle/470950_2.

(Medscape is a free service provided by WebMD; registration is required.)

***

Screening for Childhood Obesity: Chapter 30

Prepared by William Feldman and Brenda L. Beagen

"In 1979, the Canadian Task Force on the Periodic Health Examination concluded that there was no satisfactory justification for including childhood obesity among conditions to be sought in a periodic health examination, based on the lack of an effective program directed to treatment and prevention of obesity in children. However, it was considered advisable to record height and weight on standard growth charts and identify any deviations from normal growth.

Since then, several studies have investigated the consequences of childhood obesity and several randomized controlled trials have been published on the effectiveness of treatment programs. In light of these developments, it was thought to be timely to reconsider our recommendations based on the new evidence."

This chapter on obesity covers the following topics:

• Burden of suffering
• Assessment of obesity in children
• Effectiveness of screening and treatment
• Recommendations of others
• Conclusions and recommendations
• Unanswered questions (research agenda)
• Evidence

To view this chapter, visit

http://www.hc-sc.gc.ca/hppb/healthcare/pdf/clinical_preventive/s2c30e.pdf.

***

Overweight and Obesity

This article discusses the issue of overweight and obese children in the United States. It provides information on how parents can determine their child's body mass index (BMI), which can help indicate whether or not their child is overweight or obese. However, the article emphasizes the importance of asking a doctor to make the final determination.

To view this article, visit   http://kidshealth.org/parent/nutrition_fit/nutrition/overweight_obesity.html.

***

Helping Your Overweight Child

This article provides parents and caregivers of overweight children a list of questions and suggestions in supporting their child. Each question and suggestion is linked to additional information. The questions and suggestions include:

• Is my child overweight?
• How can I help my overweight child?
• Be supportive
• Encourage healthy eating habits
• Healthy snack foods for your child to try
• Encourage daily physical activity
• Discourage inactive pastimes
• Fun things for you and your child to do besides watching TV
• Be a positive role model
• Find more help

To view this article, visit http://www.niddk.nih.gov/health/nutrit/pubs/helpchld.htm#ismychildow.

***

 

Helping Your Child: Tips for Parents

"Eating well and being physically active are key to your child's well-being. Eating too much and exercising too little can lead to overweight and related health problems that can follow children into their adult years. You can take an active role in helping your child-and your whole family-learn healthy eating and physical activity habits."

This article provides parents and caregivers with a list of questions and answers about how eating healthy and physical activity can benefit their child. In addition, the article explains how eating and activity habits are formed and what can be done to change them.

To view this article, visit http://www.niddk.nih.gov/health/nutrit/pubs/parentips/tipsforparents.htm.

 

April 2004

Mental Health of Children and Youth: The Important Role of Primary Care Health Professionals

Primary pediatric and adolescent health care providers are confronted every day with youngsters who have substantial mental health and psychosocial concerns. These caregivers are in a unique position to help deal with such concerns and transform how the nation thinks about and addresses the mental health of young people. This brief explores why mental health is a basic concern in the practice of all health professionals, sketches a broad definition of mental health that focuses on strengths as well as problems, outlines a continuum of interventions, and highlights considerations related to working with families, schools, and communities.

To view the complete report, visit http://www.smhp.psych.ucla.edu/pdfdocs/primarycare/primarycarehealth.pdf.

***

Childhood Eating Behaviors: Developmental and Sociocultural Considerations

This essay focuses on childhood eating habits. The attention devoted to obesity and eating habits in the popular press and the scientific community has increased significantly in the past decade, as has the increase in obesity of children in developed countries. Given the rapid increase in obesity among children and the decline in healthful eating behavior among children of all ages, it is imperative for healthcare providers to take a proactive approach in promoting healthier eating habits among children.

To view this summary of the essay, visit http://www.medscape.com/viewarticle/467523?mpid=24466.

***

Children Whose Mothers Are Depressed after Childbirth May Be at Elevated Risk for Violence

Children whose mothers are depressed after childbirth are at elevated risk for violence by age 11, especially if the mothers suffer repeated depression, according to new research involving British families. The study also finds that in contrast to their peers, children whose mothers had been depressed at three months postpartum showed more diverse and severe aggressive behaviors than other children.

To read this summary of the study, visit http://www.apa.org/releases/depressedmothers.html .

***

Kelly, L., Sheeder, J., & Stevens-Simon, C. Teen Home Pregnancy Test Takers: More Worried or More Wishful? Pediatrics . March 2004, 113(3 Pt 1): 581-4.

This study suggests that adolescents who take home pregnancy tests may be less likely than their peers to view an unplanned pregnancy negatively. According to the authors, use of a pregnancy test by a teen should be viewed as a red flag. Although teens who have taken a test are as capable of using contraceptives as teens who have not, the test-taking teens may not be sure they want to prevent pregnancy. Most of the teens in the study were ambivalent about being pregnant, perceiving it as neither a positive nor a negative influence on future plans, self-esteem, or autonomy. The authors point out that the ease of obtaining and using pregnancy tests means a lost opportunity for in-office counseling about pregnancy prevention.

To view this summary, visit http://www.aap.org/advocacy/releases/mar04studies.htm.

 

March 2004

How to Use Your Managed Care Plan Effectively: Questions and Answers for Families with Children

The American Academy of Pediatrics has prepared a list of commonly asked questions to keep families informed about managed care plans. The questions cover topics such as pediatric primary, specialty, emergency, and hospital care; services requiring prior approval; linkage with other Child and Family Services; and cost sharing requirements.

To view this brochure of questions and answers, visit http://www.aap.org/family/mancarbr.htm

***

Consulting with Schools on Health Issues

The issues surrounding children's psychological health affect society as a whole. Children faced with psychological challenges that have not been addressed have an increased incidence of absenteeism and delinquency. The pediatrician who consults on mental health issues has the opportunity to actively influence children's psychological health and academic performance.

This section from the American Academy of Pediatrics School Health Training Kit describes the types of questions that pediatricians who consult with schools on mental and behavioral health issues should consider. The article also includes a link to a series of slides that describe ways for consultants and pediatricians to work within the schools.

To view this article and the summary, visit http://www.schoolhealth.org/trnthtrn/section2/sect2e.html

***

Familial Suicidal Behavior: A Newsmaker Interview with Maria Oquendo, MD

This interview answers questions about families and suicide. Questions include:

• Can you tell us about the work you are doing with families and suicide?
• Do you look for particular markers or for particular developmental aspects of the families?
• There are a lot of nonintact families; how do you account for that in your study?
• Do you find cultural differences in the various families, and do you balance for that in your study?

To view this interview, visit http://www.medscape.com/viewarticle/469167

(Medscape is a free service provided by WebMD; registration is required.)

***

American Academy of Pediatrics (AAP) Policy Web Page

The AAP Policy Web page is a collection of policy documents from the American Academy of Pediatrics. Policy statements, clinical reports, clinical practice guidelines, technical reports, and parent pages can now be found at http://aappolicy.aappublications.org/ .

 

February 2004

Counseling Teens on Sex

This article discusses teen pregnancy trends, teen pregnancy sexually transmitted disease (STD) figures, and the basic components of pharmacy counseling. By counseling on which methods of contraception are most effective, pharmacists can be an invaluable information resource for sexually active teens.

To view this article, visit http://www.medscape.com/viewarticle/466354 .

(Medscape is a free service provided by WebMD; registration is required.)

***

Juvonen, J., Graham, S., & Schuster, M.A. (December 2003). Bullying among young adolescents: The Strong, the weak, and the troubled . Pediatrics, 112 (6), 1231-1237.

The study "Bullying Among Young Adolescents: The Strong, the Weak and the Troubled" is the largest investigation to date on bullying and victimization among urban ethnic minority youth. After surveying 1,985 sixth grade students and their teachers, researchers found that bullies were psychologically stronger than classmates and enjoyed high social status among their peers, even though classmates also tended to avoid their company. Victims, on the other hand, suffered not only emotional distress, but also social marginalization because classmates avoided them and they had low social status. Students who both bully and get bullied (i.e., "bully-victims") were by far the most socially ostracized by their peers, the most likely to display conduct problems, and the least engaged in school. The researchers concluded that the differences among these three groups are important because some of the problems of victims are difficult to detect by others and because the needs for intervention are distinct for each of the three groups.

To view this summary of the article, visit http://www.aap.org/advocacy/releases/dec03studies.htm.

To order a copy of the article, visit http://pediatrics.aappublications.org/cgi/content/short/112/6/1231

***

Guevara, J.P., Mandell, D.S., et al. (December 2003). National estimates of health services expenditures for children with behavioral disorders: An analysis of the medical expenditure panel survey. Pediatrics, 112 (6 Pt 1), e440.

Children with emotional disorders, such as anxiety and depression, incur more medical expenses than children with disruptive disorders, such as conduct disorders and attention deficit/hyperactivity disorder. This article states that recognition of children with emotional disorders should be better and that further research should be conducted to address the high rate of hospitalization in this group of children.

To view this summary of the article, visit http://www.aap.org/advocacy/releases/dec03studies.htm.

To view the abstract of the article, visit http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=Display&DB=PubMed.

***

Hostility in Children in a Risk Factor for Developing the Precursors to Cardiovascular Disease

It is well-known that adults who respond to life events with anger are more at risk for developing cardiovascular disease than those who do not. And now, according to researchers at the University of Pittsburgh and the University of Helsinki, children and adolescents with similar hostile responses are also putting themselves at increased risk of developing metabolic syndrome-a precursor to adult heart disease, according to a study in the May issue of Health Psychology , published by the American Psychological Association.

To view the complete summary of this article, visit http://www.apa.org/releases/childhostility.html

 

Holiday 2003/2004

Tips for a Healthier New Year

This link provides physical and mental health suggestions from the American Academy of Pediatrics (AAP) for children and families as they enter the New Year.

To view these tips, visit http://www.aap.org/advocacy/releases/jantips.htm .

***

20 Healthy New Year's Resolutions for Kids

This link provides health-based New Year's resolutions from AAP for preschoolers, school-aged children, and teens.

To view these tips, visit http://www.aap.org/advocacy/releases/jankidstips.htm .

***

Prevention of Influenza in Children during Vaccine Shortage

Unprecedented demand has led to a shortage of inactivated influenza vaccine. This resource lists suggestions for prioritization of use of remaining supplies of influenza vaccine. Other means of prevention are antiviral prophylaxis for children with high-risk medical conditions and infection control measures. AAP ( www.aap.org ) will continue to provide updated information as it becomes available (update December 11, 2003).

To view this list, visit http://www.aap.org/new/vaccineshortage.htm .

***

A Look at Pediatric Vaccine Development

Development of a new vaccine is a long and complex process that must blend the functions of research, manufacturing, compliance with federal regulations, quality control, and marketing. This article leads you through the steps of the process, using the development of the conjugate pneumococcal vaccine as an illustration.

To view the complete article, visit http://www.medscape.com/viewarticle/464381_1 .

 

November 2003

Parents' Sex Ed Center

"When parents talk to and affirm the value of their children, young people are more likely to develop positive, healthy attitudes about themselves. This is also true when the subject is sex. Research shows that positive communication between parents and their children can help young people establish individual values and make healthy decisions.."

To read the full article, visit the Advocacy for Youth Web site at http://www.advocatesforyouth.org/parents/index.htm .

***

New Survey of Teens About Virginity and The First Time

This survey by the Kaiser Family Foundation and Seventeen Magazine explores perceptions of virginity and sexual activity among adolescents.

To access the survey, visit

http://www.kff.org/content/2003/3368/3368_Sexsmarts_Virginity.pdf.

This report was obtained from the Kaiser Family Foundation Web site, http://www.kff.org/content/2003/3368/ .

***

American Medical Association's

Healthy Youth 2010; Supporting the 21 Critical Adolescent Objectives

" Healthy Youth 2010 features information about the national health objectives especially the adolescent component, offers direction for working with state medical societies, describes the elements of initiating a state-based activity, outlines opportunities for obtaining programmatic support, reviews strategies for publicizing project activities, provides an action plan for implementation, and discusses the importance of program evaluation."

Read more at: http://www.ama-assn.org/ama/upload/mm/39/healthy2010.pdf .

This report was obtained from the American Medical Association Web site, http://www.ama-assn.org/ama/pub/category/1943.html .

 

October 2003

Strengthening Families To Promote Youth Development

2002

This document was written by the OMG Center for Collaborative Learning as a report on the Casey Foundation's roundtable discussions held in December 2001 to examine the approach of "family strengthening youth development." The roundtables were an attempt to document and highlight the role, influences, and contributions of the family on positive youth development. The report provides an overview of the roundtable discussions; discusses the role of family in youth development; offers insights into "linkages" between youth, family, and community; and addresses issues affecting vulnerable families and youth in transition from foster care . [This description is from the Annie E. Casey Foundation Web site, www.aecf.org .]

The report is available at http://www.aecf.org/publications/data/family_strengthening.pdf.

Copies are also available from

The Annie E. Casey Foundation

701 St. Paul Street

Baltimore, MD 21202

410-547-6600

***

Childhood Obesity Working Group Convenes at AMA To Discuss Problem, Solutions

Obesity. U.S. Surgeon General Richard Carmona, MD, called it the greatest threat to public health today. It kills more Americans every year than AIDS, all cancers, and all accidents combined. And it's causing problems in children that were unthinkable 20 years ago. That is why the AMA is working to halt the spread of obesity and, more specifically, pediatric obesity.

To read the entire article, visit http://www.ama-assn.org/ama/pub/article/3216-8158.html

***

Hutchinson MK, Jemmott JB 3rd, Jemmott LS, Braverman P, & Fong GT. (2003). The role of mother-daughter sexual risk communication in reducing sexual risk behaviors among urban adolescent females: A prospective study. Journal of Adolescent Health 33(2) : 98-107.

Abstract

PURPOSE: To prospectively examine the relationship between mother-daughter communication about sex and selected sexual risk behaviors among inner-city adolescent females. METHODS: Participants were 219 sexually experienced females, 12 to 19 years of age, recruited from an inner-city adolescent medicine clinic in Philadelphia, PA, and randomly assigned to the control group of an HIV-risk reduction intervention study. Analyses were limited to data from control group participants to avoid confounding intervention effects. Poisson regression was employed to model three self-reported sexual risk behaviors: number of male sexual partners, number of episodes of sexual intercourse, and number of episodes of unprotected intercourse. Mediation effects were evaluated using variables from the Theory of Planned Behavior. Data were analyzed using Poisson regression. RESULTS: Higher levels of mother-daughter sexual risk communication were associated with fewer episodes of sexual intercourse and unprotected intercourse at 3-month follow-up. There was evidence that the relationship of communication to unprotected intercourse was mediated by condom use self-efficacy. Mother-daughter sexual risk communication was not significantly associated with adolescents' reports of numbers of male sexual partner. CONCLUSIONS: This prospective study supports the notion that mothers who communicate with their daughters about sex can affect their daughters' sexual behaviors in positive ways. These findings lend support for the design and implementation of family-based approaches to improve parent-adolescent sexual risk communication as one means of reducing HIV-related sexual risk behaviors among inner-city adolescent females.

To read the entire article, visit

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db

=PubMed&list_uids=12890601&dopt=Abstract

 

September 2003

Medicating Children at School Needs Attention of Parents, Teachers, and School Administrators

This is a news release on a policy statement published in the September issue of Pediatrics , the peer-reviewed, scientific journal of the American Academy of Pediatrics (AAP).

Many children who take medications require them during the school day. In a revised policy statement, "Guidelines for the Administration of Medication in School," the AAP addresses over-the-counter products, herbal medications, experimental drugs that are administered as part of a clinical trial, emergency medications, and principles of student safety. This policy statement is designed to guide prescribing physicians as well as school administrators and health staff on administering medications to children at school.

For more information, visit http://www.aap.org/advocacy/releases/septmedications.htm .

***

Bridges: From Identification to Management of Common Psychosocial Problems and Mental Disorders in Primary Care Practice

Primary care health professionals encounter a broad range of cognitive, emotional, and behavioral problems and mental disorders among children, adolescents, and their families. Epidemiological data indicate that 21 percent of U.S. children and adolescents have a diagnosable mental disorder that causes at least minimal impairment, and 11 percent have a diagnosable mental disorder that causes significant impairment (Shaffer et al., 1996; U.S. Department of Health and Human Services, 1999). Primary care health professionals can play a critical role in the early identification and initiation of interventions for a broad range of psychosocial problems (e.g., child maltreatment, substance abuse, attention deficit hyperactivity disorder, and mood and anxiety disorders) and are often the primary source of mental health care. However, studies have shown that the rate identifying psychosocial problems and mental disorders by primary care health professionals is relatively low (less than 50 percent) (Bernal et al., 2000; Costello, 1986).

Read more at http://www.brightfutures.org/mentalhealth/pdf/bridges/Bridges187_190.pdf .

***

"Foster Care and Medicaid Managed Care" by Laurel K. Leslie, Kelly J. Kelleher, Barbara J. Burns, John Landsverk, Jennifer A. Rolls, in Child Welfare, May/June 2003, Vol. 82 Issue 3, p. 367, 26pp. (AN 10107749).

Children in the foster care system are often dependent on Medicaid for health care. These children, however, have more complex health care needs than the typical child receiving Medicaid. States are implementing Medicaid managed care programs as a way to control escalating costs while providing necessary services. This article reviews the issues surrounding delivery of managed health care services to children in foster care and describes several solutions.

To view this article, click here.

***

"Children's Use of Mental Health Services in Different Medicaid Insurance Plans" by David S. Mandell, Roger A. Boothroyd, and Paul G. Stiles, in Journal of Behavioral Health Services & Research, April/June 2003, Vol. 30 Issue 2, p. 228, 10pp. (AN 9722069).

This study examines the effect of different Medicaid insurance plans on children's mental health service use through survey, claims, and encounter data collected between February 1998 and February 1999.

To view this article, click here.

 

August 2003

Winston, F.K., Kassam-Adams, N., Garcia-Espana, F., & Cnaan, A. (2003 , August ). Screening for risk of persistent posttraumatic stress in injured children and their parents. Journal of the American Medical Association , 290 (5), 643-649.

The objective of this study was to develop a stand-alone screening tool for use by clinicians during acute trauma care to identify injured children and their parents who are at risk of significant, persistent posttraumatic stress symptoms. The Screening Tool for Early Predictors of PTSD (STEPP) was derived from a 50-item risk factor survey administered within 1 month of injury as part of a prospective cohort study of posttraumatic stress in injured children and their parents. Symptoms of PTSD were assessed at least 3 months after injury. The study concluded that STEPP represents a new method to guide clinicians in making evidence-based decisions for the allocation of scarce mental health resources for traumatic stress. Its brevity and simple scoring rule suggest that it can be easily administered in the acute care setting.

Download Screening for risk of persistent posttraumatic stress in injured children and their parents in its entirety.

 

***

 

Bradley, S.D., Jaycox, L.H., Kataoka, S.H., Wong, M., Tu, W., Elliot, M.N., & Fink, A. (2003 , August ). A mental health intervention for schoolchilden exposed to violence. Journal of the American Medical Association , 290 (5), 603-611.

The objective of this study was to evaluate the effectiveness of a collaboratively designed school-based intervention for reducing children's symptoms of PTSD and depression that has resulted from exposure to violence. The study concluded that a standardized 10-session cognitive-behavioral group intervention can significantly decrease symptoms of PTSD and depression in students who are exposed to violence and can be effectively delivered on school campuses by trained school-based mental health clinicians.

Download A mental health intervention for schoolchilden exposed to violence in its entirety.

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American Academy of Pediatrics. (2002, August ). Responding to children's emotional needs during times of crisis: a A n important role for pediatricians . Retrieved August 28, 2003, from http://www.aap.org/terrorism//topics/parents.pdf

Pediatricians are often the first responders for children and families suffering emotional and psychological reactions to terrorism and other disasters. As such, pediatricians have a unique opportunity to help parents and other caregivers communicate with children in ways that allow them to better understand and recover from traumatic events such as terrorist attacks or other disasters. Pediatricians also can help to facilitate timely referral to mental health services, as appropriate, for these children and their families.

To read the complete article , including tip s for parents and other caregivers, visit http://www.aap.org/terrorism//topics/parents.pdf

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American Academy of Pediatrics. (2003, August). Medicaid and Child Health Care. Retrieved August 28, 2003, from http://www.aap.org/advocacy/washing/elections/med_factsheet_pub.htm Medicaid and Child Health Care -Fact Sheets

The American Academy of Pediatrics has created fact sheets that explain the importance of the Medicaid program, and how children in every state rely on it for their health care.  

To see the Medicaid fact sheet for your state, visit http://www.aap.org/advocacy/washing/elections/med_factsheet_pub.htm

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American Academy of Pediatrics, American Academy of Family Physicians and American College of Physicians-American Society of Internal Medicine. (2002). A consensus statement on health care transitions for young adult s with special health care needs .

Pediatrics , Vol.   110 ( No. 6 ), December 2002, pp. 1304 - - 1306 .

American Academy of Pediatrics, American Academy of Family Physicians and American College of Physicians-American Society of Internal Medicine

This policy statement represents a consensus on the critical first steps that the medical profession needs to take to realize the vision of a family-centered, continuous, comprehensive, coordinated, compassionate, and culturally competent health care system that is as developmentally appropriate as it is technically sophisticated. The goal of transition in health care for young adults with special health care needs is to maximize lifelong functioning and potential through the provision of high-quality, developmentally appropriate health care services that continue uninterrupted as the individual moves from adolescence to adulthood. This consensus document has now been approved as policy by the boards of the American Academy of Pediatrics, the American Academy of Family Physicians, and the American College of Physicians-American Society of Internal Medicine.

To view the abstract and policy statement, visit http://aappolicy.aappublications.org/cgi/content/full/pediatrics;110/6/S1/1304

December 2002

Livingwood, W., Woodhouse, C., Sayre, J., & Wludyka, P. (2001, Dec). Impact study of tobacco possession law enforcement in Florida. Health Education and Behavior, 28 (6), 733-748.

This study of tobacco law enforcement was conducted in four counties in Florida, the first stat to report statistically significant annual declines in youth tobacco use during the 1990s. The primary objective of the study was to assess the impact of possession enforcement on youth attitudes. The state of Florida developed a comprehensive program that included:

•  Marketing and communication initiatives,

•  Youth leadership and community partnerships,

•  Education and training,

•  Enforcement, and

•  Evaluation and research.

The enforcement component applies penalties for stores and retail clerks who sell tobacco products to minors. There was a statistically significant difference in the rate of initiation of tobacco use by minors in those counties that enforced the law.

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Grunbaum, J., Kann, L., Kinchen, S., Williams, B., Ross, J., et al. (2002, June 28). Youth risk surveillance-United States, 2001. Morbidity and Mortality Weekly Report. Retrieved December 26, 2002, from http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5104a1.htm .

The Youth Risk Behavior Surveillance System (YRBSS) monitors six categories of priority health-risk behaviors among youth and young adults; th