Friday, September 6, 2013

Minority Kids Less Likely to Be Diagnosed, Treated for ADHD: Study

Finding points to possible disparities in careFinding points to possible disparities in care.

By Brenda Goodman

HealthDay Reporter

MONDAY, June 24 (HealthDay News) -- Minority children are significantly less likely than their white peers to be diagnosed or treated for attention-deficit/hyperactivity disorder (ADHD), new research shows.

The study, which is published online June 24 and in the July print issue of the journal Pediatrics, followed more than 17,000 children across the nation from kindergarten to eighth grade. Researchers regularly asked parents if their children had been diagnosed with ADHD.

Even after taking into account a host of factors that may influence behavior, attention and access to health care, researchers found that Hispanic and Asian children and those of other races were about half as likely to receive a diagnosis as whites. Blacks were about two-thirds less likely to be recognized as having problems with attention or hyperactivity as whites.

In addition, when minority children were diagnosed, they were less likely to receive medication than white kids with ADHD, the investigators found.

The study can't say, however, whether the differences mean that ADHD is being underdiagnosed in minorities or overdiagnosed in whites. Previous research has raised both possibilities.

A study published in the journal Clinical Psychology Review in 2009, for example, found that despite having more symptoms of distractibility and hyperactivity, black children were diagnosed with ADHD less often than whites.

On the other hand, a study published in April 2012 in the Canadian Medical Association Journal found that the youngest children in their school class were more likely to be diagnosed compared to the oldest children in those grades, suggesting that some doctors and teachers may mistake immaturity for ADHD, leading to overdiagnosis.

One expert suggested that socioeconomic and cultural differences may be at work.

Doctors still don't know if one or both problems may be driving the rates of lower diagnoses in minorities seen in the current study, said Dr. Tanya Froehlich, a pediatrician at Cincinnati Children's Hospital in Ohio.

"It does seem to be clear that there are some cultural differences at work, and also probably some differences in access to health care and access to health care information," said Froehlich, who was not involved in the research.

For example, the study noted that children without health insurance were less likely to be diagnosed with ADHD than children who had coverage. Kids from lower-income families were also less likely to be diagnosed.

Yet, children with older mothers, who tend to be more highly educated, and those with parents who spoke to doctors in English were more likely to be diagnosed with the condition. Both those factors are signs that access to health care and awareness of the problem may also be playing a role.

Several risk factors for ADHD occur more often in minority children than in whites. Those include a lower household income, less educated parents and low birth weight.


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Hungry Shoppers Pile High-Calorie Foods in Their Carts

Your body shifts to survival mode at the grocery store, expert says

By Steven Reinberg

HealthDay Reporter

MONDAY, May 6 (HealthDay News) -- People who grocery shop when hungry tend to load up their carts with higher-calorie foods and more of them, a new study suggests.

Not only does that affect the meal they will be eating at home that night, but their meals throughout the week, according to researchers Brian Wansink and Aner Tal, with the Food and Brand Lab at Cornell University.

"It's known that hungry people buy more food in the grocery store, but what happens more is that people shift their shopping patterns to contain more high-calorie foods," Tal said. "When you are hungry, you think high-calorie food can provide you with more energy."

Dieting by skipping meals might not be a good idea, Tal added. If you shop while hungry you might wind up compensating for it with the high-calorie foods that will make up meals for the next several days, he said.

Candy, salty snacks and red meat were deemed higher-calorie foods in the study. Meanwhile, fruits, vegetables and chicken breasts counted as lower-calorie choices.

Tal is now investigating whether having a snack before food shopping will tip the scale toward choosing lower-calorie foods.

The report was published as a research letter in the May 6 online edition of JAMA Internal Medicine.

Another expert explained what might be driving the urge to shop for calorie-rich foods.

"Your body does not know the difference between purposely depriving yourself of food, as in fasting or dieting, or a lack of food or a famine," said Samantha Heller, a senior clinical nutritionist at the NYU Langone Medical Center, in New York City. "Your body does not know there are grocery stores and that you can have pizza delivered 24/7. The human body has not evolved as quickly as our agriculture or technology. It thinks we still have to go out and catch breakfast."

Therefore, she said, when the body is deprived of food it goes into survival mode because it does not know when there will be another meal.

"This complex defensive response affects both psychological and physiological parameters. When you do start choosing and eating foods, the body directs you to go for high-calorie foods to replace calories lost and to store up in case of another famine," Heller said.

To make their point, the researchers did two experiments. The first was a lab experiment in which people were told not to eat five hours before the study.

Before the test began, some of the 68 participants were given crackers to appease their hunger. Then, they all were asked to "shop" in a simulated, online grocery store. Hungry people tended to choose higher-calorie foods such as regular ice cream over low-fat ice cream, the researchers found.


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Pippa Middleton on the street in London

Aviators? Wedge trainers? DON'T be afraid to mix up your style this spring like Pippa Middleton - who's departed from her more polished regular look.  

Shop Trainers


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Kids' Sinusitis Might Not Need Antibiotics, New Guidelines Say

Doctors can 'watch and wait' for an additional 3 daysDoctors can 'watch and wait' for an additional 3

By Dennis Thompson

HealthDay Reporter

MONDAY, June 24 (HealthDay News) -- Doctors don't have to automatically prescribe an antibiotic to treat children who appear to have acute sinus infections, according to new guidelines issued by a leading group of pediatricians.

Instead, they can take a "watch and wait" approach if it appears the infection might clear on its own, according to the new American Academy of Pediatrics guidelines.

"The practitioner can either treat immediately or consider waiting for a couple of days," said Dr. Ellen Wald, chairwoman of the academy's subcommittee on acute sinusitis. "If the kid doesn't look dramatically ill, you can wait an extra couple of days to see if they improve on their own."

The previous guidelines, passed in 2001, recommended antibiotic therapy for all children diagnosed with acute bacterial sinusitis, which is defined as persistent signs of sinus infection lasting more than 10 days.

Doctors now can observe kids for up to an additional three days past that 10-day period to see if their symptoms will ease without antibiotic treatment.

"There's nothing absolutely sacred about 10 days. It could be 11 days. It could be 12 days," said Wald, chairwoman of pediatrics at the University of Wisconsin School of Medicine and Public Health, in Madison. "In the child who looks sicker, we wouldn't do that. We would start on antibiotics immediately."

The new guidelines, published online June 24 in the journal Pediatrics, are driven primarily by concern over antibiotic resistance, she said. There is a lot of overlap between the common cold and acute sinusitis, and some children who are not suffering from a bacterial infection may be receiving antibiotics.

"If we prescribe fewer antibiotics, then the problem of antibiotic resistance is controlled," Wald said. "If you can avoid the use of antibiotics, then that is reasonable."

Between 6 percent and 7 percent of children who visit doctors seeking care for a respiratory condition have acute sinusitis, according to the report.

Most cases of acute sinusitis develop from a common cold. Colds usually last five to seven days and peak within two or three days, Wald said.

Acute sinusitis does not often develop into a life-threatening illness, but it can be very uncomfortable and even painful. Symptoms of sinusitis include a runny nose, a persistent daytime cough, headache and fever.

"I think cases of acute sinusitis resolve on their own, by and by," Wald said. "There are not children who are dying left and right from sinusitis. But there is a quality-of-life issue too. You get better more quickly with treatment."

The revised guidelines further underline the need for parents to seek out pediatricians who are adept at diagnosing and monitoring sinusitis, said Dr. Jordan Josephson, a sinus and allergy specialist at Lenox Hill Hospital in New York City and author of the book Sinus Relief Now.

This is especially true for children with ongoing sinus problems, he said.

"Treatment of chronic sinusitis is not simple, and I think it's important that patients get to a doctor who really understands the disease," Josephson said. "Guidelines are guidelines. The ultimate thing is to get to a physician who is a really good diagnostician who can determine whether antibiotics are needed."

The new guidelines for acute sinusitis also discourage the use of imaging tests to help diagnose the condition in uncomplicated cases.


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What to Order This Week: Panera Bread

Panera Bread Healthy Menu Items

You know how some restaurants highlight their lighter offerings in an attempt to woo their healthier customers? Well, at Panera Bread, some of the healthiest and most flavorful options don't appear anywhere on their menu. It turns out that earlier this year, Panera Breads nationwide started offering a new lineup of "power foods" with lean proteins, complex carbohydrates and veggies as part of its all-new Hidden Menu. These six "power foods" items aren't promoted in-store, but fans and followers of Panera's social media channels will get the inside scoop. Lucky for you, we've got the inside scoop now, too. Check out the six pack here -- plus the skinny on each of 'em.

Power Breakfast Egg White Bowl with Roasted Turkey: Roasted all-natural, antibiotic-free turkey, egg whites, warm baby spinach, roasted peppers, and basil pesto. (The Skinny: 180 calories, 7g carbs, 25g protein)Power Breakfast Egg Bowl with Steak: Two all-natural eggs, seared top sirloin, sliced avocado and tomatoes. (The Skinny: 230 calories, 5g carbs, 20g protein)Power Mediterranean Chicken Salad: All-natural, antibiotic-free chicken, baby spinach, romaine, tomatoes, apple-wood smoked bacon, diced eggs, fresh-squeezed lemon juice, and extra virgin olive oil. (The Skinny: 360 calories, 12g carbs, 35g protein)Power Mediterranean Roasted Turkey Salad: All-natural, antibiotic-free roasted turkey, baby spinach, romaine, tomatoes, red onions, kalamata olives, fresh squeezed lemon juice and extra virgin olive oil. (The Skinny: 320 calories, 12g carbs, 22g protein)Power Chicken Hummus Bowl: All-natural, antibiotic-free chicken, with cilantro jalapeno hummus, baby spinach, cucumbers, diced tomatoes & red onions finished with fresh squeezed lemon & fresh chopped cilantro. (The Skinny: 330 calories, 23g carbs, 33g protein)Power Steak Lettuce Wrap: Seared top-sirloin, leaf lettuce, cucumbers, diced tomatoes, red onions, basil pesto and finished with fresh lemon juice. (The Skinny: 280 calories, 7g carbs, 28g protein)

Tried any of the hidden menu items? Tweet me @sarahjaneRD and @SELFMagazine to tell me your fave!

RELATED LINKS:

Image Credit: Courtesy of Panera Bread


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New Insulin Pump Cuts Odds of Overnight Hypoglycemia

Sensor device may ease patient fear of dangerously low blood sugar levels during sleep, experts saySensor device may ease patient fear of

By Steven Reinberg

HealthDay Reporter

SATURDAY, June 22 (HealthDay News) -- A new sensor attached to an insulin pump helps prevent dangerously low blood sugar levels in patients with type 1 diabetes while they sleep, a new study finds.

The new pump automatically stops delivering insulin when the sensor finds blood sugar levels have reached a pre-set low level, and it reduced overnight episodes of low blood sugar (hypoglycemia) by a third, the researchers report.

"After years of hoping for a way to achieve our goal of getting good blood sugar control without a lot of low blood sugar, we are finally, with this new technology, getting close to our goal," said study lead author Dr. Richard Bergenstal, executive director of the International Diabetes Center at Park Nicollet in Minneapolis.

"Hypoglycemia has all of a sudden become an important topic," he said. "Now that we are able to keep blood sugar down, we are running up against hypoglycemia as being our biggest barrier to achieving the blood sugar control we want to get to prevent eye disease, kidney disease and amputations and heart disease."

The effects of hypoglycemia can range from dizziness to seizures to coma and death, according to Bergenstal. "Patients are scared to death saying, 'Am I going to go to sleep tonight and am I going to wake up tomorrow morning, or am I going to have a major problem in the night,'" he said.

This may also be another step to creating a so-called "artificial pancreas" for people with type 1 diabetes, who cannot make insulin on their own, Bergenstal added. "This is the first step that shows that the artificial pancreas can actually work," he said.

Although this device has been used in Europe, the new study is a move toward getting the device approved by the U.S. Food and Drug Administration.

The study was funded by Medtronic Inc., the maker of the device. The results of the study were published June 22 online in the New England Journal of Medicine, to coincide with a scheduled presentation at the American Diabetes Association annual meeting in Chicago.

"This is a very real difference for people with type 1 diabetes, because these patients often go to bed in fear of low blood sugar," said Dr. Ronald Tamler, director of the Mount Sinai Diabetes Center in New York City. He was not involved in the new study.

But he added that it remains to be seen whether patients are agreeable to wearing a sensor along with an insulin pump and whether they can trust the technology.

"Some patients may not be willing to wear a sensor in addition to an insulin pump and entrust themselves to devices that need to work accurately and in harmony to succeed," he said. "It's a matter of practically and trust."


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5 Rules for New Triathletes, One Woman's Secret to a Long Life and More!

If you're training for a triathlon, you automatically get points for being hardcore. Keep these tips in mind if you're a newbie. [CNN]

The key to a long life? The jury's still officially out, but this 105-year-old woman credits bacon as the secret to her longevity. Love. It. [Gawker]

Just because The Great Gatsby isn't out yet doesn't mean you can't jam to its tunes. The full soundtrack is streaming on Rdio. (Sign up for a free six-month trial to gain access.) [Rdio]

You know how there are different body types, like hourglass or pear? Well, there are different butt types, too. Find out the best exercise for yours, whether you're flat, a bubble or somewhere in between. [YouBeauty]

Image Credit: Getty Images Inc


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Half of People With Hepatitis C Don't Complete Needed Tests: CDC

News Picture: Half of People With Hepatitis C Don't Complete Needed Tests: CDC

TUESDAY, May 7 (HealthDay News) -- Only about half of Americans who are infected with hepatitis C undergo follow-up testing to determine if they are still infected, federal officials reported Tuesday.

"Many people who test positive on an initial hepatitis C test are not receiving the necessary follow-up test to know if their body has cleared the virus or if they are still infected," Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention, said in an agency news release.

"Complete testing is critical to ensure that those who are infected receive the care and treatment for hepatitis C that they need in order to prevent liver cancer and other serious and potentially deadly health consequences," Frieden said.

A blood test, called an antibody test, is used to check if a person has ever been infected with hepatitis C. For people who have had a positive result, a follow-up test -- called an RNA test -- can determine if they are still infected so they can receive necessary care and treatment.

Some people's bodies can clear hepatitis C infection on their own, but about 80 percent of people with hepatitis C remain infected and can develop major health problems.

In this study, researchers analyzed data from eight regions across the United States. Only 51 percent of the hepatitis C patients reported in these regions had a follow-up test, according to the Vital Signs report from the CDC.

"Hepatitis C has few noticeable symptoms, and left undiagnosed it threatens the health of far too many Americans -- especially baby boomers," Dr. John Ward, director of the CDC's Division of Viral Hepatitis, said in the news release. "Identifying those who are currently infected is important because new effective treatments can cure the infection better than ever before, as well as eliminate the risk of transmission to others."

About 3 million Americans are infected with hepatitis C, and as many as 75 percent do not know they are infected. The study found that 67 percent of all reported cases of current hepatitis C infection were among baby boomers, which includes people born from 1945 through 1965.

All people born in the United States during those years should be tested for hepatitis C, the CDC advised. The agency also recommended testing for other people at increased risk, including injection-drug users and people who received blood transfusions or organ transplants before widespread screening of the blood supply began in 1992.

May is Hepatitis Awareness Month, and May 19 is National Hepatitis Testing Day.

-- Robert Preidt MedicalNews
Copyright © 2013 HealthDay. All rights reserved. SOURCE: U.S. Centers for Disease Control and Prevention, news release, May 7, 2013



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looking for others who want to lose 30lbs - support and friendly chats :-)

Hi, I have 30lbs to lose and have lost 8lbs so far. I was hoping to set up a forum for people who are in the same or similar weight loss situations.

I am 21 and have a two year old son. I lie with my partner and currently don't work I just need motivation from other women who need to lose similar amounts of weight.

My stats are: Height: 5ft 4

Weight: 153lbs


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Chloe Sevigny at a TV presentation in New York

Chloe Sevigny at a TV presentation in New York - Celebrity Fashion

DO try a pinafore dress as a dungaree alternative this season - trust Chloe Sevigny (hers is Christopher Kane) to get this tricky trend nailed. 

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Do you eat the same things everyday?

One of the problems I have is trying to stay within a certain calorie intake each day..dinner is usually the hardest because of portion sizes etc..and having to essentially "guesstimate" how many calories I am eating.

I feel like if I were to eat the SAME things for breakfast and lunch each day (i.e same calorie allowance daily) I would be able to manage things better. Sometimes if I eat what I call binge foods (used to have an eating disorder) I can blow out my entire days calories EASY.

Sooo do you or do you not eat the same foods? Obviously it's better for convenience but it would get boring pretttty fast. Or do you have a couple of different meals on rotation?


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Drop 10 Success Story: "I Am Back to Loving Myself and Life. I Feel Unstoppable!"

Ten pounds down was just the beginning for Shannon Salvatoriello, of Brick, New Jersey. After losing those in just five weeks with SELF's Drop 10 plan this spring, she decided to keep going and has so far boosted her weight loss to an amazing 18 pounds. "I finally enjoy shopping again and love the way I look and feel," Salvatoriello says.

HER MOTIVATION

A mom of three young boys, Salvatoriello attributes her weight gain to pregnancy and having little time to focus on exercise or eating healthfully. After her youngest son was born, she decided to drastically change her life and lost all of her baby weight--and then some--using what she calls "good ol' fashioned" hard work. Eventually, though, she hit a weight-loss wall. "I'd lost 77 pounds in under a year, and then last October, I plateaued," she says. "I have the time, means, drive and dedication to hit my goal weight. I just needed to change things up to get over the hump."

Shannon Salvatoriello

THE PAYOFF

Salvatoriello added the Drop 10 workouts to her fitness routine, and found new favorite dishes in the meal plan. "I'm loving the lentils, which I had never really liked before trying the Drop 10 recipes. And the stuffed egg pita with the cream cheese is amazing--who knew to put cream cheese on eggs? It's out of this world!" With new meal ideas and workouts in her exercise arsenal, Salvatoriello is achieving the body she's always wanted. "I have a whole new outlook," she says. "I am literally ecstatic over my weight loss and the amazing compliments I get on a daily basis. It is so inspiring."

Now it's your turn: Sign up for the Drop 10 plan now and be on your way to losing two pounds a week!

If you shed pounds on our plan, we want to hear from you! Email us at eatright@self.com with the subject line "Drop 10 Success" and your story could be featured in the magazine or on Self.com.


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Should I worry because my resting heart rate is high?

Posted June 24, 2013, 2:00 am bigstock-Doctor-taking-patient-s-pulse--12826166

I’m a man in my 50s. I’m in good shape and I exercise regularly, but I have a high resting heart rate. Is this cause for concern?

Your heart rate changes from minute to minute. It depends on whether you are standing up or lying down, moving around or sitting still, stressed or relaxed. Your resting heart rate is how fast your heart beats when you are relaxed and sitting still.

To answer your question, there is cause for concern. Based on a recent study, even fit men with higher resting heart rates may have a higher risk of early death.

The study followed nearly 2,800 middle-aged men for 16 years. Men whose resting heart rates were 80 or more beats per minute died earlier, on average, than men with a resting heart rate of 65 beats per minute.

Experts have recognized the link between faster resting heart rates and heart disease and shorter lives for the past few years. Until recently, the leading explanation has been that resting heart rates in the 60 to 70 beats-per-minute range most often reflect better fitness. And with better fitness you are less likely to develop heart problems and more likely to live longer.

The new study found that higher resting heart rates meant shorter life expectancy — even in fit people. This was true even for men who exercised regularly when researchers factored in age and health habits.

Regular exercise does lower the resting heart rate. But even among regular exercisers, there are those with resting heart rates in the range of 55–75, and those with higher rates. In this study, those folks with higher rates were likely to die younger.

So what else causes a higher resting heart rate, besides not being fit? Genes and aging play a role. In my experience, there are some people who respond to the challenges of their daily lives by releasing a lot of the adrenaline hormone. Adrenaline raises heart rate, and constant high levels in the blood may make the heart more irritable.

People who smoke or drink too much alcohol generally have higher resting heart rates. Stress, medicines and medical conditions also influence heart rate.

Discuss your resting heart rate with your doctor at your next visit. In the meantime, you can start to lower your heart rate on your own:

Exercise more. When you take a brisk walk, swim or ride a bike, your heart beats faster during the activity and for a short time afterward. But exercising every day gradually slows your resting heart rate.Reduce stress. Meditation, tai chi and other stress-busting techniques can lower your heart rate over time.

There are medicines that can lower your heart rate. The most widely used are beta blockers. These medicines are effective in treating high blood pressure. In people with known heart disease, they reduce the risk of future heart problems.

To my knowledge, there are no studies of whether people who just have high resting heart rates would benefit from taking beta blockers.

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Victoria Beckham at JFK airport

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