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Maternal Child Health Newsletter 10/29/04

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Expand view Topic review: Maternal Child Health Newsletter 10/29/04

Maternal Child Health Newsletter 10/29/04

Post by laura » Fri Oct 29, 2004 08:46 am

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MCH Alert
Tomorrow's Policy Today
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National Center for Education in Maternal and Child Health
Search past issues of the MCH Alert and other MCH Library resources at
http://www.MCHLibrary.info/databases/search.lasso

October 29, 2004

1. Self-Study Modules Available to Help Health and Early Childhood
Professionals Promote Oral Health for Infants and Young Children
2. Surgeon General's Report Encourages Promotion of Bone Health Throughout
the Lifespan
3. Joint Position Statement Released on Adolescent Access to Care and
Reporting of Sexual Activity and Abuse
4. Article Identifies Longitudinal Predictors of Physical and Sexual
Dating Violence in Adolescence
5. Longitudinal Analysis Examines Risk and Protective Factors of Physical
Violence Against Impoverished Women
6. Study Examines Association Between Sleep-Disordered Breathing and
Performance in 5-Year-Olds

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1. SELF-STUDY MODULES AVAILABLE TO HELP HEALTH AND EARLY CHILDHOOD
PROFESSIONALS PROMOTE ORAL HEALTH FOR INFANTS AND YOUNG CHILDREN

Open Wide: Oral Health Training for Health Professionals is a series of
four self-contained online modules designed to help health and early
childhood professionals working in community settings (e.g., Head Start
and WIC staff) promote oral health in the course of promoting general
health for infants, children, and their families. The modules were
prepared by the National Maternal and Child Oral Health Resource Center
and the Center for the Advancement of Distance Education at the University
of Illinois at Chicago with support from the Maternal and Child Health
Bureau. Topics include tooth decay, risk factors for tooth decay, and
prevention of tooth decay; oral health risk assessment and oral health
screening; and anticipatory guidance for parents. Each module includes an
overview, learning objectives, key points, a self-assessment quiz, online
resources, and an evaluation form. A glossary and a list of presentations,
print materials, and videotapes are also presented. The modules are
available at http://www.mchoralhealth.org/OpenWide/index.

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2. SURGEON GENERAL'S REPORT ENCOURAGES PROMOTION OF BONE HEALTH THROUGHOUT
THE LIFESPAN

Bone Health and Osteoporosis: A Report of the Surgeon General presents
scientific evidence related to the prevention, assessment, diagnosis, and
treatment of bone disease and provides a tool for educating Americans
about how they can promote bone health throughout their lives. The report,
commissioned by Congress, was initiated by a federal interagency work
group, followed by a Surgeon General's Workshop convened in December 2002.
Experts from across the country provided guidance and insights. The report
presents information on the magnitude of the problem, challenges in
diagnosis and treatment, the impact of disease on minority populations,
promising prevention strategies, how to improve professional education and
promote public awareness, and ways to enhance access to key health
services. The report is intended for use by policymakers; national, state,
and local public health officials; health system leaders; health
professionals; community advocates; and individuals. The executive summary
and full report, along with other relevant materials, are available at
http://www.surgeongeneral.gov/library/bonehealth.

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3. JOINT POSITION STATEMENT RELEASED ON ADOLESCENT ACCESS TO CARE AND
REPORTING OF SEXUAL ACTIVITY AND ABUSE

Protecting Adolescents: Ensuring Access to Care and Reporting Sexual
Activity and Abuse presents guidance and principles in the development of
public policy concerning adolescents' access to health services, including
sexual and reproductive health services. The position statement, published
in the November 2004 issue of the Journal of Adolescent Health, was
developed jointly by the American Academy of Family Physicians, the
American Academy of Pediatrics, the American College of Obstetricians and
Gynecologists, and the Society for Adolescent Medicine. The statement
includes supporting commentary on state requirements for reporting sexual
abuse and sexual activity, the number of sexually active adolescents,
communication between adolescents and health professionals, clinical
assessment of sexual abuse and sexual coercion, access to confidential
health care, and legal requirements and interpretation of laws that may
impede provider/patient relationships.

American Academy of Family Physicians, American Academy of Pediatrics,
American College of Obstetricians and Gynecologists, Society for
Adolescent Medicine. 2004. Protecting adolescents: Ensuring access to care
and reporting sexual activity and abuse. Journal of Adolescent Health
35(5):420-423.

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4. ARTICLE IDENTIFIES LONGITUDINAL PREDICTORS OF PHYSICAL AND SEXUAL
DATING VIOLENCE IN ADOLESCENCE

"Our findings suggest groups to target with interventions to prevent
serious physical and sexual dating violence, content for interventions,
and approaches to delivering interventions," state the authors of an
article published in the November 2004 issue of Preventive Medicine.
Between 8% and 20% of adolescents have been victims of serious physical
dating violence; however, the risk factors targeted by most adolescent
dating violence programs have been identified from cross-sectional studies
that cannot distinguish causes from consequences of dating violence. The
study described in this article used data from a cohort of adolescents
assessed first in the eighth or ninth grade and then annually for 4 or 5
years, respectively, to identify potentially modifiable predictors of the
onset of and chronic victimization from serious physical and sexual dating
violence. Because the authors use a social ecological framework to
identify the predictors to be examined, their findings can potentially
guide the development of interventions that move beyond the typical
individual-level approach to dating violence prevention, to approaches
that target change in systems, such as families, peer groups, and societal
norms.

The authors assessed two subsamples of adolescents from a primarily rural
county in North Carolina. The first subsample included 1,291 adolescents
who reported at baseline that they had never been victims or perpetrators
of dating violence. The second subsample consisted of 219 adolescents who
reported at baseline having already been victims of mild forms of dating
violence.

The authors found that

* Significant baseline multivariate predictors of male onset of serious
physical dating violence victimization included having been hit by an
adult with the intention of harm, having low self-esteem, having poor
conflict-resolution skills, and having been in a physical fight with a
peer. The same three variables, as well as having a friend who had been a
victim, drinking alcohol, and being non-Hispanic white, also predicted
male chronic victimization.

* The only significant baseline multivariate predictor of female onset of
serious physical dating violence was having been hit by an adult with the
intention of harm. That variable, as well as living in a single-parent
household, predicted female chronic victimization.

* Significant baseline multivariate predictors of female onset of sexual
dating violence victimization included having a friend who had been a
victim and being depressed. These two predictors, as well as holding
traditional gender stereotypes, predicted female chronic victimization.

* Adolescents already experiencing mild forms of dating violence at
baseline were 2.4 times more likely than their non-victimized peers to
become victims of serious physical dating violence and 1.3 times time more
likely to become victims of sexual dating violence.

The authors conclude that "risk factors varied by gender and outcome,
suggesting the need for gender- and outcome-specific interventions, a
departure from current practice."

Foshee VA, Benefield TS, Ennett ST, et al. 2004. Longitudinal predictors
of serious physical and sexual dating violence victimization during
adolescence. Preventive Medicine 39(5):1007-1016.

Readers: More information about adolescent violence prevention is
available from the MCH Library's knowledge path at
http://www.mchlibrary.info/KnowledgePaths/kp_adolvio.html, and
organizations resource list at
http://www.mchlibrary.info/action.lasso?-database=Organizations&-layout=Web&-response=/databases/OrgLists/orgs_adolviolence.html&-MaxRecords=all&-DoScript=auto_search_adolviolence&-search.

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5. LONGITUDINAL ANALYSIS EXAMINES RISK AND PROTECTIVE FACTORS OF PHYSICAL
VIOLENCE AGAINST IMPOVERISHED WOMEN

"This study highlights the persistence of physical violence in indigent
women's lives and identifies plausible, prospective risk factors for
violence," state the authors of an article published in the
September/October 2004 issue of Women's Health Issues. The authors note
that although violence is an especially significant health threat among
traditionally underserved women in the United States, no study has
examined what may be responsible for prospective risk and persistence of
physical violence among impoverished women. The article describes a
comprehensive, prospective investigation of risk and protective factors
for violence in a representative probability sample of women living in
shelters and Section 8 low-income housing in Los Angeles County,
California.

Study participants included 810 women ages 18-55 who completed structured
interviews at baseline and at 6-month follow-up. Measures included
physical violence during the past 6 months, physical or sexual violence
before age 18, substance use, income from survival strategies (e.g.,
panhandling, selling drugs, selling sexual favors), psychological
distress, and social support. The authors assessed the potential influence
of risk and protective factors on whether a woman had experienced physical
violence at follow-up. They also determined whether the association of a
predictor with having experienced violence at follow-up differed depending
on whether a woman was in the sheltered or housed sample.

The authors found that

* Just over 30% of the women had experienced physical or sexual violence
before age 18.

* Approximately 15% of the women had experienced physical violence during
the 6 months before the baseline interview and during the 6 months before
the follow-up interview.

* Experiencing physical or sexual violence during childhood, having two or
more sexual partners rather than just one, experiencing psychological
distress/risk for mental health problems before the baseline interview,
and reporting poor social support at baseline predicted having experienced
physical violence at follow-up.

* A woman who had experienced physical violence at baseline had twice the
odds of having experienced it at follow-up.

* Being sheltered and having a longer interval between baseline and
follow-up interviews was associated with greater risk of having
experienced physical violence at follow-up.

"To our knowledge, this is the first study of impoverished women that has
been able to address what may be responsible for prospective risk and
persistence of physical violence," state the authors, adding that the
findings "highlight opportunities to reduce risk of experiencing violence
through enhancing women's social support and mental health."

Wenzel SL, Tucker JS, Elliot MN, et al. 2004. Physical violence against
impoverished women: A longitudinal analysis of risk and protective
factors. Women's Health Issues 14(5):144-154.

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6. STUDY EXAMINES ASSOCIATION BETWEEN SLEEP-DISORDERED BREATHING AND
PERFORMANCE IN 5-YEAR-OLDS

"In a community sample of 5-year-old children, parent-reported symptoms of
sleep-disordered breathing (SDB) are associated with impaired behavioral
control and with significantly poorer performance on a broad range of
neurocognitive tests," state the authors of an article published in the
October 2004 issue of the Journal of Pediatrics. The authors note that few
published studies use standardized measures to assess the neurocognitive
effects of SDB in children. The article describes a study to examine the
association of SDB symptoms (frequent snoring, noisy breathing during
sleep, or witnessed sleep apnea) with performance on standardized measures
of attention, planning, memory, and general cognitive ability in a large,
population-based sample of 5-year-olds.

All children in the study had been previously enrolled in the Infant Care
Practice Study (ICPS), a multicenter, prospective longitudinal study to
describe newborn sleep practices and to document changes in infant sleep
position over time. Sociodemographic variables (maternal race/ethnicity,
marital status, and educational status) were collected by interview at the
time of enrollment in the ICPS (between February 1995 and December 1998).
Beginning in March 2000, a questionnaire was mailed within 2 months of the
child's fifth birthday to all English-speaking mothers of children in the
ICPS born in Massachusetts with birthweight >2,500 g. Parents reported
their child's height, weight, frequency of upper respiratory and ear
infections, history of tympanostomy and adenotonsillectomy, daytime
sleepiness, wheezing, asthma, respiratory allergy, and SDB symptoms. A
neurocognitive assessment was conducted in one 3- to 4-hour session
(children with Full Scale IQ less than 70 were excluded from analysis).
The 205 children with complete data on sleep symptoms and laboratory-based
neurocognitive assessments were the subjects of this study.

The authors found that

* Parent-reported SDB symptoms were present in 30% of the study children;
the prevalence of SDB symptoms was similar in boys and girls.

* Children with SDB symptoms had significantly poorer performance than did
those without SDB symptoms on measures of attention and planning, memory,
and overall intellectual ability.

* There were no consistent differences between boys and girls in the
association of SDB symptoms with either neurocognitive or behavior
measures.

* The findings persisted when children with evidence of obstructive sleep
apnea were excluded from the analysis.

"The possible persistence of neurocognitive effects of early childhood SDB
into later childhood and their impact on academic performance require
further investigation," conclude the authors.

Gottlieb DJ, Chase C, Vezna RM, et al. 2004. Sleep-disordered breathing
symptoms are associated with poorer cognitive function in 5-year-old
children. Journal of Pediatrics 145(4):458-464.

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MCH Alert © 2004 by National Center for Education in Maternal and Child
Health and Georgetown University. MCH Alert is produced by MCH Library
Services at the National Center for Education in Maternal and Child Health
under its cooperative agreement (6U02 MC 00001) with the Maternal and
Child Health Bureau, Health Resources and Services Administration, U.S.
Department of Health and Human Services. The Maternal and Child Health
Bureau reserves a royalty-free, nonexclusive, and irrevocable right to use
the work for federal purposes and to authorize others to use the work for
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Permission is given to forward MCH Alert to individual colleagues. For all
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The editors welcome your submissions, suggestions, and questions. Please
contact us at the address below.

EDITORS: Jolene Bertness, Tracy Lopez
COPYEDITOR: Ruth Barzel

National Center for Education in Maternal and Child Health
Georgetown University
Mailing address: Box 571272, Washington, DC 20057-1272
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