Maternal Child Health Newsletter 4/8/05

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Maternal Child Health Newsletter 4/8/05

Postby denise » Fri Apr 08, 2005 11:13 am

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MCH Alert
Tomorrow's Policy Today
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Maternal and Child Health Library

This and past issues of the MCH Alert are available at
http://www.mchlibrary.info/alert/archives.html.

April 8, 2005

1. Fact Sheet Focuses on the Role of State Public Health Agencies in
Addressing Perinatal Depression
2. Issue Brief Addresses Key Questions About HIPAA and Language Services
in Health Care
3. Report Highlights Successful Efforts to Improve the School Nutrition
Environment
4. Article Examines Suicidal Behavior in the Family and Adolescent Risk
Behavior
5. Authors Review Research on Asthma Disparities

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1. FACT SHEET FOCUSES ON THE ROLE OF STATE PUBLIC HEALTH AGENCIES IN
ADDRESSING PERINATAL DEPRESSION

The Role of State Public Health in Perinatal Depression discusses the role
of state public health agencies in partnering with national and statewide
programs to ensure access to mental health information and services for
pregnant women and new mothers. The fact sheet, produced by the
Association of State and Territorial Health Officials, begins with an
overview containing a definition of perinatal depression and information
on its prevalence and its impact on women and their families. Other topics
include the role of state public health agencies in partnering with
federal and state agencies to increase awareness and support, and specific
state initiatives (Virginia, Texas, and Pennsylvania) to address issues
related to perinatal depression. A conclusion, quick facts about perinatal
depression, and a list of references are also included. The fact sheet is
intended for use by state public health agencies and their national and
state partners in efforts to expand depression screening and referral to
improve the overall health of women, children, and families. The fact
sheet is available at http://www.astho.org/pubs/PerinatalDepressionFS.pdf.

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2. ISSUE BRIEF ADDRESSES KEY QUESTIONS ABOUT HIPAA AND LANGUAGE SERVICES
IN HEALTH CARE

HIPAA and Language Services in Health Care discusses how the Health
Insurance Portability and Accountability Act's (HIPAA's) patient privacy
rules apply to interpreters who provide language services to individuals
with limited English proficiency in health care settings. The issue brief
was prepared by the National Health Law Program with support from the
California Endowment. Information is presented in a series of questions
and answers addressing such topics as who is covered by the HIPAA privacy
rules and how to know if the rules apply, what patient information is
protected under HIPAA, when an interpreter can disclose protected patient
information, HIPAA training for interpreters and who is responsible for
providing training, and what to do if the interpreter believes that the
privacy rules are being violated. The issue brief is available at
http://www.healthlaw.org/pubs/200503.hipaaandinterpreters.pdf.

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3. REPORT HIGHLIGHTS SUCCESSFUL EFFORTS TO IMPROVE THE SCHOOL NUTRITION
ENVIRONMENT

"Students will buy and consume healthful foods and beverages -- and
schools can make money selling healthful options," state the authors of
the report, Making It Happen! School Nutrition Success Stories. Research
shows that students in school today have more opportunities than they did
in the past to purchase snack foods and beverages high in fat and/or added
sugar that are not part of federally regulated school meal programs.
Research also shows that many schools have come to rely on profits from a
la carte offerings, vending machines, student stores, canteens, snack
bars, and fundraisers to support a variety of activities. The report tells
the stories of 32 urban, suburban, rural, elementary, middle, and high
schools that have successfully implemented innovative approaches to
selling more nutritious foods and beverages to students and staff. The
stories are supported by examples of actual policies, regulations, letters
to parents, nutrition standards, nutrition resources, and contact
information from the schools and districts.

The report, undertaken as part of the HealthierUS initiative, was a joint
project of the U.S. Department of Agriculture's (USDA’s) Team Nutrition
and the Department of Health and Human Services' Centers for Disease
Control and Prevention (CDC), Division of Adolescent and School Health and
was supported by the Department of Education. Stories were collected
between September 2002 and October 2003 and were identified through a scan
of media coverage; responses to queries on e-mail lists; and
recommendations from the project contractor, CDC and USDA staff, and
members of an advisory panel. Information was self-reported and based on
interviews with the key contact(s) for each case.

The authors found that six approaches evolved as a result of input from
schools and school districts on the types of changes they were making to
improve the quality of competitive foods (foods and beverages schools sell
that are not part of federally regulated school meal programs). These
approaches included the following: (1) establish nutrition standards for
competitive foods, (2) influence food and beverage contracts, (3) make
more healthful foods and beverages available, (4) adopt marketing
techniques, (5) limit student access to competitive foods, and (6) use
fundraising activities and rewards.

The authors conclude that "more work is needed to collect data before and
after changes are made to document their effects on eating behaviors,
revenues from food and beverage sales, and the overall impact on
children's health."

U.S. Department of Agriculture, Food and Nutrition Service; U.S.
Department of Health and Human Services, Centers for Disease Control and
Prevention; and U.S. Department of Education. 2005. Making it happen!
School nutrition success stories. FNS-374. Alexandria, VA: Food and
Nutrition Service, U.S. Department of Agriculture; Centers for Disease
Control and Prevention, U.S. Department of Health and Human Services; and
U.S. Department of Education. Available at
http://www.fns.usda.gov/tn/Resources/makingithappen.html.

Readers: More information about child and adolescent nutrition is
available from the Bright Futures Web site at
http://www.brightfutures.org/nutrition/index.html and from the MCH
Library's knowledge path at
http://www.mchlibrary.info/KnowledgePaths/kp_childnutr.html and annotated
bibliography at
http://www.mchlibrary.info/action.lasso?-database=Biblio&-layout=Web&-response=/databases/BibLists/bib_chldnutr.html&-MaxRecords=all&-DoScript=auto_search_chldnutr&-search.

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4. ARTICLE EXAMINES SUICIDAL BEHAVIOR IN THE FAMILY AND ADOLESCENT RISK
BEHAVIOR

"This study shows that adolescents who have been exposed to suicide
attempts and suicide deaths by family members are likely to be engaged in
behaviors that put them at risk for future problems including marijuana
use, binge drinking, suicidal ideation and attempt, and violence toward
others" state the authors of an article published in the April 2005 issue
of the Journal of Adolescent Health. Several studies have shown an
association between death by suicide of a family member and suicidal and
risk behavior in their relatives. However, few studies have examined the
impact of suicide attempts by a family member, an event that is much more
common than a suicide death, on adolescents' suicidal behavior and other
risk behaviors. The study described in this article examined the separate
associations of exposure to suicide attempts and suicide deaths by a
family member with (1) key demographic variables, (2) risk behaviors in
adolescents, (3) social-emotional functioning, and (4) parental and
adolescent reports of family connectedness.

The source of the data was Add Health, an in-home survey that provides a
nationally representative sample of adolescents in school, ages 11-21. The
final study population included 5,918 adolescents and 5,128 adult
caregivers.

The authors found that

* Exposure to a family member's suicide attempt in the past year was
reported by 3.9% of the adolescents, and exposure to a family member's
death by suicide in the past year was reported by 1.2% of the adolescents.

* Adolescents who had experienced a family member's suicide attempt were
more likely than their counterparts who had no such experience to report
the following: smoking, marijuana use, binge drinking, suicidal ideation,
suicide attempt, serious physical fighting, inflicting serious injury,
decreased life expectancy, emotional distress, and poor parent-child and
family connectedness.

* Adolescents who had experienced a family member's suicide death were
more likely than their counterparts who had no such experience to report
the following: marijuana use, binge drinking, suicidal ideation, suicide
attempt, inflicting serious injury, decreased life expectancy, and
emotional distress.

* Neither a family member's suicide attempt nor suicide death had a
significant independent effect on the adolescent's GPA (grade point
average) or parental reports of parent-child connectedness.

The authors conclude that a suicide attempt in the family "must now be
considered a risk that can be the focus of intervention."

Cerel J, Roberts A. 2005. Suicidal behavior in the family and adolescent
risk behavior. Journal of Adolescent Health 36(4):e9-e15. Abstract
available at
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T80-4FR4449-D&_user=655954&_handle=V-WA-A-W-AV-MsSAYVW-UUA-U-AAACBCZBYA-AAAWEBDAYA-BUUAVEYZ-AV-U&_fmt=summary&_coverDate=04%2F30%2F2005&_rdoc=12&_orig=browse&_srch=%23toc%235072%232005%23999639995%23584564!&_cdi=5072&view=c&_acct=C000035538&_version=1&_urlVersion=0&_userid=655954&md5=2a33c5e1c623a9d987228a735124ef23.

Readers: More information about adolescent mental health is available from
the Bright Futures Web site at
http://www.brightfutures.org/mentalhealth/index.html and from the MCH
Library's knowledge path at
http://www.mchlibrary.info/KnowledgePaths/kp_mentalhealth.html and
annotated bibliography at
http://www.mchlibrary.info/action.lasso?-database=Biblio&-layout=Web&-response=/databases/BibLists/bib_adolmenhlth.html&-MaxRecords=all&-DoScript=auto_search_adolmenhlth&-search.

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5. AUTHORS REVIEW RESEARCH ON ASTHMA DISPARITIES

"We understand more about factors that influence asthma morbidity (the
worsening of asthma in allergic asthmatic individuals) than we do about
factors that influence the development of allergy and asthma," state the
authors of an article published in the Annual Review of Public Health.
Asthma, the most common chronic disease of childhood in the United States,
disproportionately burdens many socioeconomically disadvantaged urban
communities. The article presents theories explaining worldwide asthma
disparities. The authors then discuss the nature of disparities in asthma
in the United States and potential partial explanations for those
disparities.

Between-Country Disparities in Asthma

* Estimated asthma prevalence varies widely according to the epidemiologic
or clinical definition of asthma used; nevertheless between-country and
within-U.S. disparities in asthma prevalence and morbidity have been well
documented and are not likely to be a function of definition.

* The International Study of Asthma and Allergy in Childhood has shown an
almost 30-fold between-country variation in asthma prevalence rates.
More-developed countries tend to have higher asthma rates than
less-developed ones, although exposures related to development do not
explain all the between-country differences noted in this international
effort to understand the patterns of asthma and allergy in children.

* A number of factors have been identified as potential partial
explanations for disparities in asthma prevalence, including factors
related to hygiene, diet, cigarette smoking, traffic pollution, antenatal
exposures, and physical activity/obesity. Despite a growing body of
worldwide literature reporting studies testing hypotheses explaining
asthma prevalence disparities, the significance of most of these factors
in the development of asthma has yet to be fully understood, and the
factors' significance for explaining disparities in asthma prevalence is
uncertain.

* In utero/early infancy exposure to cigarette smoking is consistently
found to be an important risk factor for the development of wheezing and
early asthma. However, its relationship to the development of allergy and
allergic inflammation is uncertain.

Asthma Disparities in the United States

* The prevalence of asthma in the United States is higher than in many
other countries.

* For almost two decades, socioeconomic and racial/ethnic disparities in
asthma prevalence and morbidity in the United States have been well
documented, but which environmental exposures contribute to these
disparities and why they do so is only partially understood.

* Hygiene hypotheses explaining disparities have been challenged as
irrelevant to the U.S. setting.

* Both community- and individual-level factors contribute to disparities
in asthma morbidity and in the incidence/prevalence of asthma in the
United States.

* Recent evidence suggests that in the United States, among
socioeconomically disadvantaged children with asthma and allergy, asthma
morbidity can be improved with targeted interventions.

"In the United States, effective reduction in disparities in asthma
morbidity will be dependent only in part on specific measures like
establishment of smoking cessation programs, home allergen reduction in
sensitized asthmatic children, physician feedback, and/or health
education," state the authors. They conclude that "the long-term success
of any of these specific measures is likely to depend, in great part, on
more general improvements in living conditions and life opportunities."

Gold DR, Wright R. 2005. Population disparities in asthma. Annual Review
of Public Health 26:89-113. Abstract available at
http://arjournals.annualreviews.org/doi/abs/10.1146/annurev.publhealth.26.021304.144528.

Readers: More information about asthma is available from the MCH Library's
knowledge path at
http://www.mchlibrary.info/KnowledgePaths/kp_asthma.html.

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Child Health and Georgetown University. MCH Alert is produced by Maternal
and Child Health Library at the National Center for Education in Maternal
and Child Health under its cooperative agreement (U02MC00001) with the
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COPYEDITOR/WRITER: Ruth Barzel

MCH Alert
Maternal and Child Health Library
Georgetown University
Box 571272
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Phone: (202) 784-9770
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-------
Denise (29) Co-coordinator for WI
Jason (32)
Ariana (22 months)5/3/03-just shy of 35 weeks: Class 1 HELLP
http://hometown.aol.com/oneyodafan/DeniseHomePage.htm
denise
Registered User
 
Posts: 5479
Joined: Sat Dec 06, 2003 08:03 pm

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