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The long-term effects of alcohol abuse

February 8, 2013 By 2 Comments

We’ve all heard about the dangers of binge drinking: alcohol poisoning, injury and risky decision making – for example, having unprotected sex or driving drunk – have potential lethal consequences. Here at EBL, we’ve written before about the particular dangers involved when teens consume alcohol.

Now there is new evidence that has identified long-term consequences for young people who binge drink. A systematic review published in the journal Cortex combined data from twenty separate studies to determine the effects of alcohol abuse and binge drinking on people ages 13 to 24

The researchers found a wide range of effects for young people who abused alcohol, including impaired memory and visual learning, brain shrinkage, and changes in the brain’s white matter.

According to the researchers, the brain is still developing during the teen-age and young adult years, which makes it especially susceptible to damage during that period. In fact, there’s substantial evidence that shows the parts of the brain responsible for behaviors such as controlling impulses and planning ahead are among the last to mature.

Youth who are at risk for mental health disorders or substance abuse are more vulnerable to binge drinking the review found. Programs and treatments that prevent alcohol abuse among young people are important in ensuring their cognitive abilities aren’t impaired over the long-term.

What’s a parent to do?  Research shows that modeling responsible drinking behavior, monitoring your children and maintaining a close relationship with them are effective strategies to reduce teen drinking.

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Shocking evidence: Young Americans die at high rates

January 15, 2013 By 2 Comments

Young Americans are dying at higher rates than young people in any other country in the world – primarily as a result of gun violence, car accidents and drug addiction.  This startling piece of evidence comes from a sweeping new study sponsored by the Institute of Medicine and the National Research Council and conducted by a panel of experts.

The report – titled U.S. Health in International Perspective: Shorter Lives, Poorer Health – examines the body of research on life expectancy and health in America and 16 other “high-income democracies” including the United Kingdom, Germany, Canada, Australia and Japan.

The analysis found that Americans perform the worst in the world on nine health indicators including:

  • infant mortality and low birth weight
  • injuries and homicides
  • adolescent pregnancy and sexually transmitted disease
  • HIV and AIDS
  • drug-related deaths
  • obesity and diabetes
  • heart disease
  • chronic lung disease
  • disability

In fact, the U.S. ranked at the bottom on nearly every health indicator the panel reviewed with the exception of deaths from cancer that can be detected by tests, and blood pressure and cholesterol levels.

While the report offered some potential explanations for Americans’ poor health, there is no clear-cut evidence on how to fix the problem. The panel found that Americans have less access to health care compared to people in other countries, and that they suffer from higher rates of poverty and income inequality.

The panel also found that health behaviors are a contributing factor. Americans are more likely to abuse drugs, get involved in traffic accidents involving alcohol, use firearms in an act of violence, fail to wear a seat belt and consume high levels of calories.

This disturbing news should serve as a walk up call.  Clearly eating well and exercise are important, but there are economic and cultural issues at work that require a broader response.

Filed Under: Evidence-Based Living, Health and Wellness, Youth Development Tagged With: , , ,

The consequences of child abuse and neglect

January 8, 2013 By 1 Comment

Here at EBL, we’ve written before about the horrible consequences of child abuse and neglect.  The statement we made before remains true: No one needs an academic study to understand that abuse and neglect take a terrible toll on young people, their families, and our society.  But it is helpful to understand the specific effects this behavior causes.

A new systematic review examines the long term impacts of  physical abuse, emotional abuse, and neglect in childhood on later mental and physical health.  The review synthesized data from 124 studies that followed victims of child maltreatment later in life.

The findings demonstrate  significant associations between physical abuse, emotional abuse, and neglect with mental health conditions including depression, anxiety, and suicide attempts. The researchers estimate that all three forms of maltreatment double the risk of developing a mental health disorder later in life.

Adults who were victims of child maltreatment were also more likely to use drugs, to engage in risky sexual behavior, and to contract sexually transmitted infections. Additionally, research has found a possible relationship with chronic diseases and other physical health outcomes, but the evidence is sparse and not consistent across types of maltreatment. The authors said more research is needed to better understand these consequences.

At Cornell’s College of Human Ecology, researchers manage a project called the National Data Archive on Child Abuse and Neglect (NDACAN). The project, which is housed in the Bronfenbrenner Center for Translational Research, makes existing child maltreatment data available to qualified researchers so that they can conduct their own original research and learn more about the costs, consequences, and prevention of child maltreatment. Datasets at NDACAN include large-scale surveys and annual federal efforts collect data from official child abuse and neglect reports and about maltreated children living in foster care.

“The Archive is an important tool that allows social scientists to replicate and expand on our scientific knowledge base,” said Elliott Smith, Associate Director of NDACAN.

The take home message: All forms of child abuse and neglect have serious ramifications that last throughout the life-span.

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The evidence shows preschool matters!

December 6, 2012 By 1 Comment

We have heard educators and politicians alike tout the virtues of early childhood education, and how it prepares kids for a lifetime of learning. With one of my own children in preschool and another one headed there shortly, I’m always interested in the evidence on this stage learning. Do activities like playing with blocks and paints, sitting through circle time and learning to share really impact a child for the rest of his life?

So I was fascinated to follow a series of reports on National Public Radio that detail some interesting evidence about preschool programs. While these reports didn’t include a systematic review, they did include several different longitudinal studies that make an interesting case about the importance of preschool.

On the show This American Life, host Ira Glass talks with a range of experts – a journalist, an Nobel-prize winning economist and a pediatrician – about the evidence on what researchers call “non-cognitive skills” like self-discipline, curiosity and paying attention.

One of the leading experts in this field is an economist at the University of Chicago named James Heckman. His work has found that these soft skills are essential in succeeding in school, securing a good job, and even building a successful marriage. Heckman found that children learn these skills in preschool.

One well-known longitudinal study followed a group of low-income 3- and 4-year-olds in Ypsilanti, MichiganThese children were randomly assigned to attend preschool five days a week, or not attend any preschool.  After preschool, all of the children went to the Ypsilanti public school system.

The study found  that children who attend preschool were more successful adults. They were half as likely to be arrested and earned 50 percent more in salary. Girls who attended preschool were 50 percent more likely to have a savings account and 20 percent more likely to have a car.

Another similar project conducted in North Carolina found that comparable results: Individuals who had attended preschool as children were four times more likely to have earned college degrees, less likely to use public assistance, and more likely to delay child-bearing.

There is more evidence too.  NPR’s Planet Money aired a show  earlier this year demonstrating further evidence about the benefits of preschool.  And researchers at the University of Texas in Austin found that preschool reduces the inequalities in early academic achievement.

The take-home message seems to be: Preschool matters!

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What we know about autism therapies

November 13, 2012 By 1 Comment

According to the U.S. Centers for Disease Control and Prevention, one in 88 American children have an autism spectrum disorder – developmental disabilities characterized by delays in social interaction and communication, cognitive difficulties  and repetitive behaviors.

Autism appears in children by three years of age and typical treatments include medicine and therapy. Now there’s a new meta-analysis investigating behavioral interventions to treat autistic children.

The analysis looks at 33 systematic reviews and 68 intervention studies of autistic children. The review – published earlier this month in the journal Pediatrics – found that some intervention programs did help improve behavioral symptoms.

Intensive behavior programs – which include therapy for at least 25 hours a week – were found to be moderately effective at improving core deficits such as adapting to change, decision-making and memory. The evidence showed these programs were particularly effective when they began shortly after diagnosis, and when they address the concerns of the family and offer opportunities for them to participate.

The authors agreed that there is plenty of room for improvement.  They suggested that comprehensive therapy programs need to address even more deficits including social communication, language, play skills, aggression and preoccupation with rituals.

They also identified gaps in our knowledge about autism therapies.  Researchers need to

– Develop uniform outcome measures so that future systematic reviews can more easily pool data.

– Conduct more studies on pre-verbal or non-verbal children to determine the interventions that help them best.

– Assess how individual, specific therapies impact core deficits such as IQ and communication skills.

– Collect more evidence to determine the most effective dose and duration of therapies.

All in all, the take home message is that behavioral therapy does help children diagnosed with autism, but that researchers have a long way to go to ensure that interventions are doing all that they can to help autistic children develop and thrive.

Filed Under: Evidence-Based Living, Health and Wellness, Youth Development Tagged With: , , ,

Dads influence teen sexual behavior

October 30, 2012 By 1 Comment

Here at EBL, we’ve written before about why teenagers are more likely to make risky decisions compared to adults – including engaging in risky sexual activity. But we also know that parents can influence their teens’ decisions about sex—and we’re not just talking about a mom sitting down with a teen for “the talk.”

A new systematic review in the journal Pediatrics found evidence that dads have a unique influence on the sexual behavior of their adolescent children, independent of the mother’s impact.

For their analysis, researchers found 13 studies published between 1980 and 2011 that investigated fathers’ influence on sexual risk-taking for youth ages 11 to 18.  They used a sweeping definition of fathers that included stepfathers, adoptive fathers and other men who acted as the primary male caregiver to teens.

What did they find? Fathers (and father figures) matter. The emotional quality of the father-child relationship makes a difference: teens who considered themselves close to their fathers tended to begin having sex later. When fathers are communicative about sex, their children are more likely to make healthy decisions. Fathers’ attitudes matter too: when dads approved of adolescent sexual activity, teens tended to start having sex earlier compared with teens whose dads did not approve.

Maybe the most interesting findings dealt with parenting style: teens with either overly restrictive or overly lenient fathers tended to have sex earlier than teens with dads who found a more balanced approach.

The take home message? Dads and male adults who act as father figures should communicate with teens about their expectations and rules surrounding sexual behavior. And though it may be hard as teens become more independent, keeping a close, positive relationship helps keep adolescent children healthy.

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Do exercise programs for kids really work?

October 17, 2012 By 1 Comment

Nearly 12.5 million children – or 17 percent of the U.S. population ages 2-19 – are obese.  As a response to this growing problem, schools and community groups have launched intervention programs designed to get kids moving.  But do they work?

A new meta analysis published last month in the British Medical Journal was designed to answer just that question. It included 30 studies on exercise programs for children published worldwide between January 1990 and March 2012.

Studies in the review measured the effects of intervention programs that targeted children under 16 years old and lasted for at least four weeks. To be included, studies had to definitively measure levels of physical activity in children throughout the day – not just during the intervention class period – with devices like motion sensors.

In each case, the investigators expected that the programs would increase the children’s overall daily physical activity.

The review uncovered some surprising evidence: programs designed to encourage increased physical activity among kids didn’t work. On the whole, the programs increased  children’s overall physical activity levels by about 4 minutes a day – even though the programs themselves ranged from 30 to 90 minutes in length.

One explanation is that children unconsciously compensate for the energy they use during structured activity programs by being doing sedentary activities aftewards, Brad Metcalf, a research fellow and medical statistician at Peninsula College who led the review, told the New York Times. Another explanation is that many of the programs took place after school, replacing a time period when children are typically most active anyway.

This analysis did yield some clear results: that we need to come up with additional strategies for encouraging physical activity among children.

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What we know about car seats and how kids use them

August 21, 2012 By 1 Comment

We have known for a long time that car seats save children’s lives. But even with that knowledge, do parents and caregivers use them appropriately?

A new study by researchers at University of Michigan found that while most people use child restraints properly, many do not. The researchers analyzed data on more than 21,000 children observed in cars at gas stations, fast-food restaurants, recreation centers and child care centers from 2007 to 2009 using guidelines from the American Academy of Pediatrics.

They found 21  percent of children ages 4 and younger were not following the recommendations for sitting in car seats. Thirty-three percent of 4- and 5-year olds and 66 percent of 6- and 7-year-olds were not following the recommendations for using car seats or booster seats. And – the most precarious finding – 11 percent of children were not wearing seat belts or sitting in car seats at all. Children were especially likely to be completely unrestrained if they were driving with an adult who wasn’t wearing a seat belt or if there were four or more children in the car.

While the evidence on kids using car seats is not encouraging, there are some intervention programs proven to increase the use of child safety seats. One systematic review found strong evidence that child safety seat laws increase the use of safety seats. Programs that combine education with distribution of car seats, incentives for installing car seats correctly and stepped up enforcement of laws also increase the use of car seats.

The bottom line: Car seats help save kids lives. It’s important to use them as recommended by the American Academy of Pediatrics.

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Evidence update: How are America’s children faring?

July 20, 2012 By Leave a Comment

As a society, we put a tremendous value on the health, well-being and education of our children. But how do we know how they are doing?

Each year, the U.S. government publishes a report – America’s Children in Brief: Key National Indicators of Well-Being – that combines the data from 22 federal agencies to provide a reader-friendly, evidence-based account of the status of children in the U.S.

This year’s report unveils some interesting trends:

  • Preterm births declined for the fourth straight year. And fewer children died in the first year of life.
  • Average mathematics scores increased for 4th and 8th grade students,
  • The percentage of children living in poverty increased, and the percentage of children with at least one parent employed full time, year-round decreased,.
  • Fewer you were victims of violent crimes last year
  • Fewer young children lived in a home where someone smoked.

You can get the full story at http://www.childstats.gov.

Filed Under: Evidence-Based Living, Youth Development Tagged With: ,

Studies on same-sex parenting: The details matter

June 20, 2012 By 1 Comment

Here on EBL, we’ve talked frequently about what makes for quality research. There’s new research out this month on gay parents that illustrates the importance of seeking out high quality research.

A new study by a University of Texas sociologist  surveyed nearly 3,000 Americans ages 18 to 39 to ask about their family structure growing up. Of the participants, 248 grew up in households where one parent  had a same-sex relationship at some point.  The study found that children of these parents were more likely than kids in other family structures to be on public assistance, unemployed or in therapy as adults, among other negative outcomes.

To collect information about same-sex parenting, the study asked: “Did either of your parents ever have a romantic relationship with someone of the same sex?” and then asked whether participants had lived with their parents at the time.

But the question does not collect enough information about these families. Are they parents involved in heterosexual marriages who had an affair, or divorced and then entered into a same-sex relationship?  We just know. The study didn’t ask any questions about whether participants were raised in stable homes with committed parents who were of the same sex.

The study has sparked a flurry of media attention, including the New York Times and Time magazine, among other

s, with plenty of criticism. And the criticism is merited, said Ritch Savin-Williams, Director of the Sex and Gender Lab at the Cornell’s College of Human Ecology.

“The research design of this study is sufficiently flawed (inappropriate comparison group) as to merit disbelief in the findings,” he said. “It is unclear if this major shortcoming was lack of scientific rigor or in some part influenced by the funding sources that have both religious and political agendas.”

There is a systematic review on same-sex parenting that provides more answers. The review looked at 33 studies that lesbian, gay and heterosexual parents. Their analysis found no difference in parenting ability or the children’s psychological and social success between same-sex and heterosexual parent partners.

Clearly, the issue of same-sex parenting is politically-charged for a lot of reasons. The point we’d like to make here on EBL is that it’s important to understand the details of research study, and draw your conclusions with all of the evidence.

Filed Under: Evidence-Based Living, In The Media, Youth Development Tagged With: , , , ,

The evidence on check-ups for kids

May 29, 2012 By Leave a Comment

With a one- and a three-year-old, I find myself at the pediatrician’s office fairly frequently – and not because my kids are sick. In the first two years of their lives, they visit the pediatrician every 3 months for well visits.

As a new mom, the visits provide a welcome opportunity to ask questions and make sure you’re not making any major mistakes. But the second time around, they can seem unnecessary. So I went out hunting for some evidence to determine whether well-visits are good for kids.

It turns out that they are essential.  A systematic review published in the Journal of the American Medical Association examined the found that primary medical care in the first three years of life promotes optimal development for children.

The review evaluated 47 studies published from 1979 to 1999 that looked at how activities in primary care settings such as counseling about children’s sleep habits, temperament and behavior encourage healthy development.

The review found behavioral counseling for parents with fussy infants and poor sleepers is effective in helping both parents and babies. It also found that soliciting parents’ concerns about their children’s development helped identify problems. And that structured and systematic approaches to asking about parents’ concerns are most effective.

The review did find some areas for improvement. Among them, efforts to identify developmental problems in young children need to be more methodical and identifying psychosocial risk factors can be improved by using questionnaires and parent-child assessments.

All in all, the evidence makes me feel better about our frequent trips to the pediatrician.

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Energy drinks: Bad for kids, bad for your teeth

May 8, 2012 By 3 Comments

Brightly-colored, sugar-filled energy and sports drinks are everywhere – in vending machines, cafeterias and gas stations.

While they may seem like a healthy alternative – athletes drink them, after all – most lack nutritional value, and many contain caffeine. The evidence actually shows these drinks can be detrimental to kids and harmful to teeth.

First off, a systematic review commissioned by the American Academy of Pediatrics found that sports drinks – which don’t contain caffeine, but do have a lot of sugar – lead to obesity and tooth decay among children. And energy drinks – which do contain caffeine – can interfere with sleep, lead to anxiety and cause dehydration.

A more recent study published in the journal General Dentistry and covered by National Public Radio found both energy and sports drinks contain high levels of citric acid, which erodes tooth enamel, leaving teeth more prone to cavities and decay.

There’s certainly a place for sports drinks – specifically to replace electrolytes and energy stores in both children and adults who exercise vigorously for more than an hour at a time. But for the public at large, these drinks are essentially empty calories.

So help to discourage children from downing sports drinks unless they’re actually playing a sport.  And the next time you’re picking up a beverage to go with that sandwich or need to quench your thirst on a long drive, stick with water.  It’s the healthier choice.

Filed Under: Evidence-Based Living, Health and Wellness, Youth Development Tagged With: , , , ,
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