JAMA news releases are made available to the public after 3 pm US Central time on the first 4 Tuesdays of each month. The Archives of Journals news releases are made available to the public after 3 pm Central time on Mondays. We also provide a list of previous news releases.
THIS WEEK'S CONTENTS
ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE NEWS RELEASES
(Embargoed Until: 3 P.M. (CT), Monday, December 1, 2008)
ONE-THIRD OF FARM WORKERS’ CHILDREN LACK HEALTH INSURANCE
CHILDHOOD SOCIAL PROGRAM LEADS TO BETTER-FUNCTIONING YOUNG ADULTS
FLU VACCINE ASSOCIATED WITH REDUCED ILLNESS, LESS IMPAIRMENT OF ACADEMIC PERFORMANCE AMONG COLLEGE STUDENTS
ARCHIVES OF GENERAL PSYCHIATRY NEWS RELEASES
(Embargoed Until: 3 P.M. (CT), Monday, December 1, 2008)
SYMPTOMS OF DEPRESSION ASSOCIATED WITH INCREASE IN ABDOMINAL FAT
PSYCHIATRIC DISORDERS COMMON AMONG COLLEGE-AGE INDIVIDUALS; FEW SEEK TREATMENT
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, December 1, 2008
Media Advisory: To contact Roberto L. Rodriguez, M.D., M.P.H., call Matilda Sanchez at 512-324-3073.
ONE-THIRD OF FARM WORKERS’ CHILDREN LACK HEALTH INSURANCE
CHICAGO—Children of farm workers are three times as likely as all other children and almost twice as likely as other poor children to be uninsured, according to a report in the December issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
Children of farm workers face a variety of health challenges, according to background information in the article. Most are Latino, a group that already has suboptimal access to pediatric health services. In addition, Mexican American migrant children who move around the United States with their farm-worker parents are two to three times more likely to be rated in poor or fair health than non-migrant Mexican American children. Farm workers’ children are often exposed to pesticides and are more likely to engage in dangerous agricultural work themselves.
"Health insurance improves children’s access to and use of health care services, making children’s health insurance an important proxy for children’s health care access," the authors write. Roberto L. Rodriguez, M.D., M.P.H., of the University of Texas Medical Branch–Austin and Dell Children’s Medical Center of Central Texas and colleagues analyzed results of a national survey of 3,136 farm workers with children younger than 18 years. The parents reported demographic and social characteristics along with the health insurance status of their children (all of whom lived in the United States).
Among the farm-worker parents, 32 percent reported that their children were uninsured, including 45 percent of migrant-worker parents. Parents who were older, had less education, had spent less time in the United States and who lived in the Southeast or Southwest were more likely to have uninsured children.
"Our findings highlight the particular vulnerability of U.S. farm workers’ children regarding health insurance coverage," the authors write. "These findings have important policy implications. They suggest that the low parental education among many farm workers as well as more recent immigration—which may in part reflect acculturation—negatively affect their children’s health insurance status."
"These social disadvantages may warrant increased efforts to enroll and retain eligible children in health insurance programs. Outreach efforts would need to consider other barriers that impede insurance enrollment and retention, such as the complexity of applications, language barriers, the inaccessibility of enrollment sites in rural areas and parents’ fear of using services or misunderstanding of eligibility guidelines," they conclude. "Efforts to address disparities in health insurance for farm workers’ children may lead to better access to health care and better health."
(Arch Pediatr Adoles Med. 2008;162[12]:1175-1180. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This study was supported by the Robert Wood Johnson Foundation through the Robert Wood Johnson Clinical Scholars Program and by a grant from the Centers for Disease Control and Prevention. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, December 1, 2008
Media Advisory: To contact J. David Hawkins, Ph.D., call Joel Schwarz at 206-543-2580.
CHILDHOOD SOCIAL PROGRAM LEADS TO BETTER-FUNCTIONING YOUNG ADULTS
CHICAGO—A social development intervention administered in elementary school appears to have positive effects on mental health, sexual health and educational and economic achievement assessed 15 years after the intervention ended, according to a report in the December issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
Unemployment, poverty and disorganized neighborhoods are common problems plaguing U.S. cities, according to background information in the article. Many urban families and children must contend with crime, drug use, teen pregnancy, school dropouts and mental health problems. "Public schools, available to all children in the United States beginning at age 5 or 6 years, are a potentially powerful setting for preventive intervention," the authors write.
J. David Hawkins, Ph.D., and colleagues at the University of Washington, Seattle, studied the long-term effects of one such prevention program, the Seattle Social Development Project. "The objective of the intervention was to improve the skills of teachers, parents and children to increase positive functioning in school and decrease problems related to mental health, risky sexual behavior, substance use and criminal behavior," the authors write. Beginning in fall of 1981, some first-grade students in Seattle elementary schools began the program, which was eventually expanded to 15 public elementary schools serving diverse neighborhoods. Parents, teachers and students in the intervention received special instruction in areas such as behavior management, refusal, social skills training and academic development.
At ages 24 and 27, childhood participants completed a self-assessment of their school, work and community life, along with their mental health, sexual behavior, substance use and crime. Court records were also referenced. A total of 598 young adults (146 who began the intervention in first grade, 251 who began the intervention in grades five or six and 201 in a control group who did not receive the intervention) completed the 15-year follow-up at age 27.
Participants who received the full intervention reported improved functioning in almost all areas assessed. No differences were observed in rates of substance abuse or crime. However, compared with the control group, those who participated in the intervention:
- Were more likely to be at or above the median in educational attainment or household income
- Were more likely to have continued their education beyond high school
- Reported higher levels of community involvement and volunteerism
- Had fewer symptoms of mental health disorders, and any mental health problems they reported were lower in magnitude
- Had a lower prevalence of sexually transmitted diseases
"A universal intervention for urban elementary schoolchildren, which focused on classroom management and instruction, children’s social competence and parenting practices, positively affected mental health, sexual health and educational and economic achievement 15 years after the intervention ended," the authors conclude.
(Arch Pediatr Adoles Med. 2008;162[12]:1133-1141. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This study was supported by grants from the National Institute on Drug Abuse, the National Institute of Mental Health and the Robert Wood Johnson Foundation. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, December 1, 2008
Media Advisory: To contact Kristin L. Nichol, M.D., M.P.H., M.B.A., call Nick Hanson at 612-624-2449.
FLU VACCINE ASSOCIATED WITH REDUCED ILLNESS, LESS IMPAIRMENT OF ACADEMIC PERFORMANCE AMONG COLLEGE STUDENTS
CHICAGO—College students who are vaccinated against influenza appear less likely to develop flu-like illnesses, require related health care visits or experience impairments in academic performance during flu season, according to a report in the December issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
An estimated 9 percent to 20 percent of college and university students develop illness related to the influenza virus each year, according to background information in the article. "Some reports of influenza outbreaks on college and university campuses have documented even higher rates of illness among the students," the authors write. "Undoubtedly, influenza is common among college and university students, and its prevention might have an important impact on their health and well-being."
Kristin L. Nichol, M.D., M.P.H., M.B.A., and colleagues at the VA Medical Center and University of Minnesota, Minneapolis, studied 12,975 students on two campuses and over four separate flu seasons between 2002 and 2006. Participants completed an initial questionnaire about demographic and health characteristics during October, and then monthly follow-up surveys between November and April regarding influenza-like illnesses and their effects on daily life. Vaccination status was assessed at the last follow-up survey.
Overall, 30.2 percent of the students were vaccinated, and 24.1 percent experienced at least one flu-like illness during flu season. Those who were vaccinated were significantly less likely to develop such an illness than those who were not vaccinated. "Vaccination was also associated with significant reductions in influenza-like illness–associated provider visits, antibiotic use, impaired school performance and numbers of days of missed class, missed work and illness during the influenza seasons," the authors write.
When averaged over all the seasons, flu vaccination was associated with a reduction of one-half day of illnesses, so that one day of illness was prevented for every two students who were vaccinated. In addition, for every 17 students vaccinated, one day of missed class was prevented; 11 vaccinations prevented one day of missed work; and six vaccinations prevented one day spent in bed.
"Current recommendations for the prevention and control of influenza encourage vaccination for all persons 6 months and older who wish to reduce their risk of influenza illness. Our findings highlight the kinds of benefits that could accrue to the nearly 18 million college and university students in this country if they were vaccinated."
(Arch Pediatr Adoles Med. 2008;162[12]:1113-1118. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This was an investigator-initiated study that was supported in part by unrestricted grants from Aventis Pasteur and MedImmune. Dr. Nichol received other research funding from or served as a consultant to Sanofi Pasteur, GlaxoSmithKline, MedImmune, CSL and Novartis. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, December 1, 2008
Media Advisory: To contact Nicole Vogelzangs, M.Sc., e-mail: nicolev{at}ggzba.nl.
SYMPTOMS OF DEPRESSION ASSOCIATED WITH INCREASE IN ABDOMINAL FAT
CHICAGO—Older adults with symptoms of depression appear more likely to gain abdominal fat, but not overall fat, over a five-year period, according to a report in the December issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
About 10 percent to 15 percent of older adults have symptoms of depression, according to background information in the article. "Depression has been associated with the onset of diabetes, cardiovascular disease and cardiac mortality [death]," the authors write. "To better prevent occurrence of these major disabling and life-threatening diseases, more insight into underlying mechanisms relating depression to these disorders is needed."
Nicole Vogelzangs, M.Sc., of VU University Medical Center, Amsterdam, the Netherlands, and colleagues studied 2,088 adults age 70 to 79 years. Participants were screened for depression at the beginning of the study and their overall and abdominal obesity was recorded then and again after five years. Measures of overall obesity included body mass index and body fat percentage, while abdominal obesity was assessed using waist circumference, sagittal diameter (distance between the back and the highest point of the abdomen) and visceral fat (fat between the internal organs) measured by computed tomography.
At the beginning of the study, 4 percent of participants had depression. After adjusting for sociodemographic and other characteristics associated with weight changes, depression was associated with an increase in sagittal diameter and visceral fat over five years. "Such an association was not found for an increase in overall obesity and also appeared to be independent of changes in overall obesity, suggesting that depressive symptoms are rather specifically associated with fat gain in the visceral region," the authors write.
There are several mechanisms by which depression might increase abdominal fat, they note. Chronic stress and depression may activate certain brain areas and lead to increased levels of the hormone cortisol, which promotes the accumulation of visceral fat. Individuals with depression may have unhealthier lifestyles, including a poor diet, that could interact with other physiological factors to produce an increase in abdominal obesity.
"Our longitudinal results suggest that clinically relevant depressive symptoms give rise to an increase in abdominal obesity, in particular visceral fat, which seems to be stronger than and independent of overall obesity," the authors conclude. "This could also help explain why depression is often followed by diabetes or cardiovascular disease. Future research should further disentangle these mechanisms because this will yield important information for prevention or treatment of depression-related health consequences."
(Arch Gen Psychiatry. 2008;65[12]:1386-1393. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: This study was supported by contracts from the National Institute on Aging, a travel grant from the Young Academy of the Royal Netherlands and in part by the Intramural Research Program of the National Institutes of Health, NIA. Data analyses were supported by a grant from the National Heart, Lung, and Blood Institute. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, December 1, 2008
Media Advisory: To contact senior author Mark Olfson, M.D., M.P.H., call Elizabeth Streich at 212-305-6535.
PSYCHIATRIC DISORDERS COMMON AMONG COLLEGE-AGE INDIVIDUALS; FEW SEEK TREATMENT
CHICAGO—Psychiatric disorders appear to be common among 18- to 24-year-olds, with overall rates similar among those attending or not attending college, according to a report in the December issue of Archives of General Psychiatry, one of the JAMA/Archives journals. Almost half of college-aged individuals meet criteria for substance abuse, personality disorders or another mental health condition during a one-year period, but only one-fourth of those seek treatment.
Recent tragic events at U.S. universities have called attention to the mental health needs of young adults, according to background information in the article. "For many, young adulthood is characterized by the pursuit of greater educational opportunities and employment prospects, development of personal relationships and, for some, parenthood," the authors write. "While all of these circumstances offer opportunities for growth, they may also result in stress that precipitates the onset or recurrence of psychiatric disorders."
Approximately one-half of Americans age 18 to 24 are enrolled in college at least part-time. To compare their mental health to that of individuals the same age not enrolled in college, Carlos Blanco, M.D., Ph.D., of the New York State Psychiatric Institute and Columbia University, New York, and colleagues analyzed data from the National Epidemiologic Survey on Alcohol and Related Conditions. In this national survey, individuals age 19 to 25 who were attending (2,188) or not attending (2,904) college during the previous year were interviewed and assessed for psychiatric disorders between 2001 and 2002.
A total of 45.8 percent of college students and 47.7 percent of young adults not in college met the criteria for at least one psychiatric disorder. The most common disorders in college students were alcohol use disorders (20.4 percent) and personality disorders (17.7 percent), whereas those not in college most frequently met criteria for personality disorders (21.6 percent) and nicotine dependence (20.7 percent). College students were less likely to have a diagnosis of drug use disorder, nicotine dependence or bipolar disorder and were less likely to have used tobacco. However, their risk of alcohol use disorders was significantly greater.
Treatment rates were low for all psychiatric disorders. College students were significantly less likely to receive treatment for alcohol or drug use disorders than those not in college. "In view of the high prevalence and low rate of treatment of alcohol use disorders in college students, greater efforts to implement screening and intervention programs on college and university campuses are warranted," the authors write. "The centralized delivery of campus student health services might offer an advantageous structure for carrying out such screening and interventions."
Overall, the authors note, the rate of psychiatric disorders is high among young adults, who are at a vulnerable stage of development. "The vast majority of disorders in this population can be effectively treated with evidence-based psychosocial and pharmacological approaches," they conclude. "Early treatment could reduce the persistence of these disorders and their associated functional impairment, loss of productivity and increased health care costs. As these young people represent our nation’s future, urgent action is needed to increase detection and treatment of psychiatric disorders among college students and their non–college-attending peers."
(Arch Gen Psychiatry. 2008;65[12]:1429-1437. Available to the media pre-embargo at www.jamamedia.org).
Editor's Note: The National Epidemiologic Survey on Alcohol and Related Conditions was sponsored by the National Institute on Alcohol Abuse and Alcoholism and funded in part by the Intermural Program, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health. This study is supported by grants from the National Institutes of Health, by the American Foundation for Suicide Prevention and by the New York State Psychiatric Institute. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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