Safety

Consciously Supporting Concussion Awareness

In recent years, public interest has increased surrounding concussions/mild traumatic brain injuries (MTBI). This is due in large part to the recent hypothesis that concussive forces from contact sports may be a risk factor for the development of chronic traumatic encephalopathy (CTE), a disease seen most often in former boxers and professional football players.

Research, legislation, and documentaries have sought to better define the incidence and risks of concussions, its relationship to these 2 diseases, and to increase public awareness of this issue. Currently, legislation is pending in both the U.S. House of Representatives and the Senate that has the potential to further achieve these goals by increasing general awareness about concussions and giving parents and youth the ability to make informed decisions about the sports in which they participate. We as pediatricians can advocate for the safety of our patients by contacting our local representatives and asking them to become cosponsors for the “SAFE PLAY Act” (H.R. 829).

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Binge Drinking in Adolescents, a Pediatrician’s Role.

Adolescence is a period of limit testing in which children and young adults are at increased risk of substance abuse. The most frequently used substance by adolescents is alcohol.  Adolescents who drink alcohol have an increased rate of binge drinking compared to adults. Adolescent alcohol abuse is associated with an increased risk of chronic alcohol abuse leading to serious illnesses as adults. Also, alcohol use can be associated with the leading causes of death and serious injury in ages 15 to 24 (unintentional injury, homicide, suicide).

The AAP Committee on Substance Abuse recently released a Clinical Report titled Binge Drinking (http://pediatrics.aappublications.org/content/136/3/e718.full). In the report, binge drinking is defined and characterized, risk factors are discussed, and neurobiology is addressed.  The authors provide screening guidance for pediatricians.   The report explains that at age 9, children start having positive feelings about alcohol and start thinking that alcohol may not be just for adults. This means that ages 9-15 is a critical period for screening and intervention.   The report recommends that pediatricians should screen every patient for alcohol use starting at age 9.

The NIAAA collaborated with the AAP to develop a quick two-question screening tool that varies by the  patient’s age.  The questions focus about asking the patient about their own alcohol usage and their friend’s alcohol usage.

Here is an image summarizing the screening tool:

Screen Shot 2015-09-30 at 4.29.54 PM
In addition to screening patients, pediatricians can support the Sober Truth on Preventing (STOP) Underage Drinking Reauthorization Act (H.R. 1717, S. 728).
This bill will reauthorize an act targeted at reducing underage drinking through research, a highly-visible national media campaign, and grants to public health care providers/community organizations/ and partnerships with higher education institutions.
( https://www.congress.gov/bill/114th-congress/house-bill/1717?q={%22search%22%3A[%22sober+truth%22]}&resultIndex=1 )

What YOU can do:

  • Educate yourself about alcohol use in adolescents and it’s health effects.
  • Screen every patient starting at age 9 for alcohol use; intervene as necessary.
  • Talk to your patients and their parents about alcohol-related risks.
  • Contact your federal representatives and ask them to co-sponsor and support  the Reauthorization of the STOP Act.

 

Sources and Resources:
AAP Clinical Report, Binge Drinking. http://pediatrics.aappublications.org/content/136/3/e718.full
http://pubs.niaaa.nih.gov/publications/Practitioner/YouthGuide/YouthGuideOrderForm.htm
http://www.niaaa.nih.gov/alcohol-health/special-populations-co-occurring-disorders/underage-drinking
http://www.stopalcoholabuse.gov/Default.aspx
http://www.samhsa.gov/underage-drinking

https://www.congress.gov/bill/114th-congress/house-bill/1717?q=%22search%22%3A%5B%22sober+truth%22%5D&resultIndex=1)

Paul Teran, MD

How should the FDA regulate E-Cigarettes and other tobacco products? Comments due 8/31/2015

The Food and Drug Administration published an advance notice of proposed rulemaking in July 2015 seeking public input for the regulation of e-cigarettes and novel tobacco products (i.e. dissolvables, lotions, gels, and drinks). Currently, the FDA regulates cigarettes, cigarette tobacco, roll-your-own tobacco and smokeless tobacco. The FDA is considering extending its regulations to cover e-cigarettes and other novel tobacco products.

The agency is asking for specific information as it considers an expanded regulation, and it asks for comments on two general areas:

1) What health advisory warnings, if any, should be displayed on e-cigarettes and novel tobacco products? Should pictures be included?

2) Should the FDA require child-resistant packaging for liquid nicotine and other products?

 

You can read the full Advance notice of proposed rulemaking here: https://www.federalregister.gov/articles/2015/07/01/2015-16151/nicotine-exposure-warnings-and-child-resistant-packaging-for-liquid-nicotine-nicotine-containing#page-37556

-or-

http://www.regulations.gov/#!documentDetail;D=FDA-2015-N-1514-0001

 

How can you make your voice heard?

The notice has numbered questions for both areas of concerns, which you can address in your comments. Comments can be submitted electronically and via regular mail until August 31, 2015. Make sure to include Docket No FDA-2015-N-1514 in your letter.

 

Sources:

https://www.federalregister.gov/articles/2015/07/01/2015-16151/nicotine-exposure-warnings-and-child-resistant-packaging-for-liquid-nicotine-nicotine-containing#page-37556

https://www.federalregister.gov/articles/2014/04/25/2014-09491/deeming-tobacco-products-to-be-subject-to-the-federal-food-drug-and-cosmetic-act-as-amended-by-the

 

Fariha Hussain, M.D.

Child Trafficking: A Public Health Concern

Human trafficking is not only a global issue, but also a major public health concern within the United States. Studies suggest that up to half of trafficking victims seek medical attention at least once during their trafficking situation. This represents a large, often-missed opportunity for healthcare professionals to intervene. The injustices of human trafficking include forced labor, involuntary servitude, child soldiers, and sex trafficking. Some estimate that over 20 million men, women, and children are victims of human trafficking worldwide. [1] However, the scope of the problem is difficult to quantify, given the covert nature of the crime. The U.S. government no longer includes official estimates in its annual “Trafficking in Persons” reports. In 2004, the Department of Justice estimated that 14,500-17,500 trafficking victims were brought to the U.S. each year. [2] In addition to the victims brought illegally to this country, another 300,000+ youth within the U.S. are thought to be at risk of exploitation. [3]  As many as 80% of trafficking victims are female, and one-third to one-half are minors. [4] Cases of child trafficking have been confirmed in all 50 U.S. states over the last decade. [3]

Here’s what pediatricians can do to help: (more…)

Update: Firearm Injuries and Deaths in Children and Adolescents – A Call to Action

Dr. Nancy Kelly authored a policy brief on July 15, 2014 emphasizing the importance of family counseling and legislative advocacy in preventing pediatric injury and death from firearms. Since then, the American Academy of Pediatricians (AAP) has updated their recommendations regarding keeping our children safe from gun violence. Additionally, new bills have been filed for consideration during the 84th meeting of the Texas Legislature that have the power to impact pediatricians and their patients positively or negatively. Recent tragic events in Boston shed light on the need for increased firearm regulations, especially in health care settings.

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Please support the extension of Medicaid and CHIP funding

Medicaid and CHIP are essential to children’s healthcare in the United States. It is critical that we continue to fund both of these programs to ensure that our nation’s children continue to receive well child care from their primary care provider.  Well child care includes routine visits for vaccinations, ongoing surveillance visits for chronic health conditions, or yearly “check-ups.” (more…)

Protecting Our Children from Accidental Liquid Nicotine Exposure

E-Cigarettes are quickly rising in popularity and becoming a more common household item. The liquid nicotine containers used to refill e-cigarettes are particularly dangerous to children. Ingestion or even absorption through the skin can produce very serious and potentially fatal effects. Currently there are no laws regulating child-proof packaging of liquid nicotine for E-cigarette use. We need to protect our children from accidental nicotine poisonings by supporting the Child Nicotine Poisoning Prevention Act which will require child-resistant packaging of liquid nicotine. (more…)

Improving the Safety of Child Frame Carriers

The attraction and desire to maintain an active lifestyle even as a parent has led to the development of child care products designed to be an effective mode to transport a child and to allow the parents to continue their favorite activities. However, not all of these products offer the highest level of safety for children. (more…)

Reforming Foster Care in Texas

In the wake of the tragic news that 2 Texas children drowned at Lake Georgetown earlier this month while in the care of their foster family, Texans Care for Children, an organization focused on public policies impacting children, has renewed its call for reform within the Foster Care system and Child Protective Services (CPS). In addition to advocating for higher standards in the foster family screening and training process, improvements in the role CPS plays within the system remains a core issue for the safety of these vulnerable children. (more…)

Firearm Injuries and Deaths in Children and Adolescents – A Call to Action

Just as pediatricians discuss poison prevention or using car safety restraints, we must also counsel patient-families on prevention of firearm-related injuries and deaths.  Pediatricians are in a unique position to provide anticipatory guidance to families about ways to keep children safe from firearms, particularly in light of the threat which children face from guns.   (more…)