Ann Arbor, U.S.A. – Most U.S. adults support laws that allow teens to get medical care for sexually transmitted infections without parental consent. But when asked about the vaccine against the human papilloma virus (HPV), most adults want parents to have the final say on whether their teen or pre-teen gets the shots.

The University of Michigan C.S. Mott Children’s Hospital National Poll on Children’s Health recently asked a national sample of adults about allowing adolescents age 12 to 17 years old to receive the HPV vaccinations without parental consent.

Only 45 percent of those polled would support state laws allowing the HPV vaccination without parental consent.

“But in contrast, 57 percent say they support teens being able to get medical care for prevention of sexually transmitted infections and 55 percent for treatment, all without parental consent,” says Sarah Clark, M.P.H., Associate Director of the Child Health Evaluation and Research (CHEAR) Unit at the University of Michigan and Associate Director of the National Poll on Children’s Health.

In the short term, the HPV vaccine protects against genital warts, one of the most common types of sexually transmitted infection. In the long term, the vaccine prevents development of cervical cancer in females and some head and neck cancers in men.

Routine HPV vaccination is recommended for males and females at 11-12 years of age. The vaccine is most effective if administered before the onset of sexual activity.

“That presents a challenge. Parents aren’t thinking their 11 or 12 year-old child is ready for sexual activity at that age,” Clark says. “Many parents ask to delay the vaccine until their child is a little older. But older teens go to the doctor much less than younger adolescents, and often they go without a parent.”

Public health officials have considered pushing laws that would drop the need for parental consent, in order to boost HPV vaccination rates.

“But in this poll, most agreed they are reluctant to support dropping parental consent, even though 74 percent agreed that getting vaccines is a good way to protect adolescents from disease,” Clark says.

Those who did not support dropping parental consent were asked about their reasons. The most common reason, cited by 86 percent, was that HPV should be a parent’s decision; 43 percent cited the risk of side effects of the vaccine. About 40 percent said they have moral or ethical concerns about the vaccine.

The support for state laws that would allow HPV vaccination without parental consent was not different between parents and non-parents.

“These poll results show the majority of adults view HPV vaccination as distinct from sexually transmitted infection prevention and are reluctant to support taking away parental consent,” Clark says.

“Policymakers and public health officials interested in changing parental consent rules should consider this data and provide education to ensure adults understand the importance of HPV vaccination as a form of prevention against sexually transmitted infections.”

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Ann Arbor, U.S.A. – A new free app developed at the University of Michigan Health System allows users to create a photographic baseline of their skin and photograph suspicious moles or other skin lesions, walking users step-by-step through a skin self-exam. The app, UMSkinCheck, sends automatic reminders so users can monitor changes to a skin lesion over time, and provides pictures of various types of skin cancers for comparisons. The app is designed for iPhone and iPad and is available to download on iTunes.

“Whole body photography is a well-established resource for following patients at risk for melanoma. However, it requires a professional photographer, is not always covered by insurance, and can be an inconvenience. Now that many people have digital cameras on their phones, it’s more feasible to do this at home,” says Michael Sabel, M.D., associate professor of surgery at the U-M Medical School, who was the lead physician involved in developing the app.

More than 2 million Americans are diagnosed with skin cancer each year, and some 50,000 will be diagnosed with melanoma, the most serious kind. Regular skin checks can help people discover melanoma in its earliest stages.

The app, a collaboration of the University of Michigan’s technology and clinical expertise, guides users through a series of 23 photos, covering the body from head to toe. Photos are stored within the app and serve as a baseline for future comparisons. The app will create a reminder to repeat a skin self-exam on a regular basis.

If a mole appears to be changing or growing, the photos can then be shared with a dermatologist to help determine whether a biopsy is necessary.

“We recommend skin self-exams for everyone in order to detect skin cancer at the earliest stages, when treatment is less invasive and more successful. If you have fair skin or burn easily, have had sunburns in the past or used tanning beds, or have a family history of melanoma, you are considered high-risk, and so it’s even more important,” Sabel says.

Not sure if you’re at high risk of skin cancer? The app includes a risk calculator that allows you to input your personal data to calculate your individual risk.

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New York, U.S.A – A balanced and healthy diet is crucial to good health and overcoming stress. In his forthcoming book called entitled Stress Pandemic, lifestyle and stress expert Paul Huljich shares a simple and holistic approach to nutrition, paying added attention to the effects of what we eat on our neurochemistry.

“Ensuring that we are supporting a healthy neurochemical balance is a vital and proactive step toward managing our stress,” Hulijch asserts. “When you feel tense, stress eating or emotional-eating is triggered like an automatic response. That’s especially so if your body reacts strongly to stress-released hormones.”

A 2010 study from the University of Michigan showed that when levels of the stress hormone cortisol were boosted in healthy, non-stressed adults, they ate more junk food. When people feel stressed out, most either stop eating altogether or binge on high-fat, high-sodium products such as chocolate, doughnuts, potato chips and other snack foods. And when combined with America’s growing portion sizes, people grow sicker, gain weight and develop bad habits that can endure a lifetime unless they say “NO” and take charge of what and how they eat.

Bad eating habits start young so where else to begin teaching kids about good nutrition outside of home but in this nation’s schools?  Thankfully, people like Michelle Obama are championing this crusade. Hoping to combat the growing problem of childhood obesity, the Obama administration recently announced its long-awaited changes to government-subsidized school meals, a final round of rules that adds more fruits and green vegetables to breakfasts and lunches and reduces the amount of salt and fat.

“As parents, we try to prepare decent meals, limit how much junk food our kids eat and ensure that they have a reasonable balanced diet,” Mrs. Obama said in a statement. “And when we are putting in all that effort the last thing we want is for our hard work to be undone each day in the school cafeteria.”

About 32 million children participate in school meal programs each day. The new rules are a major component of Mrs. Obama’s campaign to reduce the number of overweight children through exercise and better nutrition. The announcement came months after the food industry won a vote in Congress to block the administration from carrying out an earlier proposal.

“Children born in the year 2000 or later are not expected to outlive their parents,” stated Dr. David Katzof the Yale Preventive Medicine Research Center at a nutrition conference in April. Why are our kids so sick? One reason is that they eat too much bad food.  In March of last year, Dr. Katz quoted in a Wall Street Journal article that a “poor diet in kids is more dangerous than alcohol, drugs, and tobacco combined!”

If you can believe it, the top 3 foods consumed in America are hot dogs, white bread and coffee. And the marketing industry is capitalizing on our society’s obsession with eating junk food, evidenced by an announcement made last week by 7-Eleven, the nation’s largest convenience chain, of a low-cal line of Slurpees! The move comes at a time when companies have been marketing everything from “Spam Lite” to “skinny cocktails” aimed at calorie-conscious consumers.

Huljich believes that as a society we must revolutionize the ways in which we eat beginning with cutting out all the C-R-A-P (an acronym for coffee, refined food, alcohol and processed food). He also does not endorse the use of fad diets, counting calories or choosing to eat certain food groups over others.

His approach to a healthy diet, which is outlined in detail in his forthcoming book Stress Pandemic, is a balanced and practical one, which first identifies and bases his diet on the good foods and eating patterns in your life while eliminating the bad ones. “The human body is designed to thrive on a variety of foods therefore I feel a more holistic approach to diet is far more effective and supportive to overall health and well-being than any of those revolving popular diet fads can ever be,”  Huljich states.

“When you go on a fad diet and exclude any of the necessary nutrients, you’re putting yourself at risk for illness.” It is precisely as Gary Taubes warned in Newsweek’s recent cover story “The government has spent hundreds of millions telling Americans to exercise more and eat less. But the country is getting heavier every year. It’s time to change the way we think about fat.”

A balanced eating plan supports all of the body’s functions so that it can absorb and use nutrients efficiently and effectively. Health maintenance promotes physical fitness and disease prevention such as the risk for heart disease, heart attack, stroke, type 2 diabetes and some forms of cancer.

America is a nation trying to find a cure yet not looking closely enough at the symptoms. By finding the courage to and wisdom to look at the root cause and going back to basics, individuals can learn how to master stress and live longer and healthier lives.

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New York, U.S.A. – New, nationally projectable survey results released by The Partnership at Drugfree.org and MetLife Foundation found that past-month marijuana use – particularly heavy use – has increased significantly among U.S. high school students since 2008.

The Partnership Attitude Tracking Study, sponsored by MetLife Foundation, found that 9% of teens (nearly 1.5 million) smoked marijuana heavily at least 20 times. Overall, past-month heavy marijuana use is up 80% among U.S. teens since 2008.

Past-month use is up 42% (up from 19% in 2008 to 27% in 2011, which translates to about 4 million teens), while past-year use is up 26% (up from 31% in 2008 to 39% in 2011, which translates to about 6 million teens). Lifetime use is up 21% (up from 39% in 2008 to 47% in 2011, which translates to nearly 8 million teens).

This marks an upward trend in teen marijuana use over the past three years. The last time marijuana use was this widespread among teens was in 1998 when past month use of marijuana was at 27%.

“These findings are deeply disturbing as the increases we’re seeing in heavy, regular marijuana use among high school students can spell real trouble for these teens later on,” said Steve Pasierb, President and CEO of The Partnership at Drugfree.org.

“Heavy use of marijuana – particularly beginning in adolescence – brings the risk of serious problems and our data show it is linked to involvement with alcohol and other drugs as well. Kids who begin using drugs or alcohol as teenagers are more likely to struggle with substance use disorders when compared to those who start using after the teenage years.”

Teen Marijuana Use Has Become a Normalized Behaviour

Teens now report seeing more of their peers smoking marijuana and only 26% agree with the statement, “in my school, most teens don’t smoke marijuana” (down from 37% in 2008). Also, 71% of teens say they have friends who use marijuana regularly (up from 64 percent in 2008).

Social disapproval of marijuana among teens remained the same, with 61% of teens saying they disapprove of their peers using marijuana. (About 41% say they ‘strongly disapprove’). The PATS data also found an erosion of anti-marijuana attitudes among teens, with only about half of teens (51%) saying they see “great risk” in using marijuana, down significantly from 61% in 2005.

“We have also seen a considerable decline over the past five years in the proportion of teens seeing great risk associated with marijuana use,” says Professor Lloyd Johnston, the principal investigator of the nationwide Monitoring the Future study conducted at the University of Michigan. “We believe that this decline in perceived risk has played an important role in the increases in teen use of marijuana, as it has done in the past. The fact that perceived risk is still falling portends a further increase in use.”

As teen drug use takes a turn for the worse, a heavier burden is placed on the shoulders of parents to play a more active role in protecting their kids from the health risks posed by drug and alcohol abuse.

The removal of critical pieces of our national prevention infrastructure across the country – The National Youth Anti-Drug Media Campaign, which was highly focused on educating youth about the dangers of teen marijuana use, and the elimination of the Safe and Drug-Free Schools Program – left a gaping hole where drug and alcohol education resources should be.

“The latest findings showing an increase in marijuana use among teens is unsettling and should serve as a wake-up call to everyone in a position to prevent unhealthy behavior,” said Dennis White, President and CEO of MetLife Foundation. “While it may be difficult to clearly understand just how dangerous marijuana use can be for teens, it is imperative that we all pay attention to the warning signs and intervene anyway we can. Early intervention is critical to helping prevent teens from drug abuse and addiction.”

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Most parents report that they typically require their child to use a life-saving booster seat, but more than 30 percent said they do not enforce this rule when their child is riding with another driver.

The study, conducted by child health experts at University of Michigan’s C.S. Mott Children’s Hospital, also revealed that 45 percent of parents do not require their kids to use a booster when driving other children who do not have one.

“The majority of parents reported that their children between the ages of four and eight use a safety seat when riding in the family car,” says Michelle Macy, M.D., M.S., a clinical lecturer of emergency medicine at the University of Michigan Medical School and a pediatrician at U-M C.S. Mott Children’s Hospital. “However, it’s alarming to know that close to 70 percent of parents carpool, and when they do, they’re often failing to use life-saving booster seats.”

Researchers believe practical barriers, including limited vehicle space and difficulties making arrangements with other drivers, lead parents to abandon safety seats when carpooling.

Most state laws require children to use a booster seat, many until children are 8 years old. National recommendations encourage the use of booster seats until a child reaches 57 inches, which is the average height of an 11-year-old.

Placing a child in an adult seat belt prematurely can cause shoulder and lap belts to fit improperly, negating the life-saving benefits of seatbelts.  Click here to see the Insurance Institute for Highway Safety’s recommendations as to how seat belts should fit.

“Therefore, parents who do not consistently use booster seats for kids who are shorter than 57 inches tall are placing children at greater risk of injury,” says Macy. “Parents need to understand the importance of using a booster seat for every child who does not fit properly in an adult seat belt on every trip.”

Study authors suggest that social norms may be set by state booster seat laws, as parents are motivated to follow guidelines set forth by law.  State booster seat laws were associated with higher safety seat use, regardless of carpooling, even though half of parents surveyed admit to not knowing the age cited in their state booster seat law and another 20 percent guessed incorrectly.

“According to current recommendations most children should be using booster seats beyond the age cited in state laws.  As many parents may not even be aware of current booster seat recommendations, pediatricians should make it a priority to share this vital information with them,” says Macy.

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Researchers at the University of Michigan Health System have found a new indicator that may predict which patients with a common type of throat cancer are most likely have the cancer spread to other parts of their bodies.

Patients with oropharyngeal squamous cell carcinoma who had “matted” lymph nodes – nodes that are connected together – had a 69 percent survival rate over three years, compared to 94 percent for patients without matted nodes, according to a study published online ahead of print publication in Head & Neck.

The oropharynx is an area that includes the back of the tongue, soft palate, throat and tonsils. ”The spread of cancer throughout the body accounts for about 45 percent of the deaths from oropharyngeal carcinoma,” says the study’s senior author, Douglas B. Chepeha, M.D., M.S.P.H., an associate professor of otolaryngology head and neck surgery at the U-M Medical School.

“Our findings may help doctors identify patients who are at higher risk for having their cancer metastasize and who would benefit from additional systemic therapy. Conversely, some patients without matted nodes may benefit from a reduction of the current standard treatment, which would cut down on uncomfortable side effects.”

Notably, the findings indicate an increased risk independent of other established prognostic factors, such as the patient’s history of smoking or whether they have the Human papillomavirus (HPV), the study found. Smoking (tobacco and marijuana), heavy alcohol use and HPV infection have each been linked to the development of oropharyngeal squamous cell carcinoma.

Matted nodes appear to be an especially strong indicator of increased risk among patients who are HPV-positive, even though HPV-positive patients had better overall outcomes than their HPV-negative peers. The patients with the best outcomes were HPV-positive non-smokers.

“It’s not clear why we’re finding these survival differences for patients who have matted nodes,” says study lead author Matthew E. Spector, M.D., a head and neck surgery resident at U-M who won a national award from the American Head and Neck Society for this work. “It is possible that there are biological and molecular differences in these types of tumors, which can be explored in future research.”

The results affirm the value of having a team of doctors and researchers from different specialties, radiology, oncology, biostatistics and surgery, working together to find advances that can directly benefit patients, Chepeha says. “This was a collaborative effort and all of the authors made important contributions,” he adds.

The study tracked 78 cancer patients who were part of a clinical trial evaluating two cancer drugs in combination with intensity-modulated radiation therapy. All the patients had stage III or IV squamous cell carcinoma of the oropharynx and had not had any previous treatment. Sixteen of the 78 patients had matted nodes.

“It’s significant that we’ve identified this new marker that can help us predict which patients have worse survival odds,” Chepeha says. “Now we need to go one step further and figure out what mechanisms are at work and how we can use this knowledge to improve survival rates.”

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According to a study published by the National Institutes of Health conducted by doctors at the University of Michigan, one in two women of childbearing age in the United States is considered overweight or obese.

Weight-related complications during pregnancy are commonplace and healthcare providers are trying to dismiss the idea that pregnant women need to “eat for two” by doubling their caloric intake. Working with a healthcare provider, overweight women who are pregnant or trying to become pregnant can find a strategy to a healthy weight gain that works for them.

Increased risk of developing gestational diabetes is a crucial reason for overweight women to closely monitor how much weight they gain during pregnancy. Gestation diabetes causes the hormones released from the placenta, the baby’s support system, to be blocked by the woman’s body.

The result is that her body is unable to process insulin. High blood glucose levels build in the mother’s system and stream to the baby through the placenta causing the baby to grow rapidly and gain unnecessary weight.

Overweight pregnant women are also at risk of developing high blood pressure. This condition tightens the blood vessels in the uterus that supplies the baby with oxygen and nutrients. It also puts the mother at risk for having a heart attack or stroke resulting in a greater likelihood that she will deliver her baby early.

Having regular checkups before becoming pregnant may help prevent obesity related complication during pregnancy. The March of Dimes recommends, “If you’re overweight or obese, your health care provider or a registered dietitian can help you lose pounds so that you reach a healthier weight before trying to get pregnant. They will talk with you about exercise and eating healthy.”

What is the correct amount of weight gain? The amount a woman’s health care provider recommends will depend on her pre-pregnancy weight. If she has a normal weight and a body mass index (BMI) in the normal range (between 18.5 and 25) then she should gain between 25 and 35 pounds.

Underweight women, with a BMI less than 18.5, should try to gain between 28 to 40 pounds. Overweight women, with a BMI between 25 and 29.9, should gain between 15 to 25 pounds and obese women, those with a BMI greater than 30, should limit their weight gain to between 11 and 20 pounds.

Women who are overweight or obese should not intentionally try to lose weight while they are pregnant however it is not uncommon for plus-sized women to lose weight while pregnant without dieting. Morning sickness can contribute to weight loss because its diminished affect on appetite and associated vomiting can cause a loss of calories.

Even so, a developing baby will still get nourishment if a mother is not dieting because overweight women have an extra reserve of calories stored in fat.

Healthy eating should be a goal of every pregnant woman, regardless of her pre-pregnancy weight. Setting a goal for how much weigh to gain with a health care provider is the key to ensuring a successful, healthy pregnancy.

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