Health and Happiness

Treating Fractures: Children Are Not Miniature Adults

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Treating fractures in children requires special knowledge of growth physiology. Incorrect treatment of bone fractures in child and adolescent patients is less often caused by technical deficiencies than by a misjudgment of the special conditions in this age group. Using the example of treating fractures of the upper limb, Ralf Kraus from the Marburg-Gießen University Medical Center, and Lucas Wessel, University Medical Center Mannheim, report in the current issue of Deutsches Arzteblatt International what should be borne in mind when diagnosing and treating fractures in children, and providing aftercare. They point out possible therapeutic errors and outline strategies to avoid these (Dtsch Arztebl Int 2010; 107(51-52): 903-910).

Typical causes of therapeutic errors include imprecise diagnostic evaluation, misinterpretation of the radiograph, conservative or surgical treatment that is inappropriate for the fracture pattern, and lacking or insufficient follow-up.

In the authors' opinion, treating fractures to a sufficient degree and in a manner that is appropriate for pediatric patients should start with administering immediate adequate analgesia. Establishing a growth prognosis is a crucial component of subsequent treatment. The aim is to restore mobility as quickly as possible and to avoid sequelae in the form of impaired mobility and growth impairments. A pediatric trauma specialist should be in possession of the full range of conservative and surgical measures and should be able to use these as appropriate for the indication.

Dr. Ralf Kraus
Deutsches Aerzteblatt International


Malicious Gossip on School Playgrounds Reduced by Anti-Bullying Program

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Elementary school students who participated in a three-month anti-bullying program in Seattle schools showed a 72 percent decrease in malicious gossip.

The study, led by the University of Washington, is the first to show that the widely-used Steps to Respect bullying prevention program can curb children's gossip, an element of playground culture often seen as harmless but capable of causing real harm.

"Gossip is an element of bullying, and it can lead to physical bullying," said Karin Frey, a UW research associate professor of educational psychology. "Kids will tell you that gossip is just as painful as physical bullying."

But teachers tend to not view gossip as a significant form of bullying, Frey said. Since gossip can lead to physical bullying, she and her collaborators investigated whether the program would help suppress teasing, name-calling, rumor-spreading and other ostracizing chitchat.

The study, published in the winter issue of School Psychology Review, showed that having supportive friends and not choosing retaliation when victimized by malicious gossip helped participants in the program avoid further victimization.

Researchers used Palm Pilots to electronically record second-by-second observations of 610 students in grades 3-6 at six elementary schools in the Seattle area. Researchers recorded each child's behavior on the playground for five minutes once a week for 10 weeks in the fall and 10 weeks in the spring.

"Gossip is surprisingly visible, because you have to have more than one person, and it can last awhile," said Frey, who led development of the Steps to Respect program in 2000. "Is the cootie girl in your class?" and "Did you hear Dan cheated?" are two examples of children's gossip Frey and her co-authors mention in their paper.

Not all gossip is strictly behind the back, though. The researchers also found that sometimes gossips will huddle together and clearly talk about a victim. "Without speaking loudly enough that others will know what they are saying, they'll point and look at the person they're gossiping about," Frey said.

After observers heard gossip on the playground in the fall, the anti-bullying program began in half of the 36 classrooms. During three months, teachers taught Steps to Respect lesson plans that encouraged empathy, taught assertiveness and emphasized that bullying is not a social norm.

In a questionnaire for students, the researchers measured two factors that influence bullying: beliefs about fighting back against bullies and having supportive friends.

When students' playground gossip was observed in the spring, children in the Steps to Respect classrooms had 234 fewer instances of gossip per class of 25, or a 72 percent decrease in gossip among students who had gossiped before participating in the anti-bullying program.

"Gossip is still there, but it's better," Frey said. "That's going to make a difference in the life of a child."

Kids may mistakenly subscribe to the "don't get mad, get even," philosophy. But since victims who retaliate often end up bullied even more, Steps to Respect teaches kids to not fight back. Frey and her co-authors found that gossip victims in the fall who went through Steps to Respect in the winter were less likely to believe in retaliation as a response to bullying, and more likely to avoid being a victim of gossip in the spring.

Having supportive friends also helped gossip victims. "Maybe friends use their assertiveness skills and say, 'Come on, let's go,'" Frey said.

Frey said that bystanders are really important in decreasing gossip and bullying, but many times bystanders feel uncomfortable and don't know what to do. Bystanders' silence can give a lot of power to bullies, but if bystanders speak up, the bullying stops.

"Stand up straight, look the bully in the eye, and say 'knock it off,'" Frey said. Friends who encourage victims to retaliate, on the other hand, may inadvertently set victims up for continued bullying, she said.

Co-authors of the paper are Sabina Low, assistant professor of psychology at Wichita State University, and Callie Brockman, graduate student in clinical psychology at Wichita State University.

Molly McElroy
University of Washington


Eat Less Salt

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Everyone is familiar with the typical health resolutions of eating less and exercising more, but "eating less salt" should top the list. This small step is a big change Americans can make—and stick to—that can help them lead more heart-healthy lives. Nine in 10 Americans eat too much salt, and it's driving up their blood pressure, which can lead to heart attack and stroke. In fact, nearly 400,000 deaths each year are attributed to high blood pressure, and decreasing sodium intake could prevent thousands of deaths annually. By resolving to eat more fresh fruits and vegetables and compare food labels to find low-sodium options, consumers can help reverse this deadly trend.

    * The 2005 Dietary Guidelines for Americans recommend limiting sodium to less than 2,300 milligrams per day (about 1 teaspoon of table salt).
    * However, individuals with hypertension, blacks, and middle-aged and older adults—70 percent of the adult population—should limit intake to 1,500 mg of sodium per day.
    * The majority of Americans regularly eat more than twice the recommended daily limit of sodium every day.
    * 1 in 3 Americans has high blood pressure, and most don't realize it. More than half of adults with high blood pressure—35 million—do not have the condition under control.
    * High blood pressure is the leading cause of heart disease and stroke, the first and fourth most common causes of death in the United States.
    * When salt intake is reduced, blood pressure begins decreasing within weeks on average.

For more information, visit http://www.cdc.gov/salt/.


The Sustainable Marriage

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Researchers are studying how people sustain their relationships by using it to accumulate knowledge and new experiences, a process called “self-expansion.” These studies show that the more self-expansion a person experiences through their partner, the more satisfied and committed they are to the relationship.

To learn more about the science of sustainable relationships, read the full article, “The Happy Marriage Is the ‘Me’ Marriage.”

And to learn more about your own relationship, take the quiz below to measure how much the relationship expands your knowledge and how good it makes you feel about yourself. The quiz was developed by Gary W. Lewandowski Jr., associate psychology professor at Monmouth University in New Jersey.

Answer each question according to the way you feel, using the following scale: answers range from (1) not very much to (7) very much. Then, add up your scores and check the scale below to see how your own relationship ranks.
                                                                                                          Not Very Much…Very Much

1. How much does being with your partner result in your                                      1 2 3 4 5 6 7
    having new experiences?
2. When you are with your partner, do you feel a greater                                     1 2 3 4 5 6 7
    awareness of things because of him or her?
3. How much does your partner increase your ability to                                         1 2 3 4 5 6 7
    accomplish new things?
4. How much does your partner help to expand your                                            1 2 3 4 5 6 7
    sense of the kind of person you are?
5. How much do you see your partner as a way to                                               1 2 3 4 5 6 7
    expand your own capabilities?
6. How much do your partner’s strengths as a person                                           1 2 3 4 5 6 7
   (skills, abilities, etc.) compensate for some of your own weaknesses as a person?
7. How much do you feel that you have a larger perspective                                  1 2 3 4 5 6 7
    on things because of your partner?
8. How much has being with your partner resulted in your                                      1 2 3 4 5 6 7
    learning new things?
9. How much has knowing your partner made you a better                                    1 2 3 4 5 6 7
10. How much does your partner increase your knowledge?                                   1 2 3 4 5 6 7


60 and above — Highly Expansive. You are gaining a lot of new experiences and reaching new goals as a result of your relationship. Chances are you have a happier, more sustainable relationship as a result.

45 to 60 — Moderately Exciting. Your relationship has led to moderate improvements in your life and some new experiences. But there’s definitely room for improvement.

Below 45 — Low Connection. Your relationship is not creating opportunities that help expand your knowledge and make you feel better about yourself. Make an effort to share new experiences with your partner to improve your relationship.


Mediterranean Diet Associated with Slower Rate Of Cognitive Decline

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The Mediterranean diet, rich in vegetables, fish, and olive oil and moderate in wine and alcohol, is associated with slower rates of cognitive decline in older adults, according to researchers at Rush University Medical Center.

The results are published in the American Journal of Clinical Nutrition.

Included in the study were 3,759 older residents of the South side of Chicago who are part of the Chicago Healthy Aging Project, an ongoing evaluation of cognitive health in adults over the age of 65. Every three years, the study participants, age 65 and older, underwent a cognitive assessment that tested such things as memory and basic math skills. Participants also filled out a questionnaire on the frequency with which they consumed 139 food items ranging from cereals and olive oil to red meat and alcohol.

The researchers then analyzed how closely each of the study participants adhered to a Mediterranean diet, which includes daily consumption of such foods as fruit, vegetables, legumes, olive oil, fish, potatoes and nonrefined cereals, as well as wine.

Out of a maximum score of 55, which would indicate complete adherence to the Mediterranean diet, the average study participant scored 28. Those with the higher scores were also the individuals whose cognitive tests showed a slower rate of decline, even when other factors that might account for the result, such as education level, were considered.

The researchers also analyzed how closely study participants adhered to the Healthy Eating Index 2005, which is based on the recommendations from the 2005 Dietary Guidelines for Americans. Higher scores indicating closer adherence to this index, which gives less weight to fish, legumes and moderate alcohol intake, did not correspond with differences in rates of cognitive decline.

Christy Tangney, PhD, lead author of the study and associate professor of clinical nutrition at Rush University, said that the results add to other studies showing that a Mediterranean diet reduces the risk of heart disease, certain cancers and diabetes.

"The more we can incorporate vegetables, olive oil, and fish into our diets and moderate wine consumption, the better for our aging brains and bodies," Tangney said.

Other researchers at Rush involved in the study were Mary Kwasny, ScD, Hong Li, Robert Wilson, PhD, Dr. Denis Evans, and Martha Clare Morris, ScD.

The study was supported by a grant from the National Institute on Aging.

Source: Rush University Medical Center

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