Current Event- Anthrax Vaccination in Children 3/27/13

          Childhood vaccination usually consists of the typical measles, mumps, rubella, tetanus, influenza and the list goes on. A story that has reached national news recently is the controversy about testing anthrax vaccination in children. When I came across this article on the NBC News webpage, I honestly never even knew people got vaccinated for anthrax exposure. Caplan (2013), the head of the Division of Medical Ethics at NYU, talks about the controversy of this topic and why it is risky to approve studying the safety of anthrax vaccines in children. The reason that one may be interested in vaccinating their child in the first place is in sight of a terror attack. The U.S. government conducted a bioterrorism preparedness exercise in 2011 studying the results of anthrax spores on a major city. Results demonstrated that “nearly 8 million citizens would be affected, nearly a quarter of them children” (Caplan, 2013). The National Biodefense Science Board and other commissioners are recommending that the government start conducting studies in pediatric patients but Caplan revokes, “there is not a chance that a sufficient number of American parents are going to sign up their kids” (2013). Anthrax vaccines are given to millions of adults in the military, however no one knows what effect using this vaccine would cause in children (Caplan, 2013). Also, if a child has any other medical diagnoses such as allergies, asthma, diabetes, or cancer, the risk for testing increases greatly.

            This controversy about testing in children or not leads to a great mess of ethical and legal issues. According to Caplan’s article, “the commissioners have found a small ethical opening through which a study might pass” (2013). To me, this type of research has ethical issues written all over it. First of all, parents would need to voluntarily sign up to be part of this study. As mentioned above, I’m not so sure how many parents would be willing to jump on this band wagon. The vaccine itself is a series of five- yes I said five-shots (Caplan, 2013). Military participants find this vaccination helpful and the side effects of burning, headaches, joint and muscle aches, and rashes are nothing compared to being bombarded with an anthrax-loaded shell. In children, however, these simple side effects can be exacerbated by any other medical diagnoses or their physical immaturity in general. From a community health standpoint, I can see why commissioners would want to study this in children. If a community were to experience a bioterrorism attack, a disaster plan could be implemented and the population may see less complications if anthrax vaccines were offered to all ages. Overall, I do not see studying the safety of anthrax in a pediatric population as ethical. Parents may inquire about this vaccine for their children, and it is our duty to understand and give the best recommendation for the health of their child. According to Hockenberry and Wilson (2011), “ nurses are at the forefront in providing parents with appropriate information regarding childhood immunization benefits, contraindications, and side effects on the child’s health” (p. 506). The parents that would volunteer children may only do so because they have a healthy child. The study population may be skewed and could affect results. Overall, there are too many unknowns and preventable harm could be caused to young, innocent children.

References

Caplan, A. (2013, March 19). Bioethicist: No chance of anthrax trials in kids. NBC News. Retrieved from http://vitals.nbcnews.com/_news/2013/03/18/17361790-bioethicist-no-chance-of-anthrax-vaccine-trials-in-kids?lite

Hockenberry, M. J., & Wilson, D. (2011). Wong's nursing care of infants and children. St. Louis, MO: Mosby/Elsevier.

Current Event: The Unfinished Miracle

              Do you remember the story of the “miracle baby”?  In 2005, American troops in Iraq arranged to have baby Noor’s life saving surgery in the United States of America.  CNN did a recent article, March 20, 2013, that describes an update of where she is now and all she’s overcome.  When American troops discovered Noor, her family had just been told that she had spina bifida, and that there was nothing that could be done for her in Iraq.  As confirmed by Hockenberry and Wilson, baby Noor showed manifestations of spina bifida with the presence of a sac on her lower back, along with paralysis of her lower extremities and urinary system distress (2011). 

                After Noor’s surgery, she spent the next 6 months recovering in the United States within in the hospital and 2 foster families.  Then, she was shipped back to Iraq where her family was presented with the huge responsibility of taking care of her with very little resources.  The article talks about the “unfinished miracle”, and this is why.  After surgery, parents need constant guidance as to how to encourage and stimulate their child as they grow and develop (Hockenberry & Wilson, 2011). 

                I chose this article because it was very surprising to me at how the American troops left the situation.  It seems as though, ill-sounding, Noor and her family would have been better off had that American troops remained uninvolved.  I must say that I am disappointed at how this situation transpired.  Although I believe the troops had good intentions, they caused more challenges for Noor’s family in the long run. 

                It seems very evident to me that the main factor in this situation is the economy in which Noor and her family live.  If there had been available resources in Iraq, Noor could have accessed the surgery and treatment she needed, and her family could have consistently received the guidance they needed to maximize Noor’s recovery.  I can’t help but assume that there are also political factors in this situation due to the fact that the war was active and American troops were involved.   

Basu, M. (March 20, 2013). Iraq’s baby Noor: the unfinished miracle. CNN. Retrieved from http://www.cnn.com/interactive/2013/03/world/baby-noor/index.html?hpt=wo_t2

Hockenberry, M. J. & Wilson, D. (2011). Wong’s nursing care of infants and children (9^th ed.). St. Louis, MO: Mosby, Inc.

Extra Credit: Norovirus

The article that I chose to discuss is an article from the WebMD website.  This article discusses the high rates of children under 5 years of age being admitted to the emergency room with severe nausea, vomiting, and diarrhea due to the norovirus.  This virus seems to be more prevalent now due to the recent release of the rotavirus vaccine.  Payne was sure to note that the rate of the norovirus has not been increasing.  He then explains that the norovirus is recently responsible for more medical visits than the rotavirus because of the vaccine working well in preventing the rotavirus (2013).  The article discusses that most people recover in one or two days from the norovirus, however, “the very young and the very old have a higher risk of becoming dehydrated” (Gordon, 2013). 

 I would say that this article is reliable.  WebMD seems to be very well established, and they’re statements are supported with credible sources.  In the article that I chose, Gordon cited the CDC throughout to support her statement.

·    I have heard of the norovirus affecting several cruise ship populations, but has anyone heard of it affecting so many children every year on land?

·   It takes only 18 particles for the norovirus to infect its host.  In comparison, the much dreaded flu virus takes 100-1,000 particles to infect its chosen host.  Knowing how extremely contagious the norovirus is, what are some of the ways you would take precautions to prevent the norovirus from affecting you and your family?

http://children.webmd.com/news/20130320/cruise-ship-virus-also-sickens-1-million-us-kids-yearly

                 

Anorexia Nervosa - March 5th, 2012

            Anorexia nervosa is not a disease that discriminates. This serious mental illness can occur in any gender, ethnicity or social class and at any age group. According to the National Alliance on Mental Illness (NAMI) “anorexia nervosa is an eating disorder defined by an inability to maintain one’s body weight within 15 percent of their Ideal Body Weight (IBW). Other essential features of this disorder include an intense fear of gaining weight, a distorted image of one’s body, denial of the seriousness of the illness, and—in females—amenorrhea, an absence of at least three consecutive menstrual cycles when they are otherwise expected to occur” (Berkman, 2007). Although anorexia nervosa has the ability to affect anyone, there are certain risk factors that make an individual more likely to be diagnosed. These risk factors include being an adolescent girl, young adult female or an individual suffering from anxiety or depression. Athletes, dancers and models are also at an increased risk for developing eating disorders due to the high demand for thinness in their professions (Berkman, 2007).  According to the Department of Heath and Aging the prevalence of anorexia nervosa is one in 100 girls, or one percent.  Of those suffering with the illness 15- 20% will die within 20 years of onset. This is the highest mortality rate of all psychiatric diseases (2010).

            I chose this topic due to personal interest. I believe that there are two main issues surrounding eating disorders that make decreasing their prevalence difficult.  Firstly, eating disorders and other mental illnesses are often not recognized as actual illnesses that need medical attention. The disillusionment surrounding these illnesses permits many sick individuals to go without treatment. Enlightening the public about the dangers of eating disorders and available treatment options could help cure those already suffering and decrease future incidence rates of the illness. Secondly, the media plays a very influential role in creating an unrealistic body image to the public, which perpetuates negative body images and disordered eating.      

Social marketing and health teaching are two interventions from the public health wheel that could be applied when discussing anorexia nervosa and other eating disorders. The first method, education, could be used in schools or by families in order to teach children from about age five to 18. Education about eating disorders coupled with health promotion would be the most successful equation. Aiding children in developing healthy eating and exercise habits along with establishing a positive body image is an example of upstream thinking. Other topics of education to be discussed may include signs, symptoms, causes and treatments of anorexia nervosa and other eating disorders. Educators should also establish tertiary prevention by providing information on ways to seek help for those already suffering from an eating disorder. Examples include eating disorder hotlines and medical or counseling services.

The second intervention to help promote health would be to change social marketing and media. This method would be effective in all age groups. Body images displayed in the media are often distorted and create a false standard of beauty in the eyes of the general public. Most of the images portrayed in the media are photo-shopped and unrealistic. Several industries have made an attempt to create a more realistic image of beauty. The Dove Campaign for Real Beauty and modeling agencies who have banned underweight models are two examples that come to mind. By endorsing healthy eating habits, exercise routines and a variety of body sizes social media could help to perpetuate health instead of cause problems. Social marketing could help take a stand against anorexia nervosa by supporting Eating Disorder Awareness Week, which aims to “increase awareness of factors that lead to eating disorders” and “reduce prevalence of eating disorders and body image problems through a public education program emphasizing social factors that cause their development” (“Prevention & health promotion”, 2012).  Each day we are bombarded by images and ideas portrayed to us by social media, imagine if this powerful tool was used to encourage health instead of harm it.

Dove Campaign for Real Beauty

If you are interested in learning more about the common signs, symptoms, causes and treatments for anorexia nervosa click here for a great, informative website. More information regarding prevention and health promotion for individuals, families, educators and administrators can be found here. 

Resources

Berkman, D. (2007, May). National alliance on mental illness. Retrieved from

http://www.nami.org/Template.cfm?Section=By_Illness&template=/ContentManagement/ContentDisplay.cfm&ContentID=102975

Department of Health and Ageing. (2010, September). National Eating Disorders Collaboration.

Retrieved from http://www.health.gov.au/internet/main/publishing.nsf/content/mental-nedc

Prevention & health promotion. (2012, May 14). Retrieved from

http://www.nedic.ca/knowthefacts/preventionhealth.html

Noise-Induced Hearing Loss

Noise-induced hearing loss (NIHL), can affect all age groups. Of particular concern to the Centers for Disease Control and Prevention, however, is NIHL in adolescence. According to the CDC “children with mild to moderate hearing loss, on average, do not perform as well in school…” (CDC, 2012) Due to excessive exposure to noise, 12.5% of children ages 6-19 years old have experienced permanent hearing damage. Let me tell you a bit more about the types and concerns of hearing loss.

Excessive noise exposure that leads to NIHL can involve anything from recreational activities such as noisy football games or rock concerts, to loud working environments such as factories or construction sites. Authors Naoki Oishi and Jochen Schacht of “Emerging treatments for noise-induced hearing loss”, discuss two types of hearing loss. The first type is a ‘temporary threshold shift’ (TTS). As is evidenced by its title, this type of hearing loss is temporary and typically resolves within 24-48 hours of excessive noise exposure (Oishi &Schacht, 2011). Little concern has been built upon this type of hearing loss due to its immediate short-lived loss; however it is not yet understood if TTS has long term effects on age and hearing. The second type of hearing loss is a ‘permanent threshold shift’ in which hearing damage becomes permanent. Different levels of hearing loss can accompany PTS in ways that the damage may not even be noticed by the individual who has suffered the loss.

Any number of people can be impacted by NIHL with unknown or unrealized costs to daily living and quality of life. Noise related hearing loss is 100% preventable (NIDCD, 2008). Two effective ways of preventing NIHL among children as well as the adult population is avoiding/reducing exposure to excessively loud noises and using protective hearing devices while in its presence (CDC,2012). In order to effectively educate children at risk of NIHL, it would be important to start with educating parents on the negative effects hearing loss could have on their child and helping them understand what too much noise is and how it can be prevented. Children could be more susceptible to hearing loss during their stages of development because they are unaware of the amount of noise that is considered unsafe for their ears.  

The following link has additional information on studies being done on ways to treat hearing loss and management to prevent it from occurring.  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3102156/

     

Centers for Disease Control and Prevention. (2012). Noise-induced hearing loss. Retrieved from

http://www.cdc.gov/healthyyouth/noise/

National Institute on Deafness and Other Communication Disorders. (2008). Noise-induced hearing loss.

Retrieved from http://www.nidcd.nih.gov/health/hearing/pages/noise.aspx

Oishi, N., Schacht, J. (2011). Emerging treatments for noise-induced hearing loss. NIH Public Access,

doi: 10.1517/14728214.2011.552427