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March 2014 Briefing - Pediatrics

Here are what the editors at HealthDay consider to be the most important developments in Pediatrics for March 2014. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Topamax Approval for Migraines Expanded to Younger Users

MONDAY, March 31, 2014 (HealthDay News) -- U.S. Food and Drug Administration approval of the drug Topamax (topiramate) to prevent migraine headaches has been expanded to include adolescents 12 years to 17 years, the agency said Friday.

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Muscular Strength Linked to Teen Cardiometabolic Risk

MONDAY, March 31, 2014 (HealthDay News) -- Higher muscular strength correlates with lower cardiometabolic risk for adolescents, according to a study published online March 31 in Pediatrics.

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CDC: U.S. Autism Estimates Rise by 30 Percent for Children

THURSDAY, March 27, 2014 (HealthDay News) -- One in 68 American children are now diagnosed with autism or a related disorder, according to a report published in the March 28 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report. That's a 30 percent increase from just two years ago when the estimate was one in 88 children.

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Aggressive Cognitions Mediate Impact of Violent Video Games

THURSDAY, March 27, 2014 (HealthDay News) -- The effect of playing violent video games on later aggressive behavior seems to be mediated primarily by aggressive cognitions, according to a study published online March 24 in JAMA Pediatrics.

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NCHS Estimates Health Insurance Coverage for 2013

THURSDAY, March 27, 2014 (HealthDay News) -- In the first nine months of 2013, 6.7 percent of children and 20.5 percent of adults were uninsured, according to a study published online March 27 by the National Center for Health Statistics (NCHS).

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Focal Disruption of Cortical Laminar Architecture in Autism

WEDNESDAY, March 26, 2014 (HealthDay News) -- Most young children with autism have focal disruption of cortical laminar architecture, according to a study published in the March 27 issue of the New England Journal of Medicine.

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1 in 25 Inpatients Has Health Care-Associated Infection Daily

WEDNESDAY, March 26, 2014 (HealthDay News) -- There were an estimated 648,000 patients with 721,800 health care-associated infections in U.S. acute care hospitals in 2011, according to research published in the March 27 issue of the New England Journal of Medicine.

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White House Extends Affordable Care Act Enrollment Deadline

WEDNESDAY, March 26, 2014 (HealthDay News) -- Americans who've started applying for health insurance under the Affordable Care Act but can't complete the process by the March 31 enrollment deadline will be given an extension.

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Physically Active Youth May Retain Bone Health

WEDNESDAY, March 26, 2014 (HealthDay News) -- Bone size and strength developed with physical activity in males during youth is maintained to some extent in old age, regardless of activity level, according to research published online March 24 in the Proceedings of the National Academy of Sciences.

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AMA Introduces Medical Education Initiative

WEDNESDAY, March 26, 2014 (HealthDay News) -- The American Medical Association's (AMA) Accelerating Change in Education initiative is being introduced in 11 medical schools in an effort to shift the focus of education toward real-world practice and competency assessment, according to an AMA report.

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Americans Seem Unprepared for Health Insurance Exchanges

WEDNESDAY, March 26, 2014 (HealthDay News) -- Individuals in the United States seem not to be sufficiently informed about the health insurance exchanges established by the Affordable Care Act (ACA), according to a study published online March 24 in the Proceedings of the National Academy of Sciences.

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Childhood Abuse May Up Risk of Adult Obesity

TUESDAY, March 25, 2014 (HealthDay News) -- Early-life adversity may contribute to metabolic abnormalities that lead to obesity later in life, according to research published online March 20 in the Journal of Clinical Endocrinology & Metabolism.

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Nicotine 'E-Liquids' Pose Serious Health Threat

MONDAY, March 24, 2014 (HealthDay News) -- A potent, liquid form of nicotine poses a serious and potentially deadly threat, but is sold legally in stores across the United States and online. The so-called "e-liquids" -- the key ingredients in e-cigarettes -- are extracted from tobacco and enhanced with flavorings, colorings, and various chemicals, The New York Times reported.

Health Highlights: March 24, 2014

Direct Link Found for Physical Activity in Moms, 4-Year-Olds

MONDAY, March 24, 2014 (HealthDay News) -- There is a direct association between physical activity levels in mothers and in their 4-year-old children, which is affected by temporal and demographic factors, according to a study published online March 24 in Pediatrics.

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Patient Request Impacts Doc Prescribing Behavior

MONDAY, March 24, 2014 (HealthDay News) -- Patients requesting specific medications are more likely to be prescribed those medications, according to research published in the April issue of Medical Care.

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Practices Can Take Steps to Improve Care Transitions

FRIDAY, March 21, 2014 (HealthDay News) -- Implementation of a rigorous process can improve transitions of care, according to an article published March 10 in Medical Economics.

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Phenylephrine + Acetaminophen Ups Plasma Phenylephrine

FRIDAY, March 21, 2014 (HealthDay News) -- The combination of phenylephrine and acetaminophen results in a pharmacokinetic interaction triggering increased plasma phenylephrine levels, according to a letter to the editor published in the March 20 issue of the New England Journal of Medicine.

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CDC: Tuberculosis in the United States Hits Record Low

THURSDAY, March 20, 2014 (HealthDay News) -- Rates of tuberculosis in the United States are falling, with cases at a historic low, health officials from the U.S. Centers for Disease Control and Prevention reported Thursday, noting that improved screening of immigrants has helped reduce incidence.

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Resolved Childhood Glomerular Disease Linked to HTN Risk

THURSDAY, March 20, 2014 (HealthDay News) -- Resolved childhood glomerular disease is associated with increased subsequent risk of hypertension, according to a research letter published in the March 19 issue of the Journal of the American Medical Association.

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Review: Tamiflu Saved Lives During Swine Flu Pandemic

WEDNESDAY, March 19, 2014 (HealthDay News) -- The antiviral drug Tamiflu (oseltamivir) reduced the risk of death by 25 percent among adults hospitalized during the 2009 H1N1 swine flu pandemic, according to a review published online March 19 in The Lancet Respiratory Medicine. In addition, antiviral treatment within 48 hours of developing flu symptoms halved the risk of death compared with starting treatment later or receiving no treatment.

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Lower HPV Uptake for Women Attending Sexual Health Services

WEDNESDAY, March 19, 2014 (HealthDay News) -- For young women attending sexual health services in England, human papillomavirus (HPV) vaccination uptake and completion rates are lower than national data, with an overall completion rate of 47 percent, according to a study published online March 17 in Sexually Transmitted Infections.

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Same Meningitis Strain Behind Drexel, Princeton Outbreaks: CDC

TUESDAY, March 18, 2014 (HealthDay News) -- The strain of bacterial meningitis that killed a Drexel University student earlier this month is the same strain behind a Princeton University outbreak last year, federal health officials said Tuesday. This suggests that the outbreak strain might still be present in the Princeton community and that the situation requires close monitoring, according to the U.S. Centers for Disease Control and Prevention.

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Infant Feeding Behaviors Vary by Race and Ethnicity

TUESDAY, March 18, 2014 (HealthDay News) -- Feeding and activity behaviors of parents caring for infants differ by race and ethnicity, according to research published online March 17 in Pediatrics.

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Penicillin 'Allergy' Complicates Inpatient Care

TUESDAY, March 18, 2014 (HealthDay News) -- Patients with a history of penicillin "allergy," even though that may be inaccurate, spend more time in the hospital and have a greater risk of acquiring antibiotic-associated infections, according to research published in the Journal of Allergy and Clinical Immunology.

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For Girls, Obesity at Age 11 Impairs Academic Attainment

TUESDAY, March 18, 2014 (HealthDay News) -- For girls, obesity at age 11 years has a negative effect on academic attainment, according to a study published online March 11 in the International Journal of Obesity.

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Riding With Impaired Driver Ups Teen Risk of Driving Impaired

TUESDAY, March 18, 2014 (HealthDay News) -- Teenagers exposed to alcohol/drug impaired driving (riding while impaired [RWI]) have an increased likelihood of driving while alcohol/drug impaired (DWI) themselves, according to a study published online March 17 in Pediatrics.

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Rx Expenditures Expected to Rise in 2014

MONDAY, March 17, 2014 (HealthDay News) -- Drug costs are projected to rise 3 to 5 percent across all care settings in 2014, according to a study published in the March 15 issue of the American Journal of Health-System Pharmacy.

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Insurers Must Offer Same-Sex Couples Spousal Benefits

MONDAY, March 17, 2014 (HealthDay News) -- Health plans that offer benefits for heterosexual couples must do the same for same-sex married couples, the Obama administration says.

Other Health Highlights: March 17, 2014

Most Influenza Infections Seem to Be Asymptomatic

MONDAY, March 17, 2014 (HealthDay News) -- For individuals infected with influenza, most cases are asymptomatic, and a minority of those with confirmed disease have medically attended illness, according to a study published online March 17 in The Lancet Respiratory Medicine.

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NATA: Recommendations Issued for Sport Concussion Management

MONDAY, March 17, 2014 (HealthDay News) -- Recommendations have been developed for management of sport-related concussion. The recommendations have been published online March 7 in the Journal of Athletic Training as a National Athletic Trainers' Association Position Statement.

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Pediatric Hospitalizations for Depression Are Costly, Common

MONDAY, March 17, 2014 (HealthDay News) -- Among inpatient diagnoses for child mental health, depression is one of the most frequent and costly reasons for pediatric hospitalizations, according to research published online March 17 in Pediatrics.

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AAFP Letter to CMS Stresses Value of Primary Care Visits

MONDAY, March 17, 2014 (HealthDay News) -- The American Academy of Family Physicians (AAFP) has reminded the Centers for Medicare & Medicaid Services (CMS) about the importance of primary care, stressing the value of a three-visit requirement before meeting any deductible within health insurance marketplaces.

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Study Shows Stimulant Use Impacts ADHD, BMI Link

MONDAY, March 17, 2014 (HealthDay News) -- Children with attention-deficit/hyperactivity disorder (ADHD) not treated with stimulants have higher body mass index (BMI), while those treated with stimulants have lower BMI earlier in childhood and more rapid rebound to higher BMI in late adolescence, according to a study published online March 17 in Pediatrics.

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Concession Sales Not Impacted With Switch to Healthier Food

FRIDAY, March 14, 2014 (HealthDay News) -- Substituting healthier food options at a high school sports concession stand does not impact sales and pleases parents, according to a study published online March 12 in the Journal of Public Health.

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Improving EHR Interoperability Is a National Priority: HHS

FRIDAY, March 14, 2014 (HealthDay News) -- Interoperability of electronic health record (EHR) systems is a national priority of the Office of the National Coordinator for Health Information Technology, according to an article published March 4 in Medical Economics.

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Review: Peer Victimization Ups Child Suicide Ideation, Attempts

THURSDAY, March 13, 2014 (HealthDay News) -- For children and adolescents, peer victimization is associated with increased odds of suicidal ideation and suicide attempts, with cyberbullying more strongly linked to suicidal ideation, according to a meta-analysis published online March 10 in JAMA Pediatrics.

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AMA: CMS Wants Physician Input on Practice Transformation

WEDNESDAY, March 12, 2014 (HealthDay News) -- Physicians are being given the opportunity to describe what resources they need in order to transition to value-based models of care, according to a report published by the American Medical Association (AMA).

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Resistant Strain of Head Lice Prevalent in North America

WEDNESDAY, March 12, 2014 (HealthDay News) -- Widespread use of pyrethrins- or pyrethroid-based products appears to have resulted in selection pressure for a highly-resistant strain of human head lice in North America, according to research published in the March issue of the Journal of Medical Entomology.

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TV Viewing Time Linked to Sleep Duration in Children

WEDNESDAY, March 12, 2014 (HealthDay News) -- For children, television viewing time is inversely associated with sleep duration, according to a study published online March 10 in JAMA Pediatrics.

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White House: More Than Four Million Have Signed Up for ACA

TUESDAY, March 11, 2014 (HealthDay News) -- More than four million Americans have signed up for health coverage through state and federal insurance marketplaces established by the Affordable Care Act, the Obama administration announced Tuesday.

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Medicare Drug Plan Changes Withdrawn by White House

TUESDAY, March 11, 2014 (HealthDay News) -- Proposed changes to the Medicare prescription drug program have been withdrawn by the Obama administration after strong opposition from patient groups.

Other Health Highlights: March 11, 2014

Discrepancies ID'd in Studies on ClinicalTrials.gov, Journals

TUESDAY, March 11, 2014 (HealthDay News) -- Nearly all clinical trials reported on ClinicalTrials.gov and published in high-impact journals report at least one discrepancy in cohort, intervention, or results, according to a research letter published in the March 12 issue of the Journal of the American Medical Association.

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For Obese Teens, Sleep Duration Predicts Cardiometabolic Risk

TUESDAY, March 11, 2014 (HealthDay News) -- For obese adolescents, sleep duration independently predicts cardiometabolic risk, according to a study published online March 6 in The Journal of Pediatrics.

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Cereals, Breads Found As Major Sources of Sodium in Youth

TUESDAY, March 11, 2014 (HealthDay News) -- Despite the launch of a salt reduction campaign in the United Kingdom in 2003, dietary salt intake remains high among children and adolescents in South London, with cereals, breads, meat, and milk products as major culprits, according to research published online March 10 in Hypertension.

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Pediatric Kidney Transplant Outcomes Have Improved

TUESDAY, March 11, 2014 (HealthDay News) -- Over the last 25 years, pediatric kidney transplantation outcomes have improved in the United States, according to a study published online March 10 in Pediatrics.

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Family Routines Aid Emotional Health of Preschoolers

TUESDAY, March 11, 2014 (HealthDay News) -- Promoting family routines may contribute to greater social-emotional health (SEH) in preschool-aged children, according to a study published in the February/March issue of the Journal of Developmental & Behavioral Pediatrics.

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USPSTF: Evidence Lacking for Drug Use Interventions

TUESDAY, March 11, 2014 (HealthDay News) -- The U.S. Preventive Services Task Force (USPSTF) has found that there is currently insufficient evidence to recommend primary care interventions to prevent or reduce illicit drug use or nonmedical prescription drug use among youth. The findings are presented in a final recommendation statement published online March 11 in the Annals of Internal Medicine.

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Marijuana Use Up, Cocaine Use Down, U.S. Report Finds

MONDAY, March 10, 2014 (HealthDay News) -- Americans' use of cocaine fell by half from 2006 to 2010, but marijuana use increased by more than 30 percent during that time, according to a new report. The spike in pot use may be due to an increase in the number of people who said they use the drug on a daily or near-daily basis, said the researchers, whose study covered drug trends from 2000 to 2010. Heroin use remained fairly stable during the decade, while methamphetamine use rose sharply during the first half of the decade and then fell.

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Parental Death Increases Odds of Lower Grades, School Failure

MONDAY, March 10, 2014 (HealthDay News) -- Children who experience parental death are more likely to have lower grades and school failure, according to a study published online March 10 in Pediatrics.

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For Children, Asthma Exacerbations Peak in September

MONDAY, March 10, 2014 (HealthDay News) -- For children aged 2 to 15 years, asthma exacerbations and asthma medication prescriptions peak in September, correlating with the start of the school year, according to a study published online March 10 in Pediatrics.

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Keeping Salaries Secret Harms Worker Performance

MONDAY, March 10, 2014 (HealthDay News) -- Keeping salaries secret hurts worker performance and increases turnover of top talent, according to a study published online Jan. 13 in the Academy of Management Journal.

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Consultant Offers Tips for Evaluating Staff Pay

MONDAY, March 10, 2014 (HealthDay News) -- Setting salaries and dealing with raises for a practice's staff can be tricky, according to an article published Feb. 24 in Medical Economics.

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Outpatient Abx Culprit in Most Childhood C. Difficile Cases

FRIDAY, March 7, 2014 (HealthDay News) -- Antibiotics prescribed in doctors' offices are linked with a majority of Clostridium difficile (C. difficile) infection cases in children, according to a new study published online March 3 in the Pediatrics.

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CDC: Child Care Flu Vaccination Requirements Seem Effective

FRIDAY, March 7, 2014 (HealthDay News) -- Requiring the flu vaccination for child care admission seems to have increased vaccination rates and led to lower hospitalization rates for influenza in young children, according to a report published in the March 7 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Rising E-Cigarette Use Tied to More Smoking in Teens

FRIDAY, March 7, 2014 (HealthDay News) -- Teens who have tried electronic cigarettes may be more likely to smoke regular cigarettes, according to the authors of a new study published online March 6 in JAMA Pediatrics.

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AMA Grants Curriculum Efforts to Address Health Disparities

FRIDAY, March 7, 2014 (HealthDay News) -- Medical schools are beginning to change their curriculum to address ways to eliminate health disparities, according to the American Medical Association (AMA).

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Gender Gap Exists in Domestic Duties of Working Physicians

FRIDAY, March 7, 2014 (HealthDay News) -- Gender differences exist in domestic activities among career-oriented academic physicians with children, according to a study published online March 3 in the Annals of Internal Medicine.

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Relative Value Units Useful In Evaluating Practice Finances

THURSDAY, March 6, 2014 (HealthDay News) -- The Relative Value Unit (RVU) is a useful tool for managing practice finances, according to an article published Feb. 25 in Medical Economics.

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Drop in Compensation Gap for Primary Care Docs, Specialists

THURSDAY, March 6, 2014 (HealthDay News) -- From 2012 to 2013, there was a 5.7 percent increase in the median total cash compensation for primary care physicians, with a smaller gap seen for medical and surgical specialists, according to the results of a recent survey from SullivanCotter.

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Cautious Optimism for 'Cure' of HIV-Infected Babies

THURSDAY, March 6, 2014 (HealthDay News) -- The hope that newborns can be "cured" of HIV with early, aggressive drug treatment was bolstered this week with the announcement that a second baby appears to be free of the virus following therapy that began just four hours after her birth.

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Potentially Pathological ECG Patterns Prevalent in Young

THURSDAY, March 6, 2014 (HealthDay News) -- More than 20 percent of young non-athletes have electrocardiogram (ECG) patterns that can be considered potentially pathological based on the 2010 European Society of Cardiology position paper, according to a study published online Feb. 26 in the Journal of the American College of Cardiology.

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Value-Based Insurance Plans Can Up Rx Adherence

WEDNESDAY, March 5, 2014 (HealthDay News) -- Value-based insurance design (VBID) plans with certain features aside from solely lowering cost sharing can increase medication adherence, according to a study published in the March issue of Health Affairs.

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Most Osteopathic Med Students Matched Into Primary Care

WEDNESDAY, March 5, 2014 (HealthDay News) -- More than half of osteopathic medical students and recent graduates are matched into primary care residency programs, according to a report from the American Osteopathic Association (AOA).

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Gap in Regulatory Coverage Affects 5 to 16 Percent of Trials

WEDNESDAY, March 5, 2014 (HealthDay News) -- Human subjects protections (HSP) policies do not provide regulatory coverage for all clinical trials, while up to about a quarter of trials are considered overlap trials, according to a research letter published in the March 5 issue of the Journal of the American Medical Association.

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WHO Program Improves U.S. Medical Facility Hand Hygiene

WEDNESDAY, March 5, 2014 (HealthDay News) -- For U.S. health care facilities, participation in the World Health Organization (WHO) global campaign to improve hand hygiene practices is associated with improved hand hygiene, according to a study published in the March issue of the American Journal of Infection Control.

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HPV Vaccine Protects Against Cervical Abnormalities

WEDNESDAY, March 5, 2014 (HealthDay News) -- The human papillomavirus (HPV) vaccine is effective at protecting against cervical abnormalities in young women, according to a study published March 4 in BMJ.

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Housing Mobility Interventions Affect Boys, Girls Differently

TUESDAY, March 4, 2014 (HealthDay News) -- Interventions to encourage moving out of high-poverty neighborhoods are associated with increased rates of mental disorders in adolescent boys, but decreased rates of disorders among girls, according to a study published in the March 5 issue of the Journal of the American Medical Association.

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TV in the Bedroom Associated With Increased BMI for Teens

TUESDAY, March 4, 2014 (HealthDay News) -- For children and adolescents, having a television in the bedroom is associated with increased body mass index (BMI), while active video gaming can increase physical activity and weight loss, according to two studies published online March 3 in JAMA Pediatrics.

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Cesarean Section Delivery Linked to Increased Offspring BMI

TUESDAY, March 4, 2014 (HealthDay News) -- Compared with vaginal delivery (VD), cesarean section (CS) delivery is associated with increased offspring body mass index (BMI) and increased odds of overweight and obesity, according to research published online Feb. 26 in PLOS ONE.

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Sleep Machines May Exceed Safe Noise Levels for Infants

TUESDAY, March 4, 2014 (HealthDay News) -- Infant sleep machines (ISMs) have maximum sound levels that may damage infant hearing and auditory development, according to research published online March 3 in Pediatrics.

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CDC: Out-of-Hospital Births Continuing to Increase

TUESDAY, March 4, 2014 (HealthDay News) -- The percentage of out-of-hospital births is continuing to increase, and in 2012 these births had a lower risk profile than hospital births, according to a March data brief published by the National Center for Health Statistics (NCHS).

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Change Increases Postpartum Pertussis Vaccination

MONDAY, March 3, 2014 (HealthDay News) -- Changing in-hospital ordering procedures increases the postpartum pertussis vaccination rate to 69 percent, according to a study published in the March issue of the American Journal of Obstetrics & Gynecology.

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Women-Specific Research Is Still Inadequate

MONDAY, March 3, 2014 (HealthDay News) -- Women are still underrepresented in medical science and research, and sex differences are often ignored, according to a report published March 3 by the Brigham and Women's Hospital.

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Smoking, Smoke Exposure Up Adverse Pregnancy Outcomes

MONDAY, March 3, 2014 (HealthDay News) -- Women who were ever smokers during their reproductive years and those never-smoking women with the highest levels of secondhand smoke (SHS) exposure have significantly increased odds for spontaneous abortion, stillbirth, and tubal ectopic pregnancy, according to a study published online Feb. 26 in Tobacco Control.

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Indoor Tanning Common Among High School Students

MONDAY, March 3, 2014 (HealthDay News) -- Indoor tanning is common among high school students and is linked to engaging in other risky behaviors, according to a study published online Feb. 26 in JAMA Dermatology.

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CMS: No More Delays to ICD-10 Implementation Deadline

MONDAY, March 3, 2014 (HealthDay News) -- There will be no more delays to the Oct. 1, 2014, deadline for implementation of the International Classification of Diseases, 10th Revision (ICD-10), according to an article published Feb. 27 in Medical Economics.

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Routine Childhood Vaccines Result in Cost Savings

MONDAY, March 3, 2014 (HealthDay News) -- The 2009 routine U.S. childhood immunization schedules resulted in considerable economic savings; however, public health communications about vaccines seem not be to effective, according to two studies published online March 3 in Pediatrics.

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PFCs Linked to Metabolic Changes in Overweight Kids

MONDAY, March 3, 2014 (HealthDay News) -- Exposure to perfluorinated and polyfluorinated chemicals is associated with increased insulin and triglyceride concentrations in overweight children, according to research published online Feb. 25 in the Journal of Clinical Endocrinology & Metabolism.

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