[NFIMR] June 26 2009 NFIMR Listserv

Kathleen Buckley KBuckley at acog.org
Fri Jun 26 11:58:49 EDT 2009


To find more information about the FIMR process, log on any time to our web address www.nfimr.org (this will take you directly to the home page of NFIMR) or contact us at nfimr at acog.org 
National HIV Testing Day (June 27, 2009). This Saturday, June 27th, is National HIV Testing Day, an effort to remind individuals across the US to learn their HIV status and to take steps to protect their health. HIV remains a major health threat, and it’s important to stress the importance of HIV testing in reducing new infections. Be sure to check out the AAP web site at http://www.aap.org/sections/adolescenthealth/HIV_Testing.cfm and CDC’s Web site http://www.hivtest.org/ for more information and ways to can get involved to promote this observance day. 
Coming UP! July is Fireworks Safety Month 
Activities during this period will alert parents and children to the dangers of playing with fireworks. The Consumer Products Safety Commission also has published Fireworks Safety Tips at http://www.cpsc.gov/cpscpub/pubs/july4/safetip.html and a commentary titled Illegal and Improper Use of Fireworks Continue to Harm Consumers: More than Half of Injuries Occur Around July 4th Holiday at http://www.cpsc.gov/cpscpub/prerel/prhtml08/08308.html 
From ACOG News Releases: ACOG Refines Fetal Heart Rate Monitoring Guidelines Refinements of the definitions, classifications, and interpretations of fetal heart rate (FHR) monitoring methods were issued in new guidelines released by The American College of Obstetricians and Gynecologists (ACOG). The objective of the guidelines is to reduce the inconsistent use of common terminology and the wide variability that sometimes occurs in FHR interpretations. ACOG's Practice Bulletin, published in the July 2009 issue of Obstetrics & Gynecology, supports the recommendations of the Eunice Kennedy Shriver National Institute of Child and Health Development workshop  on electronic fetal monitoring (EFM) held in April 2008. ACOG reports that a meta-analysis study shows that although EFM reduced the risk of neonatal seizures, there is still an unrealistic expectation that a non-reassuring FHR can predict the risk of a baby being born with cerebral palsy. The false-positive rate of EFM for predicting cerebral palsy is greater than 99%. This means that out of 1,000 fetuses with non-reassuring readings, only one or two will actually develop cerebral palsy. The guidelines state that women in labor who have high-risk conditions such as preeclampsia, type 1 diabetes, or suspected fetal growth restriction should be monitored continuously during labor. To learn more, go to http://www.acog.org/from_home/publications/press_releases/nr06-22-09-2.cfm or see Practice Bulletin #106, "Intrapartum Fetal Heart Rate Monitoring: Nomenclature, Interpretation, and General Management Principles," published in the July 2009 issue of Obstetrics & Gynecology. 
 
The Association of Maternal and Child Health Programs (AMCHP) Has Developed a Preliminary Summary of Key MCH Provisions Included in the “Affordable Health Choices Act” Introduced in the U.S. Senate. On June 9, 2008, Sen. Ted Kennedy (D-MA) introduced the “Affordable Health Choices Act.” This bill will be initially considered by the Senate Health, Education, Labor, and Pensions (HELP) Committee. AMCHP reports that bill has five main principles: consumers should be able to keep the coverage they have now; health reform should reduce health care costs; it should invest in disease prevention; modernize the health system; and improve long-term care and services.
The bill includes extensive provisions to:
·         restructure the U.S. insurance market,
·         place mandates on individuals to obtain insurance and employers to provide it,
·         establish "gateways" in the states that would serve as marketplaces for consumers to obtain insurance,
·         strengthen the public health system, and
·         extend subsidies to families to assist in the purchase of insurance.
To learn more go to http://www.amchp.org/Advocacy/LegislationPolicy/Documents/summeryofkeyprovisions.pdf 
 
HHS Announces Release of $6 Billion in New CHIP Funds to Insure Children. HHS announced that $6 billion in new federal funds will be made available to states and U.S. territories for fiscal year 2009 to provide health care to millions of children across America through their Children’s Health Insurance Programs (CHIP). The new funds for CHIP were made available by the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA), which was signed into law by President Barack Obama on February 4. CHIPRA provides additional funding that will help states and territories maintain existing CHIP enrollment and expand their programs. To read more or to download a new fact sheet on CHIP, go to http://www.hhs.gov/news/press/2009pres/06/20090619a.html 
Families USA has been advocating for better health coverage for more than 25 years. To help you better understand the health care crisis and how to achieve affordable coverage for all, they have gathered a wealth of resources that outline everything you need to know about health care reform. Check out their resources at http://www.familiesusa.org/health-reform-2009/ 
 
Theme Issue on Palliative Care, Dying, and Bereavement from Arch Pediatr Adolesc Med. 2009;163(6):589. The Archives will publish a "rolling theme issue" this year on palliative care, dying, and bereavement. They are interested in original articles, narrative and systematic reviews, and commentaries that will add to the scientific knowledge about these topics. Their intent is to bring these issues to the forefront of pediatrics and adolescent medicine, just as they are in the minds of those children and families who are confronted with such loss. They hope the attention of the Archives will advance science and provide help to the physicians dealing with these issues on behalf of their patients and families. For more information, go to http://archpedi.ama-assn.org/cgi/content/full/163/6/589  
 
The Project IMPACT webcast,  Sudden Unexpected Infant Death (SUID): National Developments, Initiatives, Studies and Opportunities. with Carrie Shapiro-Mendoza, PhD, MPH and Lena Teresa Camperlengo, RN, MPH has been archived and is available on the website at the link above:              
http://webcast.hrsa.gov/Postevents/archivedWebcastDetailNewInterface.asp?aeid=487 
 
U.S. Consumer Product Safety Commission Fines OKK Trading $665,000 for a Civil Penalty for Violating Federal Lead Paint Ban and Other Child Safety Rules
WASHINGTON, D.C. - As part of its commitment to protecting the safety of children, the U.S. Consumer Product Safety Commission (CPSC) announced today that OKK Trading, of Commerce, Calif., has agreed to pay a $665,000 civil penalty for failing to comply with a 30-year old ban on lead paint on toys, as well as violating other federal child safety standards. The penalty settlement, which has been provisionally accepted by the Commission, resolves CPSC staff allegations that from November 2007 through August 2008, OKK Trading knowingly imported and sold toys with paints that contained lead levels that exceeded legal limits. In 1978, a federal ban was put in place which prohibited toys and other children’s articles from having more than 0.06 percent lead (by weight) in paints or surface coatings. Lead can be toxic if ingested by young children and can cause adverse health consequences. The penalty settlement also resolves CPSC staff allegations that OKK Trading knowingly imported and sold toys, games, rattles, pacifiers, and art materials that violated the Federal Hazardous Substances Act. These allegations include:
From December 2004 through August 2008, OKK Trading imported and sold toys that had small parts in violation of CPSC regulations. To protect young children from choking, aspiration, or ingestion hazards, federal law prohibits toys intended for children under three from having small parts. 
From November 2004 through January 2005, OKK Trading imported rattles that violated CPSC’s safety requirements for rattles. 
From July 2007 through January 2008, OKK Trading imported and sold pacifiers that violated CPSC’s safety requirements for pacifiers, including the prohibition on small parts. 
From January 2005 through April 2007, OKK Trading imported toys and games that violated CPSC’s labeling requirements for balloons, small balls, and small parts. 
From September 2005 through April 2007, OKK Trading imported art materials that violated CPSC’s labeling requirements. 
The settlement also covers staff allegations that from May 2007 through December 2007, the company knowingly exported noncompliant toys in violation of federal notification requirements. To learn more or to view some of the toys http://www.cpsc.gov/cpscpub/prerel/prhtml09/09254.html , go to
 
 
More on the BPA Industry from the Environmental Working Group (EWG): Ca. Progress Report: Leaked Industry Memo Prompts Warning on Hormones. From California Progress Report, Dan Aiello Like similar legislation in other state houses this year, California Senator Fran Pavley’s (D-Agoura Hills) SB 797, the Toxin-Free Toddlers and Babies Act, will face coordinated opposition from a chemical industry fighting to preserve $6 billion dollars in annual sales of the plastic hardening agent, bisphenol A (BPA) as the bill now heads to assembly committees on Environmental Safety and Toxic Materials and Health. But it is the leak of an industry memo this month outlining a BPA joint trade association’s political strategy designed to incite doubt, propagate fear, seek a pregnant spokesperson willing to promote the benefits of the chemical, introduce the idea through online media that banning BPA is thinly-veiled racism, and ‘befriending people that are able to manipulate the legislative process’ in California and Connecticut, that has shed an intriguing light upon a bill that, until now, none but environmentalists and anti-cancer advocacy groups knew. Read more about the continuing effort to ban BPA and the industry pushback at http://www.ewg.org/node/28050 
From FDA: FDA Warns Consumers Not to Eat Nestle Toll House Prepackaged, Refrigerated Cookie Dough. Nestle Voluntarily Recalls all Varieties of Prepackaged, Refrigerated Toll House Cookie Dough
The U.S. Food and Drug Administration and the Centers for Disease Control and Prevention are warning consumers not to eat any varieties of prepackaged Nestle Toll House refrigerated cookie dough due to the risk of contamination with E. coli O157:H7 (a bacterium that causes food borne illness).   The FDA advises that if consumers have any prepackaged, refrigerated Nestle Toll House cookie dough products in their home that they throw them away. Cooking the dough is not recommended because consumers might get the bacteria on their hands and on other cooking surfaces.Since March 2009 there have been 66 reports of illness across 28 states. Twenty-five persons were hospitalized; 7 with a severe complication called Hemolytic Uremic Syndrome (HUS). No one has died. For more information on safe food handling practices, go to http://www.fda.gov/Food/ResourcesForYou/Consumers/ucm109899.htm. For answers to consumer questions about this recall and warning, go to: http://www.fda.gov/Food/ResourcesForYou/Consumers/ucm168346.htm.Consumers who have additional questions about these products should contact Nestle consumer services at 1-800-559-5025 and/or visit their Web site at www.verybestbaking.com.For a complete listing of the recalled products go to: 
http://www.nestleusa.com/PubNews/PressReleaseLibraryDetails.aspx?id=133CC131-A79F-4E84-9C43-C9F99FE5BC99.  
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm167908.htm 
Arsenic, and chicken. The Attorney General of Maryland, Douglas Gansler  writes an op-ed in the Washington Post today titled A Deadly Ingredient in a Chicken Dinner in part as follows:
“Why do our chicken, our water and our air contain arsenic? Because in the United States, most major poultry producers add an arsenic compound known as roxarsone to their chicken feed. Inorganic arsenic is a Class A carcinogen that has been linked to heart disease, diabetes and declines in brain function. Recent scientific findings show that most Americans are routinely exposed to between three and 11 times the Environmental Protection Agency's recommended safety limit.”
Hopefully the EPA is set to shortly ban roxarsone.  Stay tuned. To read the whole WAPO article go to: http://www.washingtonpost.com/wp-dyn/content/article/2009/06/25/AR2009062503381.html
 
New Survey from the National Campaign To Prevent Teen Pregnancy: Sex and Tech. Results from this new national survey show that 21% of teen girls and 18% of teen boys have sent/ posted nude or semi-nude images of themselves. What is going on with teens, tech, and sex? Read the full survey at http://www.thenationalcampaign.org/sextech/ 
 
 
ARTICLES:
 
The June 3 issue of JAMA has several articles which focus on infant and child health interventions as a strategy to attain a healthier overall population and quite worth reading. See below:

Mercy JA and Saul J. Creating a Healthier Future through Early Interventions for Children Vol. 301 No. 21, June 3, 2009 pp 2262 – 2264 
The authors state, “Policy makers have widely endorsed the idea that educational and economic achievement are a function of early childhood experience and development and can be improved through interventions such as preschool. However, they have yet to fully embrace that adolescent and adult health is also profoundly affected by early childhood experiences and can similarly be improved through wise public investments. Neurobiological, behavioral, and social science research conclusively shows that early adverse experiences can affect brain development and increase vulnerability to a broad range of mental and physical health problems. In addition, health depends on developing psychological, behavioral, and social competencies built on a foundation of safety, stability, and nurturance that is laid down early in life and that buffers against early adversity. Programs or policies that increase children's exposure to safe, stable, and nurturing relationships and environments can improve their health over a lifetime. Moreover, these programs can be more efficient than treating health problems as they arise later in life. Such programs can also reduce criminal behavior and generate important economic benefits to society”
The authors conclude, “ The high-quality scientific evidence supporting these propositions justifies investments in prevention research and programs to support parents and communities in raising safe and healthy children. “

Broekman BF et al. The Influence of Birth Size on Intelligence in Healthy Children. PEDIATRICS Vol. 123 No. 6 June 2009, pp. e1011-e1016 
Birth parameters have been hypothesized to have an influence on IQ. However, studies within the range of normal birth size have been sparse. With this international study, the authors set out to examine the associations between birth length, birth weight, head circumference, and gestational age within the normal birth size range in relation to childhood IQ in Asian children. 
The authors recruited a cohort of 1979 of 2913 Asian children aged 7 to 9 years, recruited from 3 schools in Singapore, were followed yearly from 1999 onward. Birth parameters were recorded by health personnel. Childhood IQ was measured with the Raven's Standard Progressive Matrices at ages 8 to 12. 
The authors found that mean IQ score across the sample (n = 1645) was 114.2. After controlling for multiple confounders for every 1-cm increment in birth length, 1 kg in birth weight, or 1 cm in head circumference, there was a corresponding increase in IQ of 0.49 points 2.19 points and .62 points respectively. These associations persisted even after exclusion of premature children and children with extreme weights and head circumferences. 
The authors conclude that longer birth length, higher birth weight, or larger head circumferences within the normal birth size range are associated with higher IQ scores in Asian children. They say that their results suggest that antenatal factors reflected in altered rates of growth but within the normative range of pregnancy experiences play a role in generating cognitive potential. This finding has implications for targeting early intervention and preventative programs. 



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The National Fetal and Infant Mortality Review Program is a partnership between ACOG and federal MCHB.
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