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American Teens Struggling With Mental Health Issues

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WEDNESDAY, March 25, 2020 (HealthDay News) — Rates of anxiety, depression and suicidal thoughts are all on the rise among U.S. teens, a new study finds.

“We aren’t sure why this is occurring, but it is clear from this evidence and other epidemiological studies that anxiety, depression and other internalizing problems are becoming more prevalent among adolescents relative to other types of mental health problems,” study author Dr. Ramin Mojtabai, a professor in Johns Hopkins’ Bloomberg School of Public Health’s Department of Mental Health, said in a Hopkins news release.

The researchers also found there’s been a significant rise in the rates of teen girls seeking mental health care and their use of outpatient mental health services.

The researchers analyzed data on more than 230,000 teens collected between January 2005 and December 2018 in annual U.S. federal government health surveys.

Nearly 20% of the teens said they’d received counseling for mental health problems in the past year, and that rate didn’t change significantly over the study period.

However, the rate of mental treatment or counseling among teen girls rose from an average of 22.8% in 2005-2006 to 25.4% in 2017-2018, an 11.4% increase, while the rate among boys fell from 17.8% to 16.4%, a 7.9% decrease. Most of the rate changes occurred after 2011-2012.

Meanwhile, rates of internalizing mental health problems such as anxiety, depression and suicidal thinking among teens rose from 48.3% in 2005-2006 to 57.8% in 2017-2018 — a nearly 20% increase.

Among internalizing problems, suicidal thoughts or attempts increased the most, from 15% to 24.5% of the total, a 63.3% increase, according to the study published online March 25 in the journal JAMA Psychiatry.

The researchers also found a 15.8% increase in teens’ use of outpatient mental health services such as psychiatric and psychotherapy clinics. This went with a corresponding drop in school counseling services, and little change in inpatient mental health care.

— Robert Preidt

MedicalNews
Copyright © 2020 HealthDay. All rights reserved.




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SOURCE: Johns Hopkins Bloomberg School of Public Health, news release, March 25, 2020



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What’s the Evidence They Are Protective?

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News Picture: White House to Advise Face Mask Use: What's the Evidence They Are Protective?By Dennis Thompson
HealthDay Reporter

FRIDAY, April 3, 2020 (HealthDay News) — The Trump Administration is expected to announce guidelines that will recommend many Americans wear face masks when out in public, to curb transmission of the novel coronavirus.

The recommendation will apply to those living in hard-hit areas only, and it is not mandatory, the Associated Press reported.

Experts say there’s emerging — but still inconclusive — evidence that such a practice might help “flatten the curve” of COVID-19’s spread.

On Thursday, President Donald Trump announced that his administration was “coming out with regulations” on mask use, but no one will force individuals to do so.

“If people want to wear them, they can,” he said.

To save scarce N95 masks and surgical masks for front-line health care workers, many experts believe that cheaper versions or do-it-yourself cloth masks might be a good alternative for everyday use. Trump has said that even scarves wrapped over the mouth and nose might work.

Thursday’s announcement from the White House runs counter to COVID-19 public health guidelines in place over the past two months. Those guidelines opposed healthy folks wearing face masks in public.

That was due to concerns that cloth masks might increase a persons’s risk of infection if not worn properly or washed regularly, explained Dr. Luis Ostrosky, an infectious disease specialist with Memorial Hermann-Texas Medical Center in Houston.

“We know the virus can live on surfaces up to three days. The more porous and moist the surface, the longer it can live there,” Ostrosky said. “We don’t like cloth masks because they tend to get very moist and pull germs in, not only virus, but bacteria.”

Officials also didn’t want people to use surgical masks or respirators, given that hospitals face critically short supplies of these valuable protective devices.

But recently, U.S. Surgeon General Dr. Jerome Adams has asked the U.S. Centers for Disease Control and Prevention to investigate whether this recommendation should change, based on the spread of COVID-19 by people who have not developed any symptoms.

Although there’s not a lot of scientific evidence, there’s a growing consensus that DIY cloth masks might help protect people in crowded or poorly ventilated areas such as subways, elevators or grocery stores, said Ravina Kullar, an infectious diseases researcher with Expert Stewardship Inc. in Newport Beach, Calif.

“It goes both ways. It’s to protect other people if you’re asymptomatic, and it’s to protect yourself if someone is out there coughing and their droplet falls on you,” Kullar said.

People who are in high-risk groups — the elderly, immunocompromised or chronically ill — also might want to wear a DIY cloth mask for added protection, Kullar said.

The COVID-19 coronavirus is probably three times as infectious as the flu, CDC Director Dr. Robert Redfield noted in a Monday interview with an NPR station in Atlanta. He believes that some infected people are likely transmitting the virus as many as two days before showing symptoms.

Further, there’s a possibility that the novel coronavirus could be spread by simple conversation or breathing, and not just by sneezing or coughing, according to a letter issued Wednesday by the U.S. National Academies of Science.

Still, the evidence on that is far from solid.

“It’s unclear if aerosolized droplets from casual conversation or simply breathing — from even 6 feet away — could place others at risk of contracting COVID-19,” said Dr. Robert Glatter, emergency physician at Lenox Hill Hospital in New York City. However, he said, “since we can’t definitively exclude this possibility, wearing a face covering might be advisable at this time.

“That said, we should reserve surgical face masks for health care workers on the front lines of this crisis,” Glatter continued.

Kullar urges people to donate any store-bought surgical face masks or respirators to local hospitals in desperate need.

And, most importantly, folks who choose to wear a DIY mask must not let lapse other healthy habits that protect against infection, Kullar added.

Even with the mask, you should still practice social distancing, regularly wash your hands, and avoid touching your face, Kullar said.

“In the beginning, my stance was, I don’t think it’s a good idea because I fear that social distancing will lapse and then people will start touching their face more because it gives a false sense of security,” Kullar said. “They think they’re protected with this mask, and they don’t need to physically distance themselves anymore, and that’s not true.”

For its part, the World Health Organization is standing by its recommendation that people not wear face masks unless they are sick with COVID-19 for precisely that reason.

“There is no specific evidence to suggest that the wearing of masks by the mass population has any potential benefit,” Dr. Mike Ryan, executive director of the WHO health emergencies program, said at a media briefing in Geneva on Monday. “In fact, there’s some evidence to suggest the opposite in the misuse of wearing a mask properly or fitting it properly.”

Individual countries haven’t toed this line. For example, Japan has announced that it plans to provide two washable face masks to 50 million households.

The best-performing DIY face mask design involves two layers of high-quality heavyweight “quilter’s cotton” with a thread count of 180 or more, according to a new study by Wake Forest Baptist Health.

Other cloth with an especially tight weave and thicker thread like batiks also do well, as does a double-layer mask with a simple cotton outer later and an inner layer of flannel, the Wake Forest researchers said.

Single-layer masks or double-layer designs using low-quality lightweight cotton do not work as well to filter airborne particles, the researchers said.

People who choose to wear a mask should refrain from touching it while worn, particularly with hands that haven’t been washed, Ostrosky said.

They should wash the mask after each use, and refrain from either placing it on surfaces that might not be clean or in a storage bag or container that could be contaminated, Ostrosky said.

“There’s no clear evidence that may be guiding the discussion,” Ostrosky said. “It’s really a personal choice. If you’re going to do it, it should be done correctly or it could be detrimental to your health.”

Also keep in mind you don’t need to wear the mask when you’re out at a park or walking through your neighborhood, as long as you’re practicing social distancing.

“The risk of transmission from simple breathing or conversation is much less of an issue outside in the environment with more efficient circulation from wind currents,” Glatter said. “It’s more of a concern in poorly ventilated or closed spaces indoors.”

MedicalNews
Copyright © 2020 HealthDay. All rights reserved.

References


SOURCES: Luis Ostrosky, M.D., infectious disease specialist, Memorial Hermann-Texas Medical Center, Houston; Ravina Kullar, Pharm.D., M.P.H., infectious diseases researcher and epidemiologist, Expert Stewardship Inc., Newport Beach, Calif.; Robert Glatter, M.D., emergency physician, Lenox Hill Hospital, New York City



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Rashmika Mandanna Latest Workout Live Chat With Fitness trainer | Rashmika workout | Filmylooks

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Watch Rashmika Mandanna Latest Workout Live Chat With Fitness trainer | Rashmika workout | Filmylooks

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Key Drugs Join PPEs on List of Front-Line Shortages

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What your doctor is reading on Medscape.com:

APRIL 02, 2020 — First it was a critical shortage of personal protective equipment. Then pleas for more ventilators to sustain patients with COVID-19 and providers to care for them. Now, multiple sources are reporting deepening shortages of the drugs needed to help ventilate patients and keep them sedated.

Shortages are already evident for albuterol; neuromuscular blockers and sedatives, including fentanyl, midazolam, and propofol; and vasopressors for septic shock, even as orders increase exponentially.

The rates at which hospitals traditionally had been able to fill orders for ventilator-associated drugs was 95%, Dan Kistner, PharmD, told Medscape Medical News

“These classes of drugs have dropped to 60 or 70% in the last month alone,” said Kistner, senior vice president for pharmacy solutions at Vizient, a group purchasing organization that negotiates medicine contracts for about 3000 hospitals and healthcare facilities in the US.

“Every day it’s dropping 2 or 3 additional percent,” he continued.


Demand “Unprecedented”

The demand is simply “unprecedented,” he said, adding that the shortages are piling up even after elective surgeries have been put on hold.

A California nurse’s tweet in a nationwide thread of tweets under #WeNeedMeds poignantly described the consequences of severe shortages of some of these drugs. “Please do not put me on a vent if you can’t keep me sedated,” she writes. “I understand the alternative is death.”

Esther Choo, MD, MPH, an emergency physician at Oregon Health &  Science University in Portland, tweeted: “Those ventilators can’t really be used without a similarly vast supply of coupled medications to get people *on* the vents — and keep them on humanely. Hospitals are already experiencing shortages, before we even hit disease apex.”


15 Drugs at or Near Short Supply

Healthcare improvement company Premier, based in Charlotte, North Carolina, this week released a report that found 15 drugs used for COVID-19 care are in shortage or close to being in short supply at the same time demand is skyrocketing, particularly in New York.

Their data differ slightly from Vizient’s but still show increasing numbers of orders going unfilled.





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