Children's Health: Goth teens could be more vulnerable to depression ♦ Air pollution linked to children's low academic achievement ♦ Adolescents may not ‘grow out of’ ADHD

Differences in brain structure and memory suggest adolescents may not ‘grow out of’ ADHD Young adults diagnosed with attention deficit/hyperactivity disorder (ADHD) in adolescence show differences in brain structure and perform poorly in memory tests compared to their peers.

Air pollution linked to children's low academic achievement A new study on children's health has found that fourth and fifth graders who are exposed to toxic air pollutants at home are more likely to have lower GPAs

Goth teens could be more vulnerable to depression and self-harm Young people who identify with the goth subculture might be at increased risk of depression and self-harm.

Back to school and back to sleep  Poor sleep might explain how stress impacts health in kids, a new study suggests. Researchers found that getting a good night's sleep might buffer the impact of stress on kids' cortisol level, which is a hormone produced in the adrenal gland to regulate the body's cardiovascular, metabolic and immune systems.

Teens lose sleep after change to daylight saving time High school students lose sleep on school nights following the change to daylight saving time that occurs in March, a study has concluded. The loss of sleep during the school week was associated with a decline in vigilance and cognitive function, which raises safety concerns for teen drivers.

Kids and Tobacco Use Kids and Tobacco Use

The number of kids smoking cigarettes is down—but the number using other tobacco products is way up. That’s the word from the 2014 National Youth Tobacco Survey (NYTS), co-conducted by the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA).

“This is the only nationally representative survey of middle and high school students that focuses exclusively on tobacco use,” says Benjamin J. Apelberg, Ph.D., branch chief of epidemiology at FDA’s Center for Tobacco Products.

Survey results provided a national snapshot of what tobacco products today’s middle and high school youth are using, as well as emerging trends over time.

The key findings include:

• In 2014, one in four high school students and one in 13 middle school students reported being tobacco users (using one or more tobacco products in the previous 30 days).
• Of the then-current 4.6 million youth tobacco users, 2.4 million reported using e-cigarettes.
• Between 2011 and 2014, the percentage of students reporting current use of cigarettes decreased from 15.8% to 9.2%.
• Between 2011 and 2014, hookah use among high school students doubled and e-cigarette use increased even more dramatically.
• In 2014, nearly 2.2 million students reported using two or more tobacco products.

Since the survey started collecting data on e-cigarettes in 2011, in 2014 their current use for the first time surpassed current use of every other tobacco product, including conventional cigarettes.

“One thing the study confirms for us is that the tobacco product landscape has changed dramatically,” Apelberg says. “Middle and high school kids are using novel products like e-cigarettes and hookahs in unprecedented numbers, and many are using more than one kind of tobacco product.”

It’s something of a good news/bad news picture, says FDA epidemiologist Catherine Corey. “While we’re glad to see cigarette smoking decreasing in middle and high school youth, the increase in the use of e-cigarettes and hookahs undermines progress in reducing tobacco use among kids,” she says.

Nicotine Can Affect the Developing Brain

Nicotine is dangerous and highly addictive for kids at any age, whether it comes from an e-cigarette, hookah, cigarette or cigar. Because the brain is still developing, adolescence appears to be a particularly vulnerable time. Research has clearly demonstrated that exposure to nicotine at a young age increases the chance that kids will become addicted. In addition to nicotine exposure, tobacco use can be harmful due to the numerous other chemicals present in tobacco products that can cause disease.

“Youth should not use tobacco in any form,” Apelberg says.

At this time, FDA has regulatory authority over cigarettes, cigarette tobacco, roll-your-own tobacco and smokeless tobacco. The agency is in the process of finalizing a rule that would extend its authority to regulate additional products that meet the legal definition of a tobacco product, such as electronic cigarettes, cigars and hookahs. FDA is also proposing a minimum age of 18 for buying tobacco.

How You Can Help

FDA’s tobacco compliance and enforcement efforts range from training and education to monitoring compliance with the law and initiating advisory and enforcement actions. In addition, the agency inspects tobacco retailers to ensure, among other things, that retailers are checking IDs and not selling regulated tobacco products to anyone under the age of 18.

Consumers can help FDA by reporting potential violations of the agency’s rules for tobacco products, either online or by phone at 1-877-CTP-1373

Brain and behavioral effects of teen binge drinking

Adolescent binge drinking can disrupt gene regulation and brain development in ways that promote anxiety and excessive drinking behaviors that can persist into adulthood, according to a new study supported by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health. A report of the study, conducted in animals by researchers at the University of Illinois at Chicago College of Medicine, appears online in the journal Neurobiology of Disease.

Previous studies have shown that people who start drinking before the age of 15 are four times more likely to meet the criteria for alcohol dependence at some point in their lives, and young people consume more than 90 percent of their alcohol by binge drinking.

. To model adolescent binge-drinking in humans, the researchers gave 28-day-old rats alcohol for two days in a row, followed by two days off, and repeated this pattern for 13 days. Some rats were followed into adulthood and observed for abnormal behaviors. They were offered both alcohol and water, and their alcohol-drinking behavior was monitored.

Rats exposed to alcohol during adolescence exhibited changes in behavior that lasted into adulthood, long after their adolescent binge exposure to alcohol had ended. For example, they showed increased anxiety-like behaviors and drank more alcohol in adulthood.

Prior research has implicated a brain structure known as the amygdala in anxiety and alcohol-drinking behaviors. When Dr. Pandey and his colleagues analyzed the amygdala of alcohol-exposed rats in their study, they found that the complex of DNA and histone proteins within the amygdala cell nuclei appeared to be tightly wrapped. They also found increased levels of a protein called HDAC2, which modifies histones in a way that causes DNA to be wound tighter around them. Collectively, these kinds of changes to DNA or its associated proteins that change its function but do not affect the DNA sequence are referred to as epigenetic changes.

“Genes that lie within DNA that is tightly wrapped around the histones are less active than they are if the DNA is loosely wrapped,” explains Dr. Pandey. “The looser the DNA is coiled, the more accessible are the genes to the cellular machinery that makes relevant proteins.”

Dr. Pandey and his team found that the epigenetic changes they observed in alcohol-exposed rats were linked to lowered expression of two genes – brain-derived neurotrophic factor and activity-regulated cytoskeleton-associated -- that nerve cells need to form new connections with each other. The diminished expression of the genes persisted in adulthood, even if alcohol exposure was stopped weeks before, and the researchers observed diminished nerve connectivity in the amygdala of these affected adult rats. But they then showed that a drug that blocks the activity of HDAC2 could loosen the coiling of DNA in amygdala cell nuclei of alcohol-exposed rats, and increased the expression of the gene needed for nerve cell connectivity in those animals. The animals then also exhibited less anxiety and reduced alcohol intake.

The researchers plan additional studies of this target and other epigenetic drugs to investigate their possible use in reversing the persistent harmful effects of adolescent alcohol exposure.

Childrens Health:Exploring the teenage brain--Saliva test to diagnose autism--Teens increasingly sleep deprived--Drug exposure to autism-like effects

Exploring the teenage brain, and its drive for immediate reward  Teenage exploration and risk taking could be explained by dramatic brain changes that allow planning and encourage the need for immediate reward, according to a neuroscientist  Continue Reading

Researchers may develop saliva test to diagnose autism  A spit test may one day be able to diagnose autism according to new research. Scientists have published the first study showing that children with autism spectrum disorder have differences in protein levels in their saliva when compared to typically developing children. Continue Reading

Teens increasingly sleep deprived  A new study found that female students, racial/ethnic minorities, and students of lower socioeconomic status are less likely to report regularly getting seven or more hours of sleep each night compared with their male counterparts, non-Hispanic white teenagers, and students of higher socioeconomic status, respectively. The largest decrease in the percentage Continue Reading

Tadpole model links drug exposure to autism-like effects  In utero exposure to the epilepsy drug VPA appears to elevate the risk to babies of developing an autism spectrum disorder. A new study used a tadpole model to investigate VPA's effects on developing neural physiology and behavior. Researchers now hope to use the model to develop an intervention and to learn more about the underlying causes of neurodevelopmental disorders more broadly.  Continue Reading

Cancer Preventing Vaccine (HPV) Underutilized by Adolescents

Healthcare professionals should eliminate missed opportunities by giving a strong recommendation for HPV vaccine during the same visit they recommend Tdap and meningococcal vaccines for preteens (ages 11-12 years); bundling the recommendations for all of the adolescent vaccines—thus giving HPV vaccine recommendation the same weight and importance as the others—helps parents make the decision to get HPV vaccine for their children.

With only a modest increase in coverage, HPV vaccination rates among adolescents remained low for another year. The vaccine is safe, effective, and prevents cancer, but it continues to be underutilized and missed opportunities are common. Had HPV vaccine been administered during health care visits when another vaccine was administered, vaccination coverage for ≥1 dose could have reached 91.3 percent by age 13 years for adolescent girls born in 2000.  Only 64.4 percent of parents of girls and 41.6 percent of parents of boys reported receiving a recommendation.  

More parents of teens who received the HPV vaccine reported getting a vaccine recommendation, confirming findings from other research that a recommendation from a healthcare professional is extremely influential in determining whether or not parents get HPV vaccine for their preteen.

Teens Skipping Breakfast Increases the Risk of Coronary Heart Disease, Stroke or Type 2 Diabetes.

Skipping breakfast in the morning when you have teenagers, or simply to drink and eat something quickly, favors the possibility of being affected by the metabolic syndrome in adulthood. A research conducted by Umea University in Sweden,, reported eating habits 1083 teens at breakfast. They  evaluated then, 27 years later for the incidence of metabolic syndrome

The metabolic syndrome is a set of risk factors that increase the chance of coronary artery disease, stroke, and type 2 diabetes.. In the subjects participating in the Swedish study were found, in particular, excessive abdominal fat and higher levels of fasting blood glucose.The young people who skipped breakfast, had a higher incidence of adult metabolic syndrome 68%

The study shows that young people are used to doing a poor breakfast or skip it altogether, as adults have had a higher incidence of the metabolic syndrome 68%, compared to those who did a hearty breakfast. The Swedish researchers have come to this conclusion taking into account the socio-economic factors and lifestyles of the participants.

Research Finds Many Youth Have High Levels of HIV

Study succeeds at early diagnosis but suggests high risk of HIV infection for youth

More than 30 percent of young males who had sex with other males and who were subsequently enrolled in a government treatment and research network were found to have high levels of HIV, reported researchers from the National Institutes of Health and other institutions.

The health status of the study participants, who ranged in age from 12 to 24 years, was monitored as part of their participation in the - Adolescent Medicine Trials Network for HIV/AIDS Interventions= (ATN). The ATN provides medical care to youth with HIV and offers counseling and, medications, and other preventive measures to youth who are at risk of acquiring HIV. As part of their participation in the network, the youth have the option of taking part in research studies of the latest methods to prevent people from acquiring HIV and to treat those who have become infected.

To conduct the current study, researchers analyzed the health records of youth with HIV, soon after they enrolled in the ATN. The study authors noted that the high blood levels of the virus seen in the majority of study participants indicated that they were diagnosed early in the course of HIV infection, when the chances for minimizing the health consequences of HIV are greatest. The researchers added, however, that the study results suggest that HIV is highly likely to be transmitted among members of this group.

“This is not a time for complacency,’’ said study author Bill G. Kapogiannis, M.D., scientific director of the ATN. “Our results suggest that all health care providers who work with young people — particularly those who work with males who have sex with other males — should stress the urgency of getting tested, and, if infected, into treatment, which benefits their own health as well as reduces transmission to others.”

According to the U.S. Centers for Disease Control and Prevention, 1 in 4 new HIV infections  occur in young people from 13 to 24 years of age. About 60 percent of all youth with HIV do not know they are infected, are not getting treated, and can unknowingly pass the virus on to others. Among the groups that the CDC recommends get tested for HIV are those:

• The network is funded by three institutes at the National Institutes of Health: The Eunice Kennedy Shriver
• Who have injected drugs and shared needles and other equipment with others
• Who have had unprotected sex with men who have sex with men, had multiple partners or anonymous partners
• Have been diagnosed with hepatitis, tuberculosis, or a sexually transmitted disease
• Had unprotected sex with someone in the above groups

To conduct the study, the researchers measured the viral load and CD4 counts of 852 youth in 14 cities in the United States and Puerto Rico. Viral load is the amount of HIV in the blood. Dr. Kapogiannis explained that viral levels are highest very early in the course of an HIV infection. CD4 counts measure infection-fighting white blood cells known as T-cells.

“In the first few weeks, the viral load can be millions of copies, or higher,” he said. “Then, over the ensuing months, it stabilizes at about 30,000 to 50,000 copies. Normal CD4 counts range from 500 to 1,000, but drop substantially during the infection.”

Among the study participants, 34 percent had CD4+ counts of 350 or less, 27 percent had counts from 351 to 500, and 39 percent had counts greater than 500. Male youth who had reported sexual contact with another male had the highest average viral load, in excess of 115,000. Among all males, regardless of sexual orientation, the viral load averaged more than 106,000. For females, the average viral load count was roughly 48,000. Most of those diagnosed with HIV had been referred for medical care during the course of the study (79 percent.)

“Men with HIV tend to have higher viral loads than do women,” Dr. Kapogiannis said. “But I think there is a timing issue here as well. It’s possible that the young men who have sex with men are being diagnosed earlier than are the women, because of greater awareness of the risks and more frequent testing.”

Because of the high viral loads they detected in their study, the researchers concluded that efforts to diagnose and treat people with HIV should focus a large share of their efforts on youth, particularly young men who have sex with men.

“It’s important to get these individuals into treatment early, not only for the sake of their own health, but also for that of others, because many youth don’t even know they are infected and may risk unknowingly transmitting the virus during this time,” Dr. Kapogiannis said.

New Substance Abuse Treatment Resources Focus on Teens

Guide on treating teen substance abuse and online education for healthcare providers now available

Resources to help parents, health care providers, and substance abuse treatment specialists treat teens struggling with drug abuse, as well as identify and interact with those who might be at risk, were released today by the National Institute on Drug Abuse (NIDA). The release came before the start of National Drug Facts Week, an annual observance to educate teens about drug abuse. NIDA is part of the National Institutes of Health.

Teens hear about substance abuse resources

Adolescents’ drug use, as well as their treatment needs, differ from those of adults. Teens abuse different substances, experience different consequences, and are less likely to seek treatment on their own because they may not want or think they need help. Parents can work with healthcare professionals to find appropriate treatment, but they may be unaware that the teen is using drugs and needs help. According to the 2012 National Survey on Drug Use and Health, only 10 percent of 12- to 17-year-olds needing substance abuse treatments receive any services.

“Because critical brain circuits are still developing during the teen years, this age group is particularly susceptible to drug abuse and addiction,” said NIDA Director Dr. Nora D. Volkow. “These new resources are based on recent research that has greatly advanced our understanding of the unique treatment needs of the adolescent.”

A new online publication, Principles of Adolescent Substance Use Disorder Treatment: A Research Based Guide,describes the treatment approaches. Highlights include:

• Thirteen principles to consider in treating adolescent substance use disorders
• Frequently asked questions about adolescent drug use
• Settings in which adolescent drug abuse treatment most often occurs
• Evidence-based approaches to treating adolescent substance use disorders
• The role of the family and medical professionals in identifying teen substance use and supporting treatment and recovery.

To increase early screening of adolescent substance abuse, The Substance Use Disorder in Adolescents: Screening and Engagement in Primary Care Settings educational module was created. The online curriculum resource for medical students and resident physicians provides videos demonstrating skills to use in screening adolescents at risk for or already struggling with substance use disorders. Both the patient and physician perspectives are highlighted. Although created as a training tool, the resource is also free to anyone in the public seeking information on how to interact with teens at risk for addiction.

NIDA has many other resources that will be promoted during National Drug Facts Week, Jan. 27-Feb. 2, 2014. For more information on this observance, go to: http://drugfactsweek.drugabuse.gov.

The National Institute on Drug Abuse is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports most of the world’s research on the health aspects of drug abuse and addiction. The Institute carries out a large variety of programs to inform policy and improve practice. Fact sheets on the health effects of drugs of abuse and information on NIDA research and other activities can be found on the NIDA home page a at http://www.drugabuse.gov, which is now compatible with your smartphone, iPad or tablet. To order publications in English or Spanish, call NIDA’s Drug Pubs research dissemination center at 1-877-NIDA-NIH or 240-645-0228 (TDD) or fax or email requests to 240-645-0227 or drugpubs@nida.nih.gov. Online ordering is available at http://drugpubs.drugabuse.gov. NIDA’s media guide can be found at http://drugabuse.gov/mediaguide, and its new easy-to-read website can be found at http://www.easyread.drugabuse.gov.