After-School Exercise Yields Brain Gains: Study

Findings suggest physical education, recess may improve academic success

WebMD News from HealthDay

By Tara Haelle

HealthDay Reporter

MONDAY, Sept. 29, 2014 (HealthDay News) -- Regular daily exercise appears to improve children's attention and multi-tasking skills, according to a new study.

Elementary school-age students who participated in an after-school program with plenty of physical activity showed greater improvements in several areas of so-called "executive function" than similar students who did not participate.

Executive function refers to a range of mental or "cognitive" skills that include memory, focus, attention and the ability to switch back and forth between tasks.

Lead researcher Charles Hillman said that students who had the highest attendance in the program saw the biggest gains in mental skills.

"I think these are the hardest evidence we have available that time spent in physical activities, which would include physical education and recess, not only doesn't detract from academic goals, but it might enhance academic performance," said Hillman, a professor of kinesiology and community health at the University of Illinois at Urbana-Champaign.

The findings were published online Sept. 29 and in the October print issue of the journal Pediatrics.

The researchers randomly assigned 221 children, aged 7 to 9, to either the after-school program or a wait-list for the program. The after-school program occurred for nearly all of the school year (150 days). Over two hours, physical activity alternated with rest periods, resulting in about 70 minutes of moderate to vigorous exercise every weekday, Hillman said.

The children took tests to measure their "inhibition" and their "cognitive flexibility," which is basically their ability to switch between different tasks successfully, such as reading something and then answering questions about that reading, Hillman said.

Inhibition involves two types of thinking skills, Hillman explained: the ability to ignore distractions in the environment to focus on something specific, and the ability to stop a well-learned response quickly when necessary.

If a child automatically starts to ride his bicycle across a street when a light turns green, for example, a strong inhibition response refers to how quickly he can prevent himself from going forward when he notices a car running the red light.

Although children in both the after-school program and the wait-list group experienced improvements in physical fitness, inhibition and cognitive flexibility, the after-school program participants made bigger gains in all three areas.

The program participants also showed improvements in attention that were not seen in the wait-list group, and they had smaller gains in body mass index (BMI) than the wait-list students. BMI is a measurement of body fat based on height and weight.

Because the study directly compared two similar groups of children, the findings support the idea that the physical activity actually caused the brain improvements, though it's less clear how physical activity improves thinking skills, the experts said.

source : After-School Exercise Yields Brain Gains: Study

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Pediatricians Endorse IUDs, Implants for Teen Birth Control

These methods are more reliable than condoms, birth control pills, experts say

WebMD News from HealthDay

By Amy Norton

HealthDay Reporter

MONDAY, Sept. 29, 2014 (HealthDay News) -- Long-acting contraceptive devices should be the first choice of birth control for teenage girls, new recommendations from the American Academy of Pediatrics state.

Although most U.S. teens opt for condoms or birth control pills, two other forms of contraception -- intrauterine devices (IUDs) and contraceptive implants -- are much more reliable, according to the academy.

And they should be the "first-line" choices for teenage girls who don't want to remain abstinent, the academy says in guidelines published Sept. 29 in the journal Pediatrics.

The advice is in line with guidelines from other medical societies, such as the American College of Obstetricians and Gynecologists.

But experts said they hope the official recommendation to pediatricians will increase teenage girls' use of IUDs and implants.

The academy's move is "fantastic," said Dr. David Eisenberg, an assistant professor of obstetrics and gynecology at Washington University in St. Louis.

"I'm happy to see that every major medical or public health organization in the United States agree that IUDs and implants should be the 'default' first-line contraceptive methods for all women and girls who want them," said Eisenberg, who was not involved in writing the guidelines.

According to Planned Parenthood, IUDs are implanted in the uterus, where they release small amounts of either copper or the hormone progestin. The contraceptive implant, about the size of a matchstick, is inserted under the skin of the arm, where it releases controlled amounts of progestin.

The hormonal IUD (sold under the brand name Mirena) can prevent pregnancy for five years, while the copper version (ParaGard) is effective for about 10 years, according to Planned Parenthood. The contraceptive implant (Implanon, Nexplanon) works for up to three years.

The contraceptives are sometimes called "set and forget" birth control, noted Megan Kavanaugh, a researcher at the Guttmacher Institute in New York City -- a nonprofit organization that focuses on reproductive health.

For condoms and birth control pills to be most effective, people have to use them perfectly. Not so with IUDs and implants, Kavanaugh pointed out.

"That's important for adults, too," she said. "But teenagers are notorious for having a lot on their plates, and being forgetful."

According to the U.S. Centers for Disease Control and Prevention, between 0.2 percent and 0.8 percent of women who use an IUD will have an unplanned pregnancy within a year. The rate is just 0.05 percent with a contraceptive implant.

With the Pill, about 9 percent of women have an unintended pregnancy each year. Condoms, as people typically use them, are less effective -- with an unplanned pregnancy rate between 18 percent and 21 percent, according to the CDC.

Despite that, U.S. women and teens opt for condoms and birth control pills much more often than IUDs or implants. Part of the reason may be that young women don't realize the devices are an option for them, Kavanaugh said.

source : Pediatricians Endorse IUDs, Implants for Teen Birth Control

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Texas and Florida Expand Medicaid – For Kids

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In addition to those three and Texas and Florida, the other states that broadened eligibility for children in Medicaid are Alabama, Arizona, Arkansas, Delaware, Georgia, Kansas, Mississippi, Nevada, North Carolina, North Dakota, Oregon, Pennsylvania, Tennessee, Utah, West Virginia and Wyoming. Eleven of these states expanding kids’ coverage opted against expanding it for adults, after the Supreme Court gave them that option.

Many Kids Shifted From CHIP

In most of those states, between half and two-thirds of the children joining Medicaid were previously covered by CHIP. About 562,000 children were expected to shift from CHIP to Medicaid as a result of the law, according to a study by the Georgetown Center for Children and Families.

Experts say the benefits are generally richer in Medicaid. For instance, families had to pay monthly premiums for their kids’ CHIP coverage in six states that expanded Medicaid for children —Alabama, Arizona, Delaware, Florida, Georgia and Utah, according to Joan Alker, executive director of the Georgetown program.

“Having [to pay] premiums depresses enrollment” in CHIP, she said.

Medicaid requires that children receive comprehensive services, including physical exams, immunizations, laboratory tests and dental, vision, and hearing services. CHIP benefits are not as broad in some states.

Still, state officials and advocates in California and Pennsylvania worry that families may have to find new doctors for their kids because Medicaid does not have as many participating providers as CHIP in some places.

“It’s a mixed bag, as Medicaid has lower costs but possibly fewer providers,” said Kelly Hardy, senior director of health policy for the California advocacy group, Children Now.

But Hardy said the expansion makes life easier for parents who will no longer have to deal with having one child in CHIP and another in Medicaid because income eligibility varied by age. Siblings in different programs might have different benefits, provider networks and cost-sharing.

Unlike Medicaid expansion for adults, the federal government is not paying the full cost of expanded eligibility for the first three years. Instead, states will get the higher federal matching rate for CHIP—about 71 percent of the costs.

‘Welcome Mat’ Effect

In Texas, nearly 2.9 million children were signed up for Medicaid as of August 2014—up about 254,000 school-age kids from December 2013. In the same period, Texas’ CHIP enrollment fell by nearly 160,000. 

“There is no doubt we are seeing a welcome mat effect,” involving children who were previously eligible but not enrolled and who were signed up because of the publicity about the ACA’s open enrollment, said Dunkelberg of the Center for Public Policy Priorities.

In Florida, enrollment of school-age children in Medicaid rose by 137,000 this year, which included more than 62,000 kids who transferred from the state’s CHIP program, according to Florida Healthy Kids Corp., the nonprofit that runs CHIP in the state. That switch saved families money, since they previously had to pay a $15- or $20-a-month premium for CHIP coverage.

source : Texas and Florida Expand Medicaid – For Kids

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