Maternal and Child Health Library
This and past issues of the MCH Alert are available at http://www.mchlibrary.info/alert/archives.html.
March 7, 2008
1. Chartbook Reports New Findings from National Survey of
Children with Special Health Care Needs
2. New MCH Teaching Tool Released
3. Manual Provides Guidance in Choosing Pediatric
Developmental Screening Instruments
4. Paper Highlights State and Local Innovation in Finance
Policy for Child Behavioral Health Services
5. Article Finds Association Between Breastfeeding
Duration and Lower Prevalence of Metabolic Syndrome Among Women in
Midlife
************************************************************
1. CHARTBOOK REPORTS NEW FINDINGS FROM NATIONAL SURVEY OF CHILDREN
WITH
SPECIAL HEALTH CARE NEEDS
The National Survey of Children with Special Health Care Needs
Chartbook 2005-2006 highlights major findings on the prevalence of
special health care needs among children, both nationally and within
each state, and on access to and satisfaction with health care among
children with special health care needs (CSHCN) and their families. The
survey, sponsored by the Maternal and Child Health Bureau and carried
out by the National Center for Health Statistics, provides information
about six core outcomes used to measure progress toward the Healthy
People 2010 objectives to increase the proportion of states that have
integrated service systems for CSHCN. The chartbook is available at http://mchb.hrsa.gov/cshcn05/index.htm.
************************************************************
2. NEW MCH TEACHING TOOL RELEASED
Implementing the Medical Home Model in Minnesota: A Case Study is the
first in a series of maternal and child health (MCH) case studies
designed for classroom use by teachers of public health, MCH, health
policy, evaluation, and health education in preparing students to serve
as effective change agents working within the framework of Title V at
national, state, and community levels. The study guide, prepared by a
joint committee of the Association of Teachers of Maternal and Child
Health and the Association of Maternal and Child Health Programs,
presents one state's efforts to promote the medical home model of care
for children with special health care needs. Selected topics include
the importance of parents, the importance of physicians, the
collaborative team, funding, and the future. Information on how to use
the guide, including case study goals and objectives, key problems,
discussion questions, role-playing opportunities, and assessing student
progress, is provided. The study guide is available at http://www.asph.org/atmch/documents/ATMCHMedicalHomesCaseStudyGuide.pdf.
************************************************************
3. MANUAL PROVIDES GUIDANCE IN CHOOSING PEDIATRIC DEVELOPMENTAL
SCREENING INSTRUMENTS
Pediatric Developmental Screening: Understanding and Selecting
Screening Instruments informs practitioners' selection and application
of screening instruments in a range of practice settings. The Web-based
manual, developed by the Commonwealth Fund, is based on a review of the
scientific research on available developmental screening instruments.
Part 1 is designed to facilitate the selection of screening instruments
by helping practitioners define their practice needs. Part 2 presents
guides designed to facilitate practitioners' abilities to compare
developmental screening instruments with respect to clinical utility in
practice settings and validity, or sensitivity and specificity, in
different populations and at various ages. An interactive Web feature
(flow chart) is also available to answer questions about screening
needs and make instrument recommendations. The manual is available at http://www.commonwealthfund.org/publications/publications_show.htm?doc_id=614864.
************************************************************
4. PAPER HIGHLIGHTS STATE AND LOCAL INNOVATION IN FINANCE POLICY FOR
CHILD BEHAVIORAL HEALTH SERVICES
Towards Better Behavioral Health for Children, Youth and Their
Families: Financing That Supports Knowledge provides an overview of
sources of funding (and their policy roots) that underwrite children's
behavioral health services, illuminating the flaws and prospects of
various policy choices. The working paper is the third in a series
titled Unclaimed Children Revisited produced by the National Center for
Children in Poverty. Although the paper focuses on public funding for
mental health and on substance abuse services within the behavioral
health arena, it also addresses related funding in education, child
welfare, and juvenile justice. Topics include an overview of children's
behavioral services, an overview of federal behavioral health funding
streams and their impact, fiscal innovation in states and local
communities, and challenges and opportunities. The authors conclude the
paper with recommendations for policy actions to create and sustain a
supportive federal and state fiscal environment. The paper is available
at http://www.nccp.org/publications/pdf/text_804.pdf.
************************************************************
5. ARTICLE FINDS ASSOCIATION BETWEEN BREASTFEEDING DURATION AND LOWER
PREVALENCE OF METABOLIC SYNDROME AMONG WOMEN IN MIDLIFE
"We have found that duration of lactation is associated with prevalence
of MetSyn [metabolic syndrome] in parous midlife women in a
dose-response manner," state the authors of an article published in the
March 2008 issue of the American Journal of Obstetrics and Gynecology.
MetSyn is a clustering of the following metabolic abnormalities:
insulin resistance, dyslipidemia, hypertension, and obesity. Women with
MetSyn are at increased risk of diabetes mellitus, major cardiovascular
events, and all-cause mortality. To date, no study has examined the
association between lactation duration and MetSyn. The authors of this
article performed a cross-sectional analysis of the association between
lifetime duration of lactation and the prevalence of MetSyn in a cohort
of midlife women who participated in the Study of Women's Health Across
the Nation (SWAN).
SWAN is a multi-site, multi-ethnic longitudinal study of 3,302 midlife
women developed to characterize patterns of health in women as they
traverse the menopausal transition. Participants answered questions
about number of pregnancies and lactation duration following each live
birth. Blood samples were collected at baseline, and blood pressure,
height, weight, and waist and hip circumference were measured using
standardized procedures. The final analytical sample included 2,516
women.
The authors found that
- There were 536 prevalent cases of MetSyn (21.3%).
- Among women who breast fed, 297 (18.3%) met the criteria for
MetSyn, compared with 239 among those who did not (26.7%).
- Women who developed MetSyn were more likely to have a higher body
mass index (BMI) at time of interview and at completion of high school,
to be African American, to smoke, and to be of lower socioeconomic
status. They also breast fed for shorter periods of time.
- Duration of lactation was inversely correlated with current BMI,
waist circumference, systolic blood pressure, diastolic blood pressure,
fasting levels of glucose, insulin, triglycerides, total cholesterol,
and low-density lipoprotein cholesterol. There was a positive
correlation with fasting high-density lipoprotein levels.
- After adjusting for age, current smoking, parity, ethnicity,
socioeconomic status, study site, physical activity, caloric intake,
and high-school BMI, parous women who had ever breast fed had a
significantly lower prevalence of MetSyn.
- The rate of MetSyn was significantly lower with increasing
duration of lactation, suggesting a dose-response relationship.
The authors conclude that "in addition to the pediatric benefits of
breast-feeding, these findings of maternal benefit may encourage more
women to initiate and maintain breast-feeding behavior."
Ram KT, Bobby P, Hailpern S. 2008. Duration of lactation is associated
with lower prevalence of the metabolic syndrome in midlife -- SWAN, the
Study of Women's Health Across the Nation. American Journal of
Obstetrics and Gynecology 198(3):268.e1-268e6. Abstract available at http://www.ajog.org/article/S0002-9378(07)02226-0/abstract.
Readers: More information about breastfeeding is available from the
following MCH Library resources:
- Breastfeeding and Working Mothers (bibliography) at
http://www.mchlibrary.info/action.lasso?-database=Biblio&-layout=Web&-response=/databases/BibLists/bib_brfeedwork.html&-MaxRecords=all&-DoScript=auto_search_brfeedwork&-search
- Breastfeeding: Consumer Education Materials (bibliography) at
http://www.mchlibrary.info/action.lasso?-database=Biblio&-layout=Web&-response=/databases/BibLists/bib_brfeedcons.html&-MaxRecords=all&-DoScript=auto_search_brfeedcons&-search
- Breastfeeding Promotion, Support, and Education (bibliography) at
http://www.mchlibrary.info/action.lasso?-database=Biblio&-layout=Web&-response=/databases/BibLists/bib_brfeedcons.html&-MaxRecords=all&-DoScript=auto_search_brfeedcons&-search
- Breastfeeding (organizations resource list) at
http://www.mchlibrary.info/action.lasso?-database=Organizations&-layout=Web&-response=/databases/OrgLists/orgs_brfeed.html&-MaxRecords=all&-DoScript=auto_search_brfeed&-search
************************************************************
To subscribe to MCH Alert, send an e-mail message to
MCHAlert-request@list.ncemch.org
with SUBSCRIBE in the subject line.
You do not need to enter any text in the body of the message.
To unsubscribe from MCH Alert, send an e-mail message to
MCHAlert-request@list.ncemch.org
with UNSUBSCRIBE in the subject line.
You do not need to enter any text in the body of the message.
************************************************************
MCH Alert © 1998-2008 by National Center for Education in Maternal
and
Child Health and Georgetown University. MCH Alert is produced by
Maternal and Child Health Library at the National Center for Education
in Maternal and Child Health under its cooperative agreement
(U02MC00001) with the Maternal and Child Health Bureau, Health
Resources and Services Administration, U.S. Department of Health and
Human Services. The Maternal and Child Health Bureau reserves a
royalty-free, nonexclusive, and irrevocable right to use the work for
federal purposes and to authorize others to use the work for federal
purposes.
Permission is given to forward MCH Alert, in its entirety, to others.
For
all other uses, requests for permission to duplicate and use all or
part of the information contained in this publication should be sent to
mchalert@ncemch.org.
The editors welcome your submissions, suggestions, and questions.
Please contact us at the address below.
MANAGING EDITOR: Jolene Bertness
CO-EDITOR: Tracy Lopez
COPYEDITOR/WRITER: Ruth Barzel
LIST ADMINISTRATOR: Beth DeFrancis Sun
MCH Alert
Maternal and Child Health Library
National Center for Education in Maternal and Child Health
Georgetown University
Box 571272
Washington, DC 20057-1272
Phone: (202) 784-9770
Fax: (202) 784-9777
E-mail: mchalert@ncemch.org
Web site: http://www.mchlibrary.info/alert/default.html
************************************************************