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by Tara Haelle

Brainwaves May Help Gauge Autism Severity: Study

Seeing how fast a child processes sounds might lead to earlier diagnosis, too, researchers say
MONDAY, Sept. 22, 2014 (HealthDay News) -- Measuring how quickly a child's brain processes sounds might help identify the severity of autism, according to a new study.
Observing children's brainwaves may also allow identification of autism earlier than is currently possible, the study authors reported.
"The finding that the brain's response to certain types of information is associated with autism severity is hugely promising," said senior researcher Sophie Molholm, an associate professor of pediatrics and neuroscience at Albert Einstein College of Medicine in New York City.
"A major goal of autism research is to develop measurements to diagnose the disorder as early as possible, and that can help to identify areas of weakness, and strength, so that treatments can be optimized," Molholm said. "Our work shows that measuring brain activity is a viable approach to achieving these goals."
The findings were published in the Sept. 22 online edition of the Journal of Autism and Developmental Disabilities.
Approximately one in 68 children has been diagnosed with an autism spectrum disorder, according to the U.S. Centers for Disease Control and Prevention. But the experience of autism for these children differs significantly in terms of their symptoms and impairments.
Molholm's past research found that among children with autism, the brain takes slightly longer -- measured only in milliseconds -- to process sounds, sights and other sensory information.
In this study, Molholm and her colleagues measured this processing speed in 43 children with autism, aged 6 to 17, using electroencephalograms, or EEG (brain wave) recordings. When the children were shown an image, played a tone or provided a tone and image at the same time, they pressed a button while the EEG recorded how quickly their brains registered the stimulus.
Then Molholm's team compared the children's visual, audio and audiovisual processing speeds to the severity of their symptoms. The researchers based their assessment of autism symptom severity on how great the children's social-communication difficulties were, how severe their repetitive behaviors were and how restricted their interests were.
The more severe the children's symptoms were, the study found, the slower the children processed sounds. There was also a connection between how slow children processed combined audiovisual stimuli and the severity of symptoms, but there was no difference in how quickly they processed the images by themselves, according to the study.
"As we develop EEG probes that measure areas of dysfunction, or even areas that individuals with autism are unusually good at, we should be able to use them as tools to help diagnose autism," Molholm said.
This study's particular finding on audio and audiovisual processing, however, would only apply to those with slower sensory processing. That may not necessarily include all individuals with autism spectrum disorders, she said.
In addition, the association seen in the study does not prove a cause-and-effect relationship.
One autism expert expressed optimism about the study, but noted it has some significant limitations.
"The finding is intriguing and may well open new areas of researching the problems those with autism spectrum disorders have in interacting with their environment," said Dr. Glen Elliott. He is a clinical professor of psychiatry at Stanford School of Medicine and chief psychiatrist and medical director of the Children's Health Council.
Elliott emphasized, however, that the study is very small, with several different variables and with measurements taken at only one point in time. He added that measuring "severity" of autism can be problematic.
"There really is no standard, partly because it's multidimensional," Elliott said. "One can't just count symptoms because a severe impairment in one area might be much worse than mild impairments in a number of areas."
But if further research in this area could overcome that challenge, then using brainwave measurements may be helpful, he suggested.
"An objective measure of autism severity would, indeed, be a boon -- for example, allowing regional centers to set a cut-off of who does and does not qualify for services, even if they meet criteria for autism spectrum disorder," Elliott said.
Molholm said she plans to continue looking at ways that EEGs can be used to assess individuals with autism spectrum disorders.
The more precise these tools can become, then the more information they might be able to provide long before it's currently possible to diagnose autism based on behavior.
"We imagine that once developed, these will be used in conjunction with clinically based diagnostics, at least for the foreseeable future," Molholm said. "However, the hope is to get to the point where they can be used for very early diagnosis."
The study was funded by the U.S. National Institute of Mental Health with additional support from the U.S. National Institute of Child Health and Human Development and the U.S. Health Resources and Services Administration.
More information
To learn more about autism, visit the U.S. National Institute of Neurological Disorders and Stroke ( ).
SOURCES: Sophie Molholm, Ph.D., associate professor, and Muriel and Harold Block Faculty Scholar in Mental Illness, departments of pediatrics and neuroscience, Albert Einstein College of Medicine, New York City; Glen Elliott, Ph.D., M.D., chief psychiatrist and medical director, Children's Health Council, emeritus professor of clinical psychiatry, University of California, San Francisco, and clinical professor of psychiatry, Stanford School of Medicine; Sept. 22, 2014 Journal of Autism and Developmental Disabilities, online
by Tara Haelle

Many Parents Use Online Ratings to Pick a Pediatrician, Study Finds

Reliability of the reviews is a concern, experts say
MONDAY, Sept. 22, 2014 (HealthDay News) -- Pediatricians, take note: Many American parents are aware of online physician-rating sites, and more than one-quarter have used them to choose a pediatrician for their children, according to a new national study.
The findings -- based on responses from more than 1,600 parents -- further suggest that negative online ratings may dissuade parents from choosing a pediatrician, even if that doctor has been recommended by a neighbor.
Conversely, a positive online rating may sway parents to choose that doctor, according to the study
"The whole purpose of this study was to get a sense of who is aware of these rating sites, and who's using them," said study lead author Dr. David Hanauer, an associate professor in the department of pediatrics at the University of Michigan, Ann Arbor.
"The findings did surprise me because, frankly, a lot of doctors don't know about these sites, or don't seem to care about them," Hanauer said. "There's just not a lot of discussion about them."
Americans are relying on the Internet for health-related information in increasing numbers. Dozens of physician-rating sites exist, among them Healthgrades, RateMDs and Vitals. Just as consumers rate goods such as books or movies, patients are free to register positive or negative views of their physician on these doctor-review sites.
Hanauer and his colleagues presented their findings in the Sept. 22 online edition of Pediatrics.
The survey was conducted in 2012, and all participants had at least one child living at home who was under the age of 18. All were asked about familiarity with, and usage of, online ratings sites. They were also asked to indicate how they would handle one of three hypothetical scenarios.
In all three cases, neighbors had recommended their child's doctor. However, in the first scenario, no online ratings information was given, while in the second the participants were told the recommended doctor had received a high rating online. In the third scenario, the physician had received a low rating online.
Nearly three-quarters of the study respondents said they knew about physician rating sites, and 28 percent said they had used one to choose a pediatrician.
And the participants indicated they were significantly more likely to follow a neighbor's recommendation to choose a particular pediatrician if that doctor also had high rankings online -- compared with no online information.
But, in a case of bad online ratings, participants said they were significantly less likely to choose that pediatrician, despite a neighbor's positive comments.
"Clearly, parents are using [these sites]," Hanauer said. "They are influencing decisions. And because this study was done two years ago, I'd say that it's likely that their popularity today is even higher than what we saw."
Whether these online ratings accurately reflect a doctor's skills and performance is another issue, Hanauer said.
"We really don't know how accurate these ratings actually are. People may argue for or against a physician for any number of reasons, not all of which are clear," he said. "It only takes one bad rating to make a doctor look like a terrible person. And that's impactful, because physicians rely entirely on their reputation. So that's one concern. "
Reliability of the ratings is also a primary concern for Dr. David Dunkin, an assistant professor in the department of pediatrics at the Icahn School of Medicine at Mount Sinai in New York City.
He noted, for example, that although positive comments can help attract new patients, "to make them reliable there must be a critical number of reviews."
Dunkin also pointed out that many ratings sites are essentially one-way conversations, in which physicians lack any opportunity to comment or offer context.
This runs the risk of treating the doctor-patient relationship "like a service, like going to a hotel or restaurant," he said.
"But ideally," he added, "the physician-patient relationship is a partnership or team -- one that is based on trust, respect for each other, and good communication that results in shared decision-making."
More information
For more about online doctor ratings, visit the University of Michigan ( ).
SOURCES: David Hanauer, M.D., MS, associate professor, pediatrics, University of Michigan, Ann Arbor, Mich.; David Dunkin, M.D., assistant professor, pediatric gastroentrology, Icahn School of Medicine at Mount Sinai, New York City; Sept. 22, 2014, Pediatrics, online
by Tara Haelle

Newborn ICUs With Private Family Rooms Benefit Preemies: Study

More close contact with mothers may explain greater weight gains, fewer procedures, less stress
MONDAY, Sept. 22, 2014 (HealthDay News) -- Tiny preemies may fare better when newborn intensive care units (NICU) set up private rooms for parents to spend time with their infants, a new study finds.
Researchers at one children's hospital found that preemies gained weight faster, were more alert and were less distressed when their NICU switched from the traditional "open-bay" layout to private rooms for families.
The findings, published online Sept. 22 in the journal Pediatrics, add to evidence that private rooms are better for tiny newborns' health and development than the long-used open floor plan -- or what some researchers have described as a "baby barn."
The traditional NICU can be crowded, loud and generally stressful, explained lead researcher Barry Lester, who directs the Center for the Study of Children at Risk at Women & Infants Hospital of Rhode Island.
"With the single-family room NICU, you walk in and it's quiet. It's actually relaxing," Lester said.
More important, research has shown, that environment benefits newborns. Lester said his team's findings confirm that, and point to some reasons why -- including the bigger role for moms in caring for their babies.
"We see that mothers' involvement is really making a difference," Lester said. With the private rooms, his team found, mothers bathe their babies and breast-feed more often, and have more "skin to skin" contact with their newborn -- which research has shown to have a soothing effect on infants' nervous system.
And even with other factors considered, the study found that mothers' involvement still seemed to have a direct effect on their newborns' progress: On average, their babies required fewer medical procedures, were more alert and showed fewer signs of pain or distress.
One expert noted that any improvement in outcome matters.
"The benefits aren't dramatic. The babies aren't going home a week earlier," said Dr. David Mendez, a neonatologist at Miami Children's Hospital.
But, Mendez added, small steps in improving preemies' progress are important. "They're important from the hospitals' perspective, too," he said. Redesigning NICUs is expensive, Mendez noted, so hospitals will look to studies like this for evidence that the investment does benefit infants.
The findings are based on over 400 preterm newborns placed in the Women & Infants NICU in Rhode Island between 2008 and 2012. During that time, the unit was transformed from a traditional open-bay layout to one with private rooms. Lester's team took advantage of that "natural experiment" to compare newborns' outcomes before and after the change.
Overall, they found, newborns did better afterward. When the researchers looked for some explanations for the benefit, two factors stood out, Lester said: moms' involvement in feeding, bathing and changing diapers; and a type of care known as developmental support.
That means extra care for some of the early difficulties preemies can have; if they're having trouble feeding, for example, an occupational therapist can step in to help.
After the NICU switched to private rooms, 65 percent of infants received developmental support, versus 46 percent before. Lester said the added space, quiet and calm made it easier for staff to closely observe each newborn and give extra care when needed.
Mendez said the trend now is for NICUs to move to private rooms, and these findings give added support for that.
"It seems intuitive that it's better to be in a private room with your baby," Mendez said. "But we also need studies that show tangible benefits."
Now, he added, researchers should follow preemies over the long term, to see if those early benefits in the NICU lead to better health and development later on.
Another question is whether the findings at the Rhode Island NICU would translate to other hospitals. The families there were relatively well-educated and middle-class -- and Lester said that for low-income parents, it can be more challenging to take time from work and be with their babies in the NICU.
"It's not that they don't want to be there. They do," he said. "But it's hard."
And this study, Lester noted, shows that it's not just the layout of the NICU that matters. It's families' involvement.
"That's important," Lester said. "Parents do make a difference. They don't have to feel like they're just bystanders, crossing their fingers and hoping for the best."
More information
The U.S. Centers for Disease Control and Prevention has more on preterm birth ( ).
SOURCES: Barry Lester, Ph.D., director, Brown Center for the Study of Children at Risk, Women & Infants Hospital of Rhode Island, Providence; David Mendez, M.D., neonatologist, Miami Children's Hospital; October 2014 Pediatrics
by Tara Haelle

Could Low Iron Intake During Pregnancy Raise Autism Risk?

Study reinforces benefits of taking supplements as recommended
MONDAY, Sept. 22, 2014 (HealthDay News) -- It's something every pregnant woman wonders: What can I do to help ensure a healthy baby?
New research suggests that taking iron supplements as prescribed may play a role in reducing the risk of having a child with autism spectrum disorder (ASD).
The researchers found that mothers of children with autism were significantly less likely to have taken iron supplements before and during pregnancy than those whose children seem to be developing normally.
The study authors also discovered that mothers 35 years of age and older who had low iron intake had a five times greater risk of having a child with autism. Others at that higher level of risk were women with metabolic conditions, such as obesity, high blood pressure or diabetes.
For all participants, having a healthy amount of dietary and supplemental iron appeared to generally reduce the risk of autism, which is a neurodevelopmental disorder characterized by social deficits, language impairments and repetitive behaviors.
"While the study needs to be replicated, it reinforces the current practice of taking the recommended dose of pregnancy vitamins and folic acid when pregnant," said Rebecca Schmidt, lead study author and assistant professor in the department of public health sciences at the University of California, Davis.
Folic acid is the synthetic version of folate, a type of iron that is typically easier for the body to process, she said.
Iron deficiency, which is often associated with anemia, a commonly measured nutrient deficiency and is especially common in pregnancy, affecting 40 to 50 percent of women and their infants, according to the researchers. Iron deficiency early in life has been shown to impair thinking, motor development, social engagement and language development.
Previous work by the same researchers and others has noted an association between iron levels and autism, Schmidt said. Children with autism often have low iron levels, which could mean that they absorb or metabolize iron inefficiently, she said.
Iron is crucial to early brain development, as it contributes to the production of neurotransmitters, myelination (development of a sheath around nerve cells) and immune function, explained Schmidt. All three of those functions have been associated with autism in other studies, she added.
The researchers also learned that children in the study with autism were more likely to be born earlier than those with typical development; their mothers were more likely to have some college education but no bachelor's degree; were more likely to smoke cigarettes, less likely to have private insurance, and less likely to own their own home.
The study, published online Sept. 22 in the American Journal of Epidemiology, included 520 pairs of mothers and children with autism and 346 pairs of mothers and typically developing children. All were enrolled in the Childhood Autism Risks from Genetics and the Environment (CHARGE) study in California, from 2003 to 2009.
The researchers assessed maternal iron intake, including vitamins, breakfast cereals (which are often iron-fortified) and other nutritional supplements during the three months before conception to the end of each mother's pregnancy, and during breast-feeding. The mother's daily iron intake was assessed by trained interviewers.
Iron intake reported by mothers of those with autism was lower than that reported by the mothers of typically developing children, especially for the months before and during early pregnancy.
Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Cohen Children's Medical Center of New York, in New Hyde Park, said the research is useful. "It's one more reason to take iron in pregnancy," he said.
Yet Adesman, who was not part of the study team, acknowledges that the study isn't a major breakthrough. "It isn't the 'now-we-know-what-causes-ASD' answer, but it offers one clue," he said. "The study data shows that some women with good iron intake still had kids with ASD."
Although the study showed an association between low iron intake and the development of autism spectrum disorder, it didn't prove cause and effect.
"There are probably multiple causes or risk factors for autism and it may take having several of them to pass the threshold [and develop the disorder]," Schmidt said. "It may be a combination of risks and susceptibility."
More information
Learn more about the role of iron in pregnancy from the U.S. Centers for Disease Control and Prevention ( ).
SOURCES: Rebecca J. Schmidt, Ph.D., assistant professor, department of public health sciences, MIND Institute, University of California, Davis; Andrew Adesman, M.D., chief, developmental and behavioral pediatrics, Steven & Alexandra Cohen Children's Medical Center of New York, New Hyde Park, N.Y.; Sept. 22, 2014, online American Journal of Epidemiology
by Tara Haelle

Diabetes Drug Metformin May Affect Thyroid in Some Patients

Medicine tied to lower thyroid-stimulating hormone levels in those with underactive thyroid
MONDAY, Sept. 22, 2014 (HealthDay News) -- Metformin, a drug commonly used to treat diabetes, may raise the risk of low levels of thyroid-stimulating hormone (TSH) among patients with an underactive thyroid, a new study suggests.
The researchers cautioned that low TSH levels may be associated with heart problems and broken bones, although a cause-and-effect link was not established in this study.
Among those in the study with an underactive thyroid (hypothyroidism), there were 495 incidences of low levels of thyroid-stimulating hormone per year compared with 322 in the normal thyroid group, the report published Sept. 22 in the CMAJ concluded.
Among patients treated for an underactive thyroid, metformin was linked with a 55 percent higher risk for low TSH levels, compared to those who were taking sulfonylurea for their diabetes.
"The results of this longitudinal study confirmed that the use of metformin was associated with an increased risk of low TSH levels in patients with treated hypothyroidism," Dr. Laurent Azoulay, with the department of oncology at McGill University in Montreal, said in a journal news release.
"Given the relatively high incidence of low TSH levels in patients taking metformin, it is imperative that future studies assess the clinical consequences of this effect," Azoulay added.
Two experts agreed that the finding requires further research.
"The question this study poses is: does the suppressed TSH have clinical significance?" said Dr. Gerald Bernstein, director of the diabetes management program at the Friedman Diabetes Institute at Mount Sinai Beth Israel, in New York City.
"The answer is as follows, millions of people have type 2 diabetes and millions of people have low thyroid and take thyroid pills. And given the multiple millions of people who take both drugs there has been no mass clinical issue," Bernstein said. Also, "this study did not contain any measurements of the two forms of thyroid hormone in the blood. That data might help clarify why the TSH is suppressed."
Dr. Minisha Sood, an endocrinologist at Lenox Hill Hospital in New York City, added that "the reason for metformin's effect on TSH levels is not clear at present. It is also unclear whether the low TSH levels associated with metformin in this study put patients at risk for developing other complications such as cardiovascular diseases."
Metformin is used to lower blood sugar (glucose) levels. It works by reducing glucose production in the liver. To examine the drug's effect on TSH, the researchers examined data compiled on over 74,000 people who took metformin, along with another diabetes drug known as sulfonylurea, over a 25-year period.
More information
The U.S. National Library of Medicine has more on metformin ( ).
SOURCES: Gerald Bernstein, M.D., director, diabetes management program, Friedman Diabetes Institute, Mount Sinai Beth Israel, New York City; Minisha Sood, M.D., endocrinologist, Lenox Hill Hospital, New York City; CMAJ (Canadian Medical Association Journal), news release, Sept. 22, 2014
by Tara Haelle

Health Highlights: Sept. 22, 2014

Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:
Possible TB Exposure for Hundreds of Infants at Texas Hospital
More than 700 babies may have been exposed to tuberculosis at a Texas hospital over the past year.
An employee at Providence Memorial Hospital in El Paso was diagnosed with TB on Aug. 25 and may have exposed infants and about 40 other hospital staff members since September 2013, said Dr. Hector Ocaranza, the health authority for El Paso County, the Associated Press reported.
Officials are waiting for the results of TB tests on hospital workers, and the hospital is offering free screenings for infants who may have been exposed to the disease.
"This is an incredibly large exposure investigation, and it involves infants, so it is particularly sensitive," said Carrie Williams, spokeswoman for the Texas Department of State Health Services, the AP reported. "Babies are more likely than older children and adults to develop life-threatening forms of TB."
by Tara Haelle

Get a Flu Shot During Checkup, Doctor Says

Vaccination in October may give you the best chance of avoiding influenza this season
SATURDAY, Sept. 20, 2014 (HealthDay News) -- As flu season approaches, the best way to stay healthy and avoid infection is to get a flu shot and a checkup, according to an infectious disease specialist.
A primary care doctor can vaccinate people against the flu, and also address other health concerns or issues patients may have. Retail stores may provide flu shots for their customers, but they can't dole out medical advice, said Dr. Jorge Parada, medical director of infection prevention and control for the Loyola University Health System in Maywood, Ill.
"At the doctor's office, the focus is on you and what is going on with your health. This is your time to talk about concerns to improve your well-being beyond the flu season," Parada said in a Loyola news release.
"You trust your store employee to help you locate items you want to buy, not to diagnose what's causing a persistent symptom, schedule other annual health maintenance exams such as mammograms or offer expert medical advice," he added.
Flu season in the United States starts Oct. 1 and lasts until March 31, according to the U.S. Centers for Disease Control and Prevention. But even though it takes up to two weeks after the flu shot for its full effect to kick in, it's not a good idea to get vaccinated in September, said Parada.
"If you get your flu shot in the beginning of September, you may start running out of infection immunity by February or March, when the virus is still around," he said. "Getting the flu shot in October gives you the best chance of avoiding the flu this year."
Flu season usually peaks between late December and early February, Parada added. Throughout flu season, missed work and health-care expenses end up costing Americans millions of dollars, he noted in the news release. The flu can also claim lives.
When it comes to the flu as well as other infectious diseases, such as polio and whooping cough, everyone needs to get vaccinated in order to stop the spread of the virus, he said.
"When people are universally vaccinated, those infections are largely eliminated. It may not sound sexy but it is everyone's civic responsibility to protect themselves and their community," explained Parada.
Those typically hit hardest by the flu are the very young, the elderly or chronically ill, and pregnant women.
More information
The U.S. Centers for Disease Control and Prevention provides additional flu prevention tips ( ).
SOURCE: Loyola University Health System, news release, Sept. 12, 2014
by Tara Haelle

College Women Can Use Food Strategies, Study Finds

Freshmen unsure that they'll make the right choices
SUNDAY, Sept. 21, 2014 (HealthDay News) -- Young women starting college understand the benefits of a healthy diet and know which foods they should eat. But they aren't confident they can follow through on these wise nutritional choices, according to a new study.
The study involved 268 female college freshmen enrolled in the University of Illinois's Peer Education Exercising and Eating Right program. The students answered food-related questions such as what would they choose to eat if they were very busy with school work, were very hungry or not hungry at all. They were also asked what they would eat if they were dealing with foods that take time and effort to prepare.
"The women in our study weren't very confident about their ability to eat a healthful diet, especially if they had to do something physical like chop vegetables or go shopping. The motivation just wasn't strong if they were at a party or in places where there were other fun choices," Karen Chapman-Novakofski, a professor of nutrition, said in a news release.
Although these students believed they could stick to low-fat options, they were particularly unsure about meeting their calcium requirements. The researchers said this was potentially worrisome since it could affect their risk for the bone-thinning disease osteoporosis later in life.
"Women optimize bone mass when they're about 18 years old so we're talking about an important time for them to be consuming calcium," said Chapman-Novakofski.
Study co-author Leia Kedem, a dietitian and nutrition educator, pointed out there there are many more choices when it comes to low-fat foods. "Women have developed strategies for dealing with high- versus low-fat choices. They can have chicken instead of ground beef or have a salad instead of a Reuben," she said.
But, Kedem added, "there are fewer ways of including calcium-dense, even fortified, foods in your diet, so it's even more important to have a strategy for including dairy foods."
Chapman-Novakofski said personal, behavioral, and environmental factors influence combine to affect behavior. "If a student has strategized ways to stick to a healthy diet in challenging situations, she will be more likely to be committed to her goals and to achieve them," she said.
More information
The Academy of Nutrition and Dietetics Foundation talks about weight gain in college ( ).
SOURCE: University of Illinois College of Agricultural, Consumer and Environmental Sciences, news release, Sept. 15, 2014
by Tara Haelle

Cyberbullying Seems to Ramp Up in Middle School

Effective prevention strategies must not be 'one-size-fits-all,' researcher says
FRIDAY, Sept. 19, 2014 (HealthDay News) -- As kids transition from elementary to middle school, they are increasingly the targets of cyberbullies, according to a recent study.
But the researchers studying U.S schoolkids in grades 5 through 8 found that verbal and physical bullying declines as students get older.
Because bullying patterns vary, bullying intervention and prevention strategies must address all types of bullying as well as differences in bullying among boys and girls, the researchers said. The study was published recently in School Psychology Quarterly.
"School-based interventions need to address the differences in perpetrator and victim experiences," said study author Cixin Wang, an assistant professor at the University of California, Riverside's Graduate School of Education.
"The key is to use individualized specific interventions for bullying, not a one-size-fits-all approach," Wang said in a journal news release.
Researchers examined three semesters of data compiled on 1,180 students at schools in the Midwest. The investigators looked at the amount and type of bullying that took place as well as the number of students victimized. They also considered variables such as the children's gender, grade and whether or not English was their native language.
The study revealed that students who were bullied could be classified into four groups:
11 percent were frequent victims. 29 percent were occasional victims of traditional bullying, such as verbal or physical bullying. 10 percent were occasional victims of traditional bullying and cyberbullying. Half were infrequent victims of bullies.
The bullies themselves were also grouped into three categories: 5 percent bullied frequently; 26 percent were occasional traditional bullies; and 69 percent bullied infrequently.
Although the amount of bullying decreased over time, the authors found that it surged between fifth and sixth grade when the students in the study moved from elementary to middle school.
Overall, the study found that girls were more often the targets of cyberbullying and verbal and relational bullying than boys. Boys, however, were more likely to be physically bullied.
Whether or not students spoke English as a second language did not appear to have an impact on whether or not they were bullied, the findings showed.
The study authors said schools could help prevent bullying among students through the following strategies:
Focus bullying prevention and intervention programs on students in sixth and eighth grades, teaching them social-emotional learning skills and healthy ways to cope with new peer groups and social hierarchies. Consider different bullying interventions for boys and girls. Strategies targeting girls should focus on relationship issues and how to use social media responsibly. For boys, interventions should focus on physical bullying. Schools and parents should also talk to students about cyber safety. Children should be supervised when using the Internet and mobile devices so they learn how to avoid being victimized. Any reports of bullying should be taken seriously.
More information
The U.S. Department of Health and Human Services has more about cyberbullying ( ).
SOURCE: University of California, Riverside, news release, Sept. 12, 2014
by Tara Haelle

FDA Approves Another Weekly Injectable Drug for Type 2 Diabetes

Trulicity helps lower blood sugar levels when used alone or with other medications, agency says
FRIDAY, Sept. 19, 2014 (HealthDay News) -- The U.S. Food and Drug Administration approved a new type 2 diabetes drug, Trulicity, on Thursday. Trulicity is part of a class of once-a-week injectable drugs that help manage blood sugar levels in adults with type 2 diabetes.
"Trulicity is a new treatment option, which can be used alone or added to existing treatment regimens to control blood sugar levels in the overall management of type 2 diabetes," Dr. Mary Parks, deputy director of the FDA's Office of Drug Evaluation II, said in an agency news release.
About 26 million Americans have type 2 diabetes. More than 90 percent of all diabetes cases are type 2 diabetes, according to the FDA. The disease causes high blood sugar levels, which can lead to serious complications including heart disease, vision problems and nerve and kidney damage.
Trulicity (generic name dulaglutide) is a type of drug called a glucagon-like peptide-1 (GLP-1) receptor agonist. These drugs help to lower blood sugar levels, according to the FDA.
Before approving the drug, the FDA evaluated six clinical trials that included nearly 3,500 people with type 2 diabetes. The drug was studied alone and in combination with other types of diabetes medications, including metformin, mealtime insulin injections and others.
Those taking weekly Trulicity injections had improvements in their long-term blood sugar levels, the FDA said.
The most common side effects were nausea and vomiting, diarrhea, abdominal pain and a decreased appetite, according to the FDA.
The drug will carry a boxed warning stating that the use of some GLP-1 receptor agonists has been associated with thyroid tumors in rodents. The FDA said Trulicity should not be prescribed for patients with a personal or family history of a type of thyroid cancer called medullary thyroid carcinoma, or for patients with multiple endocrine neoplasia syndrome type 2. People with this disease have tumors in more than one gland in their body and are at increased risk for medullary thyroid carcinoma.
The drug, made by Eli Lilly and Company, is not intended for use in people with type 1 diabetes, people with severe stomach or intestinal problems, or as the first drug treatment for someone with type 2 diabetes, the FDA said.
The FDA said it will require the drug's manufacturer to conduct a number of studies after the drug approval (called post-marketing studies), including a study to evaluate cardiovascular issues for people who have a higher risk of heart problems, the news release said.
More information
Learn more about type 2 diabetes from the American Diabetes Association ( ).
SOURCE: U.S. Food and Drug Administration, news release, Sept. 18, 2014

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