7 Fitness-Inspired Halloween Costumes You Can Throw Together Fast

Between work and workouts October has been pretty hectic. Suddenly, as you absentmindedly flip past Hocus Pocus on your TV, you remember: Oh right, Halloween is this weekend! The kids have costumes, but do you have one yet? Don’t worry. Health staffers have you covered with seven last-minute, costumes you can throw together using gear you already have.

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The Zumba zombie

Pictured: Lindsey Murray, editorial assistant

When Thriller and dance cardio mix you get the Zumba zombie. With neon gear and some deathly looking makeup, no one will even notice your lack of rhythm on the dance floor. You’ll need: What you normally wear to Zumba class and non-toxic face paint.

The obnoxiously zen yogi

Pictured: Kristine Thomason, editorial assistant

Here’s a costume anyone can pull off. In addition to your outfit, be sure to greet everyone with “Namaste” instead of “Trick or Treat.” You’ll need: Yoga pants, a motivational tank top, and mat.

The boxing champ

Pictured: Jacqueline Andriakos, associate editor

Float like a butterfly, sting like a bee, this costume is easy as can be. You’ll need: silk shorts, towel, boxing gloves ($15; amazon.com), and “Eye of the Tiger” on repeat. Don’t have gloves? Use tape instead and go as UFC champ Ronda Rousey.

The color runner

Pictured: Alexis Reliford, editorial assistant

You’ve seen these beyond happy runners all over your Instagram feed. Now’s your chance to get in on the fun… without having to run a 5k. You’ll need: colored leggings, white T-shirt smeared with sidewalk chalk, safety pins, and a homemade runner’s bib (we made ours in Microsoft Word).

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A Workout #TBT

Kristine Thomason, editorial assistant

In the immortal words of Olivia Newton John, 🎶 Let’s get physical, physical… 🎶  You’ll need: leotard, leggings, leg warmers, scrunchie, and a DIY Instagram “screen” (we made ours with a cardboard box and print-outs from Google images).

The gold medalist

Pictured: Jacqueline Andriakos, associate editor

Here’s one to catapult you to #GoldMedalStatus. (Plus, it’s an excuse to carry around a healthy snack all night.) You’ll need: a box of Wheaties, race medals, track jacket, and all things red, white, and blue.

Your favorite Soulcycle instructor

Pictured: Julie Mazziota, assistant editor

They say imitation is the sincerest form of flattery. Honor the teacher that helped you find yourself by dressing up just like her this year.  You’ll need: SoulCycle T-shirt, headset, free weights, and cycling shoes.

RELATED: How to Apply (and Remove) Halloween Makeup Without Wrecking Your Skin

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Shaken Baby Syndrome Program Didn’t Reduce Injuries: Study

MONDAY, Oct. 26, 2015 (HealthDay News) — A program designed to prevent “shaken baby syndrome” in North Carolina didn’t reduce rates of infant head injuries caused by this form of child abuse, a new study finds.

“Shaken baby syndrome, also called abusive head trauma, occurs when an infant is violently shaken, and is the leading cause of child abuse deaths in the United States,” explained Dr. Minu George, an expert in pediatric care who was not involved with the study.

“The consequences of shaken baby syndrome are so devastating that prevention should be the primary focus of doctors, nurses, social workers and families,” George added.

According to the researchers, crying is typically the most common trigger of shaken baby syndrome, which can cause death or leave children with long-term brain damage.

In the new report, a team led by Dr. Adam Zolotor of the University of North Carolina, Chapel Hill, looked at the impact of a program aimed at preventing cases of shaken baby syndrome.

Nearly 90 percent of parents of newborns in North Carolina took part in the program between June 2009 and September 2012. The program taught parents about recognizing and dealing with normal infant crying. For example, when a parent feels overwhelmed by a crying baby, they are encouraged to temporarily hand the child off to another caregiver.

Two years after the program was introduced, calls to a nurse advice line for infant crying fell by 20 percent among parents of children younger than 3 months, and by 12 percent for parents of children aged 3 to 12 months, Zolotor’s team reported.

However, there was no decline in the rate of shaken baby syndrome in North Carolina. In fact, the rate before the program was 34 per 100,000 person-years and 36 after the program, the study found.

“This does not mean that the intervention does not work,” Zolotor said in a university news release. “It simply means that our study did not demonstrate that it did work, and additional studies are needed to answer that question definitively,” he added.

“There are many reasons that we may not have shown a decrease in rates of abusive head trauma, including the recession, the fact that this is a rare problem, and other factors that we did not observe,” Zolotor explained.

Economic downswings can alter child abuse statistics, another researcher pointed out.

“The intervention took place during the most significant economic recession since the great depression,” said Dr. Desmond Runyan, director of the Kempe Center for the Prevention and Treatment of Child Abuse and Neglect at the University of Colorado.

“Four previous studies have shown the recession to be associated with increased rates of abusive head trauma,” so any decrease caused by the intervention might have been masked by the impact of the recession, Runyan explained in the university news release. “In North Carolina, we may not have shown a decrease, but there was no increase in rates of abusive head trauma,” despite the recession, he said.

The study was published online Oct. 26 in the journal JAMA Pediatrics.

The findings raise questions about the effectiveness of shaken baby prevention programs and highlight the challenges in reducing rates of this form of child abuse, Dr. Joanne Wood, from The Children’s Hospital of Pennsylvania, added in an accompanying editorial.

However, the high costs of shaken baby syndrome “to children, families and society demand that we must not give up,” she said.

George, who is interim chief of general pediatrics at Cohen Children’s Medical Center in New Hyde Park, N.Y., agreed.

“We are just beginning to understand abusive head trauma and a lot more research needs to be performed in this area,” she said.

More information

The U.S. National Institute of Neurological Disorders and Stroke has more about shaken baby syndrome.

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Kids Drawn to ‘Gateway’ Flavored Tobacco Products, FDA Finds

By Dennis Thompson
HealthDay Reporter

MONDAY, Oct. 26, 2015 (HealthDay News) — Candy, fruit and other flavorings are hooking America’s next generation of nicotine addicts, a new U.S. government study finds.

Among kids aged 12 to 17 who had used tobacco, four out of five said the first product they tried was flavored, whether it was hookah, e-cigarettes, little cigars or smokeless tobacco, U.S. Food and Drug Administration researchers found.

In addition, most current teen tobacco users said that they had indulged in a flavored tobacco product within the past 30 days, according to findings published Oct. 26 in the Journal of the American Medical Association.

“This confirms our worst fears,” said Dr. Norman Edelman, senior scientific advisor for the American Lung Association. “Young people are being hooked on tobacco products through the use of flavoring that appeals to them. When you see flavorings like bubble gum in a tobacco product, it’s obvious who they’re appealing to.”

Although flavors other than menthol are prohibited in cigarettes in the United States, flavored non-cigarette tobacco products are widely available and may appeal to youth, according to background information in the article.

In the study, researchers at the FDA’s Center for Tobacco Products examined flavored tobacco use among kids using data from the 2013-2014 Population Assessment of Tobacco and Health Study, a nationally representative survey that included 13,651 U.S. teens.

The survey revealed that about 21 percent had used tobacco. About 81 percent of these teens said the first tobacco product they ever tried had been flavored to taste of menthol, mint, clove, spice, candy, fruit, chocolate or some other sweet flavor.

In addition, about 80 percent of kids who’d used tobacco over the past 30 days said they had used a flavored product, the FDA researchers found.

Kids who said they use tobacco “because they come in flavors I like” include about four out of five e-cigarette users and hookah users; nearly three-quarters of cigar users; and more than two-thirds of smokeless tobacco users.

“Flavored tobacco products have become increasingly common in the United States and are especially attractive to youth,” said FDA spokesman Michael Felberbaum. “As such, the FDA is particularly interested in monitoring and assessing the use of flavored tobacco products among youth.”

Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City, called the findings “pretty horrifying.” He noted tobacco is tremendously addictive for young people.

“These are often the patients who can never walk away from smoking,” Horovitz said. “The switch has been turned on at an early age, and it is particularly hard for them to walk away from cigarettes once they’ve started smoking.”

Patricia Folan, director of the Center for Tobacco Control at North Shore-LIJ Health System in Great Neck, N.Y., agreed.

“For most long-term smokers, just one experience with tobacco can result in addiction,” Folan said. “The flavors entice young people to try these tobacco products, exposing them to nicotine, contributing to the development of addiction, and potentially serving as a gateway to conventional cigarette smoking.”

In April 2014, the FDA announced its intention to place new regulations on all tobacco products, including e-cigarettes. These regulations could include a prohibition on flavorings, Edelman said.

However, the FDA has not yet laid down final regulations, to the dismay of anti-smoking advocates.

“As the FDA goes through its process of turning its intentions into policies, the American Lung Association strongly supports elimination of the use of all flavorings in all tobacco products,” Edelman said. “The announcement that they were in the process of framing the regulations is more than a year old. The American Lung Association very much would like to see something happen.”

Folan noted that FDA regulations could also help address other reasons teens gave in this survey for using tobacco products, including affordability, ease of use in public places, and the fact that people in the media use them.

“With stricter tobacco control measures, as we have for conventional cigarettes, teens would be less likely to use these products,” Folan said.

More information

For more on teen smoking, visit the U.S. National Institutes of Health.

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Processed Meat Can Cause Cancer: WHO

MONDAY, Oct. 26, 2015 (HealthDay News) — Processed meats, the likes of which include bacon, hot dogs and sausages, can cause cancer and red meat may do the same, experts from the World Health Organization (WHO) warned on Monday.

The International Agency for Research on Cancer (IARC), which is part of the WHO, sifted through more than 800 studies that looked at possible links between the consumption of processed or red meat and cancer. The body of research spanned several continents, and included different races and diets. Most of the studies focused on associations with colon cancer, in particular.

When the 22 international experts were done, the findings prompted them to classify processed meat as a carcinogen that is as deadly as tobacco, asbestos and diesel fumes.

“For an individual, the risk of developing colorectal cancer because of their consumption of processed meat remains small, but this risk increases with the amount of meat consumed,” Dr. Kurt Straif of the IARC said in an agency news release.

Red meat fared slightly better under the scrutiny, and was classified as a possible carcinogen that entails the same level of cancer risk as glyphosate, the active ingredient in many pesticides. But the group also noted that red meat has nutritional value.

The most powerful links were seen with colon cancer, but there were also associations with pancreatic and prostate cancer, the IARC statement said.

“There is sufficient evidence in human beings for the carcinogenicity of the consumption of processed meat,” the group concluded in its statement.

“Chance, bias and confounding could not be ruled out with the same degree of confidence for the data on red meat consumption, since no clear association was seen in several of the high-quality studies . . . there is limited evidence in human beings for the carcinogenicity of the consumption of red meat,” the group added.

Some of the studies suggested that an additional 3.5 ounces (100 grams) of red meat per day raises colon cancer risk 17 percent, while eating about 1.7 ounces (50 grams) of processed meat raises colon cancer risk by 18 percent, the IARC group noted.

Members of the beef industry were quick to react to the move.

“Cancer is a complex disease that even the best and brightest minds don’t fully understand,” Shalene McNeill, from the National Cattlemen’s Beef Association, said in a statement. “Billions of dollars have been spent on studies all over the world and no single food has ever been proven to cause or cure cancer. The opinion by the IARC committee to list red meat as a probable carcinogen does not change that fact. The available scientific evidence simply does not support a causal relationship between red or processed meat and any type of cancer.”

Even nutritionists offered some caveats on the news.

“The headlines surrounding this report are alarming, but the findings do not support that eating any and all meat will definitively cause cancer,” said Dana White, a clinical assistant professor of athletic training and sports medicine at Quinnipiac University in Hamden, Conn. “As a registered dietitian, I like to look at the big picture of the overall diet. Red meat can provide important nutrients such as essential amino acids, iron and vitamin B12. When lean cuts are consumed in moderation, it can still fit into a healthy diet.”

Meanwhile, the American Institute for Cancer Research (AICR) applauded the findings.

“For years, AICR has been recommending that individuals reduce the amount of beef, pork, lamb and other red meats in their diets and avoid processed meats like bacon, sausage and hot dogs,” Susan Higginbotham, vice president of research, said in an AICR statement.

“AICR continues to recommend avoiding processed meats and eating no more than 18 ounces of cooked red meat weekly to lower colorectal cancer risk,” the statement added. “Our own analyses show that such moderate consumption of red meat is not associated with a notable increase in colorectal cancer risk. But they do show that regular consumption of even small amounts of hot dogs, bacon and other processed meats increase colorectal cancer risk.”

Another expert explained the possible reasons why processed meats may show a stronger link to cancer risk than red meats do.

“Meats processed [treated with chemicals, or smoked/cured, to allow longer storage] seem to have a stronger relationship with the development of cancer, and may deserve special attention to ascertain why,” said Dr. Arun Swaminath, director of the inflammatory bowel disease program at Lenox Hill Hospital in New York City.

“One mechanism is that this processing increases the level of aromatic amines and aromatic hydrocarbons in the food, which can cause damage to human DNA, which increases the risk of colon cancer,” Swaminath explained.

And the AICR pointed out that although processed meat will now be considered a carcinogen on par with smoking, the actual risk is far smaller.

“In some studies, participants who eat diets high in processed meat experience a risk for colorectal cancer that is nearly double that of non-meat-eaters. But according to the CDC [U.S. Centers for Disease Control and Prevention], smoking cigarettes multiplies a person’s risk for cancer by as much as 20 times,” the agency said in its statement.

More information

Visit the U.S. National Institutes of Health for more on the health risks of eating red meat.

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Pediatricians’ Group Urges Action on Climate Change

MONDAY, Oct. 26, 2015 (HealthDay News) — Dirtier air, heat stress, greater exposure to Lyme disease — these and other threats to children will increase because of climate change, a leading group of U.S. pediatricians warns.

Doctors and policy makers must take steps to protect youngsters from the hazardous effects of climate change, the American Academy of Pediatrics said in a new policy statement.

“Every child needs a safe and healthy environment and climate change is a rising public health threat to all children in this country and around the world,” academy president Dr. Sandra Hassink said in a news release from the organization.

The threats to children also include natural disasters, more infectious diseases and problems with food and water supplies, the academy said.

“Pediatricians have a unique and powerful voice in this conversation due to their knowledge of child health and disease, and their role in ensuring the health of current and future children,” Hassink added.

The policy statement, released Friday at the start of the academy’s annual meeting in Washington, D.C., was published online Oct. 26 in Pediatrics.

The World Health Organization said more than 88 percent of current climate change-related diseases occur in children younger than 5 years old, according to the statement.

Statement lead author Dr. Samantha Ahdoot said in the news release, “Children are uniquely at risk to the direct impacts of climate changes like climate-related disaster — including floods and storms — where they are exposed to increased risk of injury, death, loss of or separation from caregivers, and mental health consequences.

“They are also more vulnerable to the secondary impacts of global warming, like disease,” she said. For example, climate warming has been linked to northern expansion of Lyme disease in North America, putting more American children at risk of this deer tick-transmitted disease, she explained.

The statement outlined various climate-change effects on children. Among them:

• Infant heat-related deaths will rise 5.5 percent among females and 7.8 among males by the end of this century.
• By 2030, climate change is expected to cause an additional 48,000 diarrhea-related deaths among children younger than 15, primarily in Asia and sub-Saharan Africa.
• Climate change influences infectious diseases that affect children worldwide. Besides Lyme disease, these include malaria, dengue fever, West Nile virus, chikungunya, Rocky Mountain spotted fever, diarrheal illness, amebic meningoencephalitis (a disease of the central nervous system) and coccidioidomycosis (“valley fever”).
• The number of heat stroke deaths among American high school and college football players nearly doubled from 15 in 2000 to 29 in 2010.

The policy statement called for greater emphasis on energy conservation, renewable energy, research on climate change-associated health effects, and public education about the issue.

More information

The World Health Organization has more about climate change and health.

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Too Few Boys Get HPV Vaccine, CDC Study Finds

By Dennis Thompson
HealthDay Reporter

MONDAY, Oct. 26, 2015 (HealthDay News) — Most boys in the United States aren’t receiving the cancer-preventing HPV vaccine alongside their other scheduled inoculations, largely because doctors fail to recommend it or adequately explain its benefits to parents, a new U.S. government study says.

Experts warned that without vaccination, these boys may face infection with the sexually transmitted human papilloma virus, a leading cause of multiple cancers.

Parents most often don’t get the HPV vaccine for their boys because their health care provider didn’t recommend it, according to researchers from the U.S. Centers for Disease Control and Prevention.

That reason was given by 24 percent of parents whose 13- to 17-year-old sons had not received the shots, when asked as part of the CDC’s annual survey on teen vaccinations. The report was published online Oct. 26 in the journal Pediatrics.

Parents also commonly cite a lack of understanding about the vaccine, said report co-author Shannon Stokley, associate director of science at the CDC’s immunization services division.

About 19 percent of parents felt the vaccine was not needed, 16 percent said they didn’t know enough about it, and 7 percent had safety concerns, the report says.

“We need to work with health care providers so they are making strong recommendations and communicating with their patients about the need for this vaccine,” Stokley said.

All the parents’ reported excuses point to their doctor as the weak link in the chain, said Debbie Saslow, director of breast and gynecologic cancer for the American Cancer Society.

Each year in the United States, an estimated 26,000 new cancers are attributable to HPV, including about 9,000 in men, researchers said in background material.

HPV causes nearly all cervical and anal cancers. The virus also causes about 70 percent of throat cancers, three-quarters of vaginal cancers and 63 percent of cancers of the penis, according the CDC.

Currently, about 79 million people are infected with HPV, and 14 million people will be infected each year.

The first HPV vaccine, licensed in 2006, initially was recommended only for girls, to protect them against cervical cancer. In 2011 the CDC began recommending HPV vaccination for boys as well.

CDC statistics show that nearly 42 percent of boys 13 to 17 had received at least one dose of the HPV vaccine in 2014, up from about one-third in 2013.

Only 21.6 percent of boys that age had received the full three-dose HPV vaccine series in 2014, Stokley said. That is up from less than 14 percent in 2013.

“We know it can go higher. We just need to work more,” she said.

Researchers found that boys are more likely to have received the HPV vaccine if they are black or Hispanic, or in a single-mother household, or in a poorer family.

This could be an effect of federal programs that provide scheduled vaccines for free to low-income families, Stokley said. It also could be caused by the Affordable Care Act, which requires that insurers cover the full cost of vaccinations.

Saslow said some doctors may be reluctant to recommend the HPV vaccine, for fear of offending parents.

“Providers have this perception the HPV vaccine is different than other vaccines,” Saslow said. “They think parents are more concerned about it, and they’re worried parents aren’t going to bring their kids back if they recommend it.”

The vaccine is recommended for boys and girls 11 or 12 years old, and some parents blanch at the prospect of inoculating their child against a sexually transmitted virus at that age, Saslow said.

Unfortunately, taking the HPV vaccine out of the regular immunization schedule drastically lowers the odds that a child will get the full series of shots, she said. It also increases the odds that they will be exposed to HPV before getting the vaccination.

The American Cancer Society and other groups offer training for doctors to help them become more comfortable discussing the HPV vaccine, Saslow said.

Boys need to get the vaccine not only to prevent transmission to girls, but also to protect themselves from genital warts and cancers of the throat, penis and anus, she said.

“This vaccine prevents six or seven kinds of cancer, in boys and girls, men and women,” Saslow said. “That’s huge.”

More information

For more on HPV vaccines, visit the U.S. National Institutes of Health.

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How Cancer Wreaks Havoc on Family Finances

By Alan Mozes
HealthDay Reporter

MONDAY, Oct. 26, 2015 (HealthDay News) — A cancer diagnosis exacts an enormous toll on a person’s health, and new research says it can also devastate a patient’s ability to continue working and maintain financial stability.

During the years following a new cancer diagnosis, the chances someone will remain gainfully employed drops nearly 10 percent, the study found. The research also revealed that cancer led to a loss of roughly five weeks of paid work.

“We’ve always known that cancer takes a huge financial hit,” said study lead author Anna Zajacova, an associate professor of sociology at the University of Wyoming, in Laramie. “But the studies that have looked at this tended to be small, and estimates of how serious the problem is have been all over the place.

“So we looked at the world’s best and most precise source on nationally representative economic information,” she said. “And what we found is that while some economic outcomes do eventually recover over time, for cancer survivors the loss of their individual earnings drops 30, 35, even 40 percent, and doesn’t come back. So the financial fallout is big.”

Zajacova and her colleagues discuss their findings in the Oct. 26 online edition of Cancer.

The study investigators reviewed survey responses from about 17,000 men and women between 1999 and 2009, before expansion of health insurance coverage under the Affordable Care Act. Of these, more than 1,100 had been diagnosed with cancer after 1990, the study said.

Survey information included employment status, total number of hours worked, total patient income and total family income.

In the first year after diagnosis the total number of hours a cancer patient worked dropped by 200 a year, compared to people without cancer. Three years following a diagnosis, those with cancer also saw their chances of having a job at all drop by 9 percent, the study found.

This dip in job prospects appeared to reverse itself by the fourth and fifth years out. Similarly, an overall drop of 20 percent in total family income two to three years following diagnosis also largely reversed itself by the fourth and fifth years, the research revealed.

But annual earnings dropped 40 percent among cancer survivors, and those earnings stayed low in the fourth and fifth years after diagnosis, the study said.

The team also found that economic losses associated with a cancer diagnosis were greater among male cancer survivors.

So what exactly explains cancer’s economic tsunami? “It would be wonderful if we could understand what’s driving this data, but unfortunately there are many reasons cancer affects income, and I would be a little hesitant to draw conclusions,” said Zajacova.

“Some patients may have had to quit jobs, some may have changed jobs, and some may have gone back to school,” she said. “And some may have chosen early retirement in response to cancer. There also might be divorces going on, and people moving in with relatives. Or a rearranging of priorities.

“But I would say that cancer, unlike other chronic illnesses, is unique in that it’s a sudden health shock,” Zajacova added. “There is no gradual descent, as you might see with diabetes or heart disease. It hits hard, and the impact on income can come fast.”

Anna Howard, a policy development principal with the American Cancer Society Cancer Action Network, said the study’s findings come as no surprise.

“We know that individuals with cancer have to deal not only with the medical and physical components of their cancer journey, but also the economic realities of their treatment decisions,” she said.

On a positive note, both Howard and Zajacova suggested that the Affordable Care Act’s expansion of insurance coverage is likely a step in the right direction in terms of providing patients and their families with a measure of economic stability.

More information

There’s more on the costs of cancer and where to get help at American Cancer Society, or call 1-800-ACS-2345 for advice and assistance.

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Safe Tackling OK in Youth Football, Pediatricians’ Group Says

By Amy Norton
HealthDay Reporter

MONDAY, Oct. 26, 2015 (HealthDay News) — There is no need to ban tackling from youth football, but players need the right training and supervision to cut their odds of injury, new guidelines from a leading group of pediatricians state.

In the policy statement, the American Academy of Pediatrics (AAP) says young players need to learn proper tackling techniques and, whenever possible, have guidance from certified athletic trainers at practices and games.

The group also suggests kids be given more opportunities to play flag football and other tackle-free variants of the game.

Dr. Greg Landry, one of two lead authors of the policy statement, presented the new recommendations Sunday at the academy’s annual meeting, in Washington, D.C. They will also be published in the November issue of Pediatrics.

This is the first time the group has come out with a policy directed specifically at tackling in youth football, said Landry, who specializes in pediatric sports medicine at the University of Wisconsin, in Madison.

The policy statement was spurred by growing concerns over the potential consequences of sports-related concussions in young athletes — with football getting much of the attention.

Much of the worry, Landry said, has stemmed from cases in which former professional football players have suffered long-term problems such as Parkinson-like symptoms, mood disorders, and memory and thinking deficits.

Autopsies from some of those athletes have revealed evidence of widespread brain damage that has come to be known as chronic traumatic encephalopathy (CTE).

The theory, Landry said, is that CTE develops from repeated blows to the head, whether they cause a concussion or not. But, he added, the causes are still unclear and researchers are not sure that CTE accounts for the symptoms some pro players have suffered.

What’s more, no one knows whether kids who play football might suffer any lasting brain damage from knocks to the head — including those with enough impact to cause concussion symptoms.

To be sure, Landry said, young players’ concussions should be taken seriously and allowed to heal completely before they return to any physical activity.

But in the AAP’s research review, “we found no evidence that tackling should be banned from youth football,” Landry said.

Instead, the group stresses the importance of teaching young players proper tackling techniques. It also says existing rules against dangerous, head-first tackles need to be strongly enforced.

Although those kinds of hits have long been banned, there’s still a “culture of tolerance” for it, according to the academy.

Mary Beth Horodyski, vice-president of the National Athletic Trainers’ Association, agreed.

“We need to change the culture from, ‘Wow, that was a great hit,'” Horodyski said. “We need to recognize when it’s not a ‘great’ hit, but a borderline-illegal one.”

Another key step, according to the academy, is to have athletic trainers on the field during games and practice. Athletic trainers are educated in preventing, diagnosing and rehabilitating injuries, and studies suggest their presence cuts players’ injury risk.

“We realize that communities and schools may not have the resources to hire an athletic trainer, especially full-time,” Landry said. “But whenever possible, have them present.”

According to Horodyski, athletic trainers can also help make another academy recommendation a reality: The group says young players should perform exercises to strengthen the muscles supporting the neck — which, some evidence suggests, could lower their concussion risk.

To perform those exercises safely and effectively, Horodyski said, kids need guidance from adults with the expertise.

“That’s not to knock on coaches,” she added. “But they don’t have the education in proper strength-training technique, or what exercises are appropriate for players’ [physical] maturity level.”

Horodyski suggested that parents of young football players take a look around during practices and games. “If you don’t see a health professional on the field, ask why,” she said.

At the same time, she and Landry both stressed that the risk of severe injury in youth football is low. Roughly 250,000 youths, aged 5 to 15, play tackle football in the United States, according to the statement.

Injuries to the head or neck account for anywhere from 5 percent to 13 percent of all football injuries, according to the academy. And “catastrophic” injuries to the brain or spinal cord strike up to 0.002 percent of young players each year — a rate comparable to gymnasts’, the academy said.

So parents should balance the risks against the benefits kids can gain from playing sports, according to Horodyski.

“Playing sports is a positive outlet for kids,” she said. “The AAP policy recognizes that.”

And for kids who like the game, but not the tackling, flag or tag football are good alternatives, Landry said. Schools and communities should offer more organized opportunities for that, he added.

More information

The U.S. Centers for Disease Control and Prevention has more on preventing young athletes’ concussions.

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Raise Smoking Age to 21, U.S. Pediatricians Urge

By Tara Haelle
HealthDay Reporter

MONDAY, Oct. 26, 2015 (HealthDay News) — The minimum age to purchase tobacco products and e-cigarettes should be raised to 21 across the United States, according to a new policy recommendation released Monday by the American Academy of Pediatrics.

The strong statement by the nation’s leading pediatricians group was among more than two dozen recommendations aimed at tightening regulations on cigarettes, e-cigarettes and other tobacco and nicotine products, to reduce youth smoking and nicotine addiction.

The group also called for the U.S. Food and Drug Administration to regulate e-cigarettes the same way it regulates other tobacco products.

“Most adolescents don’t use just one nicotine product but will commonly use or experiment with several,” said Dr. Harold Farber, lead author of two of the statements and a pediatric pulmonologist at Texas Children’s Hospital. “Research to date shows that adolescents who experiment with e-cigarettes and conventional cigarettes are much more likely to go on to become regular cigarette smokers and less likely to stop cigarette smoking.”

The new policies were presented Monday at the group’s national conference and published online simultaneously in the journal Pediatrics.

Currently, only Hawaii and about 90 cities and communities in several other states have a law requiring a minimum age of 21 to purchase tobacco products, according to the Campaign for Tobacco-Free Kids.

“As the brain matures, the ability to make decisions with important health consequences should likewise improve,” said Dr. Danelle Fisher, vice chair of pediatrics at Providence Saint John’s Health Center in Santa Monica, Calif. “Thus, slightly older young adults may choose to forgo tobacco products,” suggested Fisher, who was not involved with the new policy recommendations.

In addition, older teens often buy tobacco products for younger ones, Farber said. He added that communities requiring buyers to be at least 21 have seen youth smoking rates drop.

Another policy recommendation aimed at reducing adolescents’ attraction to smoking, using hookah pipes or “vaping” (the term for using e-cigarettes), would outlaw all flavors used in tobacco or nicotine products, including menthol in cigarettes and the various flavors in e-cigarettes.

“With flavors like peach, grape, cotton candy, gummy bear and so on, what you have is essentially highly addictive candy,” Farber said. “Other flavors, such as menthol, decrease the natural harshness of tobacco smoke, and flavored products introduce youth to a lifetime of tobacco dependence.”

More youths used e-cigarettes than any other tobacco product in 2014, according to the U.S. Centers for Disease Control and Prevention.

In addition to calling for FDA control of e-cigarettes, the AAP recommended that smoke-free laws expand to include e-cigarettes. The group recommends that use of any tobacco or nicotine products, including e-cigarettes, be banned in all workplaces, schools, dormitories, bars, restaurants, health care facilities, sidewalks, parks, recreational and sports facilities, entertainment venues and multi-unit housing.

“The jury on e-cigarettes remains out, but it is clear that carcinogens and potentially harmful substances are nonetheless present in this alternate nicotine delivery system,” said Dr. Jack Jacoub, director of thoracic oncology at Orange Coast Memorial Medical Center’s MemorialCare Cancer Institute in Fountain Valley, Calif.

Jacoub, who was not involved with the policy recommendations, said that these bans “would highlight that using e-cigarettes is a potentially harmful thing to do and hopefully will emphasize to teens, young adults and parents that one should not be reassured that it is safe.”

Other policy recommendations include a ban on Internet sales of e-cigarettes, a tax on e-cigarettes at the same rate as traditional cigarettes and a requirement for adult ratings on any entertainment depicting e-cigarette use.

The AAP also recommended banning advertising of tobacco products and e-cigarettes in all media, including television, radio, print, billboards, signs and online, and in stores where children and teens might see them.

Another major recommendation called for child-resistant packaging for liquid nicotine. Poison control centers receive more than 200 calls per month for accidental ingestion of nicotine for e-cigarettes, the AAP noted, and one toddler died last year from swallowing some.

“Toddlers and young children love to explore new things and to put things in their mouths, so it is imperative that packaging and childproofing be done to enhance the safety of their environments,” Fisher said. “This is analogous to having childproof caps on pill bottles.”

More information

Visit the AAP for more about e-cigarettes.

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Medication Errors Seen in Half of All Operations in Study

By Alan Mozes
HealthDay Reporter

SUNDAY, Oct. 25, 2015 (HealthDay News) — In a new study on how often medication errors occur during surgery, researchers report that mistakes were made during almost half of the operations they analyzed.

The mistakes included drug labeling errors, incorrect dosing, drug documentation mistakes, and/or failing to properly treat changes in a patient’s vital signs during surgery.

Overall, a medication error or adverse drug event was documented in 124 of 277 surgeries. Of the 3,675 medication administrations (most patients receive more than one drug during surgery), 193 medication errors and adverse drug events were recorded, the Harvard researchers said. And almost 80 percent of those events were determined to have been preventable.

The findings stem from the in-house efforts of Boston-based Massachusetts General Hospital to quantify and address drug-error risk during surgery.

“This is the first large-scale look at medication errors in the time immediately before, during and directly after surgery,” said study author Dr. Karen Nanji, an assistant professor of anesthesia at Harvard Medical School in Boston. “But in my opinion, while there is much room for improvement, our results are not surprising,” she added.

“In fact, it’s very likely that this issue is even more problematic given that Mass General is a national leader in patient safety, and has gone out of its way to study this issue in order to improve outcomes,” she suggested.

Nanji, who is also with department of anesthesia, critical care and pain medicine at Massachusetts General, reported her team’s findings online Oct. 25 in the journal Anesthesiology.

The study authors noted that rigorous safety checks commonly in place across many hospital settings are often loosened or bypassed in the surgical environment, when fast-moving events and changing circumstances can require quick decisions and immediate action.

With that in mind, the investigators focused on operations performed at Massachusetts General over seven months in 2013 and 2014.

All drugs and drug errors were recorded (or gleaned from medical charts) covering the time a patient entered a pre-operative area until they were out of surgery and in either a recovery room or an intensive care unit.

The result: more than 5 percent of the time, drugs were given in error or negative drug events were observed.

Two-thirds of the drug errors were categorized as “serious,” while 2 percent were considered life-threatening (though none of the patients died as a result). The remaining errors were considered “significant.”

“Hospitals across the country are constantly looking for ways to improve patient care,” said Dr. John Combes, chief medical officer of the American Hospital Association in Washington, D.C.

“This study provides important insights and highlights areas of focus for further action and study. By learning the root cause of such errors, hospitals and health systems can work to provide the best patient experience for each episode of care,” Combes suggested.

Meanwhile, Dr. David Katz, director of the Yale University Prevention Research Center in New Haven, Conn., said that “awareness of problems is where all solutions begin.”

He pointed out that “these numbers are disturbing, but not surprising. Those of us who have worked in hospitals have seen innumerable instances when such errors did occur, or could have.”

Katz explained that “medical care is intense, and often rather complex. Many parts are in motion, the stakes are high and there is often time pressure. While in some ways it is surprising that highly trained professionals working in teams would make mistakes, we might compare these teams to the other teams we know well: professional sports teams. They, too, are highly trained, exclusive teams — and yet [they] make errors routinely,” he noted.

“Of course, in medicine, it’s not about winning and losing games; it is about life and death,” Katz said. “In such context, no error is acceptable. And yet, as the saying goes, to err is human. So errors will occur if human behavior is the only safeguard against it,” he said.

“What all this means is that human behavior cannot be the only safeguard against error,” Katz added. “Rather, we need a multi-layered defense, involving careful humans backing one another up, and automatic systems backing up the humans.”

More information

There’s more on anesthesia safety at The Association of Anaesthetists.

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