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CDC, Nutrition, Pediatrics, Public Safety, Research, Stanford News

“Happy Meal ban”: Where are we now?

"Happy Meal ban": Where are we now?

MuppetBabiesA newly released Centers for Disease Control report of a study conducted at Stanford has examined the effects of San Francisco’s 2010 “Happy Meal ban.” The ban prohibited the free distribution of toys with unhealthy meals; the fast-food restaurants McDonald’s and Burger King instead sold the toys for 10 cents. Though neither restaurant complied with the ordinance’s specific calls for changes in nutritional content, improvements have been made.

As reported by SFGate.com:

…over the study’s two-year period, McDonald’s in particular made big changes to its Happy Meals, said [Jennifer Otten, MD,] of the University of Washington School of Public Health — first in California, then nationally.

The fast food giant cut the amount of French fries it serves in Happy Meals in half, replacing them with apples; stopped serving caramel sauce with apples; and began offering nonfat chocolate milk to customers. Otten said those substitutions were “pretty dramatic,” — they reduced the calories in a Happy Meal by 110, and cut the sodium and fat content of the meal as well.

Otten and her colleagues, including senior author Abby King, PhD, concluded in the study, “Although the changes…  did not appear to be directly in response to the ordinance, the transition to a more healthful beverage and default side dish was consistent with the intent of the ordinance. Study results… suggest that public policies may contribute to positive restaurant changes.”

Previously: How fast-food restaurants respond to limits on free toys with kids’ meals, Toying with Happy Meals, How food advertising and parents’ influence affect children’s nutritional choices and Living near fast food restaurants influences California teens’ eating habits
Photo by Ursala Urdbeer

Global Health, In the News, Pediatrics, Public Safety, Sexual Health, Women's Health

Stanford research shows rape prevention program helps Kenyan girls “find the power to say no”

Stanford research shows rape prevention program helps Kenyan girls "find the power to say no"

The San Francisco Chronicle has a great story today about a collaborative project that is reducing rape and sexual assault of impoverished girls in Kenya.

The story highlights the combined efforts of activists Jake Sinclair, MD, and his wife, Lee Paiva Sinclair, who founded nonprofit No Means No Worldwide to provide empowerment training to Kenayn girls, and the Stanford team that has been analyzing the results of their efforts. As we’ve described before, this work is a great example of the academic chops of Stanford experts’ being combined with on-the-ground activism to make a difference for an urgent real-world problem.

As the article explains:

The girls and hundreds of others like them have participated in a rape-prevention workshop created by Jake Sinclair and Lee Paiva, a San Francisco doctor and his artist wife who have been working in Kenya for 14 years.

Their program is working, and that’s not just according to the dozen or so testimonials online, the couple said. Two studies out of Stanford – one published in April this year, one the year before – have found that girls who have gone through the couples’ classes experience fewer sexual assaults after the workshops.

More telling, perhaps: More than half of the girls report using some tool they learned from the classes to protect themselves, from kicking a man in the groin to yelling at someone to stop.

“It’s great to see the girls just find their voice, to find the power to say ‘no,’ ” Sinclair said. “It’s so enlightening. You can see it in their eyes, that something’s changed.”

Stanford research scholar Clea Sarnquist, DrPH, who has played an important role in the project, adds:

“A lot of these girls are using voice and verbal skills first,” Sarnquist said. “That’s one of the key things, is teaching the girls that they have the right to protect themselves – that they have domain over their own bodies, and they have the right to speak up for their own self interest.”

The whole story is definitely worth a read.

Previously: Empowerment training prevents rape of Kenyan girls and Self-defense training reduces rapes in Kenya

Global Health, Health Policy, Public Safety, Women's Health

Lobbying Congress on bill to stop violence against women

Lobbying Congress on bill to stop violence against women

capitol - smallWhen I walked into the U.S. Capitol building this week, it was with the weight of history – my own and my country’s. Years ago, I had walked these hallowed halls as a writer for a Congressional publication and had lived in a house just blocks away. But this time I was there for a very different purpose: I was going to try my hand at lobbying, plying Congress for a cause that had become dear to my heart.

I came to Washington, D.C. with nearly 150 volunteers and staff from the American Jewish World Service, an international development organization that promotes human rights and works to end poverty in the developing world. This year, one of the group’s legislative priorities is passage of the International Violence Against Women Act, now pending in Congress. In February, I had traveled to Uganda as a Global Justice Fellow with AJWS, learning first-hand why this bill is so crucial to the lives of women around the world. I met a gay woman whose life had become hell because of her gender identity; she’d been beaten, raped and robbed and was suffering the emotional trauma of being ostracized by family and community. I also met sex workers, many of them single mothers just trying to make a living, who had been subjected to unprovoked beatings and police brutality. And I met a transgender woman whose home had been burned to the ground and who had been terrorized by her community simply because of who she was. In fact, I would learn that one in three women around the world are beaten, abused or raped at some point in their lifetime – an appalling figure.

The bill would help combat this trend by using the full force of U.S. diplomacy, as well as existing U.S. foreign aid funding, to support legal, social, educational, economic and health initiatives to prevent violence, support victims and change attitudes about women and girls in society. When women become victims of violence, everyone suffers; gender-based violence can reduce a nation’s GDP by as much as 3 percent because women are so key to collective productivity.

“If you want to get a barometer on how a country will fare – its stability – just look at the way it treats its women,” Sen. Ben Cardin (D-Maryland) told our group as we prepared to head out to visit Members of Congress. “Women invest in children and family. Men invest in war.”

With the recent kidnapping of more than 250 Nigerian school girls, the need for the legislation has become all the more pressing. “This is the moment to strike,” Sen. Barbara Boxer (D-Calif.) said during a meeting with 20 members of our group. We met with Boxer in the sumptuous President’s Room in the U.S. Capitol, adorned with gilt, frescoes and historical portraits and the spot where Abraham Lincoln and Martin Luther King once stood. Boxer had just come from a vote on several new judges and was gracious enough to stop by to spend 20 minutes listening to our pitch and discussing strategy.

A strong women’s rights activist, she has been an ardent supporter of the bill from the start. With 300 nonprofit groups now clamoring for its passage, she said she felt it was time to introduce it into the Senate, which she did a week ago. It’s now critical, she said, to enlist additional Republican co-sponsors of the legislation, particularly among members of the Senate Foreign Relations Committee, to give it greater weight and bipartisan appeal. In the House, the bill already has 63 Democratic and 11 Republican co-sponsors, with more being sought.

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Global Health, Pediatrics, Public Safety, Research, Stanford News, Women's Health

Empowerment training prevents rape of Kenyan girls

Empowerment training prevents rape of Kenyan girls

Adolescent girls in the slums of Nairobi, Kenya, are frequent targets of sexual harassment and assault: Nearly one in five of them is raped each year. When these crimes are perpetrated against Nairobi’s teen girls, they’re often expected to react with shame and silence.

But a small non-governmental organization, No Means No Worldwide, has a strategy to change that. The co-founders, Jake Sinclair, MD, and Lee Paiva, an American husband-and-wife team, developed a curriculum of empowerment training to teach girls that it’s OK to say “no” to unwanted sexual advances. The training also gives girls specific verbal and physical skills to defend themselves, as well as information about where to go for help after a rape or other sexual assault.

The results are impressive. Stanford researchers who work with Sinclair and Paiva report today in Pediatrics that the empowerment training cut annual rates of rape by more than a third. Among the group of 1,978 girls trained during the study, more than half used their new knowledge to fend off attempted rape, and 65 percent stopped instances of harassment, halting hundreds of incidents.

From our press release about the research:

“Clearly, girls should never be placed in these situations in the first place,” said Clea Sarnquist, DrPH, the study’s lead author and a senior research scholar in pediatrics at Stanford. Changing males’ attitudes and behavior about assault is an important area for the team’s current and future work, she said. “But with such a high prevalence of rape, these girls need something to protect them now. By giving them the tools to speak up and the knowledge that ‘I have domain over my own body,’ we’re giving them the opportunity to protect themselves.”

The video above, one of a series of testimonials that No Means No Worldwide has collected from Nairobi girls, shows the power of that sense of domain over one’s body. In the video, a schoolgirl named Catherine tells how she stopped a male student from harassing her. When the video begins, it’s impossible not to notice how young and vulnerable she seems. But then she recounts how, when this boy followed her and demanded sex, she remembered her self-defense classes.

“I stood and maintained eye contact,” she says in the video. “I warned him that day and told him he should never in his life dare follow me.”

As she says the words, her demeanor transforms: She draws herself up straight, looks directly in the camera, and raises her index finger in a gesture of commanding attention.

Maryanne Wangui, a young Kenyan woman who recorded many of the testimonials, said something to me that resonates with Catherine’s account and sticks in my mind: “If you give girls the right skills, they know what to do. It doesn’t matter the age of the girl or the size of the girl; they’re all powerful inside.”

Previously: Self-defense training reduces rapes in Kenya
Video courtesy of No Means No Worldwide

Behavioral Science, Mental Health, Public Safety, Stanford News

Stanford’s Keith Humphreys on Golden Gate Bridge suicide prevention: Get the nets

GGBridgeOver on the Huffington Post, Keith Humphreys, PhD, professor of psychiatry and behavioral science at Stanford, writes about a tragic phenomenon in the Bay Area: the popularity of suicide by jumping from the Golden Gate Bridge. He makes a case to put public money toward installing nets and other suicide-prevention services there and in other suicide “hotspots.”

From the post:

Professor Richard Seiden [PhD] painstakingly tracked down death records for the 515 individuals who had been prevented by police from jumping off the bridge from 1937 to 1971. Remarkably, only 6 percent had committed suicide. Even if every individual who died in what was believed to be an accident were assumed to have intentionally caused their own deaths, the proportion of suicides rose only to 10 percent. In other words, 90 percent or more of people stopped from committing suicide at the Golden Gate Bridge lived out the full natural extent of their lives.

Previously: Full-length video available for Stanford’s Health Policy Forum on serious mental illnessLucile Packard Children’s Hospital partners with high schools on student mental health programs and ECT for depression – not so shocking
Photo by image_monger

Parenting, Public Safety, Research, Sports

Is repetitive heading in soccer a health hazard?

Is repetitive heading in soccer a health hazard?

soccer_headerIn the 20 years that I played soccer as a child and young adult, I used my head countless times to challenge and control the ball as it sailed through the air. During practices, coaches gave instructions on which part of the head to use in making contact and redirecting the ball so that the impact was less painful. They also trained me and my teammates on the body mechanics of receiving the ball to maintain possession. But there was never a discussion on the potential health affects of repetitively heading the ball.

So I was interested to read about a paper (subscription required) recently published in Brain Injury wherein researchers raise concerns about long-term consequences of repetitive heading. In the study, Canadian researchers analyzed nearly 50 papers that examining the incidence of concussion in soccer. Among their findings:

  • Overall, concussions accounted for 5.8 per cent to 8.6 per cent of total injuries sustained during games.
  • In particular, girls’ soccer accounted for 8.2 per cent of sports-related concussions, the second highest sport after football.
  • Research papers that looked at the mechanism of injury found 41.1 per cent of concussions resulted from contact by an elbow, arm or hand to the head.
  • Another study showed 62.7 per cent of varsity soccer players had suffered symptoms of a concussion during their playing careers, yet only 19.2 per cent realized it.
  • Studies on the long-term effects of heading found greater memory, planning and perceptual deficits in forwards and defenders, players who execute more headers.
  • One study found professional players reporting the highest prevalence of heading during their careers did poorest in tests of verbal and visual memory as well as attention.

Considering that an estimated 265 million(.pdf) people worldwide play soccer, researchers say these findings show more research on the long-term consequences of repetitive heading is greatly needed.

Previously: Kids and concussions: What to keep in mind, Measuring vs. reporting concussions in cheerleading, Can a single concussion cause lasting brain damage? and A conversation with Daniel Garza about football and concussions
Photo by Gordon Marino

In the News, Parenting, Pediatrics, Public Safety

Carseats save lives, but only if kids are buckled in

Carseats save lives, but only if kids are buckled in

carseatA new study shows failure to properly restrain children in carseats or a seatbelt remains a leading cause of death for children involved in motor vehicle accidents. As reported today on the Well blog, the death rate decreased from 2002 to 2011, but  thousands of children under 12 unfortunately died because they were not buckled in. Using a carseat or seatbelt could have saved many of those lives:

In 2011, 33 percent of children who died in motor vehicle accidents were not buckled in. While only 2 percent of children under age 1 rode unrestrained, 22 percent of those in that age group who died were unbuckled. An estimated 3,308 children under 4 are alive today because they were properly buckled in.

“We can do more to help protect our children on the road,” [lead author Erin K. Sauber-Schatz, PhD] said “We have to make sure that children are buckled into age- and size-appropriate seats and seatbelts on every trip, no matter how short the trip.”

Many hospitals, including Lucile Packard Children’s Hospital Stanford, offer car seat installations and inspections for new parents.

Previously: Precious cargo: Keeping kids safe in cars and planes
Photo by Kari Bluff

In the News, Infectious Disease, Men's Health, Public Safety, Research, Stanford News

Exploring how gender affects the immune system

Exploring how gender affects the immune system

man_coldA piece published today on Slate examines how sex hormones, like estrogen and testosterone, may impact the strength of men and women’s immune systems. As noted in the article, recent research from Stanford immunologist Mark Davis, PhD, who directs Stanford’s Institute for Immunity, Transplantation and Infection, and his colleagues offers new insights on the issue:

… it’s been difficult to establish any direct link between levels of sex hormones circulating in the blood and the performance of men’s and women’s immune systems.

Recent research is now beginning to firmly establish that link. This month, a team of scientists at Stanford University has reported some of the best evidence yet that testosterone directly influences immune system function in men. The researchers took blood samples from male and female volunteers who were given a flu shot. Women had higher levels of immune system molecules circulating in their blood than men, and they produced more effective antibodies against the flu virus. And there were not only differences between men and women, but there were differences among men—the men with the weakest response to the flu shot had high levels of both testosterone and testosterone-induced enzymes, suggesting that high levels of testosterone can suppress immunity.

This finding that testosterone may dial down the immune system in humans is consistent with the results of studies of other animals, ranging from fish to chimps.

For more details on the study and why high testosterone may provide a less obvious evolutionary advantage, read this December Scope post from my colleague Bruce Goldman.

Previously: In men, a high testosterone count can mean a low immune responseAdults’ immune systems “remember” microscopic monsters they’ve seen beforeImmunology escapes from the mouse trap and Immunology meets infotech
Photo by Iain Farrell

Parenting, Public Safety

Tips from a doctor (and a mom) for a safe Halloween

Tips from a doctor (and a mom) for a safe Halloween

Avery trick or treatingHappy Halloween! Whether you’re trick-or-treating or heading to a party tonight, make sure you and yours stay safe and healthy. Recently we spotlighted a list of recommendations from Lucile Packard Children’s Hospital on how to keep the fun while ditching some of the calories (and sugar) imposed by trick-or-treating. During a Mayo Clinic Twitter chat earlier this week, Seattle pediatrician Wendy Sue Swanson, MD (@seattlemamadoc), mother of two boys, also offered tips on having a safe and healthy Halloween. Among her suggestions:

  • Start the evening with a family dinner and agree on a plan to limit candy consumption. Introduce kids to the Switch Witch.
  • Ensure a costume’s proper fit (to avoid tripping) and affix flashing lights and reflectors for better visibility after dark. Also, make sure your kids can see: Try non-toxic face paint instead of a vision-obscuring mask. Know the risks of wearing decorative contact lenses.
  • If staying in, stock your caldron with healthy treats or stickers, pencils, and other non-food items to include children with food allergies or medical concerns.
  • Stay sober when escorting children. Whether driving or walking, keep your eyes on the road and off your phone.
  • Prepare your children for surprises that may be scary, even in the spirit of fun. Make sure children have a parent’s phone number memorized and a plan of how to reconnect if they get lost.
  • For teens who go out on their own, choose small groups and have a code word in place in case they want to be picked up from a party early.
  • Inspect candy before allowing little children to eat it, and beware of choking hazards such as marshmallows and similarly squishy treats.

Swanson’s boys will be dressing up as a Seattle Seahawks fan and a Lego piece.

Previously: How to avoid a candy-coated Halloween and Debunking a Halloween myth: Sugar and hyperactivity
Photo by Michelle Brandt

In the News, Public Health, Public Safety, Technology

Now that’s using your head: Bike-helmet monitor alerts emergency contacts after a crash

Now that's using your head: Bike-helmet monitor alerts emergency contacts after a crash

kids riding bikes - big

For me, the hardest thing about loving someone is knowing I can’t always be with them. That’s why I keep my eyes peeled for the latest technological gadgets that can connect me to the people I love, even when they’re far away.

Today, a story from Wired caught my attention. It’s a bike helmet monitor – about the size of chocolate truffle – that sends a text to your emergency medical contact(s) of choice if it senses you’ve been in an accident.

From the article:

It attaches to any helmet — clipped into a vent, as pictured, or stuck on with a super-sticker — and registers impacts via both a three-axis gyroscope and a three-axis accelerometer. A proprietary algorithm determines whether the hit exceeds brain-trauma threshold. If there’s cause for worry, the ICEdot alerts your phone over low-energy Bluetooth. This triggers the ICEdot app to sound an alarm and begin a countdown. If you don’t wake up and turn it off before it times out, the app texts your GPS coordinates to your emergency contacts.

Sound complicated? It is, but not for the user. Setup is simple and fast: Register online, download the app, connect with the sensor, and you’re done.

Since bike crashes can result in potentially serious injuries, including concussions, this little device could give bikers, and their loved ones, some peace of mind.

Holly MacCormick is a writing intern in the medical school’s Office of Communication & Public Affairs. She is a graduate student in ecology and evolutionary biology at University of California-Santa Cruz.

Previously: Study shows concussion recovery may take longer for female, younger athletesCan high-tech helmets safeguard young athletes against concussions?University leaders raise awareness about the importance of bike helmetsRattled by one child’s injury, a whole family becomes accident-prone, and Health benefits of bike commuting outweigh the risks
Photo by Divine in the Daily

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