While there has been a steep decline in kids' consumption of sugar-sweetened beverages in California, African-American and Latino children may be replacing soda with 100 percent fruit juice while their white peers are not, according to a new study from UC San Francisco.

The study was the first to compare trends of sugar-sweetened beverages and 100 percent juice consumption in California.

"The decrease in the consumption of sugar-sweetened beverages among kids is a promising public health trend," said Amy Beck, MD, MPH, lead author and pediatrician at UCSF Benioff Children's Hospital and San Francisco General Hospital. "But it is concerning that minority children are increasing their consumption of 100 percent fruit juice, which often has just as much sugar as soda."

Researchers examined data from the California Health Interview Survey, a telephone survey conducted every two years from 2003 to 2009, which asked parents how many servings of sugar-sweetened beverages and 100 percent fruit juice their children, ages 2 to 11, consumed the day before.

"Parents who are thinking actively about nutrition wouldn't give their kids Coca-Cola, but might give apple juice," said Beck. "But 8 ounces of Coca Cola contains 27 grams of sugar, as does 8 ounces of apple juice. We need to make sure parents understand the best thing to replace soda is water or milk."

The results will be published in the June/July issue of journal of Academic Pediatrics.

The researchers found that sugar-sweetened beverage consumption among all ethnicities decreased from 40 percent in 2003 to 16 percent in 2009 among children ages 2 to 5. Among children 6 to 10, it also decreased from 54 percent in 2003 to 33 percent in 2009. However, there were higher rates of consumption amongst Latinos, African-Americans and children of parents with lower levels of education.

For kids ages 2 to 5, the consumption of two or more servings of 100 percent fruit juice per day decreased among white children and increased among Latinos. For kids ages 6 to 11, their consumption of two or more servings remained stable for white children and increased among Latinos and African-Americans.

"Our results stress the need for more education on healthy beverages and making sure these messages reach all ethnic groups," said Beck. "It's crucial that the public health message reflect that 100 percent fruit juice should be limited, and not used as a substitute for soda."

Over the past decade, California has passed legislation to ban sugar-sweetened beverage sales in schools and implemented public health campaigns focused on reducing soda consumption by children. However, fewer efforts have targeted reducing the amount of juice children are drinking.

"There has been a lot of focus in California on reducing the consumption of sugar-sweetened beverages, and that appears to be working," said Beck. "However, parents are getting mixed messages about juice, and some parents appear to be using it as a replacement for the sugar-sweetened beverages, rather than turning to water or milk."

The American Academy of Pediatrics recommends that children age 6 and younger consume a maximum of 4 to 6 ounces of fruit juice per day, and that children ages 7 and older consume no more than 12 ounces per day.

The public health message being sent to parents is that 100 percent fruit juice is OK, according to the researchers, due much in part to juice's distribution through federal programs.

Fruit juice is available in schools through the National School Lunch Program, which provided low‐cost or free lunches to more than 31 million children nationally each school day in 2011. Juice also is distributed to parents through the Women, Infants and Children (WIC) program, a federal grant program for low-income, nutritionally at-risk women and children up to age 5 and through the Child Care Food Program.

"We want to see kids drinking fewer beverages that give them unnecessary calories – including fruit juice," said senior author Kristine Madsen, MD, MPH of the division of community health and human development at UC Berkeley. "We don't want them replacing soda with juice. It's better to eat the fruit – not drink the fruit juice."

The study's other authors include Anisha Patel, MD, MSPH, a pediatrician at the UCSF Benioff Children's Hospital. The authors have no conflicts of interest or financial disclosures.

The study was funded by a grant from the National Center for Advancing Translational Sciences, National Institute of Health.

UCSF Benioff Children's Hospital creates an environment where children and their families find compassionate care at the forefront of scientific discovery, with more than 150 experts in 50 medical specialties serving patients throughout Northern California and beyond. The hospital admits about 5,000 children each year, including 2,000 babies born in the hospital. For more information, visit https://www.ucsfbenioffchildrens.org.

UCSF is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care.

Registration for the 2013 OSAP Symposium called "Charting a Course for Infection Prevention & Safety" in San Diego, Califorinia ends today, May 31. Recent infection control breaches provide opportunities to understand outbreak protocols, how to manage complex, rapidly changing situations and how to better assure compliance with recommended infection control recommendations. OSAP will feature a special panel presentation at this year's Symposium to address this topic.   Click here for information on the program, venue, faculty and to secure registration and room reservations.

Washington, DC – Twitter is a popular source for receiving and sharing new information about vaccines, and also a basically reliable one, according to a study published in the June issue of the American Journal of Infection Control, the official publication of the Association for Professionals in Infection Control and Epidemiology (APIC).

Researchers from the University of Texas at Austin analyzed 9,510 vaccination-related tweets from one week in January, 2012 to determine the most popular and influential messages. A final sample of 2,580 tweets that had received engagement through re-posting and sharing was then coded for frequency of sharing, tone toward vaccinations, links to sources (e.g., news outlets, advocacy groups, or healthcare providers), and whether the claims being made in each tweet were scientifically substantiated.

Overall, 33 percent of the 2,580 tweets carried a positive tone about vaccines, 54 percent were neutral, and 13 percent were negative. Of the 14 percent of tweets that contained medical information, more than two-thirds offered content substantiated by scientific research.

The most popular messages concerned a potential children's malaria vaccine, development of the NeuVax E-75 vaccine for breast cancer, the effectiveness of a herpes vaccine in women, the Centers for Disease Control and Prevention's recommendation of a human papilloma virus vaccination for boys, potential approval for a lung cancer vaccine, and a blog post discrediting vaccine-autism connections.

Frequent information sources shared through tweets included health-specific sites such as WebMD (16 percent of 341 links), national media such as The New York Times (13 percent), medical organizations such as the American Medical Association (12 percent), and digital news aggregators including the Huffington Post (10 percent). The specific outlets mentioned are representative examples, though did dominate their categories.

"News and health organizations received mostly positive attention in comparison with political or advocacy groups, indicating users are favorably viewing established sources in their health-information seeking," state the authors. "In this sample, it appears that Twitter users share mostly reputable information and sources while actively mobilizing others to seek reliable health information. Results of the snapshot can help explain what social media content patients consume and respond to, as well as help determine directions for educational campaigns." 

ANN ARBOR—A new University of Michigan study finds that mid-level practitioners who are trained to provide fillings do so competently and safely, performing these procedures as well as dentists.

U-M researchers reviewed the findings of 23 separate studies conducted in six industrialized countries over the past 60 years that assessed the clinical competence of non-dentists performing a limited set of "irreversible" procedures, such as simple fillings and extractions. These procedures are traditionally done only by dentists, and many dentists in the U.S. don't want this to change.

The report comes at a time when more states are debating the merits of adding dental therapists to their workforces to improve access to dental care for low-income and geographically remote populations. Dental therapists currently are only allowed to practice in two states, Alaska and Minnesota, although legislation promoting the concept has been introduced in a dozen others.

"We became interested in this topic out of concern over the large access to care gap," said lead author Elizabeth Phillips, a research associate at the U-M School of Social Work. "We heard about dental therapists and wondered why they weren't more common."

Phillips and colleague Luke Shaefer, assistant professor of social work, discovered that, for the most part, organized dentistry—the American Dental Association and state dental associations—is vehemently opposed to dental therapists, often arguing that patient safety is at stake.

This puzzled the researchers, who said that many other countries embrace the concept as a cost-effective means of expanding care.

"The more we read, the more it became clear to us that the empirical evidence is overwhelming—technical competence is simply not an issue," Shaefer said.

The researchers said they are not necessarily advocating the introduction of dental therapists. However, they do maintain that as the debate over their merits continues to intensify, clinical competence should not be a point of contention.

The American Association of Dental Office Managers is presenting a free Webinar for 1 pm EST on Wednesday, May 29 called Prospering in a PPO Environment. It is approved for 1 CE credit toward AADOM's fellowship Program. 

Today's economic environment and changing dental landscape present unique business challenges never seen before in our industry. There has been a large shift from "traditional" dental plans to PPOs. In fact 80 plus percent of all plans sold last year were PPOs. The # 1 concern for dental offices today is not enough new patients. We also see fewer patients covered by dental benefits. And so the temptation to participate in multiple plans continues to increase. We typically see an average discount of 20%-30% from a Doctor's full fee schedule after participating. These reduced fees are directly correlated to the next concerns for dental practices, increasing overhead and decreasing profitability. In order for a dental practice to maintain profitability and lower overhead with declining insurance reimbursements the practice will need to operate more efficiently and guard against leaving production and revenue opportunities on the table.

REGISTER NOW

OREM, UTAH—Aribex, Inc., manufacturer of the newly released NOMAD® Pro 2 handheld X-ray system, today introduced a new color option, black with gray trim, of the NOMAD Pro 2 into the U.S. dental and veterinary markets. The popular white with light blue trim Pro 2 model just released last month will continue to be available and both models can be purchased from most major dental equipment dealers. 

“Dental offices are adding more color and variety to their practices,” said Ken Kaufman, general manager of Aribex. “The NOMAD Pro 2 is the future of intra-oral dental radiography, and, as such, our customers deserve an additional sleek choice of color to best match the décor of their practices.” 

“Although the addition of the black model is new, the acceptance of handheld, battery-powered, untethered X-ray is not,” Kaufman said. “Up-ending a market void of significant improvements for decades, the NOMAD is now preferred over traditional wall-mounted intra-oral X-ray machines. It is more economical, improves workflow, reduces FMX time, and just flat-out makes sense.” 

The Pro 2 features a newly designed charging cradle, an upgraded communication system using infrared technology, an increased scratch and moisture-resistant screen, and several other improvements to electrical and industrial components. According to company officials, the Pro 2 is not a completely new device, primarily offering superior battery performance and improved reliability and durability when compared to earlier versions. 

Stress and exhaustion may turn us into zombies, but a novel study shows that mindless behavior doesn't just lead to overeating and shopping sprees — it can also cause us to stick with behaviors that are good for us.

Across five experiments appearing in the June issue of the Journal of Personality and Social Psychology, published by the American Psychological Association, the researchers provide an important new twist to the established idea that we have finite resources for self-regulation, meaning it's harder to take control of our actions when we're already stressed or tired.

Turns out we're just as likely to default to positive habits, such as eating a healthy breakfast or going to the gym, as we are to self-sabotage. Led by Wendy Wood and David Neal of USC, this research shows that lack of control doesn't automatically mean indulgence or hedonism – it's the underlying routine that matters, for better or worse.

"When we try to change our behavior, we strategize about our motivation and self-control. But what we should be thinking about instead is how to set up new habits. Habits persist even when we're tired and don't have the energy to exert self-control," says Wood, Provost Professor of Psychology and Business at USC, who holds joint appointments in the USC Dornsife College of Letters, Arts and Sciences and the USC Marshall School of Business.

Wood, who serves as vice dean for social sciences at USC Dornsife, is one of the world's leading experts on habit, the automatic behaviors that make it possible for us to function everyday (imagine if we had to relearn every morning how to brush our teeth or what route to take to work).

Learned habits also play a big role in our health; research has shown that exercise, overeating and smoking are significant risk factors for major diseases. Indeed, obesity and smoking are the two primary reasons Americans die before people in other high-income countries, according to a recent National Academy of Sciences report led by Eileen Crimmins of the USC Davis School of Gerontology.

But while most disease prevention efforts focus on self-control, the latest research from Wood shows that the best way to prevent disease might be knowing how to let go: "Everybody gets stressed. The whole focus on controlling your behavior may not actually be the best way to get people to meet goals," she said. "If you are somebody who doesn't have a lot of willpower, our study showed that habits are even more important."

For example, in one experiment Wood and her co-investigators followed students for a semester, including during exams. They found that during testing periods, when students were stressed and sleep-deprived, they were even more likely to stick to old habits. It was as if they didn't have the energy to do something new, Wood explains.

Students who ate unhealthy breakfasts during the semester – such as pastries or doughnuts – ate even more of the junk food during exams. But the same was true of oatmeal eaters: those in the habit of eating a healthy breakfast were also more likely to stick to routine and ate especially well in the morning when under pressure.

Similarly, students who had a habit of reading the editorial pages in the newspaper everyday during the semester were more likely to perform this habit during exams – even when they were limited in time. And regular gym-goers were even more likely to go to the gym when stressed.

"You might expect that, when students were stressed and had little time, they wouldn't read the paper at all, but instead they fell back on their reading habits," Wood says. "Habits don't require much willpower and thought and deliberation."

Wood continues: "So, the central question for behavior change efforts should be, how can you form healthy, productive habits? What we know about habit formation is that you want to make the behavior easy to perform, so that people repeat it often and it becomes part of their daily routine."

CHICAGO—The Dental Assisting National Board, Inc. (DANB) has introduced a new certification program for dental assistants: Certified Restorative Functions Dental Assistant (CRFDA).

The CRFDA certification program is made up of six component exams: Anatomy, Morphology and Physiology (AMP); Impressions (IM); Temporaries (TMP); Isolation (IS); Sealants (SE); and Restorative Functions (RF). To earn CRFDA certification, dental assistants must pass all six component exams within three years. There are no eligibility requirements for the AMP, IM, TMP, IS or SE component exams; however, there are eligibility requirements for the RF component exam and for earning and maintaining CRFDA certification.

DANB pretested the CRFDA certification program in 2012, and the first CRFDA certifications were issued in January this year. The CRFDA application packets became available in April, and testing through Pearson VUE testing centers began on May 1. There are currently dental assistants working in 26 different states who have earned CRFDA certification.

“DANB is committed to promoting public protection and enhancing dental assistant job satisfaction by providing a defined career ladder for the dental assisting profession,” said DANB Executive Director Cindy Durley, M.Ed., MBA. “The CRFDA certification program is one way DANB is meeting the always-advancing and ever-changing needs of the field.”

DANB certificants said there are many reasons to earn CRFDA certification — such as demonstrating commitment and professionalism to their field, setting an example to others and maintaining a professional edge.

Julie Davis, CDA, CPFDA, CRFDA, said her certifications are an asset to the office and a point of pride when working with patients. “I felt it was really important to demonstrate to my patients that I go the extra mile,” she explained. “It’s a way for me to improve myself and benefit the office. I learned so much in the studying process.”

Many dental assisting educators and program directors said CRFDA certification was something they felt they had the responsibility to earn — for themselves, their programs and their students. “I decided to earn CRFDA certification to further my professional career and show my students what is out there and how much they can achieve,” said Kim Plate, CDA, CPFDA, CRFDA.

To learn more about DANB’s CRFDA certification, visit the “Exams and Certifications” section of DANB’s website, or call DANB at 1-800-367-3262.

Chinese officials are reporting that they identifed the first cases of resistance to the flu drug Tamiflu in a patient with the H7N9 avian flu virus, known as the bird flu. 

To date, China has reported 131 confirmed cases of the new bird flu in humans with 36 deaths. However, no new cases have been reported in the past two weeks.

For more on this story, please click here. 

PASADENA, Calif. — The new 13-valent pneumococcal conjugate vaccine (PCV13) appears to be as safe as the previous version used prior to 2010, the 7-valent pneumococcal conjugate vaccine (PCV7), according to a Kaiser Permanente study published today in Vaccine.

The U.S. Food and Drug Administration approved PCV13 for use beginning in 2010 after a series of trials. These trials found that PCV13, which protects against a broader range of pneumococcal types than the previously used PCV7, did not increase the risk for any serious adverse events related to the vaccine.

In a study funded by the Centers for Disease Control and Prevention, Kaiser Permanente researchers evaluated the electronic medical records of nearly 600,000 children, ages 1 month to 2 years, who received PCV13 over a two-year period. Comparing the number of rare adverse events associated with the PCV13 vaccine to the number of events associated with the previously used PCV7 vaccine, the study authors found there were no increased risks for any of the following pre-specified conditions: febrile seizures, encephalopathy (a type of brain disorder), hives/angioedema, asthma, low platelet counts or systemic allergic reactions.

"It is important that children receive the pneumococcal conjugate vaccine as it provides protection against very serious and potentially fatal infections, including meningitis and bloodstream infections. The new vaccine protects against an additional six types of pneumococcal bacteria," said study lead author Hung Fu Tseng, PhD, MPH, a research scientist at the Kaiser Permanente Southern California Department of Research & Evaluation.

Early in the study, there was a statistically significant but very small increase in the risk of Kawasaki's disease, a rare condition in children that causes inflammation of the blood vessels, associated with PCV13 (7 diagnoses per 52,000 doses, compared to 4.24 expected). At the end of the study, when the diagnoses were confirmed by medical-record review, the risk of Kawasaki disease in the 28 days following PCV7 was 1 per 100,000 doses and 2 per 100,000 doses of PCV13. Although this difference was not statistically significant, the researchers note it warrants further studies. Researchers also emphasized that this is a statistical association and therefore may not represent a cause-and-effect relationship.

The CDC recommends all children ages 5 years and younger receive PCV13. The vaccine protects against pneumococcal disease, an infection caused by Streptococcus pneumoniae. The most common types of pneumococcal infections include middle-ear infections, sinus infections, lung infections, bloodstream infections and meningitis. According to the CDC, each year in the U.S. pneumococcal bacteria cause about 4,000 cases of bloodstream infections (bacteremia), meningitis, or other invasive disease in children younger than 5 years of age.

Researchers used medical records from the Vaccine Safety Datalink, a collaborative effort between the CDC and integrated care organizations, including Kaiser Permanente, to conduct the study. The Vaccine Safety Datalink project monitors immunization safety and addresses the gaps in scientific knowledge about any rare and serious events that occur following immunization.

This study is part of Kaiser Permanente's ongoing efforts to study the safety and effectiveness of vaccines. Last year, a Kaiser Permanente study conducted through the Vaccine Safety Datalink found the herpes zoster vaccine, also known as the shingles vaccine, is generally safe and well tolerated. Additionally late last year, Kaiser Permanente researchers found immunizing older adults with the tetanus-diphtheria-acellular-pertussis vaccine (Tdap) to prevent whooping cough was found to be as safe as immunizing them with the tetanus and diphtheria (Td) vaccine.