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It is often assumed that the schoolyard is where bullies go to make other kids miserable, but a new study suggests that classrooms are another popular site.

The study, presented recently at the American Public Health Association’s annual meeting in Philadelphia, is based on survey results from more than 10,000 middle-school students who anonymously answered questions online.

Of those surveyed, 43 percent said they’d been physically bullied within the last month. A bit more than half said they’d been teased in an unfriendly way, and half reported being called hurtful names.

About one-third said groups had excluded them to hurt their feelings. Twenty-eight percent said their belongings had been taken or broken; 21 percent said someone threatened to hurt them. According to the results, two-thirds of the students said they’d been bullied in more than one way over the previous month.

The study authors noted that 8 percent of respondents said they’d skipped school at least once during the school year because of fear of being bullied. Twenty-five percent said they’d taken other actions, such as skipping recess, not going to the bathroom or lunch, skipping classes, or avoiding some area of the school to avoid encountering a bully.

Bullies did much of their intimidating in the classroom, lunchroom and school hallways, the researchers found. Those who were bullied in the classroom felt more threatened and unsafe on campus than other students.

“These findings show that it is erroneous to think of the classroom as a safe haven from bullying and to think that more remote or less-monitored areas of school are necessarily the greatest risk for students,” H. Wesley Perkins, lead researcher on the study, said in a news release.

More than 65 percent of U.S. mothers with depression don’t receive adequate treatment, a new study has found.

Black, Hispanic and other minority mothers are least likely to receive adequate treatment. Mothers with health insurance are three times more likely to receive adequate treatment than those without insurance, wrote the researchers at the University of Wisconsin-Madison School of Medicine and Public Health.

“Health insurance facilitates access to adequate treatment for maternal depression. Expanding health insurance coverage to mothers with depression is a critical step in helping them get the care that they need,” study author Dr. Whitney P. Witt, an assistant professor of population health sciences, said in a news release from the university.

The analysis of national data on 2,130 mothers with depression also found that working mothers were less likely to receive adequate treatment, possibly because long work hours make it difficult for them to find time to seek treatment. This means that workplaces could prove a useful location for depression intervention.

“Services like employee-assistance programs can help these mothers get screened and treated, even if they are unable to visit a provider or a mental health professional in the health-care setting,” co-author Kristin Litzelman, a population health sciences doctoral student, said in the release. “Since healthy employees are productive employees, it’s often a win-win for employers to offer benefits that support employee mental health.”

Depression in mothers can have a major impact on the entire family, especially on the health and well-being of their children, the researchers noted. Treating depression in mothers can improve the long-term health of their families.

Health-care providers need to understand the racial, ethnic and educational disparities that affect treatment of mothers with depression in order to intervene and help these patients get the care they need, the study authors noted.

New research suggests that deep brain stimulation, already a common treatment for some neurological conditions, may be an effective way to treat Tourette syndrome.

“Our findings hold promise for helping people with severe Tourette syndrome, who are in need of new treatment options to improve their quality of life,” study author Dr. Andrea Cavanna, of the University of Birmingham in England, said in a news release from the American Academy of Neurology.

An estimated 2 million Americans suffer from Tourette syndrome, which is best known for making people uncontrollably shout words out loud. Other symptoms include spastic movements, facial tics, shoulder shrugging and jerking of the head or shoulders.

In the new study, 15 patients with severe Tourette syndrome plus obsessive compulsive disorder received deep brain stimulation — electrical impulses — through a surgically implanted brain pacemaker.

The subjects had about half as many tics on average after the treatment, and their symptoms of obsessive compulsive disorder, depression and anxiety fell by 26 percent to 33 percent, the researchers reported in the Oct. 27 issue of the journal Neurology.

“Despite having only 15 patients in this study, it is the largest to date on the effectiveness of deep brain stimulation as a treatment for Tourette syndrome,” Cavanna said. “The results showed that all 15 people who were assessed after two years’ treatment experienced improvements in disabling tics and neurological problems, which is encouraging,” Cavanna added.

“Unfortunately, three patients from the original group of 18 were no longer part of the study at follow-up and this limits the ability to generalize our findings. More research needs to be done to confirm that deep brain stimulation is a safe and effective treatment for Tourette syndrome,” Cavanna said.

Traditional Pap tests and the newer liquid-based cytology are equally reliable in screening for cervical cancer, a new study has found.

In the United States, liquid-based cytology testing has all but replaced the traditional Pap test, but in Europe the debate continues over which method is best, according to Dr. Mark Schiffman, a senior investigator at the U.S. National Cancer Institute, co-author of an editorial accompanying the study’s publication in the Oct. 28 issue of the Journal of the American Medical Association.

The study’s lead researcher, Albertus G. Siebers, from Radboud University Nijmegen Medical Centre in the Netherlands, reflects that debate. “Liquid-based cytology is neither more sensitive nor more specific in detecting cancer,” he said. “However, the decision to convert to liquid-based cytology cannot be based on the performance of the method alone, as other arguments also play an important role.”

The difference between the two tests is not in the way samples are collected but in how they are treated in the laboratory. In a traditional Pap test, cells are collected and smeared on a slide for evaluation. In liquid-based cytology, the cells are rinsed in a vial of preservation solution.

The advantage of liquid-based cytology is that it also screens for human papillomavirus (HPV), which causes most cervical cancers.

To find out which test was best, the researchers randomly assigned 89,784 women who participated in the Dutch cervical screening program to have either a traditional Pap tests or a liquid-based cytology test.

“The main finding of the study is that we provided strong evidence that a relatively new screening method is not necessarily better than the old way of screening with conventional PAP smears,” Siebers said.

The Dutch screening program did not allow use of liquid-based cytology testing until recently, he said, because officials did not have sufficient data comparing it with the conventional method.

“The decision to convert to a new method is a very complex one,” Siebers said. “The performance of the method is, of course, imperative, but it is not the only factor. Other things must be considered, [including] screening time, the handling of the specimen, the reduced number of inadequates, the possibility of using residue for further diagnostic procedures such as HPV testing [and] the much more standardized way of handling the material that enables computer-assisted screening.”

All these factors should be considered to objectively estimate cost-effectiveness and decide whether a change in screening method should be made, Siebers said.

The study’s findings led to Dutch officials deciding to allow use of liquid-based cytology testing, he said.

Schiffman noted that liquid-based cytology is more expensive than the traditional Pap smear, but it is preferred by U.S. laboratories because specimens are easier to handle, and more analyses can be done in a day. In addition, the specimen can be used for HPV testing, which is common in the United States.

But any Pap testing could be on the way out, he said, because the ability to prevent and screen for cervical cancer is changing. “We now have vaccines that are going to keep getting better, and we have HPV testing, which is even more sensitive than Pap smears,” Schiffman said. “And new techniques will come along.”

He predicted major changes in cervical cancer screening in the next few years, “with the powerful sensitivity of doing HPV testing plus a Pap smear that is optimally done no more than every three years starting at age 30.”

But he said it remains to be seen whether women will accept screening every three years after having been accustomed to annual testing. “That’s a major change coming,” Schiffman said.

Female veterans of the Iraq and Afghanistan wars are less likely to complain of painful physical conditions than their male counterparts are.

The findings, from a study of more than 91,000 U.S. veterans, run counter to what is seen in the general population — where women typically show higher rates of chronic pain conditions, including migraines, fibromyalgia and persistent abdominal pain.

Among veterans in the study, 43 percent reported some type of physical pain over one year. And of those who had their pain evaluated at least three times, 20 percent had symptoms lasting at least several months.

Men, it turned out, were more likely to report either problem: 44 percent said they had pain at some point over the year, compared with 38 percent of women. Of those assessed for persistent pain, 21 percent of men had lingering symptoms, versus 18 percent of women.

When women did have pain, however, they were somewhat more likely than men to describe it as moderate to severe. Among veterans with any pain, 68 percent of females had moderate or severe pain, compared with 63 percent of men.

Researchers led by Dr. Sally G. Haskell, of the VA Connecticut Healthcare System in West Haven, report the findings in the journal Pain Medicine.

Exactly why these findings in veterans differ from what’s been found among civilians is unclear, according to Haskell’s team.

The researchers speculate that combat exposure could be a factor. If men are more likely to be seriously injured or suffer from post-traumatic stress disorder after serving in a war zone that could explain their higher rate of pain complaints.

In addition, the researchers write, it’s possible that the “persistent level of threat” faced by soldiers in Iraq and Afghanistan essentially equalizes men’s and women’s risk of stress-related pain.

Understanding sex differences in veterans’ risks of various health problems will be increasingly important as more and more women enter the military, according to the researchers.

“As the VA plans care for the increasing numbers of female personnel,” Haskell said in a written statement, “a better understanding of the prevalence of pain, as well as sex-specific variations in the experience and treatment of pain, is important for policy makers and providers who seek to improve identification and management of diverse pain disorders.”

Bedwetting affects many young children and often doesn’t indicate a serious medical issue.

However, the Nemours Foundation says, if bedwetting starts all of a sudden or is accompanied by these other factors, it’s time to call a pediatrician.
Bedwetting that resumes after a child has had dry nights for at least six months.
Sudden behavioral problems, either at home or at school.
Complaints from your child that there’s burning or pain during urination.
An increase in the frequency of urination.
An increase in appetite or thirst.
Swelling of the ankles or feet.
Bedwetting that continues at age 7 or older.

Exercise is good for you, but watch it: A new study found that young men engaging in strenuous physical activity are “an often overlooked” group that’s at risk for low blood counts and iron deficiency.

Dr. Drorit Merkel from the Chaim Sheba Medical Center, Tel-Hashomer and colleagues studied 153 males, all 18 years old, who were training to join an elite combat unit in the Israel Defense Force.

In the September Journal of Adolescent Health, the investigators report that before the start of training, about 18 percent of the recruits had low blood count, or anemia. That rate almost tripled after six months of intensive military training, to just over 50 percent.

The rate of iron deficiency nearly doubled, from about 15 percent to 27 percent. The researchers do not report whether the recruits had any symptoms of anemia.

The researchers point out that the males in the study had a higher-than-average rate of anemia to begin with, which could explain some of the results. That’s because recruits who intend to compete for membership in elite units often participate in intense pre-recruitment preparatory training.

“Iron deficiency and anemia,” the investigators point out, “are generally uncommon findings in healthy male adolescents. However, athletes who engage in strenuous physical activity are known to be at increased risk for so-called ’sports anemia.’”

So why the higher risk? Potential reasons include drinking lots of water, which temporarily dilutes the blood and damage to blood cells that can result from high levels of physical activity.

“The prevalence of iron deficiency in new recruits indicates a military public health issue, and the preventive and therapeutic implications of these findings require further evaluation,” Merkel and colleagues conclude.

People who grew up in a place and time when they could legally buy alcohol before age 21 are more likely than others to be alcoholics or have a drug problem, even well into adulthood, new research shows.

“The effect lingers,” said study author Dr. Karen Norberg, a research instructor in psychiatry at Washington University in St. Louis. “A drinking-age law of 21 is associated with lower risks of long-term problems with alcohol use.”

The study is published online Sept. 18 in the journal Alcoholism: Clinical and Experimental Research.

Norberg and her research colleagues analyzed surveys of nearly 34,000 people born in the United States between 1948 and 1970, examining their records to determine if rates of alcoholism and drug abuse differed depending on their states’ liquor-buying laws at the time the participants were teens or young adults.

In the early 1970s, 26 states lowered the drinking age to 18 after the federal voting age was lowered to 18, Norberg said. After passage in 1984 of the National Minimum Drinking Age Act, the federal government pressured states to increase the drinking age or forfeit highway funds.

By the late 1980s, most states had complied, raising the drinking age back to 21. Louisiana, the researchers noted, was the last to do so, in 1995.

In the study, people who had been allowed to buy liquor legally before age 21 were 33 percent more likely to have suffered from alcoholism in the year before they were surveyed.

Drinking at a younger age also was found to increase the risk of abusing other drugs. Those allowed to drink legally before age 21 were 70 percent more likely to have had a problem with drugs than were those who had to wait until 21 to drink legally, the study found.

No differences were detected between men and women, various ethnicities or age groups.

The findings suggest, Norberg said, that the frequency or intensity of drinking in late adolescence has long-term effects.

A study released earlier this year reported that states that allow the suspension of a driver’s license for any underage alcohol violation and states with zero-tolerance laws that make it illegal for young people to drive with any level of alcohol in their system have fewer drunk-driving accidents.

So-called use-and-lose laws resulted in 5 percent fewer auto accidents related to drinking, the study found. It, too, was published in Alcoholism: Clinical and Experimental Research.

Norberg’s study is believed to be the first to look at the very long-term effects of lowered drinking ages.

The study “substantiates something that has not been substantiated this way before — that the [legal] drinking age really has long-term impact,” said Dr. Marc Galanter, director of the division of alcoholism and drug abuse at New York University School of Medicine. “Even in [people’s] 40s and 50s, this impact was felt.”

Though people nationwide continue to debate what the ideal legal drinking age should be, with some again calling for a lower age, Galanter said the results suggest that keeping the status quo would be good.

Traci Toomey, an associate professor of public health at the University of Minnesota, who also has researched the topic, agreed. The new study, she said, provides “another piece of the puzzle that looks at the policy from another angle.”

Norberg, however, said that though her research poses a “strong argument” for keeping the drinking age at 21, “there might be some other solution,” such as the drinking “learner’s permits” that some have proposed.

That concept aims to change the youth culture from acceptance of excessive drinking to preference for limited alcohol consumption. One way to do this, proponents say, could be to allow someone younger than 21 to apply for a learner’s permit that allows limited use of alcohol under monitored conditions.

Men with a rare disorder in which they carry extra female genes can still have children if they undergo a surgical procedure for collecting their sperm, according to a new study.

Men with Klinefelter’s syndrome carry an extra copy of the X chromosome; normally men have one each of the X and Y chromosomes, and women have two X chromosomes. Men with Klinefelter’s syndrome carry XXY, and the main effect of the disorder is less fertility.

However, Dr. Ranjith Ramasamy and colleagues at New York-Presbyterian Hospital in New York used a surgery technique to retrieve sperm from 45, or two-thirds, of their 68 patients. Of 91 total attempts, 62 were successful.

More than half - 57 percent - of the men’s partners became pregnant after the sperm was combined with their partners’ eggs in the laboratory, in a procedure known as in vitro fertilization. Not all of those pregnancies made it to term, however: Overall, 45 percent of those couples who attempted to conceive using in vitro fertilization had children.

The researchers report their results In the September Journal of Urology. Sperm retrieval was more likely to be successful in younger men, with success rates of 71 percent for men 22 to 30 years old, 86 percent for those 31 to 35, and 50 percent for those 36 to 52 years old, they report. The oldest patient to undergo successful retrieval was 45.

Sperm retrieval rates were lower among men given testosterone replacement therapy, which is not uncommon in men with Klinefelter’s syndrome.

Given that sperm can be retrieved from men with the syndrome up until at least age 35, the researchers conclude, men should not rush to have their sperm obtained during adolescence, the authors conclude.