Heel pain in youth athletes: A warning sign

  • Author: Health Informer
  • Filed under: Health News
  • Date: Sep 23,2009

Surgeons Urge Prompt Treatment for Growth Plate Injuries

Indoors and outdoors, youth athletes stay active year-round in competitive sports, and for many of them heel pain has become “just another part of the game.” The American College of Foot and Ankle Surgeons advises that when a child complains of heel pain, it should be diagnosed promptly because it may be a warning sign of a serious foot problem.

Karl Collins, DPM, FACFAS, a St. Louis-area foot and ankle surgeon, says heel pain occurs frequently in children ages 6 to 14 as their feet grow and the heel bone develops. “As children become more active in sports they increase their risk for growth-plate injuries and subsequent heel pain,” says Collins. This is especially true at back-to-school time when surgeons see an increase in middle and high school athletes experiencing heel pain with football and soccer seasons simultaneously underway.

“New bone forms in an area behind the heel, known as the growth plate, and cartilage is vulnerable to severe inflammation from strain or stress. With repeated stresses and strains from overactivity, the heel becomes very painful,” Collins explains.

Even though growth-plate trauma is the leading cause of heel pain in young people, Collins says the condition can be difficult to diagnose. He cautions that parents should be concerned if a child has pain in the back or bottom of the heel, limps, walks on the toes, or seems to have difficulty participating in normal recreational activities. To diagnose the condition, foot and ankle surgeons examine the child’s foot and leg and often take imaging tests to rule out other serious causes of heel pain, such as bursitis, tendonitis and fractures.

In most cases, mild or moderate heel pain can be treated successfully with shoe inserts to soften the impact on the heel, anti-inflammatory medications, stretching and physical therapy. In severe cases, the foot and ankle will be immobilized in a cast and, in some instances, surgery may be necessary.

Heel pain in young people often returns after treatment because the growth plate is still forming until the age of 14 or 15. However, the risk for recurrence can be lowered by choosing well-constructed shoes with good support and restricting use of spiked athletic shoes, especially on hard fields. It also is advised that young athletes avoid competition that exceeds their physical abilities.

For more information on heel pain in children or to find a foot and ankle surgeon near you, visit FootPhysicians.com.

Source: American College of Foot and Ankle Surgeons


New report highlights proven disease prevention programs in communities

  • Author: Health Informer
  • Filed under: Health News
  • Date: Sep 22,2009

Trust for America’s Health (TFAH) and The New York Academy of Medicine (NYAM) released a new report today featuring a range of evidence-based disease prevention programs that have shown results for improving health and reducing costs in communities.

The Compendium of Proven Community-Based Prevention Programs report includes a summary and examples from an extensive literature review that NYAM conducted of peer reviewed studies evaluating the effectiveness of community-based disease prevention programs designed to reduce tobacco use, increase physical activity, and/or improve eating habits. NYAM identified 84 articles with evidence showing how community-based prevention programs can directly reduce disease rates or disease progression. The Compendium report also includes examples of evidence-based community prevention programs that have helped reduce rates of asthma, falls among the elderly, and sexually-transmitted diseases.

“Heart disease, stroke, and diabetes account for 36.6 percent of deaths in the United States, but this could be significantly reduced by changing just three risk factors — decreasing smoking, increasing exercise, and improving healthy eating,” said Jo Ivey Boufford, MD, President of NYAM. “Despite the high rates of preventable death, investment in prevention has been historically modest in this country, accounting for only four percent of all health care expenditures. The good news is that community-based prevention programs work. Well-designed community interventions can change behavior. They help people take responsibility for their health and make healthy choices that reduce both the incidence and severity of disease.”

“To really reform health in the United States, we must actively find ways to lower disease rates. The evidence is clear that prevention is the key to better health. Well-designed and well-implemented community-based disease prevention programs, like those called for in the House Tri-Committee and Senate HELP draft health reform bills, could have a major impact on improving the health of millions of Americans,” said Jeff Levi, PhD, Executive Director of TFAH. “A smart National Prevention Strategy coupled with an investment fund for community-based prevention programs would allow millions of additional Americans to benefit from proven prevention programs that could spare people from needless suffering and trips to the doctor’s office.”

Examples of some programs featured in the report include:
– In Pawtucket, Rhode Island, the Pawtucket Heart Health Program conducted an intervention to educate 71,000 people about heart disease through a mass media campaign and community programs. Five years into the intervention, the risks for cardiovascular disease and coronary heart disease had decreased by 16 percent among members of the randomly selected intervention population.
– Researchers at Ohio State University recruited 60 women in their forties for a 12-week walking program that took place on the college’s campus. At 3 months, the intervention group saw a one percent decrease in body mass index (BMI), a 3.4 percent decrease in hypertension, a 3 percent decrease in cholesterol, and a 5.5 percent decrease in glucose.
– The Rockford Coronary Health Improvement Project in Rockford, Illinois was a community-based lifestyle intervention program aimed at reducing coronary risk, especially in a high risk group. The intervention included a 40-hour educational curriculum delivered over a 30-day period with clinical and nutritional assessments before and after the educational component, in which participants were instructed to optimize their diet, quit smoking, and exercise daily (walking 30 minutes per day). At the end of the 30-day intervention period, stratified analyses of total cholesterol, LDL, triglycerides, blood glucose, blood pressure and weight showed highly significant reductions with the greatest improvements among those at highest risk.

The Compendium report follows a release this summer by the Healthy Eating Active Living (HEAL) Convergence Partnership, which consists of The California Endowment, The Kresge Foundation, Nemours, Robert Wood Johnson Foundation, W.K. Kellogg Foundation, and Kaiser Permanente, which highlighted successful community-based disease prevention programs that these major national private foundations have supported and outlined the important health impacts that community prevention efforts can provide.

“As the country is engaged in conversations about how to best structure health systems, we strongly believe that robust provisions for community health must be a centerpiece of reform efforts,” said Marion Standish, MA, JD, Director, Community Health, The California Endowment, one of the groups involved in the Convergence Partnership. “As was stated in the recent announcement by the Convergence Partnership, a focus on community prevention will improve health, save money, reduce demands on our health care system, and most importantly, will lead to a nation of healthier people and healthier places to live.”

In 2008, TFAH released a report that found that an investment of $10 per person per year in proven community-based programs to increase physical activity, improve nutrition, and prevent smoking and other tobacco use like those featured in the Compendium report could save the country more than $16 billion annually within five years. This is a return of $5.60 for every $1.

The full Compendium report can be found on TFAH’s Web site at: www.healthyamericans.org. TFAH has also released a companion report, Examples of Successful Community-Based Public Health Interventions State-by-States, featuring a number of examples of prevention programs around the country.

Trust for America’s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority. www.healthyamericans.org.

Source: Trust for America’s Health


Report presents findings by wage level and gender and finds effective workplaces contribute to positive health;

In the midst of the most vigorous national health care debate in 15 years, and at a time of heightened economic insecurity, new data on employers show that the health of employed American workers is trending downward in a number of important areas. The State of Health in the American Workforce, a report released today by the Families and Work Institute (FWI), finds that only 28% of employees today report that their overall health is “excellent,” down from 34% just six years ago. Perhaps surprisingly, men’s overall health has declined more rapidly than women’s. The report also sheds light on the relationship between an effective workplace and employee health, underlining the significant role that employers play beyond providing health insurance and wellness programs.

Among its many findings, the report reveals:

– 41% of employees report experiencing three or more indicators of stress sometimes, often or very often;
– One in three employees experiences one or more symptoms of clinical depression; and
– One in five employees has trouble falling asleep very often or fairly often and 31% awaken too early and have trouble falling back to sleep, also very often or fairly often.
– 21% are receiving treatment for high blood pressure and 14% are being treated for high cholesterol.

Furthermore, the report finds that nearly half of U.S. employees (49%) have not engaged in regular physical exercise in the last 30 days, including 22% not engaging in any rigorous physical exercise. And despite a push to stop smoking at the workplace, one in four smokes.

In terms of health care coverage, 24% of low-wage/low-income employees have no insurance from their employers or any other source, compared with only 5% of middle- and high-income employees. Low-wage/low-income employees are also much less likely to receive at least five paid sick days — only 46% do compared with 66% of middle- and high-wage and -income employees.

As to whether having an effective workplace makes a difference for employee health and well-being, the FWI data suggest that the answer is “yes” — and wage level and gender also influence in what way. For example, FWI finds that 38% of employees in workplaces that fall into the “high overall effectiveness” category (based on six measurable criteria that include economic security, autonomy, work-life fit) report “excellent overall health.” By contrast, only 19% of employees in workplaces that fall into the “low overall effectiveness” category report “excellent overall health.”

“Few would disagree that the health care path we are on represents an untenable route to increasing costs and diminishing returns,” said Ellen Galinsky, co-founder and president of FWI. “This new report is replete with evidence that several key measures of employee health are declining, and that employer policies fostering employee engagement and satisfaction are also associated with better employee health. The message is clear that beyond any reform measures on the table in Washington, it is urgent for employers and employees to pay attention to how they can promote better health, which ultimately will save money.”

The new report is based on data from FWI’s 2008 National Study of the Changing Workforce (NSCW), the only study of its kind to provide 30+ year comparisons (from 1977 to 2008) of life on and off the job.(1) The new State of Health in the American Workforce report focuses on 2002 and 2008 data.

Among the other noteworthy findings of the new FWI report:

– Employees’ physical and mental health, stress levels, sleep quality and energy levels all significantly impact important work outcomes of interest to employers, such as engagement, turnover intent and job satisfaction. Thirty-five percent of employees who rate their current overall health as excellent are highly engaged in their jobs, compared with only 25%, 22% and 23% of employees who rate their overall health as good, fair or poor, respectively.
– Despite the prevalence of employer health insurance programs, 8% of employees in fact have no health insurance. Nearly two-thirds (66%) of U.S employees are covered by health insurance offered by their employers. Of the balance, 26% choose to access health insurance from another source (e.g., a spouse’s employer), but 8% of employees have no health insurance from either their employer or from another source.
– Income level makes a difference. Low-wage/low-income employees are less likely to have access to employer health insurance. They are also less likely to use it, if it is available, and they are less likely to be covered by another source. Sixty-six percent of low-wage/low-income employees have access to an employer health plan compared with 88% of middle- and high-wage and -income employees. — Employees who receive at least five paid days off per year for personal illness report significantly better work and health/well-being outcomes. Fifty-six percent of employees with at least five paid days off for personal illness report high job satisfaction compared to 49% with less than five days off. Within the five-plus day group, 71% report no signs of depression, versus 61% of those with less than five days off.
– Having paid vacations bode well for personal health and well-being, as well as intent to stay in one’s job — and longer vacations offer greater benefits than shorter ones. Seventy-nine percent of employees have access to paid vacations with an average yearly time off of 16 days. However, 39% of employees don’t use all of their vacation time and 24% take five or fewer days for longest vacation. Eighty-two percent of employees with 13+ paid vacation days say they are “not at all likely to leave their jobs” compared to 68% with 6-12 vacation days.

Building upon other studies stemming from the 2008 NSCW data, FWI’s State of Health in the American Workforce report also explores various components of effective workplaces and what impact they have on employee health. Among the interesting findings: being treated with respect by managers and supervisors has a stronger effect on the mental health of low-wage/low-income employees than middle- or high-wage and -income employees, and men are more positively affected by having economic security in their jobs and a good fit between their work and personal or family lives, while women are more positively affected by being challenged in their jobs and by having autonomy.

“In the daily grind of our busy lives, it’s easy to forget the price we eventually pay when we fall short on important things like sleep, diet or exercise,” said FWI Senior Research Associate and report co-author, Kerstin Aumann. “This report demonstrates how our workplaces — where we often spend most of our waking hours — can help or hinder our personal well-being and health. Our findings serve as a wake-up calls for employers and employees alike to take a closer look at how their organizations affect people’s health and well-being”

The new FWI study is fully downloadable at www.familiesandwork.org, where you can also take a simple quiz to evaluate how well your work and life fit together.

(1) The NSCW surveys representative samples of the U.S. workforce every five years. Sample sizes average about 3,500, including both wage and salaried employees and self-employed workers, though this report focuses on wage and salaried employees with a sample size of approximately 2800. The first NSCW was conducted by FWI in 1992 and it has included questions originally part of the 1977 Quality of Employment Survey conducted by the Department of Labor.

Source: Families and Work Institute


More than 35 million people worldwide will have dementia in 2010, according to the 2009 World Alzheimer’s Report from Alzheimer’s Disease International (ADI). The new report was released on September 21st, which is World Alzheimer’s Day.

This is a 10 percent increase over previous global dementia prevalence reported in 2005 in The Lancet. According to the new report, dementia prevalence will nearly double every 20 years, to 65.7 million in 2030 and 115.4 million in 2050.

According to researchers, the increases in global dementia prevalence were driven primarily by new data from low and middle income countries. Estimates for three regions are higher – Western Europe (7.29% vs. 5.92%), South Asia (5.65% vs. 3.40%) and Latin America (8.50% vs. 7.25%); East Asia is lower (4.98% vs. 6.46%) and North America is effectively identical.

The researchers found that 57.7% of people with dementia in 2010 live in low and middle income countries, rising to 70.5% by 2050. In addition, proportionate increases over the next 20 years in the number of people with dementia will be steeper in low and middle compared with high income countries.

“The information in the 2009 World Alzheimer’s Report makes it clear that the crisis of dementia and Alzheimer’s cannot be ignored,” said Marc Wortmann, ADI’s Executive Director. “Unchecked, Alzheimer’s will impose enormous burdens on individuals, families, health care infrastructures, and global economy.”

“There is hope in taking action by improving and funding dementia care and services, and increasing investment in research,” Wortmann said. “Australia, France, Korea and the UK have developed national Alzheimer’s action plans, and several more are currently in development. We strongly encourage other countries to follow their example and make Alzheimer’s a priority.”

The Emotional and Financial Impact of Dementia

Chapter 2 of the report focuses on the impact of dementia. Dementia has physical, psychological and economic impact not only the person with the disease, but also caregiver(s), the person’s family and friends, healthcare system(s), and society. For example, statistics cited in the new report suggest that 40-75% of carers have significant psychological illness as a result of their caregiving, and 15-32% have depression.

The report also outlines challenges faced by governments and healthcare systems worldwide and offers eight global recommendations based on report findings.

The full 2009 World Alzheimer’s Report, including the methodology used to prepare it, can be found at http://www.alz.co.uk/worldreport

Dementia is a syndrome due to brain disease and is characterized by a progressive, global deterioration in intellectual abilities, including memory, learning, orientation, language, comprehension, and judgment. Alzheimer’s disease, in particular, is progressive and fatal. It mainly affects older people, especially those over age 65. After this age, dementia prevalence doubles every five years. Dementia is one of the major causes of disability in late-life. Alzheimer’s disease is the most common cause of dementia; vascular dementia, dementia with Lewy bodies, and frontotemporal dementia are the next most common.

September 21 is World Alzheimer’s Day, when Alzheimer organizations worldwide raise awareness of the disease.

http://www.alz.co.uk/adi/wad/

Source: Alzheimer’s Association