Parents: Kids Spurn Emotional Help For Fear ‘They Might Think I’m The Next Shooter’

Candles spelling UCC -- for Umpqua Community College -- are displayed at a candlelight vigil for those killed during a fatal shooting at the school, Thursday in Roseburg, Oregon. (Rich Pedroncelli/AP)

Candles spelling UCC — for Umpqua Community College — are displayed at a candlelight vigil for those killed during a fatal shooting at the school in Roseburg, Oregon. (Rich Pedroncelli/AP)

By Lisa Lambert
Guest contributor

Lisa Lambert is the executive director of the Parent/Professional Advocacy League, which is subtitled “The Massachusetts Family Voice For Children’s Mental Health.”

“He doesn’t want to take the risk and have someone think he could be a shooter,” one mother said, “just because he has a mental health diagnosis.”

I was at a meeting with other parents whose children have mental health needs. This mother told us her son was reluctant to leave his high school classroom for an important evaluation, which included psychological testing.

Like much of America, we were talking about the recent and not-so-recent shootings on campuses and in communities across the country. For this mother, as with many parents whose children have mental health issues, the conversation is far more personal and troubling than for most.

Some parents said that in response to recent shooting incidents, their children are dropping out of services or refusing school supports so they won’t risk their peers or teachers finding out why they get treatment.

As a parent, this breaks my heart. Young adults shouldn’t have to choose between the safety found in avoiding treatment and the healing found in seeking it.

Lisa Lambert (courtesy)

Lisa Lambert (courtesy)

During our discussion, another mother reported that her son was in his first year of college and struggling to complete all his coursework. Freshman year is a stressful time for many students and even more so for students with depression. Because her son had had special education services in high school, he could access supports there to help him manage his academic and emotional stress.

She encouraged him to go to the college student services office to get help. He responded, “I’d rather drop the classes I am most behind in. If I go there, the professors and other students will know I have mental health problems. They might think I could be the next shooter.”

Often, as a news channel covers the latest shooting, the speculation immediately jumps to mental illness. Continue reading

Study: Thousands Of Injuries As Ziplines Proliferate, Younger Kids Most At Risk

In 2012 alone, there were over 3,600 zipline-related injuries, according to a recent report, or about 10 a day. (popejon2/Flickr)

In 2012 alone, there were over 3,600 zipline-related injuries, according to a recent report, or about 10 a day. (popejon2/Flickr)

Hannah Weyerhauser was 5 years old, playing on the zipline at her family’s house in New Hampshire, when she started complaining that her older cousins and siblings were going faster than she was. So her mother, Annie, gave Hannah an extra big push. But when Hannah sped to the end of the zipline, she stopped short, flew into the air, did a back flip, and landed on her neck.

“For a few minutes she was really pale and out of it,” said her mother, a Boston doctor (and a friend of mine). She called an ambulance, and paramedics put a collar on Hannah’s neck on the way to the local emergency department. Ultimately, the little girl was fine, although she probably had a minor concussion, her mother said. But Annie shudders as she thinks of what could have happened: “If she had fallen a little differently she could have broken her neck.”

Others are not so lucky. Increasingly, zipline disasters are making the news. A 12-year-old girl in North Carolina died after falling off a zipline at the YMCA’s Champ Cheerio in June. And last year, a 10-year-old boy died after a backyard zipline accident in Easton, Massachusetts, in which the tree holding the line fell on the child.

Indeed, injuries related to ziplines are rising as the lines proliferate, according to a new report: In 2012 alone, there were over 3,600 zipline-related injuries, or about 10 a day. The study, which researchers say is the first to characterize the epidemiology of zipline-related injuries using a nationally representative database, found that from 1997-2012, about 16,850 zipline-related injuries were treated in U.S. emergency departments.

Which states have zipline regulations (Source: Association for Challenge Course Technology)

Which states have zipline regulations (Source: Association for Challenge Course Technology)

The report on ziplines (first used over a century ago to transport supplies in the Indian Himalayas) found that most of the injuries resulted from falling off the zipline, and many involved young children. I asked one of the study authors, Tracy Mehan, manager of translational research with the Center for Injury Research and Policy at Nationwide Children’s Hospital in Ohio, a few questions about the report, published in the American Journal of Emergency Medicine.

Here, edited, is what she said.

Rachel Zimmerman: Are you surprised by this sharp increase in zipline injuries?

Tracy Mehan: The number of commercial ziplines grew from just 10 in 2001 to over 200 by 2012. When you include the number of amateur ziplines that can also be found in backyards and at places like outdoor education programs and camps, the number skyrockets to over 13,000. The increase in the number of injuries is likely due largely to the increase in number of ziplines and shows this is a growing trend. 

What are the most common types of injuries?

The majority of zipline-related injuries were the result of either a fall (77 percent) or a collision (13 percent) with either a tree, a stationary support structure or another person. The most frequent type of injuries were broken bones (46 percent), bruises (15 percent), strains/sprains (15 percent) and concussions/closed head injuries (7 percent). Approximately one in 10 patients (12 percent) were admitted to the hospital for their injury. Continue reading

Bugs And Kids: Indoor Insecticide Use Linked To Childhood Cancers, Study Finds

(Tom Simpson/Flickr)

(Tom Simpson/Flickr)

I just threw out my spray can of Raid for flying insects. With kids in the house, I never did like the idea of spewing toxic stuff around, and only ever used it when a bug was driving me to feral insanity. Now, after reading the paper just out in this week’s issue of the journal Pediatrics, I’ll stick with the flypaper and swatter no matter how intense my irritation.

The paper concludes that the sum of previous research suggests a significant link between indoor pesticide use and childhood cancer.

To be more exact, senior author Chensheng Lu says the results “suggest that when kids are exposed to pesticides — especially a group of pesticides we call insecticides — in the indoor residential environment, kids have 43 to 47 percent more chance of having childhood cancers, specifically leukemia and lymphoma.”

Dr. Lu is an associate professor of environmental exposure biology at the Harvard T.H. Chan School of Public Health. He acknowledges the study’s limitations, in particular that it could find only 16 relevant previous papers to analyze. But, he says, it showed “consistent results in terms of the positive correlation between exposure to insecticide indoors and childhood cancer.”

The study does not aim to “cause fear in parents,” Lu says. “But it’s to give you a precautionary principle that those exposures can be prevented, can be mitigated or can be completely removed.”

Of course, these findings only heighten the dilemma for households or schools that are tormented by pests, with infestations too fierce to be dented by anything but the big toxic guns. Are we supposed to just let the roaches and mosquitoes run wild?

Dr. Lu points out that preventive measures like window screens and hole-plugging can help, and among pesticides, some applications are safer than others — for example, “bait houses” that try to attract the pest inside a box-like structure to be poisoned.

“The worst-case scenario in terms of indoor pesticide use and human exposure it to use some kind of fogger,” he says. “Also, some kind of open-air application, a broadcast application, a spray can. Those are bound to significant exposures.” Continue reading

CDC: One-Third Of Children With ADHD Diagnosed With The Disorder Before Age 6

(Vivian Chen/Flickr)

(Vivian Chen/Flickr)

One-third of children diagnosed with ADHD were diagnosed young — before the age of 6 — according to a new national survey from the U.S. Centers for Disease Control and Prevention.

Earlier, the CDC found that based on parental reports, 1 in 10 school-aged children, or 6.4 million kids in the U.S., have received a diagnosis of ADHD, a condition marked by symptoms including difficulty staying focused and paying attention, out of control behavior and over-activity or impulsivity.

The percentage of children diagnosed with ADHD has increased steadily since the late 1990s and jumped 42 percent from 2003-2004 to 2011-2012, the CDC says. Last year, concerns flared when a report found that thousands of toddlers are being medicated for ADHD outside of established pediatric practice guidelines.

In the current analysis, also based on parental reporting, and using data drawn from the 2014 National Survey of the Diagnosis and Treatment of Attention-Deficit/Hyperactivity Disorder and Tourette Syndrome, the CDC also found:

•The median age at which children with ADHD were first diagnosed with the disorder was 7 years old

•The majority of children (53.1%) were first diagnosed by a primary care physician

•Children diagnosed before age 6 were more likely to have been diagnosed by a psychiatrist

•Children diagnosed at age 6 or older were more likely to have been diagnosed by a psychologist

•Among children diagnosed with ADHD, the initial concern about a child’s behavior was most commonly expressed by a family member (64.7%)

•Someone from school or daycare first expressed concern for about one-third of children later diagnosed with ADHD (30.1%)

•For approximately one out of five children (18.1%), only family members provided information to the child’s doctor during the ADHD assessment

What are we — parents, educators, doctors — to make of all this? In particular, what does it mean that so many very young kids are being diagnosed with an attention disorder? (Has anyone ever encountered a 4- or 5-year-old child who is not hyperactive, impulsive and inattentive??)

I asked two doctors — a pediatrician and a psychiatrist — for their impressions of the CDC report. Both agreed that we seem to have two problems when it comes to ADHD: over-diagnosing and under-diagnosing. Here, lightly edited, are their responses.

First, the pediatrician:

James M. Perrin, MD, is a professor of pediatrics at Harvard Medical School and associate chair of MassGeneral Hospital for Children. Dr. Perrin is also the immediate past president of the American Academy of Pediatrics and chaired the 1990s committee that wrote the first practice guidelines for ADHD (and he was on the committee for the 2011 revision).

RZ: How difficult is it to diagnose ADHD in children under 6 years old?

JP: In the pediatric community, we have worked over last 15 years to train general pediatricians to make diagnoses of ADHD reliably and follow very clear, specific guidelines on how to do so. In 2011, the AAP revised its practice guidelines for ADHD and included the opportunity to diagnose children ages 4 and 5 years old.

At the same time we recognize it’s very hard to do that well in that age group…because a lot of children are inattentive at 4 — you don’t expect them to work hard and read a Hardy boys book for an hour and half. Five is often impulsive, active, so it’s not unusual to have symptoms that children with ADHD would also have at age 4, 5. So, it’s not easy.

We did say [in the guidelines] pretty clearly that you shouldn’t make the diagnoses without significant impairment of normal behavior. What we mean by that is a child whose symptoms impair her ability to play with other children, or whose behavior is so out of control that it’s dangerous, for instance she runs out in front of cars, or has many accidents, that’s when the symptoms become impairing. Continue reading

Bleeding Disorder? National Expert Discusses Questions Around Cambridge Baby’s Death

Aisling Brady McCarthy

Aisling Brady McCarthy watches as her attorney addresses the court during a status hearing at Middlesex Superior Court in Woburn in May. McCarthy, a nanny from Ireland, was accused of killing a 1-year-old Massachusetts girl in her care two years ago. (Charles Krupa/AP)

Aisling Brady McCarthy is back in her native Ireland now, after murder charges against her were dropped in the death of Rehma Sabir, a Cambridge infant in her care. But while the case is over, the mystery remains: How did Rehma die?

The Middlesex County district attorney’s office says a review of the case raised the question of whether 1-year-old Rehma had an undiagnosed blood disorder that could have caused her brain hemorrhage. A press release from the office cites these details from the medical examiner:

“Review of Rehma’s coagulation and hematology testing, her history of bruising, the NIH guidelines for diagnosis of von Willebrand disease, and literature on the subject suggest to me that Rehma’s low von Willebrand factor could have made her prone to easy bleeding with relatively minor trauma.

“Given these uncertainties, I am no longer convinced that the subdural hemorrhage in this case could only have been caused by abusive/inflicted head trauma, and I can no longer rule the manner of death as a homicide.  I believe that enough evidence has been presented to raise the possibility that the bleeding could have been related to an accidental injury in a child with a bleeding risk or possibly could have even been a result of an undefined natural disease.  As such I am amending the cause and manner of death to reflect this uncertainty.”

So, then, a bleeding disease might have caused a spontaneous hemorrhage? Or the combination of the disease and a minor head injury led to death? And if so, could it be that quite a few of the contested accusations of baby abuse in recent years could be thus explained away?

Dr. Shannon Carpenter (courtesy)

Dr. Shannon Carpenter (courtesy)

I turned to Dr. Shannon Carpenter, a bleeding disorders specialist who has done research and written American Academy of Pediatrics reports on checking children for bleeding disorders when there’s a question of abuse. She’s the chief of hematology at Children’s Mercy Hospital in Kansas City, Missouri, and the director of the Kansas City Regional Hemophilia Center.

Dr. Carpenter was not involved in the Cambridge case, but speaking generally she says that sadly, no, there’s no kinder explanation here: Abusive head trauma — a better term than “shaken baby syndrome” because abuse can involve more than shaking — is far more common than serious bleeding disorders, and even children with severe disorders are extremely unlikely to have fatal brain bleeds. Our conversation, lightly edited:

Dr. Carpenter, what are we to make of the medical examiner’s mention of Von Willebrand disease — a not-very-rare bleeding disorder — and the suggestion that death could have resulted from disease or “an accidental injury in a child with a bleeding risk”?

One thing I would say is, most patients with von Willebrand disease have a mild disorder, mostly manifested by nosebleeds, bruising, and gum bleeding, and do not seem to have an increased risk for intracranial hemorrhage. Research is ongoing in this area and I think there may be more information coming, but from a clinical perspective, when we see patients with the most common types of von Willebrand disease, we do not have a high concern for intracranial hemorrhage in those patients, certainly not spontaneously.

“Unfortunately, child abuse is more common than bleeding disorders.”

– Dr. Shannon Carpenter

The most severe forms of von Willebrand disease occur in about 1 percent of people with von Willebrand disease, probably less than that. And even in the most severe forms, the risk of having a bleed inside of the head is probably less than 2 percent. So it’s a very rare event. This would be an unusual presentation for von Willebrand disease. I don’t know the specifics of this patient’s case, and I don’t know what her actual von Willebrand factor level was, but even if she was low enough to be diagnosed with the most common form of von Willebrand disease, this kind of bleeding would not be typical for that kind of diagnosis.

But, I suppose, possible?

While anything is possible, you have to look at what’s probable and what other patients have experienced. And patients with bleeding disorders are not immune to trauma, whether it’s inflicted or non-inflicted. I would say if a child came to me with type 1 von Willebrand disease, the most common type, the mild form of von Willebrand disease, with a typical toddler head bump that would not otherwise cause someone to seek medical care, I would not worry about intracranial hemorrhage in that patient.

And if a child had a more severe form of von Willebrand disease?

Then I might be concerned.

But if it were a severe form, wouldn’t it have likely shown up by 1 year of age? Continue reading

What Does Nanny Case Reversal Say About Shaken Baby Syndrome?

In this July 30, 2015 photo, Aisling Brady McCarthy leaves court proceedings at Middlesex Superior Court in Woburn. Middlesex DA Marian Ryan announced Monday that the murder charge against the Irish nanny had been dropped. (Keith Bedford/The Boston Globe via AP)

In this July 30, 2015 photo, Aisling Brady McCarthy leaves court proceedings at Middlesex Superior Court in Woburn. Middlesex District Attorney Marian Ryan announced Monday that the murder charge against the Irish nanny had been dropped. (Keith Bedford/The Boston Globe/Pool)

You read about the striking reversal in the latest Boston nanny case and you wonder: How does this happen? How could a medical examiner first say a baby died of “complications from blunt force head injuries” and then, two years after the baby’s Irish nanny is accused of murder, decide that the cause of death is “undetermined”?

The medical examiner’s report has not been publicly released, but the Middlesex district attorney’s press release does cite a major review process that included “expert witness reports from the defense and prosecution, additional transcripts of police interviews, transcripts of grand jury testimony, additional medical records, DCF reports, and additional laboratory testing.”

On Radio Boston today, co-host Anthony Brooks spoke with Dr. Robert Sege, a member of the American Academy of Pediatrics’ committee on child abuse and neglect, and vice president at Health Resources in Action, a public health policy organization. Here’s an excerpt of that conversation, lightly edited:

Anthony Brooks: This is the second time in a year that the Massachusetts medical examiner has reversed its finding in a baby’s death, and we’ve been reading that in the United States, 16 convictions have been overturned since 2001, including three last year. So does this raise questions about the diagnosis of shaken baby syndrome? What are your thoughts on that?

Dr. Robert Sege: To me, it doesn’t raise the question at all. If you think about it, there are people who are falsely accused of murder, robberies, all kinds of things and the justice system is not perfect. So in a situation where we have hundreds and perhaps a thousand infants a year who experience shaken baby syndrome, the fact that 16 convictions over a multi-year period were overturned lets me know that the justice system worked, and that people get a fair shot at getting their story told…

I’m very happy that we live in a country with a judicial system that looks at things skeptically and tries to make sure that justice is done. It doesn’t change anything about whether or not shaken baby syndrome or abusive head trauma exists. Sadly, it does.

I want to read you one quote from Gregory Davis, the chief medical examiner in Birmingham, Alabama, and board chair of the National Association of Medical Examiners. He told the Washington Post:

“You can’t necessarily prove [shaken baby syndrome] one way or another … Neither side can point to compelling evidence and say, ‘We’re right and the other side is wrong.’ So instead, it goes to trial.”

Do you disagree with that?

I actually do, and I think part of the issue is that many cases of abusive head trauma never make it to trial, sometimes because the police and the prosecutors can’t figure out who the perpetrator was, but often — and I’ve certainly seen this — because someone confesses. It’s a very sad situation, but frequently a person just reaches the end of their rope. They’re frustrated, the infant won’t shut up, they don’t mean to cause harm or death but they just can’t stand it anymore. Continue reading


I Never Expected To Love My Kids’ Sex Ed Course, But I Do

Oh boy... (Romana Klee/Flickr)

Oh boy… (Romana Klee/Flickr)

Truth is, I dreaded my children’s sexual education.

I’d read that parents can be a powerful force for smarts about sex, so I’d tried to script imaginary heart-to-hearts. But in my head, they all sounded like this: “Please don’t do these incredibly stupid things that I did when I was young.”

So I procrastinated, abetted by the younger generation’s point-blank refusal to let me even broach this most awkward of topics. Then, last year, word came home that middle-school health class would use a curriculum called “Get Real” that involved extensive family homework activities.

“Now I’m in for it,” I thought.

But in fact, I was in for a shockingly pleasant surprise — one that more and more parents may experience in the coming years if Get Real’s popularity continues to grow. As of this year, it has been adopted by 200 schools in seven states — 175 of them in Massachusetts. That’s up from 132 schools in 2012.

And in recent months, Get Real has scored two victories: An analysis by the Wellesley Centers for Women reported that students who go through Get Real do become likelier to delay sex, and the federal government put it on a list of “evidence-based” sex-ed programs.

No way is Get Real, which was created by the Planned Parenthood League of Massachusetts, for everybody. It strongly promotes abstinence as the healthiest choice for young people, but it’s not the sort of “abstinence-only” program that many parents and schools seek; it also includes teachings on birth control and preventing infection.

But perhaps more than any other curriculum out there, it pulls parents into the sex-ed endeavor, and here’s my pleasant surprise: It wasn’t awkward.

The Get Real homework prompted conversations about friendships, about feelings, about life lessons. I got to reminisce about my first crush, and talk about how important I think it is to stand up for yourself with a boyfriend or girlfriend. I even got to vent about how perniciously relationships are portrayed in that detestable high-school-girl series, “Pretty Little Liars.”

Sure, the course teaches intimate anatomy and the changes of puberty, but the body part it seemed to focus on most was the heart. It was teaching — well, love. Or rather, the skills that can make love better. Healthier. Skills like self-awareness and communication — useful in their own right, and also in service of sex-ed goals like preventing pregnancy and infections.

“We believe that if young people are able to develop healthy relationships in all aspects of their lives, they’re going to be that much better able to negotiate healthy sexual relationships,” says Jen Slonaker, vice president of education and training at the Planned Parenthood League of Massachusetts.

“The sad truth is that by the time young people get to college, it may be too late.”

– Nicole Cushman,
of sex-education organization Answer, on rape prevention

At this national moment of rising discussion about campus rape — from “Missoula” to this week’s New Hampshire prep school trial — the need for such skills has never seemed more urgent. And they take time to develop, says Nicole Cushman, executive director of Answer, a national sex-education organization based at Rutgers University.

“When people talk about sexual assault and rape prevention on college campuses,” she says, “the sad truth is that by the time young people get to college, it may be too late, because we haven’t really laid the groundwork by teaching them these basic concepts about communication and relationships from a younger age. So I really believe that comprehensive sex education is sexual assault prevention.”

‘Red Flags’

Ashley, a Boston high school senior who is on the Get Real Teen Council, went through the curriculum beginning in middle school but says she really started seeing its effects when she got to high school.

“I know that what I learned in Get Real classes made me see certain red flags in my friends’ relationships and my own relationships, and helped me solve what I need to do in order to get away from the red flags,” she says.

One friend who took the class with her drew on it to resist sexual pressure, Ashley says: “She didn’t know if she was ready to have sex, and she touched upon the consent part — she was like, ‘I don’t have to do this, necessarily. It’s like — consent. It’s not fair. I don’t have to engage.’ ” Continue reading


New Moms Cite Lack Of Advice From Docs On Key Issues: Sleeping, Breastfeeding

A new study found that about 20 percent of mothers said they didn’t receive advice from their baby’s doctors about breastfeeding or the current thinking on safe placement for sleeping newborns. (Mark Humphrey/AP)

A new study found that about 20 percent of mothers said they didn’t receive advice from their baby’s doctors about breastfeeding or the current thinking on safe placement for sleeping newborns. (Mark Humphrey/AP)

After I gave birth to my kids, I was bombarded with advice from family, bestselling books and even strangers on topics ranging from how to lose the baby weight, when to have sex again and which infant toys boost IQ.

But according to a new, NIH-funded study, many sleep-deprived, hormone-addled new mothers may not be getting enough advice on critical issues from a most important source: doctors and other health care providers.

When it comes to breastfeeding, infant sleep position, immunization and pacifier use, many new moms report they get no advice at all from their children’s doctors — despite medical evidence on the benefits of certain practices, like breastfeeding and placing babies on their backs for sleep.

The new study — published in the journal Pediatrics and conducted by researchers at Boston Medical Center, Boston University and Yale University — found that about 20 percent of mothers said they didn’t receive advice from their baby’s doctors about breastfeeding or the current thinking on safe placement for sleeping newborns. And more than 50 percent of mothers told investigators that doctors did not offer guidance on where the babies should sleep.

(Of course the whole issue of where newborns should sleep is controversial. Official recommendations now say babies should “room share” with parents but not “bed share.”)

The study, part of a larger national effort called SAFE (Studies of Attitudes and Factors Effecting Infant Care Practices), surveyed more than 1,000 new mothers across the country, inquiring about infant care advice they received from different sources: doctors, nurses, family members and the media.

Dr. Staci Eisenberg, a pediatrician at Boston Medical Center and lead author of the new study, said in an interview that the number of moms who reported no advice from across the board is surprising.

“These findings say to me, ‘Hmm, this is a time to stop and think carefully about how we communicate, and are we communicating in a clear, specific enough way, and are we being heard, especially by new moms — new parents — who are often tired and likely overwhelmed?’ ” she said. “Amidst this sea of information, what are the messages that need to be highlighted and communicated clearly?” Continue reading

Boston Moms: Let’s Spend Olympics Savings On Gym And Recess For Kids

(Steven Depolo/Flickr)

(Steven Depolo/Flickr)

By Kate Lowenstein
 and Ramika Smith
Guest contributors

We have a suggestion for how to spend some of the billions of dollars that Boston will likely save by not hosting the Olympics: How about we invest even 1 percent of that into the bodies and brains of our children by ensuring they get ample physical education and recess time?

Instead of spending billions to have elite adult athletes playing sports in our city, we can at least give our own Boston Public Schools kids the chance to run and play here.

Most parents of kids in the city’s public schools assume their children get recess every day, as we did when we were kids, but the reality turns out to be quite different. While the CDC recommends that all children get at least 60 minutes of vigorous exercise every day, and at least 30 minutes of school-time physical activity, many of our schools allow for as little as 20 minutes, if that.

Over the past two decades, accelerated by No Child Left Behind’s focus on testing, the tendency has been to reduce or eliminate physical education and recess. And our school administrators and legislators look the other way without recognizing the overwhelming amount of evidence that shows the significant academic and mental health benefits of these physical activity breaks.

Recess and physical education are as integral to a long school day as are Math, Science, and English.

In January of 2009, the journal Pediatrics published a groundbreaking study of 11,000 third-graders, comparing those who had little or no daily recess with those that had more than 15 minutes of recess per day. The findings show that children who have more recess time behave better in the classroom and are likelier to learn more.

In January of this year, The Boston Foundation released a report: “Active Bodies, Active Minds: A Case Study on Physical Activity and Academic Success in Lawrence, Massachusetts.” The report found that only 15 to 20 percent of Massachusetts children are meeting the 60-minute daily recommendation for physical activity and only 10.2 percent were meeting the school-time recommendation of 30 minutes.

It also underscored what we already know from many other studies; that children in schools that provide an adequate amount of time and opportunity (and encouragement) for daily physical activity, in the form of recess, gym classes and movement breaks, have higher MCAS scores in both math and ELA. Continue reading

Mass. Has Paid Sick Leave, Now We Need To Change Culture Of Working While Ill

(Office for Emergency Management/Office of War Information/Domestic Operations Branch/Bureau of Special Services, via Wikimedia Commons)

(Office for Emergency Management/Office of War Information/Domestic Operations Branch/Bureau of Special Services, via Wikimedia Commons)

As of this month, we here in Massachusetts can proudly say that we enjoy the right to paid sick time. (Those of us who work for companies with 11 or more employees, anyway; workers for smaller companies can only get unpaid time.)

The law took effect July 1, and state Attorney General Maura Healey says that while it’s not the first such law in the country, “it is the most expansive.”

Yay, right? But here’s the next challenge: It’s not enough to have the law on the books; workers have to actually use it. And a new study of health care workers suggests that when it comes to calling in sick, we may often be our own worst enemies. (OK, yes, our bosses may also be our worst enemies.) It’s a sobering look: If even doctors and nurses don’t stay home when they should because of their workplace culture, what hope do the rest of us have?

The study in JAMA Pediatrics found that among more than 500 doctors and other staffers surveyed at a large children’s hospital in Philadelphia, 83 percent reported working while sick over the past year. Like, really sick: 30 percent had diarrhea, 16 percent had fever and more than half had “acute onset of significant respiratory symptoms,” which sounds to me like the kind of cough that can spread germs.

Why, oh why, would the staffers who understand best the risks of infection still come to work while possibly infectious? Solving that conundrum was the aim of the paper, titled “Reasons Why Physicians and Advanced Practice Clinicians Work While Sick.”

“Working while sick was regarded as a badge of courage, and ill physicians who stayed home were regarded as slackers.”

Among the reasons that respondents deemed important:

• 98.7 percent cited not wanting to let colleagues down

• 94.9 percent cited staffing concerns

• 92.5 percent cited not wanting to let patients down

• 64 percent cited fear of ostracism by colleagues

• 63.8 percent cited continuity of care

Other concerns that emerged from free-text responses: “extreme difficulty finding coverage (64.9 percent), a strong cultural norm to come to work unless remarkably ill (61.1 percent) and ambiguity about what constitutes ‘too sick to work’ (57 percent).” Continue reading