The COVID-19 pandemic negatively impacted the pediatric-focused advanced practice registered nursing (APRN) workforce, which could create long-term barriers to pediatric care, according to a study conducted by the National Association of Pediatric Nurse Practitioners (NAPNAP). The study, published in the 

, surveyed almost 900 pediatric-focused APRNs.

According to the investigators, more than one-third of respondents reported moderate or extreme concern for feeling professionally burned out, while one-quarter reported anxiety. Seventy-three percent of respondents reported increased presentations of child mental or behavioral health concerns throughout the pandemic.

“This problem is, of course, multifactorial, with isolation, loss of safety net services, family stressors and trauma, and deferred care and services all compounding this issue across communities worldwide,” said Jennifer Sonney, PhD, APRN, PPCNP-BC, FAANP, NAPNAP secretary, in a press release.

The investigators said that the rapidly evolving policy changes and the constant struggle to respond to disinformation is likely to be responsible for the professional burnout.

“The sustained professional and personal impacts of the pandemic are placing pediatric APRNs at high risk for moral distress and burnout,” said NAPNAP President Jessica Peck, DNP, APRN, CPNP-PC, CNE, CNL, FAANP, FAAN, in the press release. “In addition to practicing clinicians feeling anxious or burned out, 70% of educator respondents in the study reported moderate or extreme concern with clinical training site availability, delaying the pipeline of new pediatric nurse practitioner graduates from entering the workforce to increase patient access to care.”

NAPNAP stated that they were committed to supporting a high-quality, accessible, and affordable care continuum for pediatric patients while protecting and supporting the pediatric workforce pipeline. According to the organization, NAPNAP has commenced efforts to direct resources and advocacy tools to best support the critical needs of the pediatric-focused APRN workforce.

COVID-19 Study Reveals Significant Risk for Pediatric-focused APRN Workforce [news release]. NAPNAP; June 8, 2021. Accessed June 9, 2021. 

https://www.napnap.org/covid-19-study-reveals-significant-risk-for-pediatric-focused-aprn-workforce/

According to the investigators, more than one-third of respondents reported moderate or extreme concern for feeling professionally burned out, while one-quarter reported anxiety. 

Study: Pediatric-Focused APRN Workforce Experienced Increased Burnout, Anxiety During COVID-19 Pandemic

Skylar Kenney, Assistant Editor

More than 40% of nurses and other health care professionals had risks associated with an increased likelihood of burnout early in the COVID-19 pandemic, according to a survey published in the 

The study investigates risk factors for poor well-being and factors associated with greater resilience, which may reduce the risk of burnout for hands-on care providers, according to research from Lindsay Thompson Munn, RN, PhD, and her colleagues of a North Carolina health care system.

"The insights gained from this study can help health care leaders to target these risk factors and develop strategies that allow organizations to better support well-being and resilience among clinicians," the study authors said in a press release.

The online survey of nurses and other non-physician health care workers received 2459 responses from participants who provided direct patient care and focused on risk factors for decreased well-being, which was a key contributor to the burnout epidemic among health care professionals. Data were collected in June and July 2020.

During the time of the survey, 44% of health care workers surveyed had “at risk” well-being, which is closely associated with increased risk of burnout, fatigue, and patient care errors.

The analysis of the responses identified several factors linked to increased odds of poor well-being, such as:

Feeling supplies of personal protective equipment were insufficient

Believing the organization did not understand health care workers’ emotional support needs during COVID-19

Inadequate staffing for safe patient care

Having a lower degree of psychological safety

There were opposite levels of some of these factors associated with higher scores for resilience, including:

Feeling the organization does not understand emotional support needs

Believing staff were being redeployed to areas of critical need

Having a higher degree of psychological safety

Further, fewer than one-fourth of health care workers surveyed had used available resources to support their well-being and resilience, such as meditation apps and counseling. Munn and her co-authors believe that this study had practical implications for health care professionals to promote well-being and resilience among other workers during the pandemic and beyond.

"While it may seem obvious that nurses and other [health care workers] would sustain burnout and poor well-being after dealing with providing care under arduous circumstances, it's important to establish the contributing factors and to learn how some were able to mitigate the effects of the stressors," said Maureen Shawn Kennedy, MA, RN, FAAN, in the press release. "We're in serious need of successful strategies to support frontline caregivers."

Munn noted some of the next steps that will help support resilience while addressing the factors that are negatively attached to burnout in the environment.

"[L]eaders can take crucial steps toward optimizing workers' well-being by paying careful attention to workload and staffing, creating a culture of psychological safety within teams and units, and recognizing and actively addressing the unique challenges posed by the pandemic," Munn said in the press release.

During COVID-19, nurses face significant burnout risks, reports 

. EurekAlert! July 22, 2021. Accessed July 26, 2021. 

https://www.eurekalert.org/pub_releases/2021-07/wkh-dcn072221.php

Survey Shows Nurses Face Significant Burnout Risks in COVID-19 Pandemic

Jill Murphy, Associate Editor

Starting that fateful week in March 2020 when everyone’s life changed, health care settings closed their doors en masse.

From primary care to ambulatory surgery, physical therapy to massage therapy, nearly every setting of care suspended operations, except for emergency departments connected to hospitals and pharmacies. Yes, pharmacies. More than 60,000 remained open to patients, and most pharmacists continued their role as a source for OTC products and the free-of-charge counseling that often goes with them.

Telemedicine grew at an unprecedented rate starting in April 2020, but it did not entirely fill the health care void. Individuals needing acute medications, dose adjustments, or treatment for chronic diseases lost direct access to practitioners, but pharmacies remaining open meant patients could still receive their lifesaving medications. Of course, foot traffic slowed, and the flu was practically nonexistent in 2020, but hundreds of millions of Americans had access to basic triage, care delivery, medications, and testing supplies.

More than 80% of adults use OTC products as first-line treatment for common ailments. With Americans making approximately 3 billion trips to purchase OTC products annually and 60 million Americans using them who would otherwise not seek treatment, patient access to these products is essential to a well-functioning health care system. It is inconceivable these days to schedule an office visit, procure a prescription, and have it adjudicated by insurance just to get ibuprofen for an ankle sprain. A prescription for loratadine? Laughable. Yet less than 2 decades ago, nonsedating antihistamines were deemed too unsafe to be sold over the counter.

Making products available without a prescription does not have to mean patients go without care. Pharmacists and other health care professionals can counsel patients on all types of accessible and affordable OTC products. Does an Apple Watch’s electrocardiograph or pulse oximetry app keep patients from seeing their cardiologists? Do pregnancy tests keep women from visiting their gynecologists? Do wetting drops prevent patients from going to their ophthalmologists?

Do niacin or omega oils keep patients from getting their cholesterol checked? The answer to all these questions is no. Pharmacists have multiple encounters with patients every day, and most are just as meaningful to a patient’s care as billable encounters.

Expanding Access Through OTCs and Testing

COVID-19 self-administered testing is approved and available. Health plans have picked up on the power of patient convenience. Waning resistance against self-empowerment, which the pandemic necessitated, has enlisted a host of home-based diagnostics providing accessible and affordable screening and rescreening directly to health plan members—without a prescription. Need to improve A1c testing and reporting? Why not look to pharmacies or even send the tests directly to patients’ residences?

Postpandemic Self-Care and OTC Product Use

We are only a summer away from what will likely be the first widely prevalent cough and cold season of asthma flare ups, influenza, middle-ear infections, and rhinovirus in nearly 2 years. As social distancing and masking disappear, we will again share microbes. Disease surveillance and patient care will still have a prime spot in the consciousness of the frontline pharmacist’s mind in all seasons. Education, triage, testing, and counseling have a greater meaning and purpose than ever before, and much of this purpose is enabled by access to OTC products.

Click here to view the OTC products that pharmacists recommend the most to their patients

is vice president of pharmacy provider partnerships for Community Care of North Carolina, which works collaboratively with more than 2000 medical practices to serve more than 1.6 million Medicaid, Medicare, commercially insured, and uninsured patients. He received his PharmD and MBA degrees from Drake University and a PhD in pharmaceutical outcomes and policy from the University of North Carolina. He also serves on the board of directors of the American Pharmacists Association Foundation and the Pharmacy Quality Alliance.

OTC use statistics. Consumer Healthcare Products Association. Accessed May 24, 2021. https://www.chpa.org/about-consumer-healthcare/research-data/otc-use-statistics.

COVID-19 permanently changed how pharmacists recommend and sell nonprescription options.

OTC Products Are Accessible When Traditional Health Care Delivery Is Not

Troy Trygstad, PharmD, PhD, MBA

Mary Koslap-Petraco, DNP, PPCNP-BC, CPNP, FAANP, is a clinical assistant professor at Stony Brook University School of Nursing in New York.

The pandemic has changed life as we knew it, but COVID-19 vaccines are changing lives again, this time for the better.

Grandparents are once again able to hug their grandchildren, but those same grandchildren are still at risk for COVID-19 until we can get all of them who are medically able vaccinated. At press time, children accounted for the largest number of new cases of COVID-19, because most are still not vaccinated (AAP, 2021, April).1 Hospitalization rates for children with COVID-19 have also risen, and serious cases are being seen (AAP, 2021, June).2 From March 1, 2020, through April 30, 2021, approximately 1.5 million COVID-19 cases in individuals aged 11 to 17 years had been reported to the CDC (USFDA, 2021, May 10).3

Most children will return to classrooms for school in the fall, if they have not done so already (Parents, 2021, March).4 Although handwashing, masks, and social distancing are essential public health measures and have slowed the pandemic, the best and most long-lasting way to protect children is to vaccinate them. The number of COVID-19 cases among individuals aged 50 years and older has dropped dramatically. A large segment of this population is fully vaccinated (CDC, 2021, June 13).5 There is also a serious public health threat from other vaccine-preventable diseases, such as measles and pertussis, as the rates of routine immunizations took a precipitous drop during the pandemic (Santoli, et al. 2020).6 The CDC is recommending that children receive all regularly scheduled vaccines, along with the COVID-19 vaccine (CDC, 2021 April 6).7

The Pfizer-BioNTech COVID-19 vaccine, which is an mRNA vaccine, recently received FDA approval for adolescents aged 12 through 15 years (USFDA, 2021, May 10).3 This vaccine is administered intramuscularly as a series of 2 doses (0.3 mL each) 3 weeks apart. The most common adverse effects are chills, fever, headache, joint and muscle pain, pain and redness at the injection site, and tiredness. Aside from pain at the injection site, more adolescents reported these adverse effects after the second dose than after the first dose, so it is important to advise adolescents and parents to expect that there may be some adverse effects after either dose but even more so after the second. The adverse effects in adolescents were consistent with those reported in clinical trial participants aged 16 years and older (USFDA, 2021, May 10).3

Pfizer also said that it plans to request authorization for BioNTech COVID vaccine use in children aged 2 through 11 years in September 2021 and for children younger than aged 2 years later in 2021 (Jenco, 2021, May 6).8

Recently, there have been reports of myocarditis and pericarditis following mRNA vaccines. These events occurred mostly in male adolescents and young adults aged 16 years and older. Myocarditis and pericarditis are seen more often after getting the second dose of either Moderna or Pfizer COVID-19 vaccines than after the first dose. The symptoms typically occur within 4 days after COVID-19 vaccination. As of press time, there have been 275 cases of either myocarditis or pericarditis of more than 600,000 doses administered to adolescents and children in the United States since Pfizer received its emergency use authorization on May 10, 2021 (CDC, 2021, May 18).9 Most patients who received care responded well to rest and treatment and quickly recovered. Patients can usually return to normal daily activities after their symptoms improve, and they should speak with health care providers about returning to exercise or sports. The CDC continues to monitor the situation and recommends COVID-19 vaccinations for everyone aged 12 years and older, given the greater risk of COVID-19 illness and related, possibly severe complications (CDC, 2021, May 27).10 Getting vaccinated is the best way to help protect individuals aged 12 years and older from COVID-19 illness and potential complications.

Another COVID-19 vaccine for adolescents is also moving toward approval. Moderna reported that its COVID-19 vaccine is 96% effective for adolescents aged 12 through 17 years after at least 1 dose and has no serious safety concerns (Jenco, 2021, May 6).8 The report did not provide additional details on a projected timeline for requesting FDA approval. Moderna is also continuing to study its vaccine in children aged 6 months to 11 years (Jenco, 2021, May 6).8

COVID-19 vaccines are becoming a reality for children. With the vaccines comes the return to birthday parties, in-classroom school, play dates, and sleepovers. But the COVID vaccine is not the only one children need. Routine vaccination is an essential preventive care service for adolescents, children, and adults, including pregnant women, that should not be delayed because of the COVID-19 pandemic. Parents have not been bringing their children into the offices of health care providers for well-child visits and vaccines. It is essential to assess the vaccination status of all adolescents and children at each patient visit to avoid missed opportunities for vaccination and ensure timely vaccine catch-up. All vaccines due or overdue should be administered according to the recommended CDC immunization schedules during each visit unless there is a specific contraindication. This will provide protection as soon as possible and minimize the number of health care visits needed to complete vaccination. Health care providers should identify children who have missed recommended vaccinations and/or well-child visits. Contact parents to schedule in-person appointments, starting with newborns, infants, and children up to aged 2 years, young children, and extending through adolescence. COVID-19 is still circulating, and cases among children can often be asymptomatic. Consequently, the importance of evidence-based infection prevention practices cannot be overemphasized for all patient encounters. These measures include hand and respiratory hygiene, physical distancing, source control, and surface decontamination (CDC, 2021, April 6).7

Because vaccine administration has decreased during the COVID-19 pandemic, under vaccinated or unvaccinated children are susceptible to preventable illness, such as measles, and communities are at risk for outbreaks. Strategies should be implemented to promote vaccination schedule adherence and ensure catch-up vaccination. Reminder and recall systems should be implemented to identify children who are due for or who have missed vaccine doses. Electronic health records and immunization information systems can be essential to tracking delinquent vaccine doses. In addition, the vaccination status of all children should be assessed at every health care visit to reduce missed opportunities for vaccination, including COVID-19 vaccination, and standing orders should be implemented (CDC, 2021, April 6).7

Health care providers who care for children must ensure that children receive not just COVID-19 vaccines but all age-appropriate vaccines that are due and catch up on any missed doses. It would be a travesty if children headed back to school without the vaccine-induced protection they need to stay healthy. Without all Advisory Committee on Immunization Practices (ACIP)-indicated vaccines, children could be headed back to school and out of the COVID-19 pandemic into a measles or pertussis epidemic.

1. Children and COVID-19: state data report. American Academy of Pediatrics. April 29, 2021. Accessed June 17, 2021. 

https://downloads.aap.org/AAP/PDF/AAP%20and%20CHA%20-%20Children%20and%20COVID-19%20State%20Data%20Report%204.29.21%20FINAL.pdf

2. Children and COVID-19: state data report. American Academy of Pediatrics. June 3, 2021. Accessed June 17, 2021. 

https://downloads.aap.org/AAP/PDF/AAP%20and%20CHA%20-%20Children%20and%20COVID-19%20State%20Data%20Report%206.3.21%20FINAL.pdf

3. United Stated Food and Drug Administration. (2021, May 10). Coronavirus (COVID-19) Update: FDA Authorizes Pfizer-BioNTech COVID-19 Vaccine for Emergency Use in Adolescents in Another Important Action in Fight Against Pandemic. Retrieved from 

https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-pfizer-biontech-covid-19-vaccine-emergency-use

4. Harris N. Will kids go back to school in the fall? Here’s what experts think and what it may look like. 

https://www.parents.com/kids/education/back-to-school/will-kids-go-back-to-school-in-the-fall-heres-what-experts-think-and-what-it-may-look-like/

5. Demographic characteristics of people receiving COVID-19 vaccinations in the United States. CDC. June 16, 2021. Accessed June 17, 2021. 

https://covid.cdc.gov/covid-data-tracker/#vaccination-demographic

6. Santoli JM, Lindley MC, DeSilva MB, et al. Effects of the COVID-19 pandemic on routine pediatric vaccine ordering and administration — United States, 2020. 

 2020;69(19):591-593. doi:10.15585/mmwr.mm6919e2

7. Interim guidance for routine and influenza immunization services during the COVID-19 pandemic. CDC. April 6, 2021. Accessed June 17, 2021. 

https://www.cdc.gov/vaccines/pandemic-guidance/index.html

8. Jenco M. Moderna reports COVID-19 vaccine for teens safe, effective. 

https://www.aappublications.org/news/2021/05/06/moderna-covid-vaccine-teens-050621

9. Mendez R. CDC says 600,000 kids ages 12 to 15 have received Covid vaccine shots in last week. CDC. May 18, 2021. Accessed June 17, 2021. 

https://www.cnbc.com/2021/05/18/cdc-says-600000-kids-aged-12-to-15-have-received-covid-shots-in-last-week-.html

10. Myocarditis and pericarditis following mRNA COVID-19 vaccination. CDC. May 27, 2021. Accessed June 17, 2021. 

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/myocarditis.html

Practitioners can help ensure that kids get these and all age-appropriate vaccinations before school starts in the fall.

COVID Vaccines for Children Are Becoming a Reality

Mary Koslap-Petraco, DNP, PPCNP-BC, CPNP, FAANP

Jennifer Hofmann, DMSc, MS, PA-C, and Jean Covino, DHSc, MPA, PA-C

The Advisory Committee on Immunization Practices (ACIP) recommends that all Americans 6 months and older who do not have contraindications receive the flu vaccine.

Health care providers should recommend the high-dose or adjuvanted flu vaccine for patients 65 and older. These 2 types of the vaccine are designed to spur a stronger immune response. The difference between adjuvanted and high-dose vaccines is that the adjuvanted vaccine is made with MF59 adjuvant, which is designed to enhance the immune response. The high-dose vaccine is designed for patients 65 and older and contains 4 times the amount of antigen as the regular flu vaccine. As such, it is associated with a stronger immune response, and patients who received the high-dose vaccine had 24% fewer influenza infections compared with those who received the standard-dose flu vaccine.

Children aged 6 months to 8 years who have never received the vaccine should receive 2 doses, the first as soon as it is available and the second about a month later.

showed that the vaccine significantly reduces a child’s risk of dying from the influenza virus. The study looked at data from 2010 to 2014 and found that the vaccine reduced the risk of flu-associated death by 51% among children with underlying high-risk medical conditions. Just 1 in 4 children who reportedly died from influenza had received the vaccine. As of March, 61 pediatric flu-related deaths had been reported in 2017.

From 1982-2016, peak influenza activity did not occur until January or later, but it can start as early as October.

Considering inconclusive evidence that delaying immunization may increase immunity in the latter half of the flu season, the ACIP recommends that patients get vaccinated early. The deferral of vaccination could result in a missed opportunity to vaccinate a patient or the patient becoming infected with the influenza virus prior to obtaining the vaccine.

A potential safety signal associated with the flu vaccination of pregnant women has been raised. A case control study has reported that women early in pregnancy who have been vaccinated with vaccine containing the H1N1 component had a higher rate of spontaneous abortion within 28 days of vaccination. However, the ACIP has not changed its re

commendation on not vaccinating pregnant women in any trimester. There is an ongoing study involving pregnant patients and the flu vaccine that should produce results by 2018 or 2019.

According to the CDC, the flu vaccine is associated with decreased hospitalizations among patients with diabetes (79%) and chronic lung disease (52%).

Additionally, a meta-analysis suggests that the influenza vaccine is associated with a lower risk of major cardiovascular events in patients with active coronary disease.

With these statistics in mind, health care providers should be the most prominent advocates of the flu vaccine, especially concerning these special patient populations.

Another concern when considering the flu vaccine in certain patient populations is an egg allergy. The ACIP recommends that patients who have experienced urticaria after exposure to eggs should be vaccinated. Patients who have experienced severe reactions to eggs, such as angioedema or respiratory distress, or who require epinephrine, may receive any licensed and recommended flu vaccine. However, vaccine administration should be supervised by a health care provider who is trained to manage severe allergic reactions. As always, patients who have suffered an allergic reaction to the flu vaccine previously should not receive the vaccine.

One option for patients with severe egg allergies is Flublok, a vaccine that is not produced using chicken eggs. If a patient asks for the Flublok vaccine, it should be noted that the vaccine has a slightly shorter shelf life of 9 months from the production date.

Always remember the CDC’s SHARE method: Share the reasons that the influenza vaccine is right for patients, highlight positive experiences with the vaccine, address all patient questions, remind patients that influenza vaccines protect them and their loved ones, and explain the potential costs of getting the flu. It is important that patients understand the vaccine and the reasoning behind its recommendation so that they can make informed decisions about the flu and other vaccines.

Pharmacists, nurse practitioners, physician assistants, and physicians are vital to increasing influenza immunization rates. Patients trust health care providers to provide the latest evidence involving the vaccine and data surrounding special patient populations.

is a community pharmacy resident at the University of Georgia and Kroger Pharmacy.

1. CDC. Prevention and control of influenza with vaccines. Recommendations of the Advisory Committee on Immunization Practices—United States, 2013-2014.

2. What you should know and do this flu season if you are 65 years and older. CDC website.

. Updated October 13, 2017. Accessed November 2, 2017.

3. Grohskopf LA, Sokolow LZ, Olsen SJ, Bresee JS, Broder KR, Karron RA. Prevention and control of influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices, United States, 2015-16 influenza season.

4. CDC study finds flu vaccine saves children’s lives [news release].  CDC. April 3, 2017.

cdc.gov/media/releases/2017/p0403-flu-vaccine.html

5. Grohskopf LA, Sokolow LZ, Broder KR, et al. Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices - United States, 2017-18 influenza season.

2017;66(2):1-20. doi: 10.15585/mmwr.rr6602a1.

6. Flu vaccination & possible safety signal. CDC website.

cdc.gov/flu/professionals/vaccination/vaccination-possible-safety-signal.html

. Updated September 13, 2017. Accessed November 2, 2017.

Udell JA, Zawi R, Bhatt DL, et al. Association between influenza vaccination and cardiovascular outcomes in high-risk patients: a meta-analysis.

8. Flu vaccine and people with egg allergies. CDC website.

cdc.gov/flu/protect/vaccine/egg-allergies.htm

. Updated September 2, 2016. Accessed November 2, 2017.

9. Flublok seasonal influenza (flu) vaccine. CDC website.

cdc.gov/flu/protect/vaccine/qa_flublok-vaccine.htm

. Updated October 3, 2017. Accessed November 2, 2017.

10. When & how to wash your hands. CDC website.

cdc.gov/handwashing/when-how-handwashing.html

. Updated March 7, 2017. Accessed November 2, 2017.

The deferral of vaccination could result in a missed opportunity to vaccinate a patient or the patient becoming infected with the influenza virus prior to obtaining the vaccine.

Influenza Prevention: Make Sure Patients Understand the Vaccine

Abby Case, PharmD

April is Alcohol Awareness Month, and we have simplified science on everything related—effects on the body, nutrition, and how an individual can still be on a quest with sound nutrition, making sense of how alcohol and calories mix. Patients often times have questions related to alcohol, its effects on medications, diet, and their health, so what better time to dive into this topic and share what the science has to say, to better arm healthcare providers, and to help patients.

named April National Alcohol Awareness Month in 1987 as a way to decrease the stigma associated with alcoholism, and to provide education to prevent unnecessary health risks.

There are some key terms, definitions, and implications that will prove helpful for healthcare providers to know, so that they can better educate their patients on alcohol, its effects, and the implications of certain drinking patterns.

National Council on Alcoholism and Drug Dependence

Excessive drinking is associated with a significant increase in acute health and safety risks, proportional to the amount of alcohol consumed. If this behavior becomes habitual, then over time it can lead to many other health complications.

Patients often times have questions related to alcohol, its effects on medications, diet, and their health, so what better time to dive into this topic and share what the science has to say.

The Buzz On Alcohol and the Body

Adam Martin, PharmD, ACSM-CPT

Death by external causes&#151;primarily accidents and suicide—take the lives of more than 5 million people each year, and it has evolved into a major health concern on a global scale. External causes also include violence, undetermined causes, and medical procedures.

In Japan, a country boasting one of the highest life expectancies across the globe, a recent study found that external causes take the lives of women 10 years earlier than those by all other causes. The study sought to investigate the association between female reproductive factors, and the risk of external causes of death among middle-aged women in Japan.

The study followed 49,279 women for 20 years; 8477 of the women died, and the researchers collected their death certificates to confirm their causes of death. Of these deaths, 328 were by external causes: 148 by suicide, and 167 by accident. The researchers found that women designated “ever parous” (carrying at least one pregnancy to 24 weeks) had a lower risk of suicide than those designated “never parous.” They also found that parous women who had ever breastfed were much less likely to die by accident.

The study suggests that the decreased risk of suicide in “ever parous” women is consistent with previous studies. They indicate that the presence of a child may significantly deter the decision to commit suicide, especially while the child is dependent.

In addition, researchers found that the lower risk of accidents seen among postmenopausal women may be linked to the protective effect of breastfeeding on osteoporosis, and subsequent fracture occurrences. Osteoporosis can turn a simple fall into a health crisis, ultimately traced back to an accident.

The study concludes that “suicide and accidents are never the consequence of a single cause; a combination of personal, cultural, social, and biological features likely interact with fluctuations in sex hormones among women.” The researchers acknowledge that the reproductive factors they studied are not modifiable, but emphasize that a better understanding could still help to reduce avoidable deaths by self-harm and accidents.

is a 2023 PharmD Candidate at the University of Connecticut in Storrs.

Female reproductive factors and risk of external causes of death among women: The Japan Public Health Center-based Prospective Study (JPHC Study).

9, 14329 (2019) doi:10.1038/s41598-019-50890-x

Death by external causesâ€”primarily accidents and suicideâ€”take the lives of more than 5 million people each year, and it has evolved into a major health concern on a global scale. External causes also include violence, undetermined causes, and medical procedures. 
 

Breastfeeding and Parity Linked to Lower Risk of Death by Accidents and Suicide

Adara Bochanis, PharmD Candidate

Patients with type 2 diabetes (T2D) who get the flu shot may have a reduced risk for hospitalization related to cardiovascular or respiratory issues, recent research suggests.

Researchers from the Imperial College London analyzed 7 years’ worth of flu-season data on nearly 125,000 patients with T2D seen in primary care clinic. They found that individuals who received the flu shot were 30% less likely to be admitted to the hospital for stroke, 22% less likely to be admitted for heart failure, and 15% less likely to be admitted for pneumonia or influenza than their unvaccinated counterparts.

Patients who received the flu shot also had a 24% reduced risk of all-cause mortality.

To better understand the effect of the flu vaccine on a patient’s risk for hospitalization, the researchers controlled for patients’ age, weight, smoking status, and gender. Also important to the researchers was whether or not patients had been diagnosed with or were taking prescriptions for other long-term chronic conditions, such as heart disease and asthma.

that individuals at high risk of serious flu complications include young children; pregnant women; patients with chronic health conditions like asthma, diabetes, or heart and lung disease; and those 65 years and older.

“The potential impact of influenza vaccine to reduce serious illness and death highlight the importance to renew efforts to ensure that people with diabetes receive the flu vaccine every year,” lead study author Eszter Vamos, a public health researcher at Imperial College London, told

The researchers noted that one study limitation is that those who opt to get the flu shot may be healthier overall, meaning they already had a reduced risk for hospitalization or death.

Causation notwithstanding, the best protection for those with chronic conditions is preventing the flu in the first place.

Nurse practitioners and retail clinicians should remind every patient at every visit about the importance of the flu shot.

Patients with type 2 diabetes who get the flu shot may have a reduced risk for hospitalization related to cardiovascular or respiratory issues, recent research suggests.

Flu Shot May Help Diabetes Patients Avoid Hospitalization, Death

Aine Cryts

New research has found that shelter-in-place (SIP) orders during the COVID-19 pandemic had a significant impact on the population’s weight, with the average American gaining 2 pounds per month over the last year.

Despite common discussions about the “quarantine 15,” researchers have struggled to quantify the exact impact of the pandemic on physical health and fitness levels. In the study, researchers noted that surveys asking people about their weight are typically unreliable, and because many Americans have postponed their routine medical appointments, physicians may not have been able to catch these issues.

According to the study authors, 45 state governments issued SIP orders between March 19 and April 6, 2020, to slow transmission of COVID-19. These initial orders coincided with a decrease in daily step counts, likely due to changes in physical activity and daily habits, as well as self-reported increases in snacking and overeating, according to the study.

To investigate the possible down-stream health implications of prolonged SIP orders, investigators performed a longitudinal analysis of data obtained from participants in the Health eHeart Study who volunteered to report weight measurements from their Bluetooth-connected smart scale or iHealth. Demographic characteristics and medical conditions were obtained via online surveys.

According to the study authors, 7444 weight measurements from 269 unique study participants were collected during the study period, with a mean of 28 weight measurements per participant. Of the 269 participants, 130 were men and 207 were white, and the group had a mean age of 51.9 years.

According to their findings, post-SIP participants experienced steady weight gain of 0.27 kg every 10 days, irrespective of geographic location of comorbidities. This translates into approximately 1.5 pounds of weight gain every month.

These findings could have significant implications, as weight is a clinically relevant health outcome and is independently associated with all-cause mortality. It is also a helpful proxy for physical activity, which the study authors said is also associated with all-cause mortality.

When they analyzed weight trends around the initial SIP orders, the investigators found a significant increase in weight over the post-SIP period. Although 1.5 pounds over a month may not appear clinically important, it could lead to substantial weight gain over the prolonged pandemic, the authors said.

Lin A, Vittinghoff E, Olgin J, et al. Body Weight Changes During Pandemic-Related Shelter-in-Place in a Longitudinal Cohort Study. 

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2777737?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=032221

Although 1.5 pounds over a month may not appear clinically important, it could lead to substantial weight gain over the prolonged pandemic.

Authors