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    <recommendedItem id="20090101_19_2136"
                     title="Young Athletes Resist Lure of Smoking in Movies"
                     score="-0.005"
                     href="http://www.medpagetoday.com/PrimaryCare/Smoking/tb/14974?impressionId=1265771967653"
                     
      PRINCETON, N.J., July 7 -- Adolescents who participate in team sports are better able to resist the temptation to smoke than nonparticipants, even when they watch movies that portray characters lighting up, a study found.
              &lt;br&gt;&lt;br&gt;Young people who did not participate in team sports were twice as likely to become smokers than those who did join teams (95% CI, 1.47 to 2.74), according to the study published in the July 6 &lt;em&gt;Archives of Pediatrics &amp;amp; Adolescent Medicine&lt;/em&gt;.
              &lt;br&gt;&lt;br&gt;While team sports helped counter the influence of watching smoking in movies, the likelihood of youths becoming smokers was proportional to the number of times they saw smoking depicted in movies.
              &lt;br&gt;&lt;br&gt;Adolescents exposed to the most movie smoking were 63% more likely to become smokers than those who watched the fewest smoking scenes (95% CI 1.03 to 2.57), the study found.
              &lt;p&gt; 
              &lt;p&gt;&quot;Parents, teachers, coaches, and clinicians should be aware that encouraging team sports participation in tandem with minimizing early exposure to movie smoking may offer the greatest likelihood of preventing youth smoking,&quot; Anna M. Adachi-Mejia, PhD, of Dartmouth Medical School, and colleagues wrote.
              &lt;p&gt; 
              &lt;p&gt;Previous studies have established that exposure to smoking in movies increases a person&apos;s chances of trying smoking, with 30% to 50 % of youth smoking initiation attributed to movie smoking exposure.
              &lt;p&gt; 
              &lt;p&gt;In contrast, involvement in team sports has been associated with a reduced risk of youth smoking as well as other health benefits, including enhancing well-being and improving global physical self-concept.
              &lt;p&gt; 
              &lt;p&gt;&quot;Therefore, encouraging youths to participate in team sports is an important strategy for smoking prevention efforts,&quot; the researchers wrote. &quot;However, we do not yet fully understand the ways in which other risk factors for youth smoking may counteract the protective nature of team sports participation.&quot;
              &lt;p&gt; 
              &lt;p&gt;To further explore the links between smoking initiation, movie smoking exposure, and the protective effects of team sports, Dr. Adachi-Mejia and colleagues analyzed data from school- and telephone-based surveys that assessed movie smoking exposure and team sports participation in 2,048 youths from September through November of 1999 and again from February 2006 through February 2007.
              &lt;p&gt; 
              &lt;p&gt;Baseline movie smoking exposure was reported when respondents were ages 9 to 14, and team sport participation was assessed at ages 16 to 21 at follow-up.
              &lt;p&gt; 
              &lt;p&gt;The participants were classified into four groups based on their movie smoking exposure, with 0 to 522 smoking occurrences for the first quartile, 523 to 947 for the second, 948 to 1,649 for the third and 1,650 to 5,308 for the fourth.
              &lt;p&gt;
              &lt;p&gt;Movie smoking exposure was determined by surveying participants about a sample of 601 top box-office hit movies released between Jan. 1, 1988, and Dec. 31, 1999.
              &lt;p&gt; 
              &lt;p&gt;Trained movie coders counted the number of smoking occurrences in 50 of the movies in the sample, which were then used to estimate the portrayal of smoking across the entire sample.
              &lt;p&gt; 
              &lt;p&gt;At follow-up, 353 respondents (17.2%) were established smokers, having smoked at least 100 cigarettes in their lifetimes.
              &lt;p&gt; 
              &lt;p&gt;&quot;We found that greater levels of movie smoking exposure were associated with a greater likelihood of established smoking and that at every level of movie smoking exposure, team sports participation was protective for youth smoking,&quot; the authors wrote.
              &lt;p&gt; 
              &lt;p&gt;&quot;However, we saw a dose-response relationship of movie smoking exposure for the odds of established smoking only among team sports participants.&quot;
              &lt;p&gt; 
              &lt;p&gt;The researchers were surprised to find that team sports participants were exposed to smoking in movies just as much as nonathletes were and noted that movie smoking exposure seem to exert a universal influence on the study participants.
              &lt;p&gt; 
              &lt;p&gt;&quot;In summary, this study supports the benefits of youth participation in team sports, which appears to protect against established smoking even in the face of movie smoking exposure,&quot; they wrote. &quot;However, movie smoking exposure increases the risk of established smoking among both team sports participants and nonparticipants.&quot;
              &lt;p&gt; 
              &lt;p&gt;They concluded that their study adds to mounting evidence that explicit public policies are needed to minimize youth exposure to movie smoking.
              &lt;p&gt; 
              &lt;p&gt;They noted several limitations of the study including the fact that &quot;our sample was limited in that it was predominantly white and geographically constrained to northern New England.&quot;
              &lt;p&gt; 
              &lt;p&gt;In addition, they wrote, &quot;Respondents in the follow-up survey differed from the baseline sample in that they had fewer risk factors for established smoking: being female, having both parents who completed high school, and having less movie smoking exposure.&quot;
              &lt;p&gt; 
              &lt;p&gt;&lt;table cellspacing=&quot;0&quot; hspace=&quot;1&quot; style=&quot;border-style:solid; border-width:1px; border-color:#8dabbc; font-family:arial; font-size:12px; background-color:#DBE9F2; padding:5px 5px 5px 5px;&quot;&gt;
&lt;tr&gt;&lt;td&gt;The study was funded by the National Cancer Institute.
              &lt;p&gt; 
              &lt;p&gt;The authors reported no financial conflicts of interest.&lt;/td&gt;&lt;/tr&gt;&lt;/table&gt;
       
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                     title="SCCM: Toddler Found Frozen in Creek Revives (CME/CE)"
                     score="-0.006"
                     href="http://www.medpagetoday.com/MeetingCoverage/SCCM/tb/17927?impressionId=1265771967653"
                     
      &lt;p&gt;MIAMI BEACH  --  When Scott Magley, MD, of Conemaugh Memorial Medical Center in Johnstown, Pa., arrived at the scene in December 2008, the 23-month old toddler was literally a block of ice.&lt;/p&gt;
&lt;p&gt;After going missing for at least three hours, she had been found face down in a creek. She had no heartbeat, no response. Her initial core temperature was below the reading limits of Magley&apos;s field thermometer. Ice crystals had formed in her mouth.&lt;/p&gt;
&lt;p&gt;&quot;We have learned that we can&apos;t just give up on these patients,&quot; said Ricardo Patton Po, MD, chief trauma and surgical resident at Conemaugh, who presented the girl&apos;s remarkable case study at the annual meeting of the Society of Critical Care Medicine here. &quot;We believe this was the youngest child to be revived without extracorporeal warming.&quot;&lt;/p&gt;
&lt;p&gt;Magley, another critical care specialist who lives in the countryside near the spot where the Amish child was found, managed to perform endotracheal intubation. He began advanced life support and transported her to the hospital, with multiple doses of epinephrine and atropine administered en route.&lt;/p&gt;
&lt;p&gt;&quot;On arrival the girl was unresponsive, with fixed and dilated pupils, no palpable pulse and no appreciable cardiac wall movement on ultrasound,&quot; Po recalled. &quot;Cardiac rhythm showed asystole.&quot;&lt;/p&gt;
&lt;p&gt;Over the course of the next two hours, the cardiopulmonary resuscitation Magley had begun in the field continued at the hospital. Passive warming was initiated, but the staff could not do an extracorporeal bypass because the appropriate-sized catheters weren&apos;t available. Active warming was performed using the Arctic Sun Management System.&lt;/p&gt;
&lt;p&gt;&quot;We continued working because we were encouraged that her body temperature appeared to be rising  --  from a low of 19 degrees Celsius (66.8 degrees F),&quot; Po said.&lt;/p&gt;
&lt;p&gt;The girl occasionally opened her eyes and made nonpurposeful arm movements during cardiac compressions.&lt;/p&gt;
&lt;p&gt;When her core temperature rose to 26 degrees C (79 degrees F), doctors detected ventricular fibrillation. They administered one electric shock, and regular sinus rhythm returned. That resulted in a palpable pulse and eventually a discernible blood pressure.&lt;/p&gt;
&lt;p&gt;&quot;She then began to exhibit purposeful movements and appeared to recognize her parents, who had since arrived at the hospital,&quot; Po told &lt;em&gt;MedPage Today&lt;/em&gt;.&lt;/p&gt;
&lt;p&gt;She was transferred to Children&apos;s Hospital of Pittsburgh when her internal temperature rose to 31-33 degrees C (88-91 degrees F).&lt;/p&gt;
&lt;p&gt;Po said the transfer created a problem because her parents insisted that she not be transported by powered vehicles  --  and most certainly not by an aircraft, as doctors first proposed.&lt;/p&gt;
&lt;p&gt;He said they finally compromised on an ambulance transfer.&lt;/p&gt;
&lt;p&gt;She was extubated on day one at the hospital and was discharged home on day five, with apparently normal neurological status.&lt;/p&gt;
&lt;p&gt;Po said that on follow-up, her parents thought she was having some difficulty in picking up items with either hand, but otherwise did not appear to have any lasting ill-effects.&lt;/p&gt;
&lt;p&gt;&quot;This case serves as an opportunity to review important concepts in the resuscitation of the profoundly hypothermic patient and to emphasize the resiliency of quickly cooled tissue, deprived of perfusion but before hypoxia damages cellular mechanisms involved in recovery,&quot; Po said.&lt;/p&gt;
&lt;p&gt;&quot;The abundant case reports in the literature, both children and adults, speak to the ability of prolonged and vigorous resuscitation to achieve favorable outcomes,&quot; he said.&lt;/p&gt;
&lt;p&gt;Dominic Cave, MD, a fellow in pediatric intensive care at Stollery Children&apos;s Hospital/University of Alberta in Edmonton, said he&apos;s seen similar episodes.&lt;/p&gt;
&lt;p&gt;&quot;This is another one of those amazing cases that seem to follow the rule that a person isn&apos;t dead until he or she is warm and dead,&quot; he told &lt;em&gt;MedPage Today&lt;/em&gt;.&lt;/p&gt;
&lt;p&gt;&quot;The survival of this child without apparent brain damage is also gratifying,&quot; he added. &quot;You never know if the person you are reviving is going to make such an amazing recovery.&quot;&lt;/p&gt;
&lt;div style=&quot;float:left;border-style:solid;border-width:1px;border-color:#8dabbc;font-family:arial;font-size:12px;background-color:#DBE9F2;padding:5px;&quot;&gt;&lt;p&gt;None of the doctors disclosed any relevant financial relationships.&lt;/p&gt;&lt;/div&gt;&lt;div style=&quot;clear:both;&quot;&gt;&lt;/div&gt;
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                     title="Harry Potter Keeps Muggle Kids Safe"
                     score="-0.006"
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