The new flu vaccine recommendations as flu season approaches

iStock/ThinkstockBY: DR. AMISHA AHUJA

(NEW YORK) -- When rapper Drake canceled his Miami concerts recently because he was suffering from a case of the flu, his representatives said, it was a reminder that flu season, which took a big toll last year, is near again.

"We can see influenza all year round –- 12 months out of the year," Dr. Jennifer Ashton said on "Good Morning America." Flu season, when the highest number of illnesses emerge, generally tends to run from October to March in the U.S.

That’s why the Centers for Disease Control and Prevention issues its annual recommendations on the flu vaccine. The agency recommends that everyone 6 months and older should be vaccinated for influenza every season, ideally by the end of October.

Even if that deadline passes, it's still helpful to get vaccinated, especially if influenza continues in the community late in the year. In the past, the virus has hung around as late as May.

Flu vaccine: Will it work better next season?

After receiving a flu shot, it takes two weeks to develop the antibodies needed to protect against infection. This means it's best to get the vaccine before flu season begins to have full immune benefits.

Since the flu virus changes year to year, the vaccine changes, as well. So last year's flu shot doesn’t carry over to this season. These fluctuations make it hard to predict how bad the flu will be. This was evidenced last year, with one circulating strain of the flu, H3N2, poorly matched with the vaccine.

Although the vaccine can be imperfect, it is the best defense that exists now, while advancements in the field continue.

"There’s a new flu vaccine out now; it’s made based on predictions of what this year’s strains will be," Ashton said, "so you do need to get it this fall.”

With some pharmacies stocking and administering the vaccine in the summer months, questions have emerged about how early is too early to get a shot.

"There’s a little bit of controversy now in the medical literature," Ashton said. "If you get it too early, does our immune protection wane by the end of the flu season?”

Some studies have shown that the protective antibodies produced in response to the vaccine can decrease over time. But there are a number of variables in the human immune response; some that have to do with vaccine components, some that have to do with the health of the person getting vaccinated and some involving age.

Useful protection for the year has been shown in healthy adults in the 18 to 49 age range. Although there are concerns that adults age 65 and older are more likely to have waning protection over time, research shows antibodies are still present in high levels six months after the shot, and, more importantly, even these lower levels of antibodies help prevent the flu.

Flu outbreak has killed at least 63 children: CDC officials

Influenza is a serious infection that kills many each year and older adults and young children are particularly vulnerable. This is why most health officials will agree that receiving a flu shot, even if its early, is much better than no flu shot at all.

Now that October is here, it's definitely a good time to get vaccinated for flu season.

Amisha Ahuja is an internal medicine resident at Thomas Jefferson University Hospital and a contributor to the ABC News Medical Unit

Copyright © 2018, ABC Radio. All rights reserved.


Flu season is here

iStock/ThinkstockBy  Dr. Jonathan Steinman

(NEW YORK) --  It’s the start of fall, which means flu season is here.

Last year, flu hospitalizations were the highest they’ve ever been; 106 out of every 100,000 people were hospitalized for the flu in the 2017-18 season, with people over age 65 accounting for 58 percent of those hospitalizations and 180 pediatric deaths.

Flu and the common cold can both make you feel crummy, but they are caused by different viruses. Colds are usually milder and do not result in serious health problems associated with the flu, like pneumonia or hospitalizations.

Right now, being prepared is the best thing you can do before the season hits. Here’s what you need to know.

When does flu season start?

Flu season may start as early as October in North America, but generally, it begins sometime in the fall and ends in March. The flu virus, however, can be detected at any point throughout the year, which is important to know if you ever have symptoms, even in the summer. Experts can’t really predict the severity of each flu season, as different strains of the virus can have different impacts on timing and length of the season.

Should I get the flu shot? When?

Yes. With few exceptions, the Centers for Disease Control and Prevention recommends everyone 6 months of age and older to get vaccinated every year. It is the first line of defense in treating the flu. Although people who are moderately or severely ill should wait to recover before getting the shot. Only people with severe, life-threatening allergies to the vaccine or any of its ingredients should avoid the shot. According to the CDC, anyone who is between 2 and 50 years old should get either the shot or the nasal spray. The American Academy of Pediatrics, however, says the flu shot is the preferred choice over the nasal spray for children

You can get vaccinated at any time as fall approaches, but October is probably the best time to get it done. The CDC recommends that everyone get vaccinated by the end of October, which gives your body the roughly two-week period it needs to develop an immune response to the vaccine prior to the start of peak flu season. If you miss this deadline, however, the vaccine can still offer some benefit. So it's important to get it as long as people are still getting sick.

What if I’m pregnant?

It is highly recommended that all pregnant women get the flu shot. The body changes during pregnancy — heart rate and oxygen consumption increase while lung capacity decreases. That means if a mother-to-be gets the flu, they are more susceptible to life-threatening complications than the general population. So all women who are or expect to be pregnant should get the flu vaccine. This is all the more important considering a recent CDC survey showed that only half of pregnant women get the vaccine.

I heard the flu shot makes you sick. Is that true?

No. The flu vaccine contains an inactivated virus, which means that the virus contained in the vaccine can’t actually infect you. It does take one to two weeks for your immune system to protect you from the flu. So, if someone becomes sick after their shot, it is most likely because their body wasn’t protected from the flu yet, not from the vaccine itself.

Similarly, there are sometimes mismatches between the virus strain someone gets sick with and the strains used to make the vaccine. In these cases, the vaccine might be imperfect at fighting all strains of the flu that might exist, but it's still the best defense we have.

How do I know if I have the flu?

Flu symptoms often come suddenly, and can vary significantly depending on the person. These include fever, cough, sore throat, nasal congestion, body aches, headaches, and fatigue. While the flu may seem similar to a common cold, colds are usually slower to develop, and less likely to result in fevers.

Some patients with severe infections may have symptoms — like difficulty breathing and confusion — that are cause for concern and might require immediate medical attention to treat them. Medical attention should also be sought for children with the flu who develop bluish skin, aren't waking up or aren't eating. In all cases, if the person's symptoms suddenly worsen after appearing to initially improve, a visit to a clinician is warranted.

I think I have the flu. What do I do next?

In most cases, if symptoms are mild, staying home and leaving only to get medical care is the best course of action. If you must leave the house, wear a face mask, wash your hands, and cover coughs and sneezes with your elbow.

People with severe symptoms, as well as people at high risk from the flu (young children, people 65 and older and pregnant women), should contact their doctors if they develop symptoms. In some cases, people may get antiviral medications, which can lessen symptoms, shorten the time of illness and reduce complications.

How is the shot made?

Manufacturers have many methods of producing flu vaccines. The most common method is the egg-based vaccine, where strains of the virus are injected into eggs and incubated for several days. They are then weakened or killed and afterward purified to be used in a shot or nasal spray.

The next method is through cell-based technology. In these vaccines, the eggs used to incubate the virus are replaced with animal cells. This method is faster in producing vaccines than the older egg-based method.

Another method uses recombinant technology. In these cases, a certain gene is taken from the flu virus, to be inserted into a different non-flu virus which grows in insect cells. This genetically altered non-flu virus then replicates in insect cells. After the virus has been replicated, manufacturers purify the protein produced from the flu gene, which is used in the vaccine. The advantage of this method is that it doesn't use eggs, so people with severe egg allergies can be vaccinated.

For all these methods, the FDA must test and approve the vaccines prior to their release to the public.

What are the side effects of the flu shot?

Most side effects are mild and resolve quickly on their own. Soreness in the area of the shot is pretty common. In addition, people may have headaches, fevers and nausea. Seek immediate symptoms if someone is showing signs of a severe allergic reaction, such as difficulty breathing, hoarseness or eye and lip swelling.

Where should I get the flu shot?

Grocery stores, pharmacies, doctor’s offices, and hospitals are all offering flu shots. Experts say it doesn’t matter where you get it, as long as you get it.

Flu season is here. Preventing its spread requires good hygiene and high vaccination rates. If you are experiencing any symptoms, avoid contact with other people. If symptoms are starting to get severe, contact your doctor. Working together will be critical in halting flu season.

Dr. Jonathan Steinman is a physician in radiology and writer with the ABC News Medical Unit.

Copyright © 2018, ABC Radio. All rights reserved.


Pregnant women should get the flu vaccine, but only half actually do: CDC

iStock/ThinkstockBY: DR. AMISHA AHUJA

(NEW YORK) -- Pregnant women are more susceptible to life-threatening complications if they get the flu, a fact that makes the results of a new survey showing that only half of pregnant women get vaccinated so troubling.

It’s recommended that all women who are, or might become, pregnant during flu season be vaccinated against the flu. The vaccine is safe for mothers and their unborn children. But in addition to the flu vaccine, pregnant women should also get vaccinated against pertussis, also known as whooping cough.

The vaccine for pertussis is combined with vaccines for tetanus and diphtheria in a combination vaccine called Tdap, and it’s recommended that expecting mothers receive it once between the 27th and 36th week of pregnancy (during every pregnancy) even if they’ve gotten it in the past.

The survey, from the Centers for Disease Control and Prevention, set out to find how prevalent vaccinations for the flu were during the 2017-2018 flu season by asking approximately 1,700 women to fill out a survey. The women had been pregnant during peak flu season, between October and January, and about 700 of them were advanced enough in their pregnancy to be eligible for the Tdap vaccine.

Some women who submitted the survey had to be excluded because they didn’t remember whether they had received the vaccines — a common problem in studies where participants are asked to remember something that happened, like this. But among those who did remember, their demographics were roughly the same as [who in the US?].

Surprisingly, only about half of the women (49 percent) received a flu vaccine before or during their pregnancy. A slightly higher number of women received the Tdap (54 percent). But when it came to those who received both, only 33 percent said that they had.

There were many explanations for why they didn’t get vaccinated. Many women who skipped the Tdap said they didn’t know they needed to receive it during pregnancy in the first place. There were also a lot of women who expressed concerns about the safety of these vaccines and how they would affect their babies. Women who skipped out on the flu vaccine, meanwhile, said they didn’t believe it was effective — an assertion that isn’t true.

The CDC culled some other interesting information from the survey. For example, it found that women who had health care providers that offered the vaccine were the most likely to receive them. Even women who were referred to somewhere outside of their doctor’s office received the vaccines at higher rates than those who didn’t get a referral.

The survey’s results can be disheartening for doctors and public health officials, who know about how important these vaccines are for protecting pregnant women. These findings may also be surprising for doctors who take the time to talk about vaccines, and who might assume patients are following their advice. That said, studies have shown that there may be a miscommunication between doctors and their patients on how vaccines work and why they should be taken.

While there are several factors that lead women to skip vaccines during pregnancy, including health literacy and underlying personal and cultural beliefs. However, it is reassuring to see that having vaccines available, and pointing patients to where they can find them, seems to improve vaccination rates.

In trying to ensure that all women and their future children are protected against preventable diseases, especially as flu season approaches, doctors might just need to say: “Here’s where you can get your shot.”

Amisha Ahuja is an internal medicine resident at Thomas Jefferson University Hospital and a contributor to the ABC News Medical Unit

Copyright © 2018, ABC Radio. All rights reserved.


Too much screen time, too little sleep and exercise linked to worse cognitive development in children: Study

iStock/ThinkstockBY: DR. NICKY MEHTANI

(NEW YORK) -- The average American child spends 3.6 hours staring at a computer, television, tablet, or smartphone daily -- an amount of screen time associated with inferior cognitive development and academic performance, according to a new study of over 4,500 children between the ages of eight and 11 published yesterday in The Lancet Child & Adolescent Health.

The study was conducted by Canadian researchers, but examined children in the U.S. using the Canadian 24-Hour Movement Guidelines for Children and Youth. Those guidelines recommend that children get nine to 11 hours of uninterrupted sleep, less than two hours of screen time and at least one hour of physical activity every day. The children who scored best on tests for assessing language abilities, memory, executive function, attention, and processing speed met those sleep, screen time and activity benchmarks.

Nineteen out of 20 children in the U.S. failed to meet the lifestyle benchmarks. While about half met the sleep recommendation, only 37 percent met the guideline for limited screen time and 18 percent met that for physical activity.

In their findings, researchers accounted for a variety of other factors known to contribute to cognition, including household income and education levels.

Improvements in cognition were associated with each additional recommendation met, with limited screen time and sleep having the strongest correlation to improvement. The physical activity guideline on its own demonstrated no association. This was surprising, according to the authors, and it may suggest that the physical activity measure may not have been specific enough.

While these statistics themselves are alarming, their ramifications may be even more worrisome.

“Evidence suggests that good sleep and physical activity are associated with improved academic performance, while physical activity is also linked to better reaction time, attention, memory, and inhibition,” Dr. Jeremy Walsh, the study’s lead author and a postdoctoral fellow at the University of British Columbia, said in the study’s press release. The relationship between recreational screen time and cognitive development has historically been less clear, and this type of research is in early stages, he said.

Dr. Eduardo Esteban Bustamante, an assistant professor of kinesiology and nutrition at the University of Illinois at Chicago who was not directly involved in the research, suggested that the study’s findings about screen time may reflect interruption of important childhood growth cycles involving stress related to physical activity and recovery from sleep.

“Each minute spent on screens necessarily displaces a minute from sleep or cognitively challenging activities,” Dr. Bustamante wrote in a commentary that accompanied the study. “In the case of evening screen use, this displacement may also be compounded by impairment of sleep quality.”

In his commentary, Dr. Bustamante likens the problem of screen time to the challenge of the childhood obesity epidemic, and said that both have been propagated by their profitability to industry, convenience to parents, and pleasure for children. He warns that, in that sense, the new study’s findings “are a potential canary in a coal mine. If we are to do a better job of protecting children’s minds than their bodies, we will need to be better scientists and citizens than we have been.”

According to the study’s authors, additional research is needed to better understand the effects of different kinds of screen time on cognition, and they point out that given the study’s observational nature, it does not prove a causative link between screen time on cognition. Nevertheless, the findings suggest that “pediatricians, parents, educators, and policymakers should promote limiting recreational screen time and prioritizing healthy sleep routines throughout childhood and adolescence,” Dr. Walsh said.

Nicky Mehtani is an internal medicine physician at Johns Hopkins Hospital and a part of the ABC News Medical Unit.

Copyright © 2018, ABC Radio. All rights reserved.


Youngest US face transplant recipient shares story of suicide survival and hope: 'Life is an amazing gift'

ABC News(CLEVELAND) -- As a star student and a promising athlete at her Mississippi high school, with college ambitions, it seemed that the sky was the limit for then-17-year-old Katie Stubblefield, her father said.

"She was driven for a purpose," her father, Robb Stubblefield, told "Nightline." "When she was a kid, she played soccer from the time she was, what, 4 years old? And she was not very nice at playing soccer ... they used to call her 'bulldozer.'"

But amid the stress of looking at colleges and looking ahead to graduation, the teen's life took a detour.

Now, four years later, she has a different story to tell -- one that describes the emotional struggles of adolescence, the permanence of split-second decisions and how two troubled souls came together to create a second chance.

For Katie, it started with a broken heart and a gun.

That led to her fighting for her life.

At age 21, Katie became the youngest face-transplant recipient in the United States, and only the 40th person to undergo the surgery.

Years before that history-making procedure, she was experiencing a stressful year. The high school senior was suffering health problems related to an appendectomy. Both of Katie's parents had lost their jobs, teaching at her high school.

"I think really with Katie, she absorbed it, and it hit her deeply because I was her teacher," Robb Stubblefield said.

Then on March 25, 2014 , Katie’s boyfriend broke up with her. Angry and upset, she left school early and drove over to her older brother Robert's house.

"I was like, 'What are you doing home from school?'" Robert Stubblefield said. "So, you know, I called my parents, like, 'Hey, just so you know, she's at my house right now.'"

Katie's mother, Alesia, had been out with a friend and was dropped off at Robert's house. She tried to comfort her daughter, but Katie didn't want to talk.

Robert and Alesia went outside to talk to Alesia's friend, when Robert said it sounded like a door slam. They went in, and the bathroom door was shut. Katie was on the other side.

"I tried to open the door," Alesia said. "I said, 'Katie?' And, nothing. And then I said, 'Katie.' I said, 'Are you OK?' And about the third time I said, 'Katie,' that's when my heart began to just palpitate."

"At that point I smelled gunpowder because it was, obviously, indoors and you can smell it," her brother said. "And I knew exactly at that point what had happened."

In an impulsive teenage instant, Katie had taken her brother's hunting rifle, put it under her chin and pulled the trigger.

"I screamed, 'Katie, no!' Ad my mom tried to walk in. I pushed her out," Robert Stubblefield said. "She was dead as far as I was concerned."

Alesia called her husband at work to share tell him Katie was gone. Robb rushed over to the house, where first responders initially feared the worst. But suddenly there was hope.

"They get in there, and the next thing we hear, through a chain of voices, is, 'She's alive. We have a pulse,'" Robb Stubblefield said. "And just like that, the whole world turned on a dime."

Katie was rushed to the emergency room. Somehow, she could still speak.

"When she was in that ER ... she said, 'Tell my mom and dad I love her -- love them. I'm sorry,'" her father said. "It took a lot of strength."

Not knowing if she would make it, doctors began reconstructing Katie's disfigured face. From the first night she was brought into the hospital, Robb Stubblefield said the trauma surgeon told them a face transplant would be her best chance at normalcy again.

"He said, 'This is the worst wound I've ever seen, and I think the only thing that will give her any kind of life again will be a face transplant,'" Stubblefield said. "That was the first time we'd ever heard that term."

After a month at a trauma hospital in Memphis, Katie was transferred to Cleveland Clinic. Plastic surgeon Brian Gastman was the first to see her. He said at the time that he was not confident Katie would survive, but he was impressed by her will to live.

"Katie was a fighter. I think this was a unique, singular event in her life, and she was willing to overcome it," Gastman said. "Not just to be alive, but to live her life."

Cleveland Clinic is where the first face-transplant surgery was performed in the U.S., led by the hospital's plastic surgery chair, Frank Papay, in 2008. The team has learned a great deal about this type of surgery since then. Before Katie's case, the hospital had performed two other face transplants.

"And we learned a lot about what it takes," Papay said. "Not just the surgery of a face transplant, but thereafter. What it takes to monitor these patients. What it takes for the family and support group to help monitor these patients. "

Gastman was part of the team that performed Cleveland Clinic's second face transplant. He said Katie's not the first transplant patient who had attempted suicide.

"Being 17, 18 years old, without any history of depression, with having the type of family support that she has, it seemed that she just did something impulsive," he said. "We see people doing impulsive things all the time, we just don't hear about it as much, because they don't end up in Katie's situation and then lead to something as fantastic as a -- as a face transplant."

When Katie first arrived in Cleveland four years ago, she and her family moved into the Ronald McDonald house to be close to the hospital for Katie's constant care, including more than 17 surgeries before her face transplant.

For one of those operations, doctors made a 3D model of Katie's sister's jaw to help them reconstruct her face.

The surgical team also took skin from her leg to help reconstruct her nose. All the while, they waited for a donor face to become available.

Katie could have survived with the face the team was able to reconstruct for her, but she wanted to feel normal again, even if that mean risking serious complications -- or even her life.

In March 2016, she was officially placed on the face-transplant list. She and her family waited patiently.

"She said, 'Well, then I'll just have to get the best reconstruction and I still want to live,'" Robb Stubblefield said. "She didn't just want a face back. She wanted function ... her life back."

Two years ago, National Geographic began documenting Katie and her family as they awaited a donor for their September cover story, "Katie's Face."

In May 2017, after a year of being on the transplant list, a potential donor came through.

Her name was Adrea Schneider, a 31-year-old single mother who had struggled with addiction and died of an overdose.

"Based on all her facial characteristics, her size, age and her basic orthology, she’s a very good candidate," Gastman said. "She's a 31-year-old, about nine years older than Katie, individual, a good-sized match."

Schneider had been raised by her grandmother, Sandra Bennington, who had to make the profound decision of donation. Schneider was registered as an organ donor, so Bennington agreed.

"If Adrea was willing to donate her organs, why would she need a face?" Bennington told National Georgraphic. "I still wrestle with that every now and then, it was something. I don't know. But this is the right thing to do so that someone else can have maybe a better life. That's what made my decision."

The day before Katie's operation, the surgical team, made up of more than 50 personnel including 11 surgeons, met to walk through the procedure.

Katie thanked Gastman for giving her a second chance at life before was wheeled into surgery on May 4, 2017. The planned 30-hour surgery was supposed to be for a partial face transplant, but around hour 24, the team felt confident it could move forward with a full transplant.

Gastman and Papay asked Katie's parents for permission to attempt the full face transplant before proceeding. Robb and Alesia Stubblefield had to weigh what their daughter would want a completely new face, as opposed to just a portion. They decided to go for a full face, and the surgical team went for it.

After 31 hours on the table, with intricate nerve endings and blood vessels restored, Katie finally had her new face. Her parents and brother were able to visit her in recovery afterwards, and see their daughter’s new face for the first time.

"I knew she wasn't going to look like her old self anymore with that, but I was still -- I was speechless," Robert Stubblefield said.  

Katie said she doesn't remember her life-changing accident. But now, after more than a year of grueling rehab, Katie still has a long way to go.

"When I touch my face now with my hand, I feel whole again," she told "Nightline." "I wanted my face back, and I was willing to whatever it took to get my face back."

"Before my transplant, people looked at me like I was disgusting," Katie continued. But now "I can go out in a crowd, and people will just see me as another person and not as some kind of monster."

Katie is still adjusting to life with a new nose and lips -- and a new outlook. Now 22, she still doesn’t have her vision back, but she said it's improving.

"I think that I see shadows -- silhouettes, figures," she said.

Four years after first arriving in Cleveland, the Stubblefields still live in the Ronald McDonald house. Her parents oversee everything with Katie, from her therapy to her anti-rejection medications. But through the ordeal, it’s clear to them that Katie has never lost her essence -- and her wicked sense of humor.

"Obviously," Robb Stubblefield said, "she does not look like her old self, but her actions, her personality, her interests and everything are very much the old Katie."

Katie still has to undergo more procedures, including getting a new palate, which will enable her to improve her speech. But the health risks of being a face-transplant recipient are never far away.

Just last month, Katie was rushed to the emergency room at Cleveland Clinic because her feeding tube had fallen out, leaving her with a painful wound on her side.

There are also the extensive medical costs, which are in excess of $1 million. Katie's operation and much of her care are being covered by the Department of Defense as part of its research to find ways of helping wounded soldiers. Since it’s still an experimental procedure, insurance does not cover any of the costs related to Katie's face transplant.

"The type of wound she had, where it was located, the age factor, is just so classic of what these soldiers go through,” Robb Stubblefield said.

Katie did get the chance to thank her donor’s grandmother in person for giving her a new chance at a better life. Dr. Gastman said his hope for Katie is that she continues to get better so that she can help others. According to the CDC, suicide is the third-leading cause of death for young people between the ages of 10 and 24, at about 4,600 per year.

“My hope for her is that her articulation improves, and she can get up there and tell that story,” Gastman said. “A fleeting moment can lead to something so devastating, not just for yourself, but for your family, and you're seeing somebody who survived it.”

Katie now sees her life as a cautionary tale for preventing suicide. She hopes in the future she will be able to go into counseling or teaching.

“I really truly want to help everything in any possible way that I can,” she said. “Life is an amazing gift. Life's beautiful. ... Find someone to talk to, someone who will listen to you because life is a wonderful gift.”

Copyright © 2018, ABC Radio. All rights reserved.


Majority of American teens say they are cyberbullied, Pew study finds 

iStock/Thinkstock(NEW YORK) -- A majority of American teenagers say they have been bullied or harassed online, and teenage girls are more likely to be targeted for certain types of cyberbullying, according to a comprehensive new study from the Pew Research Center.

While traditional forms of bullying have been around for as long as time, 59 percent of teens in the U.S. say they have also personally experienced cyberbullying, according to the Pew study published today.

The study defined cyberbullying as offensive name-calling, spreading of false rumors, receiving unsolicited explicit images, constant inquiries about where they are or what they are doing by someone other than a parent, physical threats or having explicit images of them shared without their consent on a computer or their phones.

The results were from taken from surveys of 743 teens (between the ages of 13 and 17) conducted between March and April of this year.

While overall boys and girls say they have been cyberbullied at similar rates (60 percent of girls, 59 percent of boys), when breaking down the different categories of online harassment, researchers found girls were more likely to be targets of online rumor-spreading and the receiving of unsolicited explicit images.

Perhaps most interestingly, however, was the finding that a majority of teens (79 percent) said they don't think elected officials are doing a good job at addressing online harassment.

The study comes as first lady Melania Trump is using her platform to speak out against cyberbullying, despite the fact that her husband has become notorious for using his Twitter handle to go at others.

At a summit last month, the first lady spoke out about her "Be Best" initiative, which focuses on children's wellness, especially related to their behavior online.

“Let's face it, most children are more aware of the benefits and pitfalls of social media than some adults,” she said, and called on adults to listen to young people about the issues they face online.

“By listening to children's ideas and concerns, I believe adults will be better able to help them navigate these often difficult topics,” Trump said. “But we still need to do all we can to provide them with information and tools for successful and safe online habits.”

If parents are concerned that their teen is being cyberbullied,, a website managed by the U.S. Department of Health and Human Services recommends they take time to investigate their child's digital behavior.

First, parents can notice if their child has had a change in mood or behavior. Next, initiate a conversation about what is happening. Document what is happening by taking screenshots of online harassment. Finally, many social media platforms and school have clear ways you can report cyberbullying.

Copyright © 2018, ABC Radio. All rights reserved.


Gym for pregnant women gives moms a safe place to workout, build a community

ABC News(NEW YORK) -- At one gym in New York City, you will find a group of women who all have something in common: They are either pregnant or have newborns.

The gym, Fit Pregnancy Club, or FPC, focuses exclusively on helping pregnant and postpartum women exercise safely in a supportive, welcoming environment.

It is the brainchild of two moms, Carolina Gunnarsson and Joanie Johnson, who saw a problem and created a solution.

Gunnarsson, a mom of three, was scared to exercise during her first pregnancy and ended up gaining more weight than she planned. She also had a difficult labor and delivery. For her second pregnancy, she said she hired a personal trainer, but ended up with postpartum complications as a result of her workouts.

By the time of her third pregnancy, Gunnarsson had been introduced to Johnson, a former professional dancer and personal trainer, through a mutual friend.

Gunnarsson said the difference between her first two pregnancies and her third, during which she trained at FPC under Johnson's guidance, was "night and day."

"Coming out of this pregnancy, I was in better shape than I have been in my entire life," she said. "I was doing classes up until the day I gave birth, and feeling great with no pain."

Johnson noticed when she was pregnant with her daughter, now 2, the lack of safe workouts available to pregnant women, in addition to a lack of information.

"Women are just accepting, 'Oh, I’ve had a baby. I have to pee my pants every time I sneeze,' or 'I just have to deal with this pain,'" she said. "We have so much re-educating to do that, no, this is not the norm and we can prevent it."

Johnson used her own research and fitness background to develop her own workout, which is now FPC’s signature workout.

"It's a total-body workout that is low-impact and high-intensity," she said. "It's a way to strategically strengthen the muscles that you need for an easier pregnancy, better delivery and more complete postpartum pregnancy."

The key focus at FPC, according to Johnson, is on a low-stress way of breathing, using the diaphragm.

"It's about moving with a different intention and focusing on your core and pelvic floor as opposed to just going into class and cranking it out and sweating and forgetting about your body," Johnson said. "Everyone really should be using these breathing and moving mechanisms that we're teaching these women."

The instructors at FPC not only have fitness backgrounds, but also specialties in pregnancy. Among them are three doulas, a pelvic floor specialist, a childbirth educator, a prenatal nutrition specialist and a lactation counselor.

"Prenatal certification for trainers is not enough," Johnson said. "We're really training women to move at a functional level and retraining their breathing mechanism and the way they’re activating their core."
Is a gym for pregnant women necessary?

Physical activity during pregnancy is endorsed and supported by the American College of Obstetrics and Gynecology, so a place where women can feel they are doing it safely and being supported is a "fantastic idea," said Dr. Jennifer Aquino, clinical assistant professor in the Department of Obstetrics and Gynecology at NYU Langone Health.

"Often times, I feel like pregnancy is treated like this crazy disease," she said. "I often have patients who will say, 'I went to the gym and they told me I should get on the bike.'"

Aquino added, "I tell patients, 'If you exercise on a routine basis, you can continue to exercise at the same level you normally do."

Women who did not exercise routinely before pregnancy are safe to start, but should exercise with a moderate intensity that allows them to talk at conversational pace, according to Aquino.

A pregnancy-specific gym like FPC can play a "super important" role in helping reduce anxiety in pregnant women, Aquino noted.

That was the case for Dr. Rachel Goldman, a New York psychologist who is pregnant and attends FPC classes.

"I've seen huge progress in my confidence," she said. "Whenever I go to the gym and I do my workouts I always kind of question myself. 'Am I doing this safe? Is it effective? Is it OK?' And here, there is no question about it."

Goldman added, "Things that I'm learning in the class, I’m actually taking home to do on my own, to practice, which I know is going to help me have an easier labor and delivery."

No matter where they are exercising, pregnant women should remember to stay well-hydrated and eat a snack before a workout. Exercise should be stopped if she feels symptoms like dizziness, painful contractions, headaches or weakness, according to Aquino.

Pregnant women should check with their doctors before starting any exercise routine and should avoid strenuous exercise if they have conditions that make it unsafe, she added.

"It's really individual," Aquino said about developing a pregnancy exercise routine. "Women often have questions regarding safety for the baby and the baby can tolerate the mom doing a strenuous exercise really well for 30 minutes or so."
Gym becomes a community for women

In addition to providing a safe and effective place to workout, FPC has become a place where new moms and pregnant women can socialize and learn.

"The goal is for us to be empowering these women and strengthening their bodies for motherhood, but they’re also getting this really amazing community out of it," Johnson said. "They can ask all their questions and they feel supported."

FPC hosts workshops on childbirth, breastfeeding, postpartum recovery and more.

"We get a lot of moms who are pregnant for the first time and are kind of scared about what they can and cannot do because there is just so much information out there," said Gunnarsson. "We feel like we have a huge job to educate and hopefully change something along the way."

Clients often take a class and then stick around to talk with other expectant or new moms, according to Johnson and Gunnarsson.

"FPC isn't just a gym, it's a fabulous community," said Goldman, the FPC client. "I've met so many new moms throughout different stages that they’re in. I've also really gotten to know some of the instructors and it's just very warm and a welcoming environment that I hope to continue to come even after my pregnancy."

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When moms use marijuana, kids try it at a young age: Study

iStock/Thinkstock(NEW YORK) -- The children of mothers that use marijuana are more likely to try the drug at a younger age, according to a new study.

The study, published in the American Journal of Preventive Medicine, looks at how a mom’s cannabis use affects the age at which her children first try it. As states and municipalities across the country have been legalizing marijuana use in recent years, moms who use cannabis for recreational or medical reasons are left to wonder about potentially hazards to their children.

Dr. Natasha A. Sokol, social epidemiologist at Brown University and lead author of the study, explained to ABC News that that there is some evidence that connects the legalization of marijuana with increased frequency of parent marijuana use.

“We’ve seen this relationship mimicked in tobacco use,” Dr. Sokol added.

Sokol and colleagues analyzed two large-scale national surveys conducted by the U.S. Bureau of Labor Statistics. The first survey was originally given to young women ages 14 to 21 between 1980 and 1998. The second was given to the children of those women every year between 1988 and 2014.

The surveys asked about a variety of health behaviors, and explicitly asked questions about cannabis use, such as:“How old were you when you first used marijuana?”

According to the study, mothers who used cannabis during the first 12 years of their child’s life had children that began using cannabis earlier. Even when moms used cannabis for less than a year, their child was 36 percent more likely to try marijuana, compared to the children of moms who never used it. For mothers who used cannabis for more than a year, that likelihood rose to 44 percent.

Kids who were never exposed to cannabis use through their mothers tried marijuana for the first time at an average age of about 18-years-old. Kids with childhood exposure to maternal cannabis use started their own marijuana habits two or more years earlier.

“Parents tend to be the most influential people in a child’s life,” said Dr. Sokol. “The potential changes in social norms may be linked to this early initiation seen in children.”

Medical marijuana can have several positive effects, but prior studies show negative cognitive and psychosocial effects of cannabis use in young adults. In some cases it is connected to increased anxiety and depression, psychosis, mood disturbances, and developmental delays. More controversially, the behavioral effects of cannabis use have been linked to substance dependence -- marijuana is the second most common drug for which adults seek substance abuse treatment.

Dr. Sokol acknowledged the public health implications of the study, noting that successful intervention models have involved both parents and their children.

“Parents can be counseled on how to talk to their kids about marijuana use, which can be helpful in delaying initiation,” said Sokol.

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'Daddy, help me, I can't breathe': Family blames mislabeled food for death of 15-year-old with sesame allergy

Spencer Platt/Getty Images(LONDON) -- Two years ago Natasha Ednan-Laperouse suffered a fatal allergic reaction after eating a Pret a Manger sandwich that her family says did not list one critical ingredient: sesame.

Natasha, 15, was allergic to sesame.

This week, the West London Coroner's Court will hear from her family, British Airways and Pret a Manger.

There are two central questions: Was the allergen information listed correctly? And who is to blame for Natasha's death?

On July 17, 2016, Natasha ate an artichoke, olive and tapenade baguette sandwich from Pret a Manger in London's Heathrow Airport while waiting for her flight to Nice, France, with her father, Nadim Ednan-Laperouse, and her best friend. According to a statement from her father, read in court Monday by the family's lawyer, Jeremy Hyam, she fell ill about 20 minutes later on her British Airways flight.

After Natasha broke out in hives "like a jellyfish sting" and complained of an itchy throat, her father administered the first EpiPen injection to her leg, according to the statement.

"Natasha said that she still couldn't breathe and desperately looked at me, she said 'Daddy, help me, I can't breathe,'" her father said.

When her symptoms failed to improve, her father said he administered a second EpiPen injection, also to her leg. Natasha fell unconscious on the flight and was pronounced dead in a hospital in Nice a few hours later.

According to EU regulations, sesame is one of 14 allergens that must be listed on food products made off premises.

But EU rules also say that each country has some leeway in how it communicates information for freshly made food, and UK regulations don't require freshly made, non-pre-packaged food to be individually labeled.

In a statement, Pret said the individual sandwich would not have been labeled with allergen or ingredient information. But the company said there are signs that tell consumers with allergies to speak to managers for additional information. The family's lawyer also questioned the Heathrow branch manager on Monday about the specific stickers that should have been in place around the shelves and cash registers.

On Tuesday, Jonathan Perkins, director for risk and compliance of Pret, testified in court.

"I don't accept that allergy signage was failing," he said, admitting that the company has made alterations to the way it provides information since Natasha's death.

Perkins clarified that the company is "not legally obliged to label each individual package."

A Pret spokesman said in an earlier statement: “We were deeply saddened to hear about Natasha’s tragic death, and our heartfelt thoughts are with her family and friends. We take food allergies and how allergen information is provided to our customers extremely seriously. We will continue to do all that we can to assist the coroner’s inquest.”

There have been nine cases of sesame-related complaints from Pret and four of those required hospital treatment, according to Hyam.

In a statement, Natasha's family described her as a popular, mature and fun-loving girl who enjoyed horseback riding and ice-skating.

"As a family of four, we had a very close relationship. Our home was quite noisy with laughter, joking and teasing. As a teenager Natasha was always open with us and would readily talk to us about any problems she may be experiencing and would ask us for our advice. She had a strong moral compass and often showed maturity beyond her years."

Her father also said Natasha had dealt with allergies for years and "put her trust in food labeling."

"I was stunned that a big food company like Pret could mislabel a sandwich and this could cause my daughter to die, he said.

Holly Shaw, a nurse adviser to Allergy UK, a non-profit that provides support, resources and advice to those living with allergies, emphasized that effective communication can save lives.

"Especially with young adults," Shaw told ABC News. "When they're at that risk-taking age, susceptible to peer pressure, it's so important that they feel empowered and confident to ask those questions and talk to their friends about it."

She went on, "The food provider, whether a grocery store or a cafe, needs to be able to provide accurate and consistent information. It's where those chains have broken down that there are problems."

The inquest is expected to last five days.

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Bride on honeymoon paralyzed by monster wave

Family Handout(HONOLULU) -- It was supposed to be a dream wedding. Instead, for Nikki and Will Lewis, their honeymoon in Hawaii turned into a nightmare when a monster wave crashed onto Nikki and left her paralyzed.

The newlyweds were bodyboarding on Maui's Big Beach, in Makena State Park, a few days after their wedding earlier this month, when the wave, at least 6 feet high, slammed her into the ground and engulfed her completely, JaMikal Moorer, one of her best friends, told ABC News.

"I lost sight of her for a good bit," said Moorer, who was watching, aghast, from the beach. "It was probably five to 10 seconds, but it felt like time had stood still. I was saying in my head, 'Get up, get up.' Once the water receded, we saw her lying headfirst in the sand with her body kind of crunched up and the water flowing over her body."

Will rushed to her aid, as did Moorer, another friend, and a bystander who happened to be a paramedic. They brought her out of the water, trying to keep her neck straight, but her spine was already broken in two places and she couldn't move or speak.

"You could just tell her eyes were asking for help," Moorer said.

Later, when she was able to speak, Nikki would recount the helplessness and terror of those moments when she was lying on the ocean floor, unable to swim toward the surface or breathe, Will said.

The beaches in Makena State Park have a reputation both enticing and menacing. They are popular with surfers and bodyboarders for their beauty and shore break, which creates big waves to ride on. But they are also the most dangerous among Hawaii's 48 beaches -- 22 people ended up in hospital from there with spinal-cord injuries between 2009 and 2013, more than at any other beach, according to Hawaii's Trauma Registry.

Nearly two weeks after her accident, Nikki remains in a hospital in Honolulu, slowly recovering movement in the extremities of her body and gaining strength in her legs. Her husband says he's thankful for the progress she's made -- most people with her injuries never make it off a respirator.

Nikki's family and friends are now trying to raise funds to help transport her home to Texas, where she can be cared for by loved ones and be reunited with the couple's three children.

In photos and videos posted by her family on Facebook, despite being confined to a bed with her neck strapped in a brace, Nikki often smiles and laughs.

"Her upbeat personality is what is getting us through it," Will said. "Don't get me wrong, there are lots of tears, but she's doing her best to recover, she's giving it her 100 percent. We both miss our kids and just want to be back with them."

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