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Your Baby

Which Fish is Healthier for Pregnant Women?

1:45

New federal nutrition guidelines say that pregnant and breastfeeding women should eat 2 to 3 servings of fish every week. However, there are certain fish that should be eaten only once per week and other fish that should be avoided entirely by pregnant and nursing women.

One reason for the differentiation between certain types of fish is its likelihood of containing either very low or high levels of mercury.

Nearly all fish and shellfish contain traces of mercury. But some contain high levels.  A type of mercury called methylmercury is most easily accumulated in the body and is particularly dangerous.

Eating large amounts of these fish and shellfish can result in high levels of mercury in the human body. In a fetus or young child, this can damage the brain and nervous system.

The highest mercury concentration belongs to fish that typically live a long time. Pregnant and breastfeeding women should avoid King mackerel, Marlin, Orange roughy, Shark, Swordfish, Tilefish from the Gulf of Mexico and Bigeye Tuna. These are fish that usually contain high levels of mercury.

The new guidelines come with a handy chart that gives you the best choices of fish, good choices and fish to avoid.

Naturally, many pregnant women are concerned about eating fish after hearing about the possibility of consuming any mercury whatsoever. It’s important to remember that most of the fish consumed by Americans falls into the safe category.

Studies show that fish provide an array of nutrients that are important for your baby's early development. Most experts agree that the key nutrients are two omega-3 fatty acids – DHA and EPA – that are difficult to find in other foods. Fish is also low in saturated fat and high in protein, vitamin D, and other nutrients that are crucial for a developing baby and a healthy pregnancy.

How do fish end up consuming mercury? Some of the sources (such as volcanoes and forest fires) are natural. It's also released into the air by power plants, cement plants, and certain chemical and industrial manufacturers, landfills and farming runoff.

When mercury settles into water, bacteria convert it into a form called methylmercury. Fish absorb methylmercury from the water they swim in and the organisms they eat. Methylmercury binds tightly to the proteins in fish muscle and remains there even after the fish is cooked. Fish that live a long time consume more mercury.

There are many benefits to eating fish; you just need to be aware of the kinds of fish you eat. To help you make the best choices, the new chart released by the FDA and EPA is shown below.

Story sources: Megan Thielking, https://www.statnews.com/2017/01/19/fda-guidelines-fish/

http://www.babycenter.com/0_eating-fish-during-pregnancy-how-to-avoid-mercury-and-still_10319861.bc

http://www.fda.gov/downloads/Food/FoodborneIllnessContaminants/Metals/UCM536321.pdf

Your Teen

Knee Surgeries Increasing for Female Teen Athletes

2:00

In 1972, Title IX of the Education Amendments Act was passed. The law requires educational institutions to maintain policies, practices and programs that do not discriminate against anyone on the basis of gender. 

Young women and girls were given the opportunity to equally participate in school sports programs and receive athletic scholarship money proportional to their participation.

It was a monumental advancement for young girls and women, but along with opportunity came injuries.

A growing number of teenage girls are joining their male counterparts on the operating table to repair torn knee ligaments, according to a new study.

Researchers focused on surgery for a common knee injury known as an anterior cruciate ligament (ACL) tear, which has long been linked to intense participation in sports like basketball and soccer which require constant pivoting as well as contact sports like football.

The study of private insurance data for 148 million U.S. residents found that overall, the average annual ACL surgery rate climbed 22 percent from 2002 to 2014, when it reached 75 procedures for every 100,000 people.

For teen girls, however, the average annual knee surgery rate rose by 59 percent during the study period to 269 procedures for every 100,000 people. 

“Although there are proven ACL injury prevention programs available, they are not being widely adopted, particularly among young women,” said lead study author Mackenzie Herzog of the University of North Carolina at Chapel Hill.

The study didn’t focus on why the injuries are happening, but Herzog noted a few reasons why he thinks the increase in injuries might be happening in youth sports.

“Two particular trends that concern us are increased trends toward year-round sports participation at a young age and the tendency to specialize in one sport early,” Herzog said.

For teen boys, the average annual knee surgery rate climbed 44 percent during the study period to end at 212 procedures for every 100,000 people, researchers report in JAMA Pediatrics. 

Surgery rates also rose faster for women than for men, although adult male athletes still had more procedures. By the end of the study, 87 men and 61 women out of every 100,000 people had ACL surgery each year.

In an email to Reuters, Dr. Devin Peterson, a researcher at McMaster University in Hamilton, Ontario, who wasn’t involved in the study, said cross-training programs that include exercises to improve strength, balance, coordination and muscle control could help prevent ACL tears.

Pediatric sports medicine expert R. Jay Lee, offers these tips and more from the Johns Hopkins Medicine website:

Get a preseason physical. A preseason or back-to-school physical is a great way to determine if your young athlete is fit to play. “Sports physicals help assess any areas of concern for athletes before they start an activity, and in turn keeps them from further injuring themselves during play if a condition is present and needs to be treated,” says Dr. Lee.

Encourage cross training and a variety of sports. “I see kids today who play on two baseball or lacrosse teams on the same day or throughout the week and year. But it’s important for athletes to change the sports or activities they are doing so they are not continuously putting stress on the same muscles and joints,” warns Dr. Lee. Parents should consider limiting the number of teams their athlete is on at any given time and changing up the routine regularly so that the same muscles are not continuously overused.

Warm up before the sports activity. Stretching is an important prevention technique that should become habit for all athletes before starting an activity or sport. Dr. Lee suggests a mix of both static and dynamic stretching during warmups to help loosen the muscles and prepare them for play. Toe touches and stretches, where you hold the position for a certain amount of time, are considered static, while jumping jacks and stretches, where the body continues to move during stretching, are considered dynamic.

Make sure the proper equipment is used. Protective equipment, like helmets, pads and shoes, are very important for injury prevention. Parents should talk with coaches before the season starts so that they have adequate time to properly outfit their child before practices begin.

Recognize injury and get help quickly.  “I’ve seen a number of young athletes who have serious injuries and didn’t do anything about them, and now the damage has progressed,” Dr. Lee warns. “We need to get these kids in to see a doctor earlier to keep this from happening.”

If parents notice that there is a change in their athlete’s technique, such as a limp when running, throwing differently or rubbing a leg during activity, they should pull the athlete out of play. If the problem persists, parents should seek an assessment for their child prior to returning to the activity.

Dr. Lee warns: “Athletes will alter the way they do things because of pain, but then they can end up with a more serious injury because of it.”

Story sources:  Lisa Rapaport, http://www.reuters.com/article/us-health-acl-surgeries-girls-idUSKBN1952SE

http://www.hopkinsmedicine.org/health/articles-and-answers/prevention/10-tips-for-preventing-sports-injuries-in-kids-and-teens

 

Parenting

Have a Family Plan for Disasters

2:00

Would your family members know what to do if faced with a disaster?  Thousands of families learned the answer to that question with the recent hurricane catastrophes. 

"The biggest issue that we as first responders run into is that people fail to plan. Then things that could have been simple issues become big problems," said Scott Buchle, program manager for Penn State Health Life Lion EMS. The emergency service operates throughout south central Pennsylvania.

While hurricanes may be somewhat limited in their geographical impact, other types of disasters are far more common. Countless Americans live in areas prone to blizzards, wildfires, tornadoes or earthquakes. Even severe thunderstorms or ice storms can bring flash floods or widespread power outages. 

Having a plan on what to do if faced with any of these disasters can save lives, as well as lower the amount of anxiety and unpreparedness that comes with a natural or man-made calamity.

If you live in an area where the weather can challenge your safety, you should have enough water, non-perishable food, medications and a medication list, battery backups, a generator and other supplies to get through 48 to 72 hours, Buchle said in a Penn State news release.

Research your neighborhood and find out how close fire and police stations are.  Do you know in what direction you would need to go to find higher ground, where a tornado shelter is located or an emergency room? Is there a municipal building with a generator nearby?

Discuss and come up with a plan with your family the best way to respond during an emergency. Have a contact list of state and federal emergency agencies, and decide where you will meet up if separated.

You should also understand how your house is built and where you can go to be safe in case of flooding or a tornado. Many homes these days are “open concept” and don’t have sheltered inner rooms. Consider purchasing a tornado shelter if you live in areas prone to tornados.

"You also need to know who your emergency contacts are and the numbers," says Russell Knapp, supervisor of fire safety for the Penn State Health Medical Center campus.

What if you lose your cell phone – would you know the numbers off the top of your head? A laminated contact list that is in your wallet or purse is helpful to have when faced with an emergency.

It's also important to keep a current list of medications you take, the dosage, and how often you take each one, in case you have to seek safety in a shelter.

"You can give that [information] to people who can help you get the medicine you need," Buchle said.

People who use home medical equipment that requires electricity should consider what they would do if the power is out for several days. Plan ahead and if necessary have a generator and fuel on standby.

If you require medications that must be refrigerated, keep a cooler and ice packs on hand in case of power outages, these experts suggested.

Families with young children can also have a stash of diapers, formula, bottles, clean water and wipes ready to grab and run.

And don’t forget the pets. For many people, these animals are part of the family. Keep an adequate supply of pet food on hand and extra kitty litter.

In the middle of an emergency is not the time to try and find all these things. Have a separate location where your emergency supplies are located and in bags, ready to grab and leave with. Most of these supplies can be packed; medicines will need to be easily accessible.

Having an emergency plan that everyone is aware of in case of a disaster can help immensely when time is of the essence.

Story source: Robert Preidt, https://consumer.healthday.com/public-health-information-30/safety-and-public-health-news-585/how-would-your-family-weather-a-disaster-726589.html

Parenting

New Year Resolutions for the Family

2:00

As 2015 closes its tired eyes, 2016 is ready for full steam ahead! The beginning of a new year is often the time when people take stock of where they’ve been and where they want to go. It’s a great time for families to set new goals and discuss what is important to them.

Resolutions do not need to be difficult or overwhelming. In fact, the simpler the resolution, the better.

One small step at a time and before you know it 2017 will be here and your family will have accomplished more than they thought they would!

If you’re searching for ideas, here’s a list of suggestions.

1.     Spend one day out of the week unplugged from any unnecessary electronics or social media. Cell phones and computers have become a necessity these days, but too often they are overused for texting, social media and mindless Internet searches. Set a goal of spending at least one day a month (if not per week) without your gadgets, and instead, enjoy the outdoors or have a board or card game marathon.

2.     Commit to better eating schedules and choices. Healthy eating habits provide benefits for the whole family. Ask for your kids input when planning meals and discuss ways to make everyone’s choices healthier. Positive discussions about health and food can have a big impact on a child’s lifetime eating habits.

3.     Plan family outings that involve exercise. Make it fun and easy. Daily walks, bicycling, swimming even an indoor dance party can get everyone moving without a lot of expense.

4.     Read with and to your kids. Libraries are great places for young children to experience new books and reading programs. A whole new genre of books have peaked an interest in reading for many teens. Summer is a great time to start a family book club, when the kids don’t have homework competing for their time.

5.     Spread the household responsibilities. Having a system for household responsibilities spreads out the work instead of having it all fall on one person. Try keeping a chore jar with slips of paper for kids to pick which chore they'll do that week, such as taking out the trash. Print out this chore chart and put it on the refrigerator or a clipboard to help your family stay on task.

6.     Teach and reflect kindness. Kids learn how to be kind by their parent’s example. Bring unkind or rude comments to your child’s attention. Discuss how to handle frustration or angry feelings. Most of all, exhibit kindness towards your mate and others. Teach compassion through community service when an organization needs volunteers. Children who volunteer to help others in need have a broader view of the world.

7.     Get more sleep! The fact is, you all need at least eight hours of sleep to stay healthy and productive. Some children need more than that. Make sure bedtime is quiet and computers and cell phones are shut down at least an hour before bed.

8.     Teach your children how to manage money. Have them create a budget with their allowance or gift money and help them stick to it. Again, being a good example not only helps the whole family’s budget, but also teaches children the difference between want and need.

Also don’t forget to take a little time out for just you and your spouse. The occasional date night can help you reconnect and have fun together. Being a parent is hard work – one of life’s most demanding and rewarding. Don’t forget that you need to take care of yourself emotionally, physically and spiritually to be the example you want to be.

Have a Happy New Year!

Source: Erin Dower, http://life.familyeducation.com/slideshow/new-years/67775.html

Image: http://colongan.xyz/happy-new-years-eve-2016/happy-new-years-eve-happy-holidays/

Your Baby

No Link Found Between Induced Labor and Autism

1:30

In 2013, a study suggested there might be a link between induced labor using a medication such as oxytocin, and a higher risk of the baby developing autism.  New research out of Boston, Massachusetts says there is no connection between the two.

"These findings should provide reassurance to women who are about to give birth, that having their labor induced will not increase their child's risk of developing autism spectrum disorders," said senior researcher Dr. Brian Bateman. He's an anesthesiologist at Massachusetts General Hospital and Brigham and Women's Hospital in Boston.

Induced labor is sometimes needed when a mother’s labor stalls or the infant is endangered. Because of the former study, many women have had concerns about labor induction and the risk of autism.

Bateman's team of American and Swedish researchers, led by the Harvard T. H. Chan School of Public Health, decided to investigate the issue.

They used a database on all live births in Sweden from 1992 through 2005, and looked at child outcomes for more than 1 million births through 2013, to identify any children diagnosed with a neuropsychiatric condition.

They also identified all the children's brothers, sisters and cousins on their mother's side of the family. The health of the children's mothers was also taken into account.

Eleven percent of the inductions were due to health complications such as preeclampsia, diabetes or high blood pressure. Twenty-three percent were induced because of late deliveries (after 40 weeks of pregnancy).

Results showed that 2 percent of the babies in the study were later diagnosed with autism.

When just looking at unrelated children, the researchers did find a link between induced labor and a greater risk for an autism spectrum disorder. This association disappeared, however, once they also considered the women's other children who were not born from an induced labor.

"When we used close relatives, such as siblings or cousins, as the comparison group, we found no association between labor induction and autism risk," said study author Anna Sara Oberg, a research fellow in the department of epidemiology at the Harvard Chan School.

Explaining further, she said in a university news release, "many of the factors that could lead to both induction of labor and autism are completely or partially shared by siblings -- such as maternal characteristics or socioeconomic or genetic factors." Therefore, Oberg said, "previously observed associations could have been due to some of these familial factors, not the result of induction."

Other experts have agreed with the new study’s findings.

"Pregnant women have enough things to worry about," said Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Cohen Children's Medical Center of New York, in New Hyde Park, N.Y.

"If a woman's doctor recommends that labor be induced, the expectant mother should not worry about an increased risk of the child having an autism spectrum disorder," Adesman said.

If you have concerns about a connection between labor induction and autism, speak to your OB/GYN to learn more. 

The study was published in  in the July 25th online edition of JAMA Pediatrics.

Story source: Mary Elizabeth Dallas, https://consumer.healthday.com/cognitive-health-information-26/autism-news-51/induced-labor-won-t-raise-autism-risk-in-kids-study-suggests-713155.html

 

Your Baby

Mom and Baby Benefit by Skin-to-Skin Contact Right After Birth

1:30

Over the years, modern birth methods have changed how newborns and mothers interact with each other. Typically, the baby is cleaned up and wrapped in a blanket then given to the mother to hold. A new scientific review suggests that skin-to-skin contact is better for the mother and gives her infant a better start in life.

The review noted that women who had skin-to-skin contact with their naked babies soon after delivery were more likely to breastfeed longer and be breastfeeding months later than women who didn't have their babies placed on their skin right away.

"The more you can do to place the mother and baby together and disturb them as little possible during that first hour, the better off they’ll be," said lead author Elizabeth Moore, of the School of Nursing at Vanderbilt University in Nashville, Tennessee.

Researchers looked through medical literature and found 46 randomized controlled trials to include in their review. The trials included 3,850 women and their newborns from 21 countries. All babies were healthy and most were born at term.

"We compared those trials to usual care, and usual care was very different depending on the trial," said Moore. Trials from the 1970s may have separated mothers from their babies for hours. In more modern trials, babies might be swaddled in a blanket before being handed to the mother.

Moore and her team found evidence that babies who had received skin-to-skin contact were more likely to breastfeed successfully during their very first breastfeeding session, and they also tended to have higher blood glucose levels and stronger heart and lung function.

 “It’s just something that if at all possible should happen," Moore told Reuters Health.

Skin-to-skin contact should begin as soon as possible and last for at least 60 minutes, she said. The hour will give babies time to recover from the birthing experience, find the mother's nipple and latch on.

"It’s not something you can do in just 15 minutes," Moore said.

Not all physicians and hospitals are on board when it comes to immediate skin-to-skin contact after birth.

“I would recommend that a woman make sure she adds skin-to-skin to her birth plan," Moore said. "I think it’s a really good thing for a woman to put together a birth plan before she heads to the hospital and show it to her physicians or midwife."

What if your baby is premature or is delivered by cesarean? The researchers didn't find any benefits to initiating skin-to-skin contact immediately after birth versus after the baby had been examined and washed. They also failed to find any clear benefits to skin-to-skin contact that lasted longer than an hour.

"The evidence supports that early [skin-to-skin contact] should be normal practice for healthy newborns," the researchers wrote, "including those born by cesarean and babies born early at 35 weeks or more."

The review was published in the Cochrane Library in November. 

Story sources: Andrew M. Seaman, http://www.reuters.com/article/us-health-birth-skin-idUSKBN13V2UZ

Kenza Moller, https://www.romper.com/p/why-skin-to-skin-contact-after-birth-could-be-beneficial-for-mothers-babies-alike-24423

 

Parenting

Host A CPR Party!

2:00

Many of us are familiar with kitchenware, make-up and clothes parties. You know, the kind where someone hosts a get-together of 10-15 family members, friends and friends of friends to sell you something you can’t live without.

A new trend is beginning to catch on for parties with a different take on something you can’t live without- the breath of life. They’re called CPR parties.

Parents around the country are hosting CPR parties to educate other parents and community members on how to properly apply CPR in cases of an emergency such as a drowning, electrical shock or choking.

There are different types of parties. Some are non-certified classes that are often associated with organizations that promote family CPR education.  Sometimes there’s a small fee associated with the party. No one receives a certificate of completion or takes a written test at the end of the instruction; however, they are asked to participate in the CPR exercises.

Certification classes are also available where participants do take a written test as well as do the CPR exercises.

A CPR party can include any level of CPR such as infant, child or adult. You can also learn what do in case of a choking.

DVDs with step-by-step instructions are often used in the non-certified parties.

For certification parties, a host may receive free training, take the test at the end of the class and receive his or her 2-year certification, plus training manuals and materials with ideas on how to host the party.

If you’re uncomfortable with instructing a small group, many times a certified instructor can be brought in for a fee.

The main reason for hosting a CPR party is to help neighbors, friends and family members be prepared if a child or an adult goes into cardiac arrest. Calling 911 should always be the first step, but before medical professionals arrive, immediately performing cardiopulmonary resuscitation (CPR) will greatly increase his or her chance for survival. In fact, a recent study by the National Institutes of Health shows CPR to be effective in children and adolescents who suffer from non-traumatic cardiac arrest due to drowning, electrocution, or choking.

When someone suffers an out of hospital heart attack, they often don’t receive the help they need before the ambulance arrives, simply because the people around them don’t know CPR.

CPR party experts recommend making the get-together a fun experience with heart decorations and treats. You can combine them with baby showers, moms groups, and family reunions; any time that friends and/ or family are gathered together.

There are several organizations that offer information on how to host a CPR party. A few of them are:

·      Code Blue CPR - http://www.codebluemedcpr.com/cpr-parties.html

·      CPR Party - https://www.thecprparty.org

·      The Stork Stops Here - http://www.thestorkstopshere.com/TrainingHealth.html

·      Hands on Heart CPR - http://www.handsonheartcpr.com/cpr-party.html

Next time you’re searching for a party theme, consider a CPR party. What a marvelous gift you’ll have given your guests- the knowledge to possibly save a life one day!

Parenting

Flour with Added Folic Acid Is Reducing Birth Defects

2:00

Folic acid is a B vitamin that is known to help prevent certain types of birth defects in newborns. In January 1998, the FDA added a requirement that folic acid be added to breads, cereals, and other products that use enriched flour. These fortified foods include most enriched breads, flours, corn meals, rice, noodles, macaroni, and other grain products.

Since then, a new report shows that serious birth defects have fallen 35 percent. While that is certainly wonderful news, a 2014 study found that as many as 25 percent of American women are still not receiving even the minimum amount of recommended folic acid from either their diet or through supplements.

Women who don't get enough folic acid have an elevated risk of giving birth to a child with conditions called neural tube defects, the best known of which is spina bifida, which often causes paralysis.

Health experts began recommending that women of childbearing age take folic acid in 1992 because studies showed that taking 400 micrograms a day could reduce spina bifida and related birth defects by up to 70%.

Doctors now recommend that women who are considering having children start taking folic acid before trying to get pregnant. Since some pregnancies are not necessarily planned, many doctors recommend that women of childbearing age take a daily multivitamin that contains folic acid.

The benefits of folic acid have been researched for quite some time and since food producers began adding folic acid to grains, that simple step has prevented more than 1,300 babies a year from being born with spina bifida or related conditions, according to a report from the Centers for Disease Control and Prevention.

Authors of the new study found that Hispanic women are more likely to have a baby with spina bifida or a similar birth defect.

That's partly because the "masa harina" corn flour used in tortillas and other Hispanic foods isn't fortified with folic acid, the study says. The March of Dimes has petitioned the FDA to require that folic acid be added to corn flour. Adding folic acid to corn flour would prevent another 40 cases of spina bifida or related conditions each year, the report says.

"Even with fortification, there will be some women that do not get the recommended amount of folic acid every day," says Candice Burns Hoffmann, of the CDC's National Centers for Birth Defects and Developmental Disabilities. "We still have more work to do."

If you’re considering having a baby, talk to your doctor before becoming pregnant about the benefits of folic acid and how much you may need.

Sources: Liz Szabo, http://www.usatoday.com/story/news/nation/2015/01/15/folic-acid-birth-defects/21784019/

http://www.spinabifidaassociation.org

Your Teen

HPV Vaccine, Proving Effective in Teenage Girls

2:00

While the controversy over the HPV vaccine may continue in some circles, a new study says the vaccine is proving effective in teenage girls.

The human papillomavirus (HPV) vaccine was introduced 10 years ago and its use immediately became a hot topic. The vaccine is recommended for young girls and boys ages 11 and 12, to protect them from the sexually transmitted virus that can cause cervical as well as anal, penile, mouth and throat cancers. 

The study found that in teenage girls, the virus’s prevalence has been reduced by two-thirds.

Even for women in their early 20s, a group with lower vaccination rates, the most dangerous strains of HPV have still been reduced by more than a third.

“We’re seeing the impact of the vaccine as it marches down the line for age groups, and that’s incredibly exciting,” said Dr. Amy B. Middleman, the chief of adolescent medicine at the University of Oklahoma Health Sciences Center, who was not involved in the study. “A minority of females in this country have been immunized, but we’re seeing a public health impact that is quite expansive.”

HPV vaccinations rates, in young girls and boys, have slowly been increasing, since the vaccine was introduced, but 4 out of 10 adolescent girls and 6 out of 10 adolescent boys have not started the recommended HPV vaccine series, leaving them vulnerable to cancers caused by HPV infections.

That is partly because of the implicit association of the vaccine with adolescent sexual activity, rather than with its explicit purpose: cancer prevention. Only Virginia, Rhode Island and the District of Columbia require the HPV vaccine.

The latest research examined HPV immunization and infection rates through 2012, but just in girls. The recommendation to vaccinate boys became widespread only in 2011; they will be included in subsequent studies.

Using data from a survey by the Center for Disease Control and Prevention (CDC), the study examined the prevalence of the virus in women and girls of different age groups during the pre-vaccine years of 2003 through 2006. (The vaccine was recommended for girls later in 2006.) Researchers then looked at the prevalence in the same age groups between 2009 and 2012.

By those later years, the prevalence of the four strains of HPV covered by the vaccine had decreased by 64 percent in girls ages 14 to 19. Among women ages 20 to 24, the prevalence of those strains had declined 34 percent. The rates of HPV in women 25 and older had not fallen.

“The vaccine is more effective than we thought,” said Debbie Saslow, a public health expert in HPV vaccination and cervical cancer at the American Cancer Society. As vaccinated teenagers become sexually active, they are not spreading the virus, so “they also protect the people who haven’t been vaccinated,” she said.

Many doctors are pressing for primary care providers to strongly recommend the HPV vaccine in tandem with the other two that preteen children now typically receive.

Many health experts are hoping that the positive results from this study will encourage more pediatricians and primary care physicians to discuss getting the vaccine with parents of young children.

The study was published in the online journal Pediatrics.

Source: Jan Hofman, http://www.nytimes.com/2016/02/22/health/vaccine-has-sharply-reduced-hpv-in-teenage-girls-study-says.html?ref=health

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