Types of Child-Resistant, Senior-Friendly Drug Closure Systems - Part 2
Instead of relying on force to get the package open, closure designers can use certain qualities that seniors have but children do not, such as reading comprehension, the ability to follow a multistep process, and to a lesser extent, dexterity.
In addition to Alcan Packaging’s injection-molded, single-piece closure, they have also developed a Slide-and-Tear closure. It is a cross between a standard unit-dose blister card with paperboard and a combination of various structural systems. This closure is practically un-tearable but can be opened in three easy steps. The package received the highest level of child resistance and a near-perfect score in the senior-friendly portion of the tests.

A similar design, the Slide Pack, was developed by Packaging Coordinators, Inc. It looks like a regular blister on a folded card, but the pills can’t be pushed out until the consumer moves a sliding mechanism within the package. Independent testing indicated that sliding is an activity that children can’t do but seniors can.

Dosepak designed a closure that features an inner blister sealed to an outer (tear resistant) paperboard carton that provides child resistance through a locking mechanism. Once the locking mechanism is released and the package is opened, the individual blisters are not difficult for seniors to open. Additional benefits to this packaging are the ample room the carton provides for compliance-related information, and the stay-attached paper-to-blister feature, which keeps the labeling in tact with the product.

The Envelope Package, designed by Algroup Wheaton Pharma, requires unfolding the package and pulling out a carton piece from the middle of it before the tablet can be pushed through. The closure also has the benefit of providing additional billboard for marketing and compliance purposes.

Other designs have been proposed, such as clean-cut blisters with units that can’t be peeled until separated from the blister. To avoid breaking and tearing of all the blisters upon one opening attempt, each cavity’s lidding is independent. Due to the concern of children using their teeth to open blister packages, No-Tear films require scissors for opening.

Another proposal is the Bitpak paper. It contains denatonium benzoate, a bitter substance that would be used as an overcoat to the blister package. The designers’ intent is that the taste would present an unpleasant experience and discourage the child from trying to bite another package.

The Break Tab has also been proposed. This requires the consumer to break the perforation in the blister, and then peel it open. It has been proposed for fragile tablets and other products where the peel-push action won’t work.

Yet another proposal has been the Peel-Peel-Push blister. The consumer must peel two layers before pushing the product through the foil.

The focus of these new concepts is on cognitive ability since many seniors do not have the dexterity or strength to open most conventional packages. However, the most frequent concern with blister packaging is heavier thickness material for bite resistance.

Many package designers work with drug companies to collaborate on new designs. However, the drug companies are reluctant to adopt the new designs in fear that replacing familiar closures with new ones will scare consumers away. Also, the drug companies aren’t willing to pay for these more expensive designs.

Many child-resistant, senior-friendly package closures are available to drug companies, and many more are designed each day. The challenge closure designers face is to design closures that meet the CPSC’s protocol requirements, is cost efficient and aesthetically pleasing, and is accepted by consumers.

However, even when closure designers are able to overcome these challenges, children may still be at risk of poisoning. As one closure designer pointed out, if the consumer doesn’t replace or close the closure, all the designs in the world won’t keep children safe. He stated that the most troublesome challenge is making closures so easy to use that the consumer won’t even think about leaving the cap off.
           By Stacey Lloyd
Published: 12/12/2004 

Drug Closure Systems: Child-Resistant, Senior-Friendly Testing
The most important issue with closures is security. Since it is the gateway to the product, manufacturers must counter the weaknesses in closures by developing tamper and child resistant features.
When the Consumer Product Safety Commission (CPSC) revised its protocol requiring that drug packages be senior friendly as well as child resistant, package designers were faced with a challenge.

Since children between the ages of 18 to 24 months are most likely to ingest poisons, the Poison Prevention Packaging Act mandates the use of child-resistant packaging to protect children under the age of 5. The protocol requires children between the ages of 42 and 51 months be tested sequentially in panels of 50, up to 200 children.

The children are given empty bottles with closures and told to try to open them. They are then given a demonstration on opening packages and told they can use their teeth. They are given a total of 10 minutes to open packages. A minimum of four testers, with each tester conducting no more than 30% of the tests, is used in order to avoid testing bias. A minimum of five test sites are also used, with no more than 20% of the panel from one site. Eighty-five percent of the children must not be able to open the closures before the demonstration, and eighty percent of the children must not be able to open them after the demonstration (based on 200 children).

Seniors are also tested. The testing panel must consist of 100 seniors between the ages of 50 and 70 years old, with 25% of the group between the ages of 50 to 54 years, 25% 55 to 59 years, and 50% 60 to 70 years. Seventy percent of the group must be female. There is a minimum of three testers and a minimum of five sites. The testers first ensure that the seniors can read English, use any necessary eyewear, and understand the test. The seniors are then given 5 minutes to open and re-close the package, and then given 1 minute to do the same with an identical package. Ninety percent of the panel must be able to open and close the package correctly.

Even when effective closures are used, children may still be at risk of poisoning. If the consumer doesn’t replace or close the closure, all the designs in the world won’t keep children safe. The most troublesome challenge for closure designers is making closures so easy to use that consumers won’t even think about leaving the cap off.
           By Stacey Lloyd
Published: 12/11/2004 

Pediatric Drug Studies: Children Are Not Little Adults
Drug manufacturers are not sufficiently testing their drugs for pediatric safety and efficacy even when they know the drugs will or are already being prescribed to and used by children.
More than half of the drugs approved every year that are likely to be prescribed to children are not adequately tested for use in children.

Vaccines and antibiotics are notably marketed with information for pediatric use, however many drugs, such as those for treating depression, epilepsy, severe pain, gastrointestinal problems, allergic reactions, and high blood pressure, do not contain any information for pediatric use. According to FDA estimates, more than half of the drugs approved every year that are likely to be used in children, are not adequately tested or labeled for treating children.

What’s the harm? Children have been harmed, and even killed, because of the lack of knowledge of how drugs might affect children. Children have immature organs and different metabolic and immune systems than that of adults. Therefore, children cannot be treated as little adults.

So, what is the FDA doing about this? The FDA finalized a rule in December 1998 requiring drug manufacturers to provide safety and efficacy information for pediatric use of their drugs, and provide labeling information on safe pediatric use. This is adequate for new drugs coming to market. However, drugs already on the market are exempt. The FDA can only require children’s studies in certain situations, such as when they believe that "significant risks" could be avoided.

The December 1998 rule expanded on a 1994 regulation that required drug manufacturers to look at existing data and determine if drug safety and efficacy in children could be supported. To avoid having to re-examine the safety and efficacy data, drug manufacturers just stated in their data that "safety and effectiveness has not been established for children". Yet some doctors continue to prescribe the drugs to children. And, it is legal for them to do so.

Is this all bad? No. There are some drugs, such as those for treating AIDS that may be beneficial to children even though they may not have been tested for safety and efficacy in children. Although the risks of prescribing the drugs are great, the alternative of not prescribing the drugs may be even greater. It places doctors in a tough situation.

What can you do to protect your child/children? Read the labeling and package inserts. Talk to your child’s doctor. There may be alternative treatments. Become an informed parent. Ask questions. Do your own research. Your children are depending on you to keep them safe!
           By Stacey Lloyd
Published: 12/2/200 

Healthy Snacking For Kids
Countless mothers down centuries have dreaded this decision…making snacks for their children, healthy, nutritious, fast and attractive has always been ONE BIG TASK. Here’s some help...
It is never easy to run the fine balance between great taste, good health and visual appeal, more so if the customer is a child. Adults can be told about health benefits of certain foods, but a horde of hungry kids will not listen to this voice of wisdom. For them, health, calories, fiber and nutrition are the last considerations when they need to eat. So what’s to be done about teaching them healthy eating styles? The oft touted idiom that good habits should be formed early falls flat here, when is the early that is referred to? Teenage, pre- teens? How can you persuade an eight year old to eat a stick of celery when she would much rather have fries? Well, there is a way, make the stick of celery as attractive as a French (!) fry. A good way to do is to make an accompanying dip with low fat cheese, a dash of paprika and half a teaspoon of garlic flakes (or powder). Then even sticks of carrots, broccoli flowers, green beans, cucumbers, zucchini or mushroom slices can be downed without too much trouble. Convincing youngsters to eat fresh fruits may be an onerous task, but made into smoothies with low fat yoghurt, nuts and a combination of fruits will always go down well.

Fresh fruits also taste very good with dips that go with the fruit. For instance, a dip made by blending together cottage cheese, cinnamon powdered, and a tablespoon of skimmed milk is an excellent idea for accompanying a variety of sliced fruit – pears and apples, to name a few. A caramelized banana or a banana fritter will also make an excellent accompaniment to this dip. This specially if the dip is chilled for a while before serving, because then it tastes divine with hot and crisp caramelized banana fritters.

The power to take decisions is a very important part of growing up. Allowing the kids to choose what they want to have out of a list laid down by you will get you two pronged success, the kid eats well, and also feels he or she actually took the decision. A great recipe for his exercise in freedom of choice is layered delight. You can offer to have a tortilla, a slice of full grain bread, a khoboos (a Lebanese corn bread), or even a naan roti (from an Asian store). The next set of choices will be the spread on the base. It could be low fat cheese, low fat cream or plain olive oil drizzle. You could also offer mashed up cottage cheese or hung curd from low fat yoghurt (low fat yoghurt pressed by hanging up in a cloth to drain out all liquid – an excellent spread, tasty and very healthy). After this comes on a layer of fresh lettuce (sorry, no choice on this one), then the next choice is between a mixture of diced smoked chicken, shredded carrots and nuts combination, or a turkey mince with tossed green peas or beans with raisins combination to spread onto the bed of lettuce. The whole thing can then be rolled up into a kind of roll available everywhere in the Asian countries, making a whole meal out of a snack..full of choices. You can choose to name it, better still, let the youngster do the naming…and then come up with possibilities of filling combinations. But remember, no white bread base, fatty cheese or mayo spreading and no red meat or mince inside. Tortillas, cut into little triangles are very interesting for kids, and this interest is best encouraged because tortillas fill up the little tummy, satisfy an after-school appetite but do not weigh down the system, because they are easily digestible.

Tomato ketchup never fails to do the trick. You could use old slices of whole wheat bread for an interesting tomato stick snack. Cut the bread into about three quarters of an inch square fingers, brush with olive oil and tomato ketchup. Dust with a bit of oregano or basil and bake lightly, till crispy. These sticks can be refrigerated after cooling, and then popped into the microwave or even an ordinary over just before pangs-time.

For slightly elder children, Soya nuts are a very healthy alternative to greasy nut sacks. Roasted walnuts, soy nuts, raisins, dates, and almonds when roasted together, make an excellent little bowl to dip into without worrying about calories, fat and whatnot. Soy nuts, remember, are one of the healthiest food known to humankind.

For add excitement, try skewering together interesting combinations of fruits and cheeses. A good combination can be pineapple, chicken chunks and mozzarella, or try grapes, a cube of cheddar and apples. These can be skewered together on toothpicks or longer sticks…the possibilities are endless and so are the taste combinations.

The most important ingredient of a great snack is your imagination, creativity and the child’s involvement in preparation. It is a great idea to get the youngsters to decide what they want, but the options need to be well thought of…then any choice is great choice. But the bottom-line is – snack healthy, stay fit. Something every child should learn in the crib itself.
           By Kanika Goswami
Published: 11/18/2004 

Spend more to save children from malaria, west urged
Malaria, already responsible for at least a fifth of all deaths of children under five in Africa, will continue to increase its hold on the continent unless Britain and the US provide more effective, but more expensive, medicines, it was claimed yesterday.

Médecins sans Frontières, whose volunteer doctors run clinics in malarial areas, called on the Department for International Development and the US government agency USAid to stop their "go-slow" policy on malaria. This focuses on prevention of mosquito bites by means of bednets and treatment with traditional drugs.

"Donors must stop wasting their money funding drugs that don't work," MSF said in a report. It called on Britain and the US to help African countries to introduce combinations of drugs which include artemisinin, a treatment derived from a Chinese plant which has proved extremely effective in Asia.

MSF points out that the World Health Organisation has recommended that artemisinin-based combination therapy (ACT) be introduced wherever resistance to the old drugs is high.

"Lack of political and financial support on the part of donors means that endemic countries are often encouraged to 'leave alone' failing malaria, and are not given financial and technical help to implement more effective strategies," the report says.

Resistance to chloroquine, once the drug of choice for malaria, is more than 90% in some parts of west Africa. Resistance to its replacement, sulfadoxine-pyrimethamine, is fast growing, particularly in east and southern Africa.

MSF made its plea for action as the WHO and Unicef launched a report on the malaria crisis. Deaths in west Africa remain high, according to the WHO, while "the number of children dying of malaria rose substantially in eastern and southern Africa during the first half of the past decade compared with the 1980s".

That did not mean efforts to combat malaria, through the WHO's Roll Back Malaria programme, had failed, it said - the situation might be substantially worse without them.

The WHO report noted that despite its recommendation, use of ACT "is constrained by high costs and limited operational experience in Africa. To date, four African countries have adopted ACT as first-line treatment."

There is greater use of bednets than ever before, but only 15% of young children sleep under them and just 2% of the nets are impregnated with insecticide.

Although the price of the treated nets has fallen, some African countries have failed to lift taxes on them. The campaigning organisation Massive Effort said yesterday that only 17 out of 43 countries that signed a declaration on malaria three years ago had fulfilled a promise to remove the tax.

The organisation also accuses the World Bank of failing to deliver on funding it promised to combat malaria. Since it undertook to provide up to $500m (£310m) in additional funds, it has been spending at the rate of just $44m a year, according to campaigners.

By Guardian Unlimited © Copyright Guardian Newspapers 2006
Published: 4/24/2003

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Fast food and Obesity in Children
We all know what causes obesity, and that is eating too much of the wrong kinds of food and not getting enough exercise. Some studies have shown that fast food causes obesity in children. However, the fast food industry claims that their foods do not cause obesity in kids. So, is there a link between fast food and obesity in children?
Fast food and Obesity in Children
Well, there appears to be both a link between fast food and obesity and fast food and obesity in children. Some of these links are large serving sizes, low fiber content, and increased content of fat, sugar and salt in most fast foods. Also, since kids are usually out running and playing together, lack of exercise does not seem to be a link in most kids. Studies have also shown that there has been a dramatic increase of the number of times per day and per week that families eat out since the 1950's. Therefore, it is conceivable that fast food causes obesity.

Fast food and obesity-a link?
The first step is to decide: is there a link between fast food and obesity at all? Yes, there are several things about fast food that contribute to obesity in children. First, there are the large serving sizes that are easy to note. In recent years most fast food restaurants have come out with "super-size" portions of burgers, fries. In addition there are "pizza by the slice" restaurants, where one slice is almost the size of a plate.

Studies on what children eat and where they get it have shown that children got anywhere from 29-38% of their food from fast food sources. This adds up to approximately 6 pounds a year. This taken out to its extreme: a child from age 5-15 can gain an amazing 60 pounds, and that is a lot for someone who for most of that time is less than 5foot tall and should only weigh 100lbs (at 5ft) or even less. This shows that fast food restaurants are responsible for at least some of the overweight kids in our society.

More than just obese kids
The fast food industry does need to realize that there are other effects of fast food than just obesity. While anyone, but especially overweight children, are eating burgers, fries, pizza and coke products they are not getting the nutritious food that they need. Instead, they are getting empty calories. Calories, which have no nutritional value, are setting themselves up for diabetes, heart problems and other fatal disorders. This also leads to the stark realization that if this poor nutrition in our obese children.

Fast food in school
Since the late 70's, schools have been offering fast food type meals in place of the regular school lunches. These schools report over 15,000 items sold each week, especially to those from higher income level families. In addition there are those teenagers that who work for the fast food restaurants and eat there at least one meal during their work schedule.

Advertising and obese children
Advertising, including television ads, billboards, and other advertising, including toys in boxed meals, has had an effect upon children as never before. Children these days are growing up with low concern for their health and more concern for what tastes good.

Without enough parental supervision, these kids grow up with little nutritional discretion and usually these kids grow into adults with both weight and health problems as well as teaching another generation that it is ok to waste money on unhealthy foods. So it is not only the young people of our generation that are being affected by the fast food industry, it is going to have an effect for generations to come, if something isn’t done about the consumption of fast food.

It’s up to us!
As is expected the fast food industry is not going to think it possible to suddenly change its direction after years of offering poor food choices. It will have to come from the consumer demanding healthier food choices. Our vote comes with where we shop and what we buy. Our children and grandchildren will grow up with weight and other health problems if they continue eating the fast food.

We can read all the studies that show links between fast food and obesity and fast food and obesity in children. We can look on as medical science proves that fast food causes obesity, but if we, as consumers do nothing and continue to feed these foods to our children, the health problems that will be the end result will be our own fault.
           By Jayashree Pakhare
Published: 7/9/2007 

Getting The Right Wheelchair For Your Child
Wheelchairs come in many different shapes and sizes and can be created to fit each individual user's particular needs. However, choosing a child's wheelchair can be somewhat more problematic, as you may need to take other things into consideration that an adult would not have to worry about. To choose a child wheelchair, keep the following tips in mind.

Assessing The Child's Specific Needs

Most importantly, when you buy a child wheelchair the specific needs of the individual child are of paramount significance. What is the child's health? Does he or she need a lot of physical support? Or, is he or she very active? Each of these considerations will impact what type of chair is needed and what elements you include in the chair you buy.

There are electric wheelchairs that are very sophisticated and can adjust the height, position and many other features, which your child can use in order to perform any activity of choice such as, writing or playing a favorite game. Other power wheelchairs come with a full remote control or joystick attached the wheelchairs hand stand, which will give your child full control of the wheelchair at all times.

Use Caution When Purchasing A Powerful Child Wheelchair

Of course, price is probably not of the most importance when you consider what type of wheelchair best suits your child. Of greater importance is the fact it meets your child's needs as fully as possible, while providing them the most mobility they can have. For children's wheelchairs, keep in mind that if you need to purchase a power wheelchair, the motor should be significantly powerful enough to carry the child through his or her day at adequate speeds to keep up with his or her peers, such as when they are playing or running, and without having to recharge the battery more than once per day. On the other hand, make sure your child can adequately and safely manage the wheelchair so as not to injure him or herself, or others. Just like any powered vehicle, an electric wheelchair is not a toy, and must be managed prudently to avoid injury.

You should note that today, many wheelchairs come with the ability to grow and adapt as your child does. For example, you can start out with a chair that has lower speed controls and exchange them for more powerful ones as your child grows and can handle a more powerful wheelchair.

The Purchase Of A Child Wheelchair

As with any medical device, wheelchairs aren't cheap, especially electric ones. Even manual chairs usually run approximately $2000, and electric ones are proportionately more expensive. However, if you're not able to afford one, there are programs and/or financing available to help you purchase one that best fits your child needs regardless of financial status.

Should you need assistance, contact a wheelchair manufacturer or retailer local to you. Although they may not be able to help you obtain financing for the chair themselves, they should be able to direct you to resources that can help you obtain the funding regardless of your actual ability to pay.

Visit us for more information on manual wheelchairs, pediatric power wheelchairs and get mobile power wheelchairs scooters.

By Christopher Smith
Published: 6/25/2007
 

Choosing a Hospital that Treats Childhood Cancer
Facing the fight against childhood cancer is something that none of us ever want to experience. If you do find yourself in this situation, you want to make sure that you are choosing the best hospital to meet the needs of your child. By doing research and asking the appropriate questions, you can help give your child the best possible chance of fighting and beating this disease.
Across the nation and around the world you will find hospitals that have oncology or cancer programs geared towards childhood cancer. Through research and trials, it is evident that the diagnosis and treatment of childhood cancer is different than treating the disease in adults. For this reason, it is imperative when seeking cancer care for your child that you do research and make sure that you are going to the hospital that is right for your child.

Some pediatric cancer programs might concentrate on one or two types of cancers and treatments whereas others, such as St. Jude Children’s Research Hospital, treat all types of childhood cancers as well as doing research and clinical trials. Before you choose a hospital to treat your child’s disease, you need to make sure that you are going to a hospital that will give your child the best chance in the fight against cancer.

When researching children’s hospitals and oncology programs or cancer care, you should have a list of questions that are relevant to his/her cancer and ask each hospital the same questions for comparisons sake. Questions to include in your research are to ask about research, clinical trials, success rates, number of cancer patients they see each year, whether they have ever treated a child with your child’s type of cancer, which cancers they specialize in, if they offer support groups and do they offer family-centered care which allows families to be a part of the treatment plan.

Since pediatric cancer care is different than cancer treatments for adults, many families opt to go to a children’s hospital for care. However, this is a very personal choice. Whether you choose cancer care at your hometown hospital or choose to travel and stay at a larger hospital, make sure that you are getting the best possible care for them that you can. Since you are their voice and their advocate, you have to do what you can to make sure that you are giving them the best opportunity to fight and beat childhood cancer.

By Kathy Gupton
Published: 6/19/2007 

Children and Body Mass Index (BMI)
Obesity is growing alarming in children at younger and younger ages and, unfortunately, it is not always easy to spot a developing problem is a rapidly growing child. It is however part of your doctor's job to monitor your child's weight for you and, for several reasons, it is vital that you ensure that this is being done.
Obesity is a well known problem amongst the adult population of many western countries but, much more worrying, is the alarming rise in obesity being seen in our children at younger and younger ages.

Obesity is typically assessed initially by eye and is then measured in terms of your body mass index (BMI) which is a simple calculation made using your height and weight. In the case of children however the rate at which an individual child grows, and the presence of such things as 'puppy' fat, mean that judging obesity simply by eye doesn't work. Additionally, conventional BMI calculations don't give a true result either and it is necessary to track BMI for a child over a period of time and to assess BMI measurements against a set of special charts produced by the federal government.

For this reason it is essential that your doctor measures and records your child's height and weight as part of a routine check-up and that the doctor monitors the progression of these over time.Unfortunately, all too many doctors fail to do this, frequently quoting a lack of time as the reason, both in terms of the time taken to make the measurements and of the time taken to explain the child's progress to the parents. Some doctors also feel that there is little point in counseling parents as their advice is often ignored.

Well, time or no time, it is part of your doctor's job to monitor your child's health fully and you have a right to expect that this will include monitoring your child's weight. Whatever the doctor's reason for not carrying out this work, once your child has put on too much weight it is extremely difficult to change the lifestyle habits that have caused this situation and to get that weight off again. Obesity is not simply a problem in itself but can be the start of a whole series of problems for your child including diabetes, high blood pressure and cardiovascular problems. In the vast majority of cases however all of this can be avoided quite easily and part of the secret lies in knowing when the problem is developing.

So, next time you take your child to the doctor don't be afraid to bring up the subject of BMI tracking and make sure that your doctor is giving you the service your child needs.

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By Donald Saunders 

Do Children And Adolescents Get Depressed?
Unfortunately, the answer is yes. Depression is much more common in children and adolescents than once believed. For reasons that are not well understood, there has been a trend toward an earlier age at onset of depression (and manic-depression) in people born since the 1940’s. Also, clinicians are doing a better job of looking for and recognizing depression in these age groups. Quite often, depression in young people consists of the same symptoms as found in adults. At times, however, the diagnoses may be more elusive. The youngsters may not recognize the discomfort that they are experiencing is an illness known as depression.

Although young children may not be able to express their sad mood in words, they often show it with persistent sad expressions. Other indications of depression in young people are loss of motivation and enthusiasm, fatigue, difficulty making decisions, social withdrawal, weight change (up or down), irritability and anger, deterioration of school performance, truancy, acting out and behavioral difficulties, and physical complaints.

Families or teachers may recognize behavioral changes indicative of depression even though the youngster may deny being depressed. Whenever depression is suspected, the child should be evaluated by a doctor experienced in working with this age group. Just as in adults, depression in young people can have a number of causes, and recognizing these causes can lead to very effective treatments. Recognizing and treating depression in youngsters is especially important considering the critical stages of development they are passing through. Also, there has been a disturbing increase in suicide in adolescents over the last few decades, and although suicide is quite rare in children, it does occur.

Treatment for childhood and adolescent depression are the same as those used in adults and include psychotherapies, medications, and combinations of both.

M Adley is webmaster at stopdepressiontoday.com, an unbiased resource of information for those seeking a depression treatment , or those who wish to take a depression test to diagnose their condition.

By m adley
Published: 4/12/2007