Pandemic still setting records in Kentucky; more than 1 in 4 who get tested are positive; hospitals and schools are disrupted

Chart by The Washington Post, adapted by Kentucky Health News; to enlarge, click on it.

By Melissa Patrick
Kentucky Health News

Kentucky's coronavirus cases continued to skyrocket Tuesday, and the state's positive-test rate hit yet another record and hospital numbers kept going up.

Kentucky reported 9,450 new cases Tuesday, the fourth most of the pandemic. The top three days were all last week, as were Nos. 5 and 6. Of today's cases, 24.8%, more than 2,000, were in people 18 and younger. 

The seven-day rolling average of new cases is 8,175, a new record that is 4.6% higher than Monday and 60% higher than it was a week ago.

The share of Kentuckians testing positive in the last seven days is 26.79%, another record, and that does not include any at-home test results. 

"Folks, we’re seeing an impact in our hospitals, our schools and our communities. Get your vaccine and booster and mask up," Gov. Andy Beshear said in a Facebook post.

Kentucky hospitals are asking the public to stop using emergency rooms for Covid-19 testing, Deborah Yetter reports for the Louisville Courier Journal.

"We are running into a lot of problems with patients coming into the emergency department simply for testing," Dr. Mark Spanier, medical director of the emergency department of Baptist Health Lexington, said Tuesday: "If you show up for routine testing, you'll be delaying care of other patients."

Kentucky hospitals reported 1,953 Covid-19 patients Tuesday, 80 more than Monday and one of the largest daily gains of the pandemic. Hospitalizations have gone up 47% in the last 14 days. 

The number of Covid-19 patients in intensive care and on mechanical ventilation both went down. The state reported 449 in intensive care, three fewer than Monday and 237 on mechanical ventilation, down one.

Nine of the state's 10 hospital-readiness regions are using at least 80% of their intensive-care beds, with five over 90%. Northern Kentucky is highest at 100%. 

The state's seven-day infection rate is 169.27 daily cases per 100,000 residents. Eight counties have rates above 200 per 100,000 people, including Fayette, 264.6; Jefferson, 261.5; Campbell, 238; Oldham, 217.3; Shelby, 211.6; Boone, 208.6; Jessamine, 203.8; and Boyd, 201.2. That's two more counties than Monday, and like then, all are in metropolitan areas. 

The New York Times ranks Kentucky's infection rate 30th among the states, a drop of 10 slots from Monday.

The state reported nine more Covid-19 deaths. The pandemic death toll in Kentucky is now 12,434. 

In other pandemic news:

• Covid-19 vaccinations in Kentucky are trending upward after a four-week decline. The seven-day average of doses given is 16,392, almost 50 percent higher than the 10,991 average recorded Jan. 5. That's still well below the 21,726 average recorded Dec. 11, after which the decline began. Just over 58% of the eligible population, 5 and older, are vaccinated, and just under 38% of those have received a booster shot, which experts say is needed for immunity from the Omicron variant. Most shots being given now are boosters.
• "Health departments are now asking people who have tested positive to notify others they may have exposed," WKYT-TV reports, quoting Woodford County Health Director Cassie Prather: “You want to make sure that those who live in your household are notified, and also anyone that you were with 24 to 48 hours prior to you becoming symptomatic or testing positive.”
• The state Department for Public Health says people who have been in close contact with someone who has Covid-19 and is not fully vaccinated should quarantine for 10 days. That may be shortened to five days if you have no symptoms and test negative on the fifth day.
• In his Monday press conference on the state's education budget, Beshear proposed adding $6.2 million a year for eight regional centers with staff to address the social, emotional and mental-health needs of students, which have been worsened by the pandemic. “We must do more to help our youngest Kentuckians heal, and deal with the adversity in their lives,” he said.
• Lt. Gov. Jacqueline Coleman played video clips from students, including Julia Eady of Rowan County Senior High School, who said, “My peers are struggling with mental-health needs and obstacles . . . being safe and healthy is a basic need.”
• Jefferson County Public Schools went on remote instruction Tuesday after being closed Monday. The county has state's second-highest coronavirus infection rate. It became impossible to safely staff schools, Supt. Marty Pollio told reporters Monday. Hundreds of staff members are out because of positive tests or quarantine, and about 600 requests for substitute teachers Thursday went unfilled, Olivia Krauth reports for the Louisville Courier Journal. JCPS is tentatively scheduled to reopen to in-person learning Tuesday.
• Private insurance will pay for up to eight at-home Covid-19 tests per person per month starting Saturday, Jan. 15, says the U.S. Department of Health and Human Services: "Over-the-counter test purchases will be covered in the commercial market without the need for a health-care provider’s order or individualized clinical assessment, and without any cost-sharing requirements such as deductibles, co-payments or coinsurance, prior authorization, or other medical management requirements." Tests are reimbursable up to $12 per individual test. Click here for more information on how to get your at-home test for free.
• Pope Francis suggested Monday that getting vaccinated against the coronavirus is "a moral obligation." He spoke at an annual event in which he takes stock of the world and sets out the Vatican's foreign policy goals for the year, NPR reports. Francis previously called vaccination an "act of love," but on Monday, he said people have a responsibility to care for themselves "and this translates into respect for the health of those around us. Health care is a moral obligation."

Suicide, ideas of it, depression, and anxiety have affected more Kentucky students since the Covid-19 pandemic began

Kentucky Youth Advocates image

By Melissa Patrick

Kentucky Health News

Kentucky's students are experiencing more anxiety, depression and ideas of suicide in the pandemic, and schools need more resources to help them, mental-health experts told state legislators Oct. 5. 

Before the Interim Joint Committee on Education, they called for putting more mental-health professionals in schools, giving teachers more first-aid training in mental health, and programs that would help students be more resilient and keep them from taking their own lives, an increasing problem.

“The needs are many, but the resources are few,” Marsha Duncan, a social-emotional learning specialist for LaRue County Schools, told the committee.

Among Kentuckians under 25, deaths by suicide increased 11% in 2020, according to state-provided data. Emergency-room visits related to self-harm were 5% below historical averages last year, but hospitalizations for self-harm rose 8%. Figures for 2021 are not yet available. 

One three-month period in the last year had a youth suicide rate 57% higher than the previous year, said Linda Tyree, crisis response director for the Green River Regional Educational Cooperative, which serves 45 school districts.

The Bowling Green-based co-op has crisis teams that are typically called in when there is a death or serious injury of a student or staff member, but during the pandemic they've been called in for issues of anxiety, depression and having ideas of suicide, Tyree said.

 

"When students transitioned to remote learning, we know there was a lot of exposure to trauma, to stress, family stress, even exposure to pornography when they're learning online," she said. "So all of these things just compound the problems of adolescence that are just part of normal growing up." 

Amy Riley, a school counselor in Mercer County, told the legislators, "The isolation of the Covid pandemic has had a profound effect on the mental health of my students and students across the state."

In her Mercer County Intermediate School in Harrodsburg, "There were weeks this past spring, shortly after returning from virtual learning, that we would assess two to three students a day for viable suicidal threats," Riley said. "Just this morning, I had to do a suicide risk assessment on a 9-year-old in my school before I came to this hearing today."

She said the reasons for these suicidal threats include unmanageable anxiety, home problems and often loneliness. 

Duncan, of LaRue County, added grief to the list of things students are dealing with, and not just for those who have died of Covid-19. 

"Grieving for these students has taken on a grief of the loss of the normal … fun, activities and programs that are offered and provided at the schools," Duncan said. "Dealing with the lack of consistent routines has been detrimental to the mental health of our students."

Similar issues are reported around the world. A global analysis of 29 studies that included more than 80,000 youth, published in JAMA Pediatrics, found that anxiety and depression has doubled in children and adolescents over the course of the pandemic. It also found they occurred more later in the pandemic, in older adolescents and in girls. 

Duncan said it has been "impossible" to meet students' mental-health needs during remote learning and "extremely difficult" under the hybrid model. She said access to mental-health professionals in her small, rural community is limited, as are the funding sources to pay for it, which makes school-based mental-health care vital. 

In a survey conducted by The Prichard Committee Student Voice Team, Kentucky students expressed a desire for increased access to mental-health services. 

Asked open-ended questions about what challenges they were facing in the pandemic, 15% of the students reported a concern related to mental health. Among that group, 35% said they wanted mental-health services but did not have access to them. That's 5% of the total. The share of students who wanted but lacked access to mental-health services was 15% during the pandemic and 10% before it.

Another indicator that young people are struggling with their mental health is the increase in mental-health screenings done by youth at MHAScreening.org. 

According to data provided by Mental Health America of Kentucky, there has been a 191% increase in  voluntary mental-health screenings among the state's 4- to 10- year-olds, from 23 done in the first half of 2020 to 67 in the first half of 2021. Among 11-to-17-year-olds, the increase was 231%, from 1,077 to 3,562.  

"These screening increases reflect anecdotal evidence that our children and youth have been negatively affected by the pandemic," Marcie Timmerman, executive director of MHA, said in an e-mail. 

Rep. Shane Baker, R-Somerset, asked what parents, educators and the community could do. Riley said all students should receive support through a "tier one" program, and Tyree agreed. 

"We don’t want to be reactive. We want to be proactive," Tyree said. "Tier one means that every single student, every kindergartner, every first grader that comes in the door, before they ever show any kind of problems or at-risk behavior, we’re already talking about articulating their feelings, how to be socially acceptable with the way that they address those feelings, how they can regulate themselves and have social regulation."

Riley wrapped up her prepared comments with a plea for more mental-health professionals in schools.

“It is my earnest plea that when making crucial funding decisions, you not forget the mental health needs of Kentucky students,” she said. “Any money and resources spent on mental health needs in Kentucky schools is money that will have an infinite return for the investment.”

If you or someone you know may be considering suicide, contact the National Suicide Prevention Lifeline at 1-800-273-8255.

Cameron challenges Beshear's school masking order; state school board is set to issue its own mask mandate tomorrow

Photo from Salon.com

By Melissa Patrick

Kentucky Health News

The emergency order Gov. Andy Beshear issued Tuesday to require universal masking in all school districts is already being challenged in court by Attorney General Daniel Cameron,  even as the state school board is scheduled to review --  and likely pass -- an emergency regulation Thursday that would do the same. 

The draft regulation prepared for the Kentucky Board of Education and the Local Superintendents Advisory Council says, "The regulation is necessary to mitigate the spread of Covid-19 in Kentucky public schools and prevent public school closures during the 2021-22 school year due to Covid-19. Specifically, this emergency administrative regulation requires all individuals inside public school facilities to wear a face covering over the nose and mouth, absent an exemption set forth in the regulation." 

The emergency regulation would expire 270 days after filing or if the board withdraws it. It is based on a state law that authorizes the board to issue "regulations necessary or advisable for the protection of the physical welfare and safety of the public school children."

Education Commissioner Jason Glass said in a Tuesday news release, “With strong and consistent precautions in place, Kentucky’s schools have proven that we can safely open for in-person instruction. The governor’s executive order and the Kentucky Board of Education’s pending emergency regulation to require masking both put the health and learning of Kentucky’s children first, and I support them unconditionally.”

The governor's 30-day executive order requires all individuals older than 2 to wear a mask when indoors in all public and private pre-schools, Head Start, and elementary, middle and high schools in Kentucky, regardless of vaccination status. The school board's regulation would apply only to public schools.

Both the governor's order and the board's regulation allow for exemptions.

Beshear had recommended that local school boards impose mask mandates, but fewer than a third did. He said Tuesday that his order was needed to preserve in-person learning and thwart spread of the coronavirus. Only a third of students older than 12 are vaccinated for the virus; younger students are ineligible.

The state school board is appointed by the governor. In one of his first actions as chief executive, Beshear disbanded the board and appointed a new one that promptly fired the commissioner who had been hired by the board that had been appointed by Republican Matt Bevin, whom Beshear defeated.

Cameron, a Republican, argues to the Supreme Court that the Democratic governor's latest order disregards laws the legislature passed this year and violates a Boone Circuit Court injunction that Beshear has appealed to the high court.

“The legitimacy of our government depends on the governor respecting the judicial power of the courts and the law-making power of the legislature, and right now he is disregarding both,” Cameron's filing says.

“The governor does not have to choose between following the science and following the law. The two can and should work together. If he believes that the science requires a statewide mask mandate for schools and childcare centers, then he needs to do what the law requires and work with the General Assembly to put the necessary health precautions in place.”

Several other elected Republicans objected to Beshear's order.

“We fully support today’s action by Attorney General Cameron to uphold the integrity of the law,” Senate President Robert Stivers said in a prepared statement. “The governor represents one branch of our government, and he cannot ignore the laws passed by the legislature and the judicial orders pertaining to them.”

The 2021 General Assembly passed a law that limits emergency orders by governors to 30 days unless extended by the legislature. Beshear's challenge to that law is awaiting a decision by the state Supreme Court. A lower court has temporarily blocked parts of the bills pending the decision.

House Speaker David Osborne issued a statement saying, “Local school districts across the state have carefully considered mandatory face coverings and made decisions regarding their own policies. The governor may not agree with their choices, but he must respect their authority. Instead, at the eleventh hour, he chose to politicize this issue and flout their decisions by issuing an executive order with extremely questionable legal standing.”

Stivers said Beshear had exceeded his legal authority. "If Governor Beshear feels so strongly that action needs to be taken, he can call the General Assembly into a special session." 

Also pending at the Supreme Court is a decision about two other laws, one that gives the legislature more oversight over the administrative regulation process; one that allows businesses and schools to follow federal Centers for Disease Control and Prevention guidelines, instead of those set by the state. 

Osborne pushed the court to decide the matter. "Until the Supreme Court of Kentucky rules on the governor’s challenge to these measures, this issue remains unresolved. It is their unwillingness to act that has left so much in limbo."

Osborne also referenced House Joint Resolution 77, which lists the pandemic orders that would stay in place if the legislature gets the court to overturn a Frankfort judge's injunction.

On the other side of the aisle, leaders of Democrats in the state House issued a statement saying, “If we want our children in school instead of learning online, and if we actually want to follow CDC guidelines as this year’s House Bill 1 calls for, then Gov. Beshear’s statewide mask mandate for students and school staff alike is the only appropriate step to take. The CDC recommends universal masking for everyone in a school setting, regardless of vaccination status." 

On August 5, the CDC issued a guidance recommending universal indoor masking for all teachers, staff, students, and visitors to K-12 schools regardless of vaccination status.

In a widely shared Twitter message, Science Hill Independent Schools Superintendent Jimmy Dyehouse called Beshear a "liberal lunatic" in an audio message informing parents in the Pulaski County town of Beshear's new mask mandate, reports the Lexington Herald-Leader.

Dyehouse said, “As you already know, and probably have already heard, this liberal lunatic that we have up in Frankfort has signed another executive order mandating masks for all students and adults in school. What this means is the professional opinion of your superintendent doesn’t matter, the opinion of your school board doesn’t matter, and you as parents, your opinion doesn’t matter.”

Beshear's order has the support of the Kentucky Chamber of Commerce and teachers' unions. The Kentucky Education Association said on Facebook, "Requiring masks for all students is vital to help slow the spread of Covid-19 as schools reopen across the commonwealth. That is particularly true for students under age 12, who are not currently eligible for vaccination and are, therefore, among those most at risk for infection." 

The Kentucky Student Voice Team of the Prichard Committee for Academic Excellence also issued a statement in support: "While we were hopeful to return to school without masks, rising Covid-19 rates and the spread of the Delta variant have made doing so unsafe. Despite what some have said about the negative effects of wearing a mask in school, public-health experts tell us that masks are the least invasive way to protect students and ensure a return to the type of education experience we know and miss."

Webinar focuses on importance of nutrition and physical activity to improve the health and learning of Kentucky's children

Photo: Kentucky Coalition for Healthy Children

By Melissa Patrick
Kentucky Health News

The third of five webinars about reducing disease and unhealthy behaviors in Kentucky's children focused on policies and programs to improve nutrition and physical activity.

The Nov. 9 webinar, "Promoting Healthy Lifestyles Through Nutrition & Physical Activity," came in a monthly series that is serving as the Foundation for a Healthy Kentucky's annual policy forum, due to the coronavirus pandemic. 

"We need to come back to the realization that student health improves student learning and outcomes," Bonnie Hackbarth, the foundation's vice-president for external affairs, told Kentucky Health News. "If we really want to improve scores in our state, health is a key part of improving those scores." 

Amanda Goldman, health-care industry strategist, Gordon Food Service, talked in the webinar about the importance of nutrition to growth and learning. 

"We know that a good, balanced diet ensures essential vitamin and mineral support to support healthy growth," she said. "We also know that healthy eating, in addition to regular physical activity, helps children and young adults to decrease their risk of such chronic diseases as Type II diabetes, obesity, hypertension, cardiovascular disease, as well as certain types of cancers."  

She also noted that school nutrition programs, like the national school-breakfast program that serves over 80% of U.S. schools, has not only improved students' nutrition, but their learning, attendance and test scores.

Goldman added that throughout the pandemic, school districts across Kentucky have worked to find ways to make sure their students get nutritional meals even if they are learning from home.

The foundation is partnering with Kentucky Youth Advocates on this year's Howard L. Bost Memorial Health Policy Forum. The next webinar, "Understanding Youth and Building Good Mental Health," will be held at 2 p.m. ET Monday, Dec. 14. 

Jamie Sparks, school health program manager for ETR, a national nonprofit working to advance health equity, pointed out that while health and wellness is a priority in some Kentucky schools, it is not  in every school. "Why do all students not have the same accessibility and the same amount of time allocated around these issues?" he asked. 

He pointed to a national shift toward a "whole child" approach when it comes to education and stressed that "nutrition and physical education and physical activity are all critical components" that need to be included.

Further, he said many of the changes that have resulted from the pandemic, like taking away the focus on standardized testing, has created an opportunity to move toward this "whole school, whole community, whole child" approach. 

Sparks also spoke to the challenges schools face to improve achievement gaps, which often comes at the expense of physical education and physical activity time within the school day. 

Added to that, Kentucky only requires a half-credit of physical education to graduate high school, though school districts can require more. 

So, as Kentucky works toward increasing physical activity in the school day, Sparks said mandating daily PE time is not the solution, largely because schools don't have enough PE teachers or building space. Instead, he said schools must find ways to incorporate movement throughout the day and ways to partner with communities to increase movement. 

Sparks is also the executive director for SHAPE America in Kentucky and the former coordinated school health director for the Kentucky Department of Education. 

An example of how schools and communities can work together to improve nutrition and activity, especially in children, can be found in the Healthy Hometown Project in Clinton County, said Paula Little, assistant superintendent of Clinton County Schools.

The project, which is made up of about 30 community partners, is part of a six-year grant-funded by the foundation that addresses both nutrition and physical activity in the community. 

Clinton County (Wikipedia map)

Little said that in 2012, 74% of adults in Clinton County were overweight; only 17.1% of school-aged children ate the recommended amount of fruits and vegetables; and only 21% of kids were active on a daily basis. Further, the county's rates of diabetes, heart disease, hypertension and other chronic diseases related to obesity were significantly higher than the rest of the state. "Clearly, we were a county that needed to do some work," she said.

She said the Healthy Hometown Project, created in 2013, has worked to change the culture of the community with a "strong, consistent, good health message everywhere" and to make "the healthy choice the easy choice." She added that the focus has been on changing children's nutrition and physical activity behaviors, which is thought to be more doable than changing those behaviors in adults.

"We wanted our children everywhere they looked in the community to be able to say, 'Oh, that's a good healthy choice. That's easy. Let's do that'," she said. "And that needed to come not only from the school, but the community, the media, the church, everybody we could get, we tried to get involved." 

Some of their efforts include providing healthy meals to students during the summer in a mobile café, offering after-school supper programs, offering free fruits and vegetables in the elementary schools, providing a grab-n-go breakfast carts in the schools, creating student walking clubs, offering classroom activity programs as well as increasing PE time, and they built a community playground. "The focus is on being healthy, moving and eating better," she said. 

And the results are paying off, she said. Since starting the program, Clinton County moved up 30 notches in health outcomes in the latest county health rankings issued by the Robert Wood Johnson Foundation, from 94 to 64. 

Little closed her presentation with her favorite quote by Margaret Mead: "Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it's the only thing that ever has." 

"If our community can do it, so can others," she said.

Nellie Ellis, a freshman at Centre College and graduate of Whitley County High School, spoke about the importance of positive messaging when it comes to talking to students about nutrition and activity. 

"So, when we're talking about food, we should do it in a neutral way, instead of using terms like good, bad, clean, nice, etc.," she said. "Talk about what bodies do or how they feel, rather than what they look like. Encourage exercise for the sake of health and enjoyment, not for weight control." 

Click here to register for the Dec. 14 webinar. The panelists will be Felicia S. Smith, licensed psychologist, co-owner of StrongMinds; Dr. Allen Brenzel, medical director, state Department for Behavioral Health; Kerry Gallagher, director of K-12 Education, ConnectSafely; and youth speaker Beatrice Roussell of Louisville Manual High School's STAMINA suicide prevention group. The moderator will be Sheila Schuster, executive director of Advocacy Action Network. The webinars are free, but registration is required for "attending" each one. 

The foundation is also seeking members for the Kentucky Coalition for Healthy Children, which will work to identify and promote policies to improve children's health in school settings. Go to kentuckyhealthychildren.org to learn more about this coalition.

Case numbers virtually assure worst week yet; student parties near UK stir worry about campus cases thwarting K-12 classes

Students partied on University Avenue in Lexington Saturday. (Herald-Leader photo by Alex Slitz) 

By Al Cross
Kentucky Health News

The state recorded 456 more cases of the novel coronavirus yesterday, virtually guaranteeing that it will report the highest weekly number of cases yet, once the numbers are checked and adjusted.

The seven-day rolling average of daily new cases was 733, midway between the previous two days, and the unadjusted number of cases for each of those 7-day period was more than 5,100. The highest number for any of the state's official Monday-to-Sunday reporting weeks has been 4,742, Aug. 31-Sept. 6.

“We know we must do better if we want to continue on the path toward regaining the parts of our lives that have been on hold,” Gov. Andy Beshear said in a press release. “If we want to protect each other and our economy, if we want to get our kids back to school, the message is clear for Team Kentucky: Wear a mask, maintain social distance, wash your hands regularly and avoid crowds.”

Neighborhoods around the University of Kentucky campus were filled Saturday afternoon "with large groups of young people, most of whom were not wearing masks," Karla Ward reports for the Lexington Herald-Leader. "Scores of students attended parties in yards in the area around Elizabeth Street," off South Limestone Street, as the UK football team played its opening game in Auburn, Ala.

Also on Saturday, Lexington reported 110 new coronavirus cases, exactly half of whom were college students. Ward noted concern that cases from the campuses are keeping Fayette County from returning to in-person schooling, as most counties will Monday.

Nikki Fast Pollock, who lives in a neighborhood near UK's football stadium, told Ward that seeing students in hold parties without masks or social distancing is “just kind of like a slap in the face.” Ward reports, "She said her son started kindergarten this year, and she’s had to explain to him that maybe he’ll get to go to school later, but he has to learn on the computer first."

University spokesman Jay Blanton "said UK and Lexington police have been sharing information about reports of large gatherings, and university officials are 'following up with property managers' when they get reports about specific addresses where parties are being held," Ward reports. Blanton said a socially-distant football watch party at UK's baseball stadium drew about 500 students.

"Students who violate UK’s social distancing policy, even if the violation is off campus, can face consequences ranging from a warning to suspension or expulsion," Ward notes. "So far this year, UK has found about 100 students guilty of violating the rules."

Lance Poston, a UK official helping run the university's response to the pandemic, told the Fayette County school board last week that only 5.5 percent of total exposures in UK's tracking system are among Fayette County residents not affiliated with UK, "meaning the university is not contributing in any substantive way to what would be characterized as community spread," the Herald-Leader reported.

In other covid-19 news:

• Schools in Clinton County resumed in-person classes Wednesday, Sept. 23, after going remote and initially planning to be on a covid-driven hiatus until Oct. 12. Supt. Tim Parson "said he didn't think the county would recover so quickly, the Clinton County News reports.
• Beshear announced three more covid-19 deaths Sunday, bringing the state’s death toll to 1,157. The fatalities were a 97-year-old woman from Bell County, an 87-year-old man from Kenton County, and an 81-year-old woman from Fayette County.
• Counties with more than five new cases on the state's daily report were Jefferson, 94; Fayette, 61; Madison, 20; Warren, 19; Henderson, 16; Hardin, 13; Daviess, 10; Greenup, Jessamine, Kenton, Letcher and McCracken, 9 each; Bell, 8; Boone and Harlan, 7 each; and Boyd, Campbell, Estill, Knott, McCreary and Oldham, 6 each.
• Sixty of the newly reported cases were in Kentuckians 18 and younger, of whom 10 were 5 and younger, the release said. The youngest was 2 months old. Other figures won't be announced until Monday due to limited reporting on Sundays, Beshear's release said.

Louisville campaign works to decrease high suicide rate among LGBTQ+ youth; focuses on importance of parental support

A new campaign in Louisville is working to decrease the high suicide rate among high school students who identify as lesbian, gay, bisexual, transgender and questioning by emphasizing the importance of parental support.

In the United States, high school students who identify as LGBTQ are almost five times more likely to attempt suicide than their cisgender, heterosexual peers, according to the National Alliance on Mental Illness. (Cisgender is the term for a person whose sense of personal identity and gender corresponds with their birth sex.)

“Though educating their parents can’t solve everything LGBTQ+ youth face, it’s a great place to start especially when the statistics speak so loudly for themselves,” Ryan Combs said in the news release. “When parents support their kids, youth have better mental health outcomes.”

The project, called "Embrace the Journey," is led by Combs, an assistant professor in the School of Public Health and Information Sciences at the University of Louisville, and Maurice Gattis, associate professor in the university's Kent School of Social Work. It was developed through the guidance of local health providers, public health professionals, LGBTQ+ youth and community members, says the release. (The + at the end of LGBTQ stands for "and others" and ensures an inclusiveness of all identities.)

Combs told Kentucky Health News that the campaign will start in Louisville and includes a 40-mile radius, with hopes of expanding it if successful.

The project stems from the findings of the U of L 2017 LGBTQ+ Adolescent Health Study, which found that 100 percent of the participants had heard homophobic or transphobic language, 61 percent felt unsafe and 27 percent had experienced physical violence at school, according to the release.

“We wanted to understand the health needs of LGBTQ adolescents in Louisville. We learned that the largest concern locally is mental health, especially depression, anxiety and suicidality,” said Combs. “We designed a campaign to target parents because they play such a key role in the mental health of LGBTQ youth."

The reason LGBTQ+ adolescents report higher levels of poor mental health than heterosexual and cisgender youth isn't because of their identity, "but rather that LGBTQ+ youth are often bullied and mistreated for their sexual orientation and / or gender identity / expression, feel misunderstood by other peers and adults in their lives, lack access to affirming health and social services, and are made to feel that who they are is wrong, shameful or politicized," according to the campaign's website.

It continues, "Studies show that when LGBTQ+ adolescents have support from even one adult – especially support from a parent or guardian – they are much more likely to maintain mental healthiness."

The campaign launched at a recent Louisville Pride Foundation event, where organizers spoke to participants and handed out posters that read: “LGBTQ+ youth are more likely to experience depression, anxiety, and suicide – supportive parents greatly reduce this risk.”

Parents of LGBTQ youth can find more information about this campaign and additional resources at
embracethejourneylou.org, including advice from other parents, personal narratives from youth and a glossary of LGBTQ vocabulary.

The campaign was developed with grants from the Cooperative Consortium for Transdisciplinary Social Justice Research at U of L and JustFundKY, an anti-discrimination foundation, and works closely with Louisville Youth Group.

Kentucky schools lack immunization certificates for thousands of children, worry about immuno-compromised students and staff

American Academy of Family Physicians photo

A Louisville Courier Journal analysis found that as of March, the Jefferson County Public Schools had no record of whether 4,300 students had received their shots for measles, mumps and rubella, despite a law that requires students to hand in those documents within two weeks of enrollment.

That's a story that can be told in school districts across the state.

According to the state Department of Education, in the 2017-18 school year, of the 99,113 first and sixth graders who were supposed to have immunization certificates, 7,738 of them had expired certificates, 5,993 were missing, 241 had medical exemptions and 695 had religious exemptions.

The KDE data is broken down by school and grade to show how many students have a current immunization certificate, including whether it is a provisional, standard, medical or religious certificate. The data are not broken down by type of vaccination, and current-year data aren't posted.

Jefferson County school officials told the Courier Journal that many students may have simply not turned in their immunization documents, but they worry about those who haven't been vaccinated.

"We're putting immuno-compromised children, children too young to get immunized — and pregnant teachers and pregnant moms at risk," Troi Cunningham, an immunization nurse with the state, told reporter Allison Ross about the low immunization rates in some areas.

Public health officials say about 95% of students need to be fully immunized in order to protect vulnerable kids and others who are immuno-suppressed from measles, which is highly contagious.

Jefferson County data shows that it's not just the measles, Ross reports; some schools are also missing immunization records for other diseases, like chickenpox and hepatitis A.

It's a challenge to know what to do when students don't turn in their immunization documentation, Dr. Ruth Carrico, an infectious-disease expert at the University of Louisville, told Ross.

"What do we do when a child is not vaccinated? Where do they go?"she asked. "If they get sent home, they miss out on education. If we don't send them home, they may not realize we really mean it that you need that vaccination."

Earlier this year, the Northern Kentucky Health Department barred students who had not been vaccinated against the chickenpox from attending school and all extracurricular activities at a private Catholic school because of an outbreak. One of the students sued the health department over the ban, but the courts ruled in the health department's favor.

Eva Stone, district health coordinator for JCPS, told Ross there are several obstacles to getting children immunized, including a lack of access to medical care; that very few health-care providers will give vaccines to children on Medicaid, which forces parents to take their children somewhere else, like the local health department; and that parents have told her that doctor's offices charge for copies of updated immunization records.

"This is a community issue," Stone said. "How do we make sure children have access to health care?"

Cunningham, the nurse with the health cabinet, told Ross that the state is trying to encourage pediatricians and other health-care providers to use the state's immunization registry to keep track of patients' vaccinations.

Ky. nursing leaders call for a full-time nurse in every school to keep students safe and healthy, and therefore able to learn

Kentucky's nursing leaders are calling on state lawmakers to recognize the vital role school nurses can play "to support student learning in a safe and healthful environment," and are urging them to find "innovative funding" to put a nurse in every school.

"The school nurse is in a prime position to lead this effort but must be present in every school," lead author Kathy K. Hager,  president of the Kentucky Nurses Association, writes in an op-ed for the Lexington Herald-Leader. Only 54 percent of Kentucky's secondary schools have a full-time registered nurse, she notes.

Hager says that nationwide, an estimated 27 percent of students have a chronic health condition and 17 percent experience a mental-health issue each year. In addition, she notes that students are struggling with bulllying, drug-use and gun violence issues.

"In this climate of school violence, along with children’s increasing struggles with physical, behavioral and mental health challenges, much is being debated regarding strategies and resources to support student learning in a safe and healthful environment," Hager writes. She argues that a nurse in every school is the best way to address these needs.

Hager notes that daily access to a full-time nurse as part of the strategy to improve health and safety in schools is supported by the American Academy of Nursing and the American Academy of Pediatrics; the World Health Organization has also identified school health services as an important strategy toward this end.

A recent Academy of Nursing brief on this issue said, “School nurses deliver skilled health care to students, provide referrals to other providers, and assist families in gaining access to specialized care. Yet, despite these undisputed benefits, many schools do not have daily access to a full-time school nurse due to inadequate funding and lack of integration of school health services to the broader health-care system.”

Kentucky adults are overwhelmingly supportive of a law to require a nurse in every school, with 92 percent of them in the latest Kentucky Health Issues Poll saying they supported such a measure.

"We are fully aware of the current budget constraints in Kentucky; however, for the health and welfare of our Kentucky children, we must find innovative funding sources to place a nurse in every school as part of a comprehensive health and education system," she writes. "Contact your local school board and legislators and be the voice your children need. For the health, safety and welfare of our children, every Kentucky school needs a nurse and a comprehensive school health-care plan. Kentucky children are counting on you."

Patricia V. Burkhart, Carol Komara and Lois Davis, who represent the nurses association’s Kentucky School Nurse Committee, also contributed to the the op-ed.

2017 sees a sharp drop in the number of Kentucky school districts implementing 100 percent tobacco-free school policies

Nov. 16, 2017 correction: This story has been edited to reflect that 12 school districts passed 100 percent smoke-free laws in 2016, not 16. 

By Melissa Patrick
Kentucky Health News

Only two school districts have passed 100 percent smoke-free school policies in Kentucky this year, compared to 16 12 in 2016, perhaps because they are waiting to see if the state will require such action.

"Sometimes when the state legislature takes things on, local officials kind of wait and see if the state's going to do it," Ellen Hahn, director of the Kentucky Center for Smoke-free Policy, said in an interview. "We've noticed that, actually, with local smoke-free ordinances, that when the state took it on, people just kind of waited. So, that could be why."

A bill in the 2016 legislative session would have required all Kentucky schools to be 100 percent tobacco-free. It passed quickly out of the Senate, but couldn't garner enough support in the House to bring it to a floor vote.

Sen. Ralph Alvarado of Winchester, who sponsored the legislation, said in an e-mail that he plans to sponsor the bill again in the upcoming session and anticipates that a similar one will be introduced in the House, where his fellow Republicans gained control this year.

"Kentucky has the worst youth smoking rate in the country," Alvarado said in an email. "With all of our current research, everyone is now keenly aware of the devastating health impacts and societal cost of tobacco use. If we hope to reduce the financial burden and promote the healthiest lifestyles for our children, it will have to begin by setting the best examples in our schools."

Almost 17 percent of Kentucky's high-school students are smokers and 23 percent of the report using electronic cigarettes, according to the Campaign for Tobacco-Free Kids. The organization also reports that 3,200 children become new daily smokers each year.

Elizabeth Anderson-Hoagland, a youth tobacco policy specialist with the state Department for Public Health, said she encourages local school districts to pass 100 percent tobacco-free school policies, regardless of what happens at the state level.

"When school districts work on tobacco-free policies at the local level, they can increase community engagement, create buy-in with parents and families, and ultimately help with policy compliance," she said in an email. "A 100% Tobacco-Free School policy is an important way for school districts to protect youth from the effects of secondhand smoke while role modeling smoke-free lifestyles."

Schools are considered 100 percent tobacco-free if they don't allow tobacco products, including vapor products and alternative nicotine products, by staff, students and visitors at any time on school owned property and during school sponsored events.

As of July 2017, just over half of Kentucky's public school students were in school districts with tobacco-free policies: 64 of the 173 districts, covering 681 Kentucky schools. Many districts still need to update their policy to meet new standards for vapor products and e-cigarettes.

Owen County just passed what looks like a 100 percent tobacco-free school policy, but it is still in the process of being verified.

"We want our community to be healthier, and if we all agree that being 100 percent tobacco-free starting in schools, where we have children who are looking at adults and sometimes doing what adults do -- that with education, hopefully, we can prevent that tobacco use from becoming an issue," Owen County Schools Director of District Wide Programs Joretta Crowe told The News-Herald of Owenton.

Most Kentuckians support such policies. According to the 2015 Kentucky Health Issues Poll, 85 percent of Kentucky adults favor tobacco-free schools.

Hoagland said the 100 Percent Tobacco Free School website offers resources for school districts interested in implementing such policies, including success stories from Warren County and Russell County.

"These success stories show that tobacco-free is possible no matter how large or small your school district," she said. "Additionally, support from your local health department will really make a difference, such as trainings for school personnel on the impact of secondhand smoke exposure to smoking cessation classes for interested staff."

Frankfort Independent Schools offer programs for students at risk of attempting suicide; experts offer guidance

Frankfort Independent Schools are working to prevent teen suicide, attempts of which are probably more common than most people think.

Austin Horn reports for The State Journal in Frankfort that a 2016 survey of Kentucky high-school sophomores found that 8.2 percent said they had attempted suicide, and the rate was 8.4 percent in the Bluegrass, where Frankfort is located. The national rate is 9.4 percent.

“It’s a very serious issue,” Dr. Julie Cerel, a psychologist and professor at the University of Kentucky College of Social Work and president of the American Association of Suicidology, told Horn.

School social worker Marci Fritts told Horn that she coordinates mental-health services for at-risk students at Second Street School and Frankfort High School through a partnership with the Kentucky Counseling Center.

“We have clinical therapists working with all of our identified students that (we identified) either through talking with parents, through collaboration with teachers, through referral in school, and approaching guardians and parents about services that potentially would benefit the student,” Fritts said. “We have two full-time therapists at Second Street School, and we have a therapist on-site at the high school.”

The school system also partners with Operation Making a Change, a program designed to provide young males with mentorship, and Fritts heads her own program called “My Life, My Choice,” a prevention-based program provided to all female sophomores at Frankfort High School.

Statewide, all middle and high-school students are required to receive some form of suicide prevention education by Sept. 1, and teachers are required to receive at least two hours of training. In addition, the state is also rolling out a “Sources of Strength” peer-led prevention program this year.

The biennial “Kentucky Incentives for Prevention” survey is given to students across the state in even-numbered grades starting in the sixth grade. It has only asked about suicide since 2014, when the suicide attempt rate for Kentucky's 10th-graders was 8 percent, compared to 8.6 percent nationwide. Suicide is the second leading cause of death among Kentucky's teens and young adults.

Cerel told Horn that there is never just one factor that leads a person to attempt suicide, but one study found that teens who had attempted suicide reported that the most common reason was a recent break-up, regardless of the length of the relationship. Cerel warned parents to take these break-ups seriously.

“If a teen is stressed or feels like something has happened and they’re never going to get over it, the adult response shouldn’t be, ‘Oh, that’s nothing, you’re going to grow up and find somebody else,’” Cerel told Horn. “The response probably should be, ‘I understand that this feels like the worst thing ever; let’s figure out a way to get you some help.’”

Dr. Vicki Hayes, a psychologist in Frankfort, told Horn that sometimes there are warning signs that shouldn't be ignored.

“One of the biggest behavioral things you want to watch for as a parent is abrupt change in a child’s behavior,” Hayes said. “Pay a lot of attention to that and try to find out what’s going on. If they’re saying anything morbid or that sounds suicidal, don’t let that ride. Don’t ever call a bluff or think that they don’t mean it. It’s better to err on the side of caution.”

Bullying is often cited as a reason for youth suicide attempts in Franklin County, Hayes told Horn.

“There are very few people who have not been bullied. I think there’s a huge bullying problem in Franklin County, and I’m concerned about it — all the schools,” Hayes said. “I don’t think any of them are doing enough to stop the bullying here in this particular county.”

In the 2015-16 school year, the Frankfort schools, with an enrollment of 735, reported 47 events of harassment, a rate of 6.4 percent, while the Franklin County Public Schools, with an enrollment of 6,131, reported 312, a 5 percent rate. The county system has two high schools, Franklin County and Western Hills. "The State Journal reached out multiple times to both Franklin County public high school psychologists but did not receive a response by press time," Horn reports.

Horn notes that the recent Netflix television series "13 Reasons Why," which depicts the aftermath of a fictional teenage girl's suicide, has also exposed teens to suicide and may have "adverse effects." This series has prompted schools throughout the state to send resource letters home with guidance on how to talk to children about suicide and has also warned that "vulnerable youth" should not watch it.

"Cerel referenced a recent study that showed Google searches for suicide methods increased by as much as 28 percent in the two weeks following the release of “13 Reasons Why," Horn reports.

Mobile dental unit in Floyd Co. will provide oral-health evaluation and treatment; will be free, but can bill insurance for treatment

In an effort to make sure its students have access to dental treatment, the Floyd County School District has partnered with a regional health-care center that will provide dental services at its schools via a mobile dental unit, Mary Meadows reports for the Floyd County Chronicle.

The school board approved the contract with Big Sandy Health Care at its June 26 meeting. Meadows reports that the contract will not cost the district any funds and that Big Sandy Health Care will bill Medicaid or private insurance “where applicable.”

Supt. Henry Webb, who resigned June 30, told the board members that the district had partnered with Big Sandy Health Care for dental services for years, noting that the center had evaluated about 2,000 students each year for dental issues. But he added, "The issue’s always been when they find cavities and things like that, they recommend follow-up, but unfortunately, lots of times that never happens."

The new contract allows dentists in the health center's mobile dental unit to not only evaluate the students, but to also provide treatments, such as fillings and extractions, with consent of parents or guardians.

“I just think it’s a huge step forward,” Webb said. “Unfortunately, we have a lot of dental issues with kids, and I think this will really make a significant difference for the health and well-being of our kids.” (This story is behind a paywall.)

A Delta Dental of Kentucky and Kentucky Youth Advocates study, released in October, found that the oral health of Kentucky's school children is getting worse, even though access to oral health care is better now than it was 15 years ago.

The analysis of third and sixth graders found that two out of five children in the study had untreated cavities and that this problem was "significantly greater" in Appalachian Kentucky, where more than half of the children in the study had untreated cavities.

With pushes from Obama administration, Kentucky schools focused more on health; example: less junk food is available

Lexington Herald-Leader file photo

Sugary drinks, fatty snacks and chocolate candy are becoming harder to buy in Kentucky schools, which are paying more attention to health issues, according to the latest survey by the federal Centers for Disease Control and Prevention.

The CDC's latest biennial School Health Profiles for 2014 found big declines in the availability of junk food since 2014. Here are the specifics:

• Chocolate candy: 7.8 percent in 2016, down from 22.6 percent in 2014
• Salty snacks that are not low in fat: 13.7 percent in 2016, down from 26.1 percent.
• Cookies, crackers or other baked goods that are not low in fat: 12.0 percent in 2016, down from 24.1 percent.
• Soda or fruit drinks that are not 100 percent juice: 15.7 percent in 2016, down from 33.1 percent in 2014.

There was also a big increase last year in the number of Kentucky schools that banned less nutritious foods and beverages from being sold in fundraising, up to 36 percent from 23 percent in 2014, a news release from the state Department of Education said.

Schools are systematically paying more attention to health issues. The survey found that 66 percent have used the CDC’s School Health Index or another self-assessment tool to evaluate them in the areas of physical activity (66 percent in 2016, 56 percent in 2014), nutrition (62 percent in 2016, 53 percent in 2014) and asthma (35 percent in 2016, 21 percent in 2014).

More schools are offering opportunities for students to participate in physical activity before the school day through organized activities or access to facilities or equipment: 29.4 percent in 2016, up from 19.3 percent in 2014.

"Nearly three-fourths of schools have one or more groups such as a school health council, committee or team that offers guidance on the development of policies or coordinates activities on health topics," the release said. "There were such groups in 74.7 percent of schools in 2016, up from 63.8 percent in 2014."

The department and the Kentucky School Nutrition Association attributed the improvements to the Healthy, Hunger-Free Kids Act that Congress passed 2010, the U.S. Department of Agriculture’s "Smart Snacks in School" regulation of 2014 and a review of the state education department’s Practical Living Career Studies program.

Janet Tietyen Mullins, a University of Kentucky extension professor of food and nutrition, said the improvements are encouraging, "because they can help Kentucky students reduce their risk of developing diabetes and other chronic diseases," Valarie Honeycutt Spears writes for the Lexington Herald-Leader.

Mullins told Spears, “These changes in the school food environment are a positive way to help students choose more nutritious foods. Everyone benefits from an environment where healthy foods are readily available, and the changes could also benefit school staff and guests.”

Read more here: http://www.kentucky.com/news/local/education/article143288254.html#storylink=cpy

Study finds that frequent consumption of energy drinks, even without alcohol, is associated with more frequent drunk driving

Image: childrensmd.org

Energy drinks don't have to be combined with alcohol to increase the risk of drunk driving, according to a new study.

Researchers had already found that frequent mixing of alcohol with energy drinks contributed to drunk driving, but they didn't expect to find that "consuming energy drinks without alcohol contributed additional risk for drunk driving, regardless of alcohol drinking patterns," said a Research Society on Alcoholism news release.

The report called this finding "unexpected" and said it "suggests that mechanisms other than the promotion of heavy drinking by energy drinks are involved in promoting drunk driving."

The researchers found that 57 percent of students consumed energy drinks; 9 percent drank them exclusively with alcohol, 16 percent drank them exclusively without alcohol, and 32 percent drank them both with and without alcohol, depending on the occasion.

"The authors encourage parents, clinicians, and college administrators to regard any style of energy drink consumption, whether with or without alcohol, as a warning sign that students might be at high risk for alcohol-related consequences such as drunk driving," the release said.

Seeing statewide smoking ban unlikely, Grayson County group asked Fiscal Court for a local one; only one magistrate favored it

By Al Cross
Kentucky Health News

The efforts to pass smoking bans in Kentucky continue on three fronts: in the General Assembly, for a statewide ban; with local governments, for city or county bans; and school boards, for campuses free of tobacco and electronic cigarettes. Students have played a role on the school front, and even with local governments.

New Republican Gov. Matt Bevin has said smoking bans should be a local issue, but hasn't said if he would veto a ban passed by the legislature, where the Democratic-controlled House passed one narrowly last year but watched it die in the Republican-controlled Senate.

The opposition of Bevin and the Senate has prompted new efforts in some localities, but the latest one has fallen short, even with lobbying by high-school students. And it resulted in racial comments by a top county official.

A motion for a smoking ban died for lack of a second in the Grayson County Fiscal Court meeting Friday, Jan. 15, after a group of local health-care providers, business leaders and five students from Grayson County High School spoke in favor if it.

The effort was led by the local hospital, the Twin Lakes Regional Regional Medial Center, which formed a Population Health Committee with local industries, schools and the Kentucky Cancer Program. The committee conducted an online survey that showed strong support for a smoking ban.

"This is a major public health issue facing our communities," hospital CEO Wayne Meriwether told The Record, a local weekly newspaper. "Everyone has the right to breathe smoke-free air at work and in public places."

Meriwether said that with the failure of a statewide ban in the legislature last year, and the election of Bevin, "We decided to proceed on the local level. . . . It won't cost our county a penny, but it's something we can do to improve the health of our county."

The Record's story noted that adjoining Hardin County has a ban, and "Researchers say second-hand smoke is the third leading preventable cause of death in the United States."

Meriwether speaks to fiscal court (K105)

Meriwether made similar arguments at the fiscal court meeting, where the idea ran into opposition from business owners. "I have the right to choose what to do with my business," said Winston Davis, owner of the popular Farmers Feed Mill restaurant. Others argued for the personal freedom to smoke.

Magistrate Harold Johnson made the motion for a smoking ban, saying his constituents wanted it, but it died when none of the other five magistrates would second it. They said the issue should be decided by voters in a referendum, but Meriwether and County Attorney Clay Ratley told them that state law doesn't allow such referenda.

Judge-Executive Gary Logsdon, who recently received a double lung transplant, made his opposition clear, reports Ken Howlett of WKHG (K105) in Leitchfield. “Are we going to be a nanny county or a nanny state?” Logsdon asked. “Smoking is bad. I've got two lungs out of a 42-year-old; that was seven months ago. I don't know where he come from, but Lord, I do pray for him, because I wouldn't be here; I was dead [and] never smoked a cigarette in my life, but the good Lord takes care of us. We do ask that everybody that does smoke, and the majority does, respect us."

Actually, there is no county in Kentucky where even 40 percent of adult residents smoke, according to KentuckyHealthFacts.org. Grayson County's rate is 28 percent, slightly below the statewide rate of 26.5 percent, the highest in the nation.

Howlett reports, “Grayson County High School senior Tristan Deering, who had already eloquently stated his preference that a smoking ban is passed, asked magistrates, 'If it’s not the role of government to protect people, then what is the role of government?'

Logsdon replied, "I’m not black and I’m not Obama, and I’m not passing, making you do anything." After a few seconds of apparent confusion in the audience, he added, "And I love blacks and whites; I respect blacks, but you know, I’m not Obama." Logsdon is a Republican who has been repeatedly re-elected.

In a follow-up story, Mark Buckles of K105 reports that members of the audience "were audibly confused" after Logsdon's reply. "Whether or not the response had racial overtones or was simply a struggle to articulate a point regarding the court's role in such public policy matters, many residents both in attendance and not have been led to have questions over what some have called a very 'odd' meeting." Buckles posted audio of the smoking-ban discussion here and Logsdon's part of it here.

Bill requiring high-school students to learn CPR goes to Senate floor; House has passed similar legislation in previous sessions

UPDATE: SB33 passed the state House on consent March 28 and now heads to the governor's desk for his signature. 

UPDATE:   SB33 passed the state Senate on Jan. 28  by a 32-6 vote and will now go to the state House of Representatives for further consideration. 

A bill that would require every high-school student in Kentucky to learn cardiopulmonary resuscitation, commonly called CPR, has moved to the Senate for passage after the chamber showed no interest in similar House bills in previous years.

Sen. Max Wise

"Each year nearly 424,000 people have sudden cardiac arrest outside of the hospital and only 10 percent of those victims survive," the bill's main sponsor, Sen. Max Wise, said at the Jan. 13 Health and Welfare Committee meeting. "Yet when a CPR trained bystander is near, they can double or triple these victims survival rate by giving the victim the help they need until the EMS arrives."

Tanner Demling, a Trinity High School junior, is one of the few who survived.

Tanner's father, Jody Demling, a sportswriter and radio host of "Early Birds" on Louisville's WKRD, told the committee that Tanner, who was born with a heart defect, but had checkups every year and was cleared to play sports, had a sudden cardiac arrest in 2014 while at lacrosse practice, going 30 minutes without a pulse. He said Tanner's coach immediately started CPR, and was soon helped by another bystander.

"There were hundreds of people around that day, but they could only find a couple of them that knew CPR," Demling said. Later adding, "If two people in that crowd didn't know CPR, then Tanner wouldn't be sitting here."

Wise's Senate Bill 33 would require every student in grades 9-12 get CPR training in either a health or physical education class or in a junior ROTC class. Wise said the training takes only 30 minutes to an hour, and because the bill includes a community component, it adds no additional financial burden to the schools.

Wise, a Republican from Campbellsville, presented a spreadsheet that included an EMS volunteer in every Kentucky county that had agreed to provide this training at no charge. "If the school system says we don't have anybody that can do this, there is a volunteer," Wise said in a follow-up interview.

The training would be in the form of CPR limited to rhythmic chest compression, which has become preferred and does not include mouth-to-mouth resuscitation. It is already part of the Kentucky Academic Core Standards for high school education, but it isn't always provided. About 27 states have some type of law to require high school student be trained in CPR before graduation.

"This can be a potential life saver," Wise said in the interview. "It reduces the chances of someone being a bystander and not knowing what to do in the situation."

Rep. Jeff Greer

Rep. Jeff Greer, a Brandenburg Democrat who has passed similar legislation out of the House the last two years, said in an interview that he plans to file a bill in the House soon.

While Greer said the most important thing is to pass this bill, he also expressed some puzzlement as to why the Senate was on board this year, when it wouldn't even allow it a hearing the past two years.

"It just seems so strange to me that for the past two years, they were telling me, 'We won't pass that; we have no appetite for that; it is a mandate,' and then all of a sudden it is one of the first bills out of the chamber."

Wise said that as a senator elected in 2014, he couldn't speak to the previous roadblocks. He said that he decided to sponsor the bill after one of his Russell County constituents who was a strong proponent of last year's House bill because her son has a heart condition brought it to his attention. "I think it is a common-sense law," he said.

Greer said he felt confident that this year's bill would pass out of the House again and that, "Hopefully, between one or the other, it will become law," he said. "We need to make sure that this gets done."

Boone County Schools strategically implement healthy changes to lunch menu

Boone County Schools began serving healthier food and offering low-fat, low-sodium meals in their lunchrooms before the Healthy, Hunger-Free Kids Act was implemented in 2010, Amy Scalf reports for the Community Press.

"Whole grain is our largest issue," Food Service Director Barbara Kincaid told the weekly paper published by The Cincinnati Enquirer. "We work really hard on that because some students find these products unacceptable. . . . Sometimes we don't point out that items are whole-grain, but they are."

Dr. Randy Poe, superintendent, said nutrition education is important in the school environment: "A healthy child can make healthier choices, which leads to improved academic performance. So, it's beneficial to not only make sure our students are eating healthy but to make sure they understand the importance of eating healthy and how it affects their brain, body functions and growth."

Kincaid said introducing new foods is a little easier with younger students, and "adding unusual vegetables as a garnish can generate interest among students," Scalf reports. "The students get used to seeing them and begin to try them," Kincaid said. "Kids who say they don't like tomatoes may try them if they're offered as a garnish." They have been careful to make a few changes at a time. Boone County school cafeterias no longer serve foods with trans fats and high-fructose corn syrup.

"Nationwide, there's a 15 percent reduction of kids eating school lunches," Kincaid said. "In the past four years, there has been a 7 percent reduction in Boone schools. That's significant, and it's still troublesome to me because those are kids we're not feeding, and I want to feed all of them."

Ashland teachers will incorporate physical activity into lessons

Teachers from Ashland Independent Schools attended a Take 10 workshop to learn how to incorporate physical activity into the classroom, Adam Black reports for The Independent: "The program, which has been provided . . . through a grant, encourages teachers to give students 10 minutes twice a day in physical activities while learning core curriculum subjects."

The workshop included colorful scarves, stress balls and Chinese jump ropes. Teachers said the alphabet backwards while jumping rope and used scarves to write out letters. John Smith, educational consultant for Flaghouse Inc., said, "There is a 42 percent obesity rate in the Ashland area." Smith told teachers who attended the workshop that the Take 10 program could positively affect their schools. "Kids get better test scores after physical activity," he said.

Smith demonstrated activities students could do even in a small classroom and shared some analogies and stories with the group. "Imagine you are a car, and you fill your tank up, drive around the block and fill up again. Eventually you will explode since you're not burning it all off," he said, Black writes.

"They are really practical activities that don't require a lot of prep time," said Oakview Elementary School music teacher Braun Ream.

Girls are more likely than boys to have overuse injuries while participating in high school sports

Overuse injuries make up more than 50 percent of athletic injuries and are most common in children ages 13 to 17. Girls are at a higher risk than boys of overuse injuries while participating in high school sports, according to a study by researchers at The Ohio State University Wexner Medical Center and published in the Journal of Pediatrics. Tendonitis, stress fractures and joint pain are examples of overuse injuries, which happen when athletes perform the same motion again and again.

In the study, Thomas Best analyzed 3,000 injury cases during a seven year period of time associated with 20 high school sports such as soccer, volleyball, gymnastics and lacrosse. Best and his team discovered the highest rate of overuse injuries happened in girls' track (3.82), followed by girls' field hockey (2.93) and girls' lacrosse (2.73). The most common overuse injuries for boys occurred in swimming and diving (1.3).

"These young people spend more time playing sports both in competition and in practice," said Best, an endowed professor in Ohio State's department of family medicine. "So there's a correlation there between the amount of time that they're playing and the increased incidence of injuries."

Over the past 10 years, high school athletic participation and intensity has gone up. Best said some high school athletes spend more than 18 hours per week participating in athletics, and some play more than one sport at a time. The most common site of overuse injuries is the lower leg, followed by the knee then the shoulder, Best said. To avoid overuse injuries, Best recommends varying movement, playing more than one sport and prioritizing rest and nutrition.

"During this point of their lives, this is when girls are developing bones at the greatest rate," Best said. "It's incredible important that they're getting the proper amounts of calcium and vitamin D."

A leading authority on bullying in schools offers ideas for recognizing, preventing and dealing with it

By Melissa Landon
Institute for Rural Journalism and Community Issues

How do we recognize, deal with and prevent bullying, particularly in schools? A leading authority on bullying offered some ideas June 12 in a University of Kentucky training session called "The Meanest Generation: Teaching Civility, Empathy, Kindness and Compassion to our Angriest Children," at Eastern State Hospital in Lexington.

Malcolm Smith, right, between sessions

Malcolm Smith, founder and director of the Courage to Care Project who serves on the faculty of Plymouth State University, said one myth about bullying is that it only occurs in large schools. "Actually, I'm more worried about children in a rural school," Smith said. In rural areas, he said, bullying can be a huge problem because there's nowhere to hide, everyone is often into everyone else's business, and an issue can escalate into a feud when families get involved.

Smith defined bullying as a single incident or pattern of written, verbal, electronic or physical actions intended to harm a pupil or his or her property; cause emotional stress; interfere with that student's right to an education; or disrupt the school's operation. Smith debunked a common theory about bullying that became popular in the 1980s—that bullies lack self-esteem. "Bullies are not kids who have low-self-esteem," Smith said. "The average bully is the kid who is a narcissist." Smith believes that a person becomes narcissistic if he or she never learned to bond and love as a child.

He argued that a lack of empathy and rising narcissism—which is characterized by an overinflated view of one's talents and a high level of selfishness—are the true causes of bullying. Empathy is the tendency to react to other people's observed experiences. Research shows that 70 percent of current students score higher in narcissism and lower in empathy than they did 35 years ago. Smith believes this is related to the rise in technology, the culture of self-esteem, the decline of time spent playing—which is often when children gain social competencies—and the overexposure of children to meanness and violence through the media.

Bullies are more likely to have been involved in domestic violence and child abuse; are more likely to commit crimes, drink and smoke; and have a greater propensity toward becoming anti-social adults. Signs that a child is a victim of a bully include exclusion, fear, lack of friends, erratic attendance, depression, withdrawal or clinging to teachers and staff.

Because bullying is characterized by an imbalance of power between the perpetrator and the victim, Smith urged school counselors and teachers not to try mediating a bullying situation, especially not by talking to both the victim and the bully in the same room or worse, leaving them to "work it out." Smith said, "You have to educate the social-emotional deficit in the bully, and you have to comfort the victim." Instead of simply punishing the bully, an authority must discipline him or her, which involves teaching.

To properly discipline a bully, he or she must be required to take responsibility for the behavior and explain to the authority why the behavior was wrong. Then the student must discuss alternative actions that could have been employed. Finally, the student must not only apologize but also perform an act of kindness toward the student he or she bullied.

Smith urged teachers and counselors to recognize and address bullying, explaining that it is not ever a good thing or a positive part of a growing experience, as some people think. He pointed out that adults in the workplace are protected by harassment laws and don't have to face bullying alone, so children shouldn't have to, either. He said to combat bullying, "model good social skills yourself, advocate for safer schools and better laws, work with your school parent-teacher organization, engage parents and students in prevention and work on culture and climate."