Wednesday, January 26, 2011

South Davis rehab patients sure make the news a lot

Teen returns to school after life-changing accident

Al Hartmann | The Salt Lake Tribune Lina Nguyen was paralyzed in a car accident shortly before her junior year of high school. After a year and a half she's now returning to school at Granger High School to finish her senior year and graduate with her class. Lina rolls to her first class and goes past the Granger High School Lancer and athletics trophy case. Her first day back both her aides Cassandra Scott, left, and Jennie Figueroa accompanied her to learn the routines. Normally she will have one aide throughout the day.
West Valley City • Lina Nguyen’s life will be forever divided into two parts: before and after.
Before, she was an independent, active teenager. She relished going to school to see her friends and loved playing basketball and volleyball at Granger High School. She spent most of her free time working as a waitress to help her family pay the bills.
After an accident in 2009, she was paralyzed from the chest down and able to fully move only her neck and head. She was a passenger in her friend’s car when it rolled in Parleys Canyon. Lina had to learn to live a life of total dependence on others, an existence she calls “hurtful.”
But Lina kept going, conquering one goal at a time: getting off her feeding tube, re-learning how to talk and how to help control an electric wheelchair.
Now, she’s determined to conquer another goal — graduating on time from high school with her class. After a year and a half away from school, the 18-year-old returned to Granger High for her senior year on Monday, her body impaired but her drive to succeed perfectly intact.
“I just needed to finish what I started,” said Lina, a petite, gregarious teen with a broad, quick smile. “I need to go to school because getting an education is what I need to do right now to help myself. If I quit school, that’s quitting on myself.”
After the accident, Lina kept up with her school work at South Davis Community Hospital, working with a teacher an hour or two every day. She might have spent the rest of her senior year working from the hospital bed that’s now stationed in her family’s living room.
But she didn’t want to miss her senior year, a year she had always imagined as full of fun and adventure. So she decided to face her fears and return to the hallways of her old high school, a decision her family supported.
“It’s better for her to go to school, for her to clear her mind” said Lina’s mother, Hoa Tran, in Vietnamese. Tran and her daughter have become closer since she began taking care of Lina after the accident. “When she’s at home, she thinks too much.”
Lina’s best friend, senior Tina Tran, encouraged Lina not to worry.
“It’s really great that she’s actually overcome her fear of being judged,” Tina Tran said. “It’s like Lina to get back on her feet and try again. She’s always been determined like that.”
But Lina knew her decision wouldn’t be an easy one to carry out. For months, a team of educators and Granite workers have been preparing for her return.
District specialists trained aides to take turns staying with her all day to help her take notes, turn pages, open doors and eat lunch. A custodian worked to make sure all the school’s automatic doors opened correctly. A school bus with a lift will usher her to Granger and back each day. And a team of district therapists are setting up a laptop that will allow her to dictate notes and papers. She’ll control the laptop’s mouse by moving her head.
But beyond the practicalities of her return, she worried about how her classmates will react to her.
“I’m scared,” Lina said several days before her return. “What if people don’t see past the wheelchair, and think, ‘Oh, she’s a girl in a wheelchair. Don’t talk to her. She’s weird.’ I don’t want people to see the wheelchair. I want people to see me.”
Lina’s anxiety only intensified as her return drew nearer. On Monday morning, she nervously joked with the team assigned to helping her: a school nurse, a district physical therapist, two aides and her counselor. The pack surrounded her in an empty school hallway working out the logistics of the day to come.
“Oh, I don’t want to be here. I’m so nervous,” she said several times with a smile and uncomfortable laugh. She asked an aide to apply her lip gloss and accepted compliments on her turquoise-colored nails, painted with intricate flowers.
Within an hour, she moved through the hallways with her aides, and several teens excitedly greeted her.
“Hi Lina! You look cute!” one girl shouted.
“Hi Lina!” another girl exclaimed.
“Oh, [expletive],” a boy said, stopping in his tracks to flash her a smile. “Lina!”
She smiled back.
But others simply glanced at Lina before walking by.
“I see people I used to know and stuff in the hallway,” Lina told one of her aides. “They’re scared to say hi.”
But after her long absence, she was eager to get to class. When science teacher Henry Tanner asked his zoology class to explain what Golgi apparatus do, no one answered — except Lina.
She grew bolder still in her next class, public speaking. Teacher Marilyn Miller began the period by introducing Lina and her aides. Without being prompted, Lina made her own announcement to the class after Miller finished speaking.
“And don’t hesitate to ask any questions if you guys are curious or anything,” Lina said in a loud, clear voice. “I’m the same. Just because I’m paralyzed doesn’t mean I’m different. You guys don’t have to be scared of me. I just wanted to get that out in the open.”
She then dove into the class assignment for the day, interviewing a classmate and then answering that classmate’s questions in order to give speeches about one another in front of the group.
The prepared list of what would normally be basic questions proved a reminder of the line between “before” and “after” in Lina’s life.
“What are the activities you like?” her partner asked.
“Before, I used to play basketball and volleyball,” Lina answered. “If I weren’t paralyzed, I would still be playing them.”
“What are your career plans?” her partner asked.
“Before my accident, I wanted to go graduate school and become a nurse,” Lina answered. “But ever since I got in my accident, I either want to be a motivational speaker or work in medicine.”
“Your ultimate goal?” her partner asked.
Lina paused for a moment.
More than half of her first day at school was already behind her.
“My ultimate goal is to have a successful life, finish high school and college and prove to the world that even though I’m paralyzed, it does not mean I cannot succeed,” Lina replied.
It wasn’t the answer she would have given before the accident. But it was an answer that showed she wouldn’t give up after it.

© 2011 The Salt Lake Tribune

Monday, January 3, 2011

Can anyone tell me why we reunify abusive parents with children???

Young beating victim recovering; adoption possible

Steve Griffin | The Salt Lake Tribune Eight-year-old Karen Meza Reyna listens to her DCFS caseworker, Abbie Ogaard, as she reads her a book in her room at the South Davis Community Hospital in Bountiful Monday, December 6, 2010. Reza awaits a foster/adoptive family after being beaten by her mother and left in vegetative state. She may be in a wheelchair for life.
Her mischievous smile slips from her face, her head lolls forward involuntarily, and the big dark eyes of the princess of South Davis Community Hospital are no longer on her state caseworker.
Yet for a child viciously beaten by her mother in 2009, Karen Meza Reyna hasn’t lost her spirit.
It’s typical for Karen, a pigtailed 8-year-old robbed of everyday living — including the ability to walk and talk — to drift in and out of a direct connection with the world around her.
But don’t write her out of the picture just yet. Caseworkers said Karen’s smile won’t let them.
“She wasn’t supposed to survive,” said Chris Chytraus, her state-sponsored medical care supervisor. “The doctors thought she might permanently be in a vegetative state.”
Survive she has — enough that the young girl was put up for adoption this fall and perhaps will start over with a new family, leaving the hospital room that has been her home for more than a year.
“She has stolen the hearts of everyone here,” said caseworker Abbie Ogaard, still holding the limp hand of the girl sitting quietly in a wheelchair.
Should she be adopted, Karen would leave behind a former life with her mother in West Valley City that was a nightmare.
It started in 2008, when Emperatriz Meza Reyna, 23, first lost her child to the state.
Meza Reyna eventually admitted in court she had choked her child multiple times, beat her with a belt and cable cord, and wrote on the girl’s face with a black marker.
Then the child’s life got worse.
The younger Meza Reyna was taken to Pioneer Valley Hospital last summer with bruises, bites and injuries all over her body.
During a CT scan, the girl went into cardiac arrest and was flown to Primary Children’s Medical Center. There, she underwent brain surgery and fell into a coma.
Her mother, an undocumented immigrant, initially told police her daughter fell down the stairs.
But doctors said her injuries — including bruises under her right eye, an ear, buttocks, left leg and ankle, as well as a broken clavicle and bite marks on her torso — were not consistent with a fall.
A doctor reported some of the injuries appeared to have been caused by being hit with a hard object, such as a baseball bat or board, or being slammed into a hard surface, according to court documents.
Doctors had to remove a portion of the girl’s skull to save her life. With brain damage, the long-term prognosis was not good.
But flash forward to a wintry day in December — after a year and half of rehabilitation and other medical care — and view a girl with a penchant for pink and princesses that has more than survived brain damage.
Caseworkers believe she’s improved enough since the beating that she can leave the hospital for outside schooling.
She has also progressed from a vegetative stare to shyly teasing the people around her —not using words, but simply by shaking her head or waving her one working arm.
This from a girl with a temporarily toothless grin who may not ever fully walk and talk again. Never have a fully functioning brain, never regain the half of her body that has gone partially limp.
Sitting next to her caseworkers, Karen lets out a sigh, the only way she is able to verbalize, for now.
“She’s made a lot more progress, more than anybody thought,” Chytraus said. “But we don’t know how much progress she’ll make.”
For the second beating, Karen’s mom was sentenced in January 2010 to spend 20 years in prison.
The Meza Reyna case was “frustrating and heartbreaking” for workers at the Utah Division of Child and Family Services because the mother was a repeat offender, said spokeswoman Elizabeth Sollis.
By federal and state statute, Sollis said her agency cannot further comment on the case or detail why the decision was made to initially return the child to her mother.
In the first case, Meza Reyna, admitted to the abuse of her daughter.
According to court documents, the mother told police she was glad she was arrested because she was afraid she might kill her daughter.
The girl, then 5, was taken into DCFS custody in January 2008.
Meza Reyna pleaded guilty to two charges of third-degree felony child abuse, served 17 days in jail and was placed on 36 months probation.
After the woman completed parenting classes, her daughter was returned home.
But just three months after regaining custody of her daughter, doctors determined Meza Reyna beat the girl with force that inflicted critical brain injuries.
Sollis explained that DCFS works closely with all parties in any case — parents, courts, doctors, schools and others — to try to reunify children with their parents if appropriate. A judge ultimately signs the order to send a child back home.
Sollis said parental rights had to be terminated for Karen to be put up for adoption, so the father, for reasons not disclosed, is out of the picture, too.
Chytraus points out there are other children with special needs waiting for adoption, but that Karen is the most severe case when it comes to combined physical and emotional needs.
For example, she has an IV tube constantly delivering medicine to her body, and brain injuries that will likely be a lifelong problem requiring occupational and speech therapy.
She also has trouble keeping her head up straight.
Caseworkers say adopting her would be no easy matter, for any family.
Yet three adoption inquiries were sent in once Karen was featured in an adoption program in the fall.
One couple, potential new parents, have visited, but the process may take until spring — if it all works out, Ogaard said.
“I want to take her home with me,” a nurse said quietly as she walked out of Karen’s room.
Ask just about any nurse or doctor at the Bountiful hospital, and they will confirm that Karen is the darling of the third floor, and holds the princess title, if she wants it, until the day she leaves.
“Our staff will be heartbroken,“ said Nancy Murphy, a pediatrician who treats the girl. “I think her future is good.”
Adoption information
Anyone interested in adopting a child in foster care can contact the Utah Adoption Exchange,

© 2011 The Salt Lake Tribune

Sunday, January 2, 2011

US teen birth rate still far higher than W. Europe

 December 30th, 2010 @ 5:26pm
AP Medical Writer

ATLANTA (AP) - The rate of teen births in the U.S. is at its lowest level in almost 70 years. Yet, the sobering context is that the teen pregnancy rate is far lower in many other countries. The most convincing explanation is that contraceptive use is much higher among teens in most Western European countries.
Last week, U.S. health officials released new government figures for 2009 showing 39 births per 1,000 girls, ages 15 through 19 _ the lowest rate since records have been kept on this issue.
That's close to the teen birth rate for Romania, Turkey and Bulgaria in 2007, the latest numbers available from the World Bank, which collects a variety of data gauging international development.
The teen birth rate for Western Europe and a few other countries is dramatically lower. In the United Kingdom it's 24 per 1,000 girls. In traditionally Catholic Ireland, it's 16 and in Italy it's 5. France's rate is 7 per 1,000. Canada's rate is under 13, Sweden's is under 8, Japan's is about 5, and in the Netherlands it's close to 4.
The disparity has existed for decades. Several experts say the reason mostly has to do with more realistic approaches to birth control.
Birth control is less expensive and easier for teens to get in many other developed countries than in the United States. And teachers, parents and physicians tend to be more accepting of teenage sexuality and more likely to encourage use of contraception, said Sarah Brown, chief executive of the Washington, D.C.-based National Campaign to Prevent Teen and Unplanned Pregnancy.
Teen births are a concern: The hazards of teen pregnancy include higher dropout rates, as well as possible health and other problems for young mothers and their kids.
There are few comprehensive studies of why teen birth rates vary from country to country. And experts say there's probably not one overarching explanation. For example, the reason for a low teen birth rate may be different in the Netherlands, where prostitution is legal, than in Japan, which traditionally has a more conservative culture when it comes to sex and sex education.
Some countries may have predominant social values that discourage teenage sex, but abstinence-only education programs _ a hot topic in the United States _ are generally not considered a major reason other countries have lower teen birth rates.
"Not at all," said Cecilia Ekeus, a researcher in international public health at Stockholm's Karolinska Institute.
"We're working the opposite way," she added, describing Sweden's comprehensive sex education and easy teen access to condoms and birth control pills.
Experts say teen births can be lower when:
_Teens have less sex.
_Teens use contraception correctly and often.
_A larger proportion of pregnant teens has an abortion.
But do those explain the international differences?
As to the first, there is no evidence teens in Europe are having less sex than American teens, so that's not considered a likely explanation.
If anything, "there may be more sex there than here" among teenagers, said Carl Haub, a demographer with the Washington, D.C.-based Population Reference Bureau.
As to the third, most international comparisons of abortion rates are considered dated and somewhat unreliable because of incomplete information. One smaller study found the United States had a higher abortion rate than Canada and some European countries, and not all experts think it's a major reason for different birth rates.
But some researchers say abortion is a significant factor in some nations. In Sweden, for example, abortions are legal without parental consent _ and quite common. Indeed, one in two women who get pregnant in their lifetime has an abortion, said Ekeus.
There's much more consensus that birth control is the key to a lower teen birth rate.
Studies indicate that about 80 percent of sexually active teen girls in Sweden and about 88 percent in England and France use contraception. In the United States, it's about 61 percent.
And in some European countries they are more likely to use longer-lasting forms of birth control, such as the IUD, experts said.
Other explanations? Perhaps race and ethnicity, said Dr. Monique Chireau, a Duke University assistant professor who researches adolescent pregnancy.
She noted the birth rate for white U.S. teens _ about 26 per 1,000 _ is much lower then the black and Hispanic rates (59 and 70, respectively).
"There are distinctions between different ethnicities," and the U.S. whites are more comparable to countries with more homogenous white populations, she said.
Factors like proportions of teens that are married in each country, proportions living in poverty, and other demographics also should be considered, she and others said.
Cultural expectations have a lot to do with it, too, said several sources pointing to societies where teen childbearing is not considered an attractive option.
In Sweden, teen motherhood is so far outside the norm that young moms often are assumed to have other problems like a psychiatric diagnosis or drug addiction, Ekeus said.
Swedish teen mothers "differ very much from the general population," she said.

Utah expecting flu season to peak in coming weeks


 FARMINGTON, Utah (AP) — Utah health officials are encouraging flu shots after seeing an increase in hospitalizations and new cases in Europe.
The Standard Examiner of Ogden says Davis County health director Lewis R. Garrett suspects influenza season will peak in the next few weeks.
Cases tend to increase after holiday gatherings and children return to school.
Weber County reported seven flu-related hospitalizations this month. Three involved children.
Those numbers are down significantly from 2009, when 107 Weber County residents were hospitalized with the flu through October.
Davis County reported five hospitalizations this month, including three children.
Flu season typically peaks in January and February, but can extend through March.
Officials say vaccines are available.

Robot Nurse Assistants?????

Vanderbilt Team Seeks To Bring Robotic Nurse Assistants To Eds

Computer engineers and emergency medicine specialists at Vanderbilt University in Nashville, Tenn., think the time is approaching when robot assistants will help manage patients in the ED.

Mitch Wilkes, associate professor of electrical and computer engineering, represented the team in presenting a paper, “Heterogeneous Artificial Agents for Triage Nurse Assistance,” about hospital ED robots earlier this month at the Humanoids 2010 Conference in Nashville.

Among the purposes of using robots would be to shorten patients’ waiting times and, by lightening the workload of ED staff, cut down on the number of mistakes that may occur. The cognitive robots would be able to gather medical information, take basic diagnostic measurements and offer tentative diagnoses to staff.

Robots would allow patients to enroll themselves via a robotic kiosk upon arriving in the ED, and have their vital signs recorded even without staff present. If the patient needs urgent care, the robots would immediately alert staff.

The robot prototype features a camera system and touch-screen display, and the capacity to measure weight, blood oxygenation and pulse. One possibility is to build triage nurse assistant robots into waiting-room chairs, while using more mobile robots to periodically check on patients’ conditions while they are in the waiting room.

Making the system a reality will take at least five years, according to team members.