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Tuesday, August 24, 2004; Page HE02

GET THE TRAIN MOVING Children who start toilet training older, or who are constipated, are more likely to finish their training later, concludes a study of nearly 400 youngsters.

Pediatricians have noticed that the average age at which toilet training is completed has been on the rise recently, the authors point out in their article in the Journal of Pediatrics.

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In the 1950s, U.S. children completed toilet training at an average age of 29 months; more than 97 percent were toilet trained by age 3. Recently, only 40 to 60 percent of children have completed toilet training by age 3. In this study, kids who were started later were also done later, and 16 percent were not completely toilet trained until 42 months.

The results do not mean toilet training should be started earlier, said Nader Shaikh of the Children's Hospital in Pittsburgh. Shaikh points out in a related editorial "that the younger . . . toilet training was initiated, the longer it took for the process to be completed."

One limitation, the authors note, is that the children studied were mostly from white, suburban, affluent families, so results may not apply to other groups.

WHERE'S THE MONEY GO? Health care spending rose nearly $200 billion between 1987 and 2000, thanks to a rise in the number of individuals who were treated for a handful of chronic conditions as well as the increased the cost of treating them, says a new study appearing on the Web site of the journal Health Affairs.

The Emory University study shows that five of the most costly medical conditions accounted for 31 percent of the growth in health spending. The U.S. health bill is growing rapidly mostly because more people are getting treated for mental disorders, cerebrovascular disease, pulmonary disease and diabetes, the report says.

While there was little change in the number of people treated for heart disease between 1987 and 2000, the rise in the cost per treated case accounted for nearly 70 percent of the total rise in medical spending over that period.

The 15 most expensive medical conditions were: heart disease, mental disorders, pulmonary conditions, cancer, trauma, hypertension, diabetes, back problems, arthritis, cerebrovascular disease, skin disorders, pneumonia, infectious disease, endocrine disorders and kidney disease.

SO NOTED "I fought and clawed for every pound I could get in this business, and it breaks my heart that we aren't able to ship more."

-- Bob Gilbert, president of the company that makes Laughing Cow cheese. Demand has far exceeded supply since the cheese was recommended in the South Beach Diet.

-- From News Services and Staff Reports

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