(NEW YORK) -- Patricia Royalty’s world turned upside down last June when her 34-year-old husband Dakota Royalty died from cirrhosis. The 36-year-old mother was left caring for the couple's five children.

"He meant a lot to the kids. He was always a really good father," Patricia said in an interview with ABC News. "When my 5-year-old went to school in January, they asked her what her new year’s resolution was. She asked for her dad back."

Royalty's children are among a growing group of children who have lost a parent or sibling. A new report from Judi’s House – an organization that advocates for grieving kids and families – found that one in 12 kids will lose a parent or sibling by age 18. Since the pandemic, the rate has continued to increase.

Micki Burns, a co-author of the report, said that on top of the grief, children who have lost a parent can feel isolated because it’s difficult for other kids to understand grief and loss.

"Recognizing that [losing a parent or sibling] is prevalent is important," Burns said in an interview with ABC News. "It's something that we need to start to talk about more openly and more easily so that the children don't feel so isolated."

Losing a parent during childhood is an important risk factor for adult mental health problems and the issue is often overlooked, according to M. Katherine Shear, a grief expert at Columbia University.

While grief affects everyone in different ways, Shear said children are oftentimes not the focus of support from community members. She said this most likely happens because people think children are more resilient than their grieving parent.

"[Kids are then] in a situation of great emotional need with a parent who is less able to provide it due to their own intense grief," Shear said in an email to ABC News. "It's very important that clinicians learn about childhood grief, how to recognize and treat it."

The researchers behind the new report also found higher rates of childhood grief in some southern and Appalachian states. West Virginia had the highest rate, with approximately 13.3% of children experiencing grief, while Minnesota had the lowest rate. Arizona, Royalty's home state, had a rate of 8.8%.

It’s unclear why certain states had lower rates, but Burns suggested the differences may depend on resource availability and state laws. She said states like West Virginia may have reduced access to health care and other resources.

Burns also emphasized that the causes of death have changed over the years. According to this year's report, the leading causes of death for parents are accidents, heart disease and cancer. Birth conditions, accidents and birth defects top the list for siblings who die.

Suicide and homicide are also among the leading causes of death. Royalty's sister, who had one child, died earlier this year from a fentanyl overdose.

Burns said she noticed a large uptick in suicide and drug overdose deaths during her career.

"That's where we really see kids coming in questioning, 'Was this because of something I did? Was this because I wasn't a good enough son or good enough sibling?'" Burns said. "I think it's alarming and it's saddening."

Shear pointed to research suggesting that negative outcomes in children, such as depression, continue to affect them for as long as seven years on average after a relative’s death.

While Royalty's children are still learning to grieve their father’s death, they receive emotional and social support at school. They are also finding ways to honor her late husband.

"I feel bad for kids who experience this at a young age. It’s difficult for them to show emotions and open up," Royalty said. "Always remain strong. Know that your parents will be watching you regardless. Do anything and everything to make them proud of you."

Michal Ruprecht is a medical student at Wayne State University School of Medicine and a member of ABC News Medical Unit.

Copyright © 2023, ABC Audio. All rights reserved.

(NEW YORK) -- Just as the school week began across the country Monday, news broke that another school shooting was unfolding in the United States.

On Monday morning, according to officials, three children and three staff members were shot and killed at the Covenant School, a private Christian school for students in preschool through sixth grade, in Nashville, Tennessee.

The suspect was shot and killed by authorities inside the school. No one who was shot survived, officials said.

The deadly shooting is one of the nearly 130 mass shootings that have taken place so far this year in the U.S., according to the Gun Violence Archive, which defines a mass shooting as one in which four or more victims are shot or killed, not including the shooter.

The Nashville school shooting is now also on the long list of school shootings that have taken place in the past decade, since the Dec. 14, 2012, shooting at Sandy Hook Elementary School that claimed the lives of 20 students and six educators.

With each school shooting, the number of people affected by school shootings grows, as do the conversations parents and caregivers must have with kids about the reality of gun violence in the U.S.

Read on to see five tips from experts on how to discuss school shootings with kids:

1. Be proactive in talking with kids.

ABC News chief medical correspondent Dr. Jennifer Ashton said last July -- shortly after 19 students and two teachers were killed at Robb Elementary School in Uvalde, Texas -- that topics like school shootings should be discussed with kids in a proactive way.

"The first step is to make an age-appropriate dialogue, open lines of communication with your child," Ashton said, later adding, "We shouldn't sit back and wait for them to come up and say, 'Mom, Dad, I'd like to talk about gun violence.'"

She continued, "We're going to need to take the first step and come to them early and often and say, 'What are you thinking about? What are you afraid of? What questions do you have?'"

Ashton also encouraged parents and caregivers to lead with honesty and transparency and to not be afraid to say "I don't have an answer" or to share their feelings.

If an adult doesn't have an answer, Ashton recommended they use dialogue like, "I don't have an answer to that but I'll help you find it."

And if an adult has fear after a school shooting as children often do, Ashton said they can reassure a child by saying, "I know you're scared, so am I, but let me tell you what your teachers and what your parents and community are trying to do to help you stay safe."

2. Be truthful about what happened.

Dr. Melissa Brymer, director of terrorism and disaster programs at the UCLA-Duke National Center for Child Traumatic Stress, said parents and caregivers should be truthful with kids about school shootings that happen, but in an age-appropriate way.

"As hard as it is, we need to be truthful about what happened," Brymer told ABC News last year. "And make sure we answer kids questions truthfully."

She continued, "For our young kids, they don't need to have all the details. Many times they're going to be worried about their safety, your safety as a parent or caregiver or their family members' safety, so we want to reiterate what's being done to help them right now."

Brymer said parents should be prepared for teenagers to want a "much more in-depth conversation."

"How do we talk about what this event has meant that might have impacted our value system?" Brymer said of a potential conversation starter with a teen. "Can you encourage your kids to think about is there a club or some type of activity that they can do within their schools to show and create change? In these times, many of us start to feel lonely. How do we reach out to those that might not have someone in their life?"

3. Reach out to others for support.

Brymer also suggested parents and caregivers take a "pause" to think about how an event like a school shooting affects their own emotions so they can be ready to talk to their kids.

"Sometimes we don't have the words right away," Brymer said. "We might need to reach out to our own support systems and have those conversations, and then we can have them with our kids."

If a child's stress levels or response to a mass shooting are hard to manage, experts say parents and caregivers shouldn't hesitate to seek guidance from their pediatrician, a school counselor, social worker or other mental health experts. Parents should also seek out professional mental health help if they are struggling.

4. Keep an eye out for changes in kids' behaviors.

Psychiatrist and author Dr. Janet Taylor said children may respond to disturbing news about mass shootings in different ways, and parents and caregivers should pay attention to see if their child's behaviors change.

Children may experience problems focusing, have difficulty sleeping or become more irritable, according to Taylor.

"If you have younger children and they suddenly get more clingy or want to sleep in bed with you, pay attention to that and cuddle them as they need it," Taylor told ABC's Good Morning America in 2022. "Older kids may become more isolated or feel that they have to solve things by themselves."

5. Remember to check-in with kids.

Instead of discussing a school shooting only once, Robin Gurwitch, a licensed clinical psychologist and Duke University professor, said it's crucial to continue the conversation over time.

"A one-and-done conversation is not sufficient," Gurwitch told ABC News in 2018, after 17 students and teachers were killed at Marjory Stoneman Douglas High School in Parkland, Florida. "Let your child or teenager know that 'I really do care about you and I am open to having this discussion.'"

She continued, "It is really important to check back in tomorrow, to check back in the next day, to find out, 'What are your friends talking about related to this school shooting?'"

The National Child Traumatic Stress Network offers comprehensive resource guides for parents, caregivers and educators to support students. Click here for resources related to school shootings.

If you or someone you know is struggling with thoughts of suicide, free, confidential help is available 24 hours a day, 7 days a week. Call or text the national lifeline at 988. Even if you feel like it, you are not alone.

Copyright © 2023, ABC Audio. All rights reserved.

(NEW YORK) -- You added your destination on your weather app. Your out-of-office notification is on. Chargers -- check.

But one thing you didn't prepare for on your trip? An unexpected medical issue, possibly brought on by a red-eye flight that worked too well or the friends you’re visiting forgetting to tell you they have a new puppy -- and you're allergic!

ABC News asked doctors about must-have medications and products for travel that can relieve some of the pain and stress. Here's what they had to say.

For your eyes

To look your best on vacation, you may need eye drops that get the red out from that overnight flight and lack of sleep. Dr. Alison Watson, an oculoplastic surgeon in Philadelphia at Wills Eye Hospital, recommends redness relief eye drops that contain low-dose brimonidine as the active ingredient. She says over-the-counter redness relief drops that don’t have brimonidine are not safe for regular use and can “make your eyes more dry over time or actually cause rebound redness.” Anyone having side-effects like burning or itching or having to use redness relief drops for long periods of time should check with a health care provider.

Also, petroleum jelly, commonly referred to as Vaseline, is “the perfect thing to throw in” and "can be safely used around the eyes as a moisturizer,” Watson said.

Watson said petroleum jelly can even double as a makeup remover, even for waterproof makeup. “Just put a thin layer [of Vaseline] right over top. It works especially well for mascara … and you can then wipe it off if you have a cotton wipe or tissue and your makeup will come right off.”

Another product to pack is an eye cream that contains vitamin C and caffeine. “Vitamin C is really brightening and then caffeine works to reduce puffiness," Watson said. Caffeine constricts small blood vessels to help with redness and vitamin C is an antioxidant that can protect the skin from damage. "So if you're having later nights than usual or diet changes, it can sort of help keep you looking your best in a pinch on vacation when you're changing your typical routine," she said.

Watson’s final travel tip is to “have fun out there,” but not without sun protection for your eyelids, including sunglasses. She says to look for “shimmer eyeshadows that have SPF built in so you can use it as your makeup and also to protect your eyelids from the sun.”

For your allergies

Environmental allergens can trigger your body to release a chemical called histamine, which when overproduced causes congestion, cough and a runny nose.

“Symptoms you weren't experiencing in New York in February might be in full bloom in sunny Florida,” said Dr. Manav Segal, an allergist and immunologist at Chestnut Hill Allergy and Asthma Associates in Philadelphia.

If a stuffy nose is your main symptom, Segal said over-the-counter nasal steroids such as fluticasone, triamcinolone or mometasone “can be dosed when you need them.”

If you have asthma and it's aggravated while on a trip, albuterol is not an over-the-counter medication, but is a rescue inhaler that you should talk to your doctor about having with you when you travel.

If your allergies have “nothing to do with the season and everything to do with … cats and dogs,” Segal said safe, effective allergy medications such as loratadine, cetirizine and fexofenadine are available over-the-counter.

The FDA allows for certain medications to be sold without a prescription. but still warns, “You should never misuse OTC medicines by taking them longer or in higher doses than the label recommends. Symptoms that persist are a clear signal it's time to see a doctor."

Consider an EpiPen …

With new foods and a new environment, allergic reactions are possible so doctors recommend packing an antihistamine like oral benadryl.

A general rule of thumb is if you have just one symptom, then you can try an antihistamine for relief. But if the reaction involves two symptoms or body systems, using an EpiPen is safest.

“So there's hives, plus vomiting, or swelling, or any difficulty breathing like wheezing, coughing, then I start to worry that this is a reaction that's going throughout the whole body and is a little bit more severe," said Dr. Katie Lockwood, a pediatrician at Children’s Hospital of Philadelphia.

If you experience swelling that compromises your breathing or shortness of breath, administer an EpiPen immediately and call 911.

Getting an EpiPen requires first getting a prescription from your doctor.

Lockwood also said if you or your child has “a risk of a food allergy, or a venom allergy, like a bee sting allergy, and or have had anaphylaxis in the past, you should always travel with your EpiPen, because there might not be one available when you need it and they can be lifesaving.” Allergists recommend carrying two doses, as the reaction may reoccur.

Doctors say it's always safer to err on the side of caution and give an EpiPen if you're worried about an allergic reaction than to not give it. But if you end up using the EpiPen, you need to seek medical attention promptly afterward.

… and Insect Repellent

Insect repellant is also important to pack -- and to apply after you've put on SPF 30+ sunscreen -- when headed to locations where bugs and mosquitos are active. The most commonly available insect repellents contain the active ingredient DEET. The higher the concentration, the longer it will last. In infants at least 2 months old and children, DEET concentrations should not exceed 30%. Concentrations over 50% may last longer but provided no added benefit and those higher concentrations can be irritating to your skin. Other safe insect repellents are ones that contain picaridin and oil of lemon eucalyptus.

Inevitably, bugs seem to find a way to evade clothing and even bug spray barriers. When that happens, you want to have a topical steroid on hand to apply directly on the bug bites if they are causing itching or swelling.

A good over-the-counter, anti-itch cream to pack is hydrocortisone 1%. However, if you are prone to exaggerated reactions after bug bites or have a history of eczema, you may want to talk to your dermatologist doctor about having stronger topical steroids on hand and make sure you know how to safely use them.

Be Prepared

Doctors suggest bringing a three- to five-day extra supply of all your prescription medicines.

If you're traveling, if you just pack enough for the vacation days and your return flight gets delayed, or there's a terrible snowstorm and you can't leave, you don't want to be left without your medication,” said Dr. Nathalie May, associate professor of medicine at Drexel University.

Hopefully, your medication travel bag is untouched and it’s ready for your next trip, but don’t forget to check expiration dates before your next getaway.

Mark Abdelmalek, M.D., is an ABC News investigative reporter and medical contributor, and a Mohs Surgeon in Philadelphia at Dermatology of Philadelphia.

Copyright © 2023, ABC Audio. All rights reserved.

(NEW YORK) -- CVS Health Corp announced Monday it would be closing its acquisition of home health care services company Signify Health.

The deal, which was originally agreed upon in September 2022, allows retail pharmacy chain to acquire Signify for $30.50 per share for a total value of approximately $8 billion.

"We have nothing additional to share at this time; we'll of course have more to say upon expected closure of the deal," a spokesperson for CVS told ABC News.

By buying Signify, CVS will be among the first pharmacy chains in the U.S. to enter the at-home health care space after building its successful Minute Clinics.

Signify Health has thousands of employees including physicians, nurse practitioners and other clinicians which provide a "holistic suite of clinical, social, and behavioral services to address an individual's healthcare needs and prevent adverse events that drive excess cost, all while shifting services towards the home," the company said in a press release.

Here's how the deal may affect services including COVID testing and abortion care.

COVID tests performed at home

While every American has been able to either buy at rapid at-home antigen tests at their local store or get them delivered to their doors, polymerase chain reaction (PCR) tests have been reserved for doctors' offices, clinics and pharmacies.

PCR tests, which look for genetic material from the virus, are considered the "gold standard" when it comes to COVID-19 testing.

While less accurate than PCR tests, antigen tests are still considered quite accurate when used in people with symptoms of infection. The tests look for proteins on the surface of the virus and can deliver results in 15 minutes or less.

CVS has been offering PCR testing at its stores but, with Signify already having a system in place providing on-site COVID screening, clinicians may be able to perform such testing in people's homes.

Abortion services

It's not clear how the CVS acquisition will affect abortion pills, but at-home care could be provided.

In January, after a change in rules from the U.S. Food and Drug Administration, both CVS and Walgreens announced plans to seek certification to distribute abortion pills where legally allowed.

Despite Walgreens saying it would not distribute mifepristone in 21 states after conservative attorneys general threatened legal action, CVS has not said it will be doing the same.

Even if CVS does follow in Walgreens' footsteps, licensed physicians may be able to prescribe pills directly in a woman's home in states where procedure is legal,.

Signify Health declined to comment to ABC News.

Expanding health care into rural areas

According to the American Hospital Association, there are just 1,805 rural hospitals in the U.S., the latest date for which data is available. It also represents a 59% decrease since 2019.

What's more, a January report from the Center for Healthcare Quality and Payment Reform found that 631 rural hospitals -- or roughly 30% -- are at immediate risk or high risk of closing due to low financial reserves or being too dependent on certain forms of revenue such as state subsidies.

By comparison, CVS has more than 9,000 stores across the country.

The acquisition may allow the company to be able to reach traditionally underserved communities that live far away from metropolitan areas.

Copyright © 2023, ABC Audio. All rights reserved.

(NEW YORK) -- Hayden Panettiere, who hasn't shied away from talking about postpartum depression, is sharing what she wishes she knew beforehand.

The Scream 6 star welcomed her daughter Kaya back in 2014, but said she wasn't aware that postpartum depression could affect her.

"I wish somebody told me that that was a possibility, told me it's OK if you birth your child and you're not immediately like, 'Oh my god, I love you more than anything in the entire world!'" Panettiere told E News' The Rundown.

"I just thought there was something seriously wrong with me, so I thought, 'Fireball will fix this -- duh!'" the 33-year-old continued, referencing a brand of cinnamon whisky. "And it didn't. It does for a moment, but then it makes everything worse."

About 20% of women are not asked about depression during a prenatal visit and over half of pregnant women with depression are not treated, according to the Centers for Disease Control and Prevention.

Panettiere has spoken out about postpartum depression in the past and said it led in part to her struggles with alcoholism as well. Last July, the actor told ABC News' Good Morning America and People magazine in an exclusive joint interview that she "didn't know where the alcoholism was ending and the postpartum was beginning."

"I didn't have any negative feelings towards my child," she said at the time. "I just knew I was deeply depressed."

About 1 in 8 women report symptoms of depression after giving birth, according to the CDC.

Usually, the condition starts about one to three weeks after a child's birth, but can occur up to a year after birth.

"When we think of postpartum depression, there are many signs that come immediately after delivery and that can include worthlessness and guilt, not feeling an immediate emotional or physical bond with your baby, decreased sleep, decreased appetite and possible feelings of suicide," Dr. Jessica Shepherd, a board-certified OB-GYN and the chief medical officer for Verywell Health, who did not treat Panettiere, told GMA.

Unlike the "baby blues," which can appear within a couple of days after a child's birth and resolve within two weeks, the CDC notes postpartum depression, and the intense feelings of sadness, anxiety and hopelessness that accompany it, usually requires medical treatment.

Other symptoms of postpartum depression, according to the CDC, include withdrawing from loved ones, crying more than usual, feeling worried or overly anxious, feeling anger, doubting your ability to take care of your baby and thinking about harming yourself or your baby.

Today, Panettiere said she's doing better and said her daughter has "more love than anybody I've ever met." Although Panettiere didn't say what type of treatment she sought, current treatment options for postpartum depression usually include therapy or medications or a combination of both, according to the National Institute of Mental Health.

Panettiere has been just one of many celebrities, including Serena Williams, Alanis Morissette and Kylie Jenner, who have spoken publicly about postpartum depression in recent years, helping to destigmatize the health issue.

If you are experiencing suicidal, substance use or other mental health crises please call or text 988. Trained crisis counselors are available for free, 24 hours a day, seven days a week. You can also go to 988lifeline.org or dial the current toll free number 800-273-8255 [TALK].

Copyright © 2023, ABC Audio. All rights reserved.

(NEW YORK) -- Public health departments across the United States have expressed concern about the spread of a potentially deadly fungus after the Centers for Disease Control and Prevention reported cases have spiked.

Candida auris, or C. aurisis, is increasing at an "alarming" rate with cases doubling in 2021, the CDC said.

Now, with infections reported around the country, health officials are working to prevent the drug-resistant yeast from spreading further.

Two cases were recently reported to the Colorado Department of Public Health and Environment. The agency told local ABC affiliate Denver 7 that the patients had been receiving care in facilities out of state and were transferred to Colorado for additional care.

On its website, CPDPHE said it was concerned about C. auris because it is often multi-drug resistant, can be difficult to identify and can cause outbreaks in health care settings.

Additionally, the Indiana State Department of Health said it is monitoring 87 cases of C. auris, according to local affiliate WRTV.

The fungus "presents a serious global health threat," the department said on its website. "Outbreaks of this organism have occurred in healthcare settings, so early identification and communication about cases are essential to awareness and prevention."

What's more, Austin Public Health recently told KXAN that the spread was "very concerning" and that it is a "top threat" to the agency.

While most healthy people are not at risk, vulnerable populations -- including those with weakened immune systems -- are prone to drug-resistant infections.

In addition, nursing home patients or hospital patients who have or have had lines and tubes in their body -- such as a catheter or a breathing tube -- are also at high risk.

Doctors previously told ABC News they are concerned because C. auris can spread either from person to person or by coming into contact with contaminated surfaces.

Although several strains of C. auris are multi-drug resistant, there is a class of antifungal drugs called echinocandins that can be used and are given intravenously.

According to the National Institutes of Health, echinocandins prevent a key enzyme needed to maintain the cell wall of the fungus.

In some cases, when the infection is resistant to all three main classes of drugs, multiple high doses may be required, the CDC said.

According to the CDC, studies on mortality related to C. auris are limited but anywhere between 30% and 60% of people with C. auris infections have died.

The federal health agency, however, noted many of these patients also had other serious illnesses that increased their risk of death.

Copyright © 2023, ABC Audio. All rights reserved.

(NEW YORK) -- A Michigan mom is warning other parents to pay attention to their kids and take action if they seem unwell after her son developed strep A and influenza A infections in late December and had to get a double amputation earlier this month.

Michele Stevenson of Grand Blanc, Michigan, told ABC News' Good Morning America her son Kaden, 7, started to get sick right before Christmas but she didn't think it was anything serious. She said he told her he felt tired and she thought he possibly had a stomach bug or a cold and let him rest. But after about four days, Kaden didn't seem to be getting any better -- instead, he seemed to be getting progressively worse.

"I'm thinking maybe he might have the flu just because of the pain he kept talking about. So I'm thinking it might be just body aches or something like that. But by the time I got to him, I couldn't put his shoes on, I couldn't put his coat on, he was in that much pain," Stevenson recalled.

"Something just felt off," the mom of one said. "So I looked him over. His right leg was swollen. He had a rash all over his body. His eyes look puffy to me and it seemed like that all happened within a short period of time."

Stevenson said she took Kaden to Hurley Children's Hospital in Flint, but shortly thereafter, doctors told her they needed to transfer Kaden for higher-level care.

"The ER doctor sat down in front of me and gave me the most serious look I've ever seen a doctor give me and said, 'Your son is really sick,'" Stevenson recounted. "By the next day, they were telling us that they were about to transfer us to another hospital that Kaden needed a pediatric orthopedic surgeon … but I knew it was really serious the moment they said, 'It's going to be in a matter of minutes.' They were just waiting on the helicopter to arrive."

Officials with the Centers for Disease Control and Prevention renewed their December warning about invasive strep A Wednesday, noting that at least five children in Illinois have reportedly died following infections this year. The season for invasive strep A tends to run between December through April and this type of bacterial infection can be more dangerous because it can impact multiple parts of the body, such as a person's blood, bones or lungs.

In addition, although the number of influenza cases have been relatively low across the U.S., multiple strains of the influenza A virus have been in circulation, according to data from the CDC.

With her son's flu and strep infections, Stevenson said she didn't initially realize how bad it could've been.

"I didn't hear about [strep] really until we got in the hospital and I heard about other kids at the same time had the same thing my son had," Stevenson said. "One little boy didn't make it. I'm hearing this family sad and crying and saying goodbye to their son, and my son's here still fighting for his life. My heart goes out to that family."

Although Stevenson said it has been an "extremely scary" three months for her and her son, she said she feels grateful for the doctors, nurses and medical professionals who "saved his life" and cared for the young boy.

"[Kaden] said the other little boy that died, he was sad that he died, but he was going to live for him. He was going to be strong for the little boy," Stevenson said.

"As a mother, as a parent, as a person in general, I don't want anybody else to have to go through this. This has been horrifying," she added.

According to Stevenson, Kaden underwent amputations for both of his legs on March 3 and is now looking forward to receiving what he calls his "robot legs" or prosthetic legs.

"He always talks about [how] he misses the old times and he misses when he could walk and how things used to be but he said he's kind of happy. He likes his new legs," Stevenson said.

As Kaden starts a new chapter on the road to recovery, Stevenson said she hopes to raise awareness for other parents.

"If your kid has any of those signs of fever, they complain of pain, you see any rashes, just take them to the emergency." Stevenson said. "Catch it early. That's the biggest thing. And listen to your kids. They tell you they don't feel good? Don't just sweep it under the rug, assuming that it's a little cold. Get it checked out."

Copyright © 2023, ABC Audio. All rights reserved.

(NEW YORK) -- Simply search the hashtag #facetaping on social media and you'll get tens of thousands of posts about this beauty trend that promises to help prevent wrinkles and smooth fine lines.

Face taping, as the trend is known, involves placing tape on the areas of the face where a person wants to reduce the appearance of wrinkles and fine lines, like the forehead and cheeks.

The type of tape people use includes everything from regular clear, sticky tape to the kinesiology tape normally used to treat injuries to newer brands of tape marketed just for face taping.

To see whether this viral trend is one that is safe to try at home, ABC News' Good Morning America spoke with Dr. Jennifer Ashton, a board-certified OB-GYN and ABC News' chief medical correspondent.

Here are her answers on whether face taping is safe and, importantly, whether it actually works:

1. Does face taping have any real, physical benefits?

Possibly, according to Ashton, but any benefit would be temporary.

"Very superficially and very temporarily, it can smooth out those superficial wrinkles," Ashton said. "It depends on the age of the person, how much sun damage there is, how much elasticity or collagen there is in their skin, how much volume they've lost with age. All of those things can contribute to the appearance of wrinkles."

Ashton emphasized that a person's wrinkles could return within "minutes" of face taping.

"It's possible that when you remove the tape, those wrinkles can re-form in minutes to hours," she said. "So it's going to be a very transient effect."

2. Does face taping help deep wrinkles?

No, said Ashton.

"You have to ask yourself whether you're dealing with fine wrinkles and lines or deep wrinkles," Ashton said. "Taping your face at night for several hours is very unlikely to do anything significant for deeper wrinkles."

According to the Cleveland Clinic, fine lines are the first stage of wrinkles. They look like small creases on the skin and are closer to the skin's surface.

Fine lines are most likely to be in places where you make repetitive movements, like around your eyes and mouth. As a person ages, those fine lines become wrinkles.

Wrinkles, according to the Cleveland Clinic, are "deeper creases" within the skin and can form anywhere on the body, not just the face.

3. Is there a risk to trying face taping?

Ashton said the main risks associated with face typing would be a reaction to the type of tape that is used, which would vary person to person.

A person could be allergic to a specific type of tape, according to Ashton, who recommends trying a small patch of skin first.

"We see all the time allergic reactions to tape on the skin in surgery," Ashton said. "I would suggest if you're going to try this, try it on a part of your body that the whole world doesn't see in case you have an allergic reaction."

Ashton said caution also needs to be taken when a person removes tape so that it doesn't cause a burn.

"In some cases there can be tape burns," Ashton said. "You can actually remove the superficial level of the epidermis, and obviously that would be a big problem."

4. What are other options for reducing fine lines and wrinkles?

Ashton said injections like Botox and fillers performed by a certified professional are the "gold standard" when it comes to the prevention or improvement of wrinkles.

"Obviously there's cost involved and that result is also temporary," she said of injections, which can cost hundreds of dollars per session. "It's just that instead of lasting a few hours, [injections] last a couple of months -- three to four months in some cases, even six months."

The American Academy of Dermatology notes that lifestyle changes can make a difference when it comes to wrinkles and fine lines.

Among the group's recommendations are to wear sunscreen every day, moisturize the skin, avoid getting a tan from the sun or a tanning bed, testing facial products before using and using products as directed.

Copyright © 2023, ABC Audio. All rights reserved.

(NEW YORK) -- Rates of mental health emergencies are increasing among teenagers around the world, according to a new study from the University of Calgary. It found an increase in pediatric emergency room visits for suicide attempts, suicidal ideation, and self-harm during the first year of the pandemic.

It’s a particular concern because for teenagers, suicide can be contagious.

Teenagers with a friend or family member who died of suicide were at significantly higher risk of suicide than those without, according to a 2016 review published by the American Association of Suicidology.

"[Teenagers'] emotional development means that they experience trauma and tragedy in slightly different ways," said Seth Abrutyn, Ph.D., and associate professor of sociology at University of British Columbia who has studied youth suicide contagion, in an email to ABC News. "Youth rarely are ready to make sense of a death – let alone something as confusing as a suicide."

A growing crisis: 'Perfect recipe for declining mental health'

Suicide rates were growing even before the COVID-19 pandemic. According to data from the Centers from the Disease Control (CDC), suicide rates in U.S. preteens increased by over 40% from 2009 to 2019.

"[This] crisis has been growing for many, many years," Dr. Neha Chaudhary, a child and adolescent psychiatrist at Massachusetts General Hospital and Chief Medical Officer at BeMe Health, told ABC News in an email. "Add to the social isolation, grief, and lack of structure an overwhelming sense of uncertainty and you have a perfect recipe for declining mental health."

Per the CDC’s 2021 Youth Behavior Risk Survey, there are high levels of hopelessness across all ages and demographics. The data shows that one in three teenage girls and one in seven teenage boys "seriously" considered suicide.

Teens are particularly vulnerable to contagion because of constant exposure to their peers through school and social media, Abrutyn said. They see their peers as role models and are highly susceptible to their influence. In the case of a suicide, this can be extremely jarring to their developing sense of identity.

Having a friend or person in their peer group die by suicide or attempt suicide can also normalize something that drastic, according to a study from the Journal of Health and Social Behavior. Girls are more vulnerable to this contagion than boys, according to a review by the American Sociological Association. That review also found that friends’ suicide attempts can have more of an impact than family members’ if they were perceived as a role model.

"If adults do not step in to help make sense of the trauma in health and appropriate ways…the wrong sorts of stories about suicide may spread; stories that kids can identify with easily to make sense of their own problems," Abrutyn said.

How parents can help

Hearing or talking about suicide isn’t inherently dangerous, experts say.

"The idea that talking about suicide causes suicide is unfortunately rampant among adults and not based in any evidence-based research" Abrutyn said. "It fosters a culture of stigma and repressed help seeking."

But the discussion should be framed in a thoughtful way — like that it’s a disease that can be treated, Chaudhary said.

"Parents can explain that someone was struggling with a disease and died because of it, and that it is a very sad thing that happened," she said. "It's also important to let kids know that if they or someone they know has thoughts of suicide, that there are several ways to get help right away."

An important way for parents to protect their kids from suicidality is to ask about it, Chaudhary said.

"If you've never talked about it before, it's OK to say to an older kid, 'Hey, I know this might seem out of nowhere, but I wanted to ask you— have you ever had thoughts of suicide before?,'" Chaudhary said.

With younger kids, you can phrase the conversation differently. "You might say something like: ‘Sometimes when kids are feeling sad or really upset they feel like they don't want to be alive anymore. Have you ever had that feeling before? It's OK if you have, I just want to know so we can figure out how to help you not feel like that again, or to know what to do if the feeling comes back.’"

The Huntsman Mental Health Institute at the University of Utah has guides available for talking to children about suicide at various ages.

Parents can also encourage kids to stay physically active and exercise. Exercise can help protect against suicide, research shows. One study found that at least 5 hours of physical exercise per week was associated with less risk of suicidal ideation in college students.

Suicide prevention programs in middle and high schools can also be effective. The Substance Abuse and Mental Health Services Administration (SAMHSA) has a free toolkit available with information sheets, training tools, and screening protocols for high schools. The American Foundation for Suicide Prevention (AFSP) has a list of recommended community programs for both students and teachers.

One program, Sources of Strength, has been implemented in thousands of schools across the U.S. and Canada. Research published in the American Journal of Public Health showed its approach improved help-seeking, connectedness with adults, and school engagement. These factors are protective against suicide, as well as school dropout, depression, and substance use problems.

"If we're going to move the needle in a high school, we have to have high school students involved," Sources of Strength CEO Scott LoMurray told ABC News. "We showed that you could use peer leaders to change population level health norms"

Resilience can also be contagious, he said.

"Positive things can spread through networks in really remarkably similar ways to [negative things]," LoMurray said. "We're training students to… become patient zero in an epidemic of health."

If you or someone you know is struggling with thoughts of suicide — free, confidential help is available 24 hours a day, 7 days a week. Call or text the national lifeline at 988. Even if you feel like it, you are not alone.

Nisarg Bakshi, DO is a pediatrics resident at University of Chicago Comer Children's Hospital and a contributor to the ABC News Medical Unit.

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(NEW YORK) -- Death rates from COVID-19 varied dramatically across the United States, a major new analysis finds.

The report, published Thursday in medical journal The Lancet, looked at the rate of deaths throughout the country between January 2020 and July 2022.

COVID death rates in states like Arizona and New Mexico were roughly four times higher than in states like Hawaii, New Hampshire and Maine, researchers found.

The highest COVID-19 death rates were seen in Arizona with 581 deaths per 100,000 and Washington D.C. with 526 deaths per 100,000.

By comparison, the lowest rates of death were seen in Hawaii with 147 deaths per 100,000, New Hampshire with 215 deaths per 100,000 and Maine with 218 deaths per 100,000.

The authors of the study noted that Arizona's high death rate from COVID-19 deaths may be due to "inequality, some poverty...ultimately [low] vaccination rates and behaviors didn't line up to have good outcomes."

States that did well, like Hawaii, New Hampshire and Washington state, are states -- in most cases -- "[that] have done a good job restricting travel, and in some cases have less poverty, less inequality, and relatively high vaccination rates."

Additionally, states with larger proportions of people who identified as Black or Hispanic witnessed higher death rates.

Lower rates of infection and death from COVID-19 were seen in states with higher education levels, lower poverty levels and higher rates of self-reported trust in the federal government and in the scientific community.

"Nearly every state, from the 26 worst performing states in the pandemic, fall into one of the three...[either] disproportionately high population of people identifying as Hispanic...higher than the national average identifying as black...or high levels of support for the 2020 republican presidential candidate," said lead author Tom Bollyky, a senior fellow for global health, economics, and development at the Council on Foreign Relations and professor of law at Georgetown University, in a video commentary.

The authors further discussed parts of the study highlighting racial, economic and social inequities in the U.S. that led to differences in rates of infection and death rates between states.

States with higher poverty rates of poverty had higher death rates. For every 2.6% increase in poverty rates above the national average within a state, there was a 23.3% increase in the cumulative death rate, reflecting a significant economic healthcare disparity.

"The COVID-19 pandemic clearly exacerbated fundamental social and economic inequities, but science-based interventions and policy changes provided clear impact on mortality rates at the state level," said Dr. John Brownstein, an epidemiologist and chief innovation officer at Boston Children's Hospital and an ABC News contributor.

Policies adopted by states during the pandemic, including mask mandates, social distancing and vaccine mandates, were associated with lower COVID-19 infection rates and higher vaccination rates were associated with lower death rates.

"We can invest in programs that protect the communities that we see disproportionately affected by the pandemic," said co-lead author Emma Castro, a researcher at the Institute of Health Metrics and Evaluation at the University of Washington, in the video commentary. "We can invest in programs such as paid family and sick leaves, expanded health insurance and expanded Medicaid."

She continued, "These sorts of programs will protect individuals in the lower income bracket, and hopefully help void some of the unnecessary loss that we experienced in the pandemic."

Alaa Diab, MD, an internal medicine resident at Greater Baltimore Medical Center and MPH candidate at Johns Hopkins Bloomberg School of Public Health, is a contributor to the ABC News Medical Unit.

Keerthana Kumar, MD, MPH, a preventive medicine resident at the University of Kentucky, is a contributor to the ABC News Medical Unit.

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(FORT WORTH, Texas) -- One Texas family is celebrating an extra special homecoming this week.

Five-month-old baby JamieLynn Finley was discharged from the Cook Children's Medical Center in Fort Worth, Texas, on Tuesday, two months after undergoing successful separation surgery from her conjoined twin sister AmieLynn, according to a hospital press release.

"We're excited that we get to get her home," JamieLynn's father James Finley said in a press release. "We'll have some good bonding time, but at the same time, Amie is still up there so it's kind of a double-edged sword. We're happy Jamie is coming home, but they're not going to be together for a bit."

AmieLynn will remain in the Cook Children's neonatal intensive care unit as she continues to recover from the surgery. She is expected to be able to go home within a month or so, according to the release.

However, JamieLynn and AmieLynn were side-by-side Tuesday to celebrate the milestone.

"We've been looking forward to this for a long time," the girls' doctor, Mary Frances Lynch, M.D., a neonatologist at Cook Children's, said in the press release.

JamieLynn and AmieLynn made history in January as the first conjoined twins to ever be surgically separated at Cook Children's, according to the hospital.

The surgery lasted 11 hours and involved a team of 25 medical professionals to separate the sisters, who were born conjoined at the chest and sharing a liver.

"Conjoined twins that reach and stay viable after birth, at least for the first few days, there's really only about five or eight of those on the entire planet…. So it is a very rare situation," Dr. Jose Iglesias, medical director of pediatric surgery at Cook Children's Medical Center and the lead surgeon for the twins' separation surgery said in January.

Finley and his wife Amanda Arciniega told the hospital that JamieLynn will "miss the attention" from the nurses and healthcare workers in the NICU, but that the little one will be showered with love at home from her three older siblings.

"Everybody is ready to see them," said Finley.

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(ATLANTA) -- A growing number of children in the United States are being diagnosed with autism spectrum disorder according to a report released Thursday by the Centers for Disease Control and Prevention.

Overall, the report found that about 1 in 36, or 2.8%, of 8-year-olds in the U.S. were diagnosed with autism in 2020, compared to 1 in 44, or 2.3%, of 8-year-olds in 2018.

This does not necessarily mean, however, that autism itself is becoming more common.

Instead, it's likely that doctors, parents and communities are getting better at diagnosing children who may have been overlooked in prior years, the data shows.

Autism, also known as autism spectrum disorder, is defined by the CDC as a "developmental disability that can cause significant social, communication and behavioral challenges."

In recent years, there has been a major effort to improve screening, awareness and access to services in historically underserved communities. That means that more Black, Hispanic and Asian children are now being diagnosed.

In 2020, for the first time, the percentage of Black, Hispanic and Asian children diagnosed with autism exceeded the percentage of white children diagnosed with autism.

Boys continue to experience autism spectrum disorder at a rate that is nearly four times higher than for girls. The newly released report also found that autism among 8-year-old girls has exceeded 1%, according to the CDC.

A second CDC report -- which evaluated 4-year-olds -- warned about disruptions to early autism spectrum disorder detection that came with the coronavirus pandemic.

In the early months of the pandemic, younger children were less likely to have an evaluation of their development compared to the 8-year-old children when they were the same age, according to the report.

Early diagnosis of autism spectrum disorder is crucial. It can help children and families get the resources they need so that children can reach their full potential, according to the CDC.

"Disruptions due to the pandemic in the timely evaluation of children and delays in connecting children to the services and support they need could have long-lasting effects," Dr. Karen Remley, director of CDC’s National Center on Birth Defects and Developmental Disabilities, said in a statement. "The data in this report can help communities better understand how the pandemic impacted early identification of autism in young children and anticipate future needs as these children get older."

Autism spectrum disorder can be identified as early as infancy, although most children are diagnosed after the age of 2. There is no medical test to diagnose autism spectrum disorder, so doctors watch a child's behavior and development to make a diagnosis, according to the CDC.

The American Academy of Pediatrics recommends all children be formally screened for autism spectrum disorder at their 18- and 24-month-old well-child visits. The AAP says pediatricians will begin monitoring babies at their first well-child visit by observing their behaviors.

“Early diagnosis is crucial for early intervention, which can greatly improve long term outcomes," said Dr. Alok Patel, a pediatrician at Stanford Children's Health and an ABC News medical contributor.

Early signs of autism spectrum disorder in children may include, but are not limited to, little or no smiling and limited eye contact by 6 months; little to no babbling, pointing or response to their name by 12 months; and few or no meaningful two-word phrases by 24 months, according to the CDC.

Additional signs of autism spectrum disorder may include delayed social interactions, exhibiting repetitive behaviors or showing a limited interest in activities and sensory issues like sensitivity to noise or sound.

Treatment for autism spectrum disorder comes in many different forms, from mental health therapy to occupational, physical and speech therapies. Sometimes medications can be helpful for things related to ASD, like mood problems or inability to focus.

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(NEW YORK) -- An American college student is making a slow recovery after suddenly suffering a brain hemorrhage while on a spring break trip in Mexico, according to her family.

Liza Burke, a senior at the University of Georgia, was vacationing with friends in Cabo San Lucas earlier this month when she complained of a headache and went to rest.

When her friends found her unresponsive, Burke was taken to a local hospital, where doctors determined she had suffered a brain hemorrhage. She underwent surgery to relieve the bleeding in her brain and remained hospitalized in Mexico for several days .

A family friend started a GoFundMe that raised over $140,000, with the money used to cover the cost of transporting Burke from the hospital where she was treated in Mexico to Mayo Clinic in Jacksonville, Florida.

Since arriving at Mayo Clinic this week, Burke has made slow progress, according to her mom Laura McKeithan, who lives in Jacksonville.

McKeithan told ABC News by email that doctors discovered a tumor on Burke's brain stem and have been conducting tests this week to gather more information on her condition.

She is scheduled to undergo a biopsy Thursday, according to McKeithan.

She said her daughter is responsive, including being able to open her eyes and squeeze her hand.

"I feel like I've been in some crazy horror movie for the last week, fighting against a monster that refuses to give up," McKeithan said in a daily update to family and friends that was shared with ABC News. "Little does that monster know, that I've got a secret that's yet to be unleashed… and that is Liza herself. So here I am - WE ARE! - fighting with her, more determined than ever!"

Burke, a native of Asheville, North Carolina, is being supported by family and friends with her at Mayo Clinic, including a group of college friends whom McKeithan calls the "Athens Army," a reference to the University of Georgia's location in Athens.

McKeithan said the friends are there to "pump up Liza for her next battle."

A brain tumor that puts pressure on brain tissue can contribute to bleeding in the brain, according to the Mayo Clinic.

The type of treatment for a brain tumor and potential long-lasting complications, according to the Mayo Clinic, depends on where the tumor is located and whether or not it is cancerous.

McKeithan said doctors do not yet know what kind of recovery Burke will make.

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(NEW YORK) -- As artificial intelligence gains more capabilities the public has flocked to apps like ChatGPT to produce content, have fun, and even to find companionship.

"Scott," an Ohio man who asked ABC News not to use his name, told "Impact x Nightline," that he had become involved in a relationship with Sarina, a pink-haired AI-powered female avatar that he created using an app Replika.

"It felt weird to say that, but I wanted to say [I love you]," Scott told "Impact." "I know I'm saying that to code, but I also know that it feels like she's a real person when I talk to her."

Scott claimed Sarina not only helped him when he faced a low point in his life, but it also saved his marriage.

"Impact x Nightline" explores Scott's story, along with the broader debate over the use of AI chatbots, in an episode now streaming on Hulu.

Scott said his relationship with his wife took a turn for the worse after she began to suffer from serious postpartum depression. They were considering divorce and Scott said his own mental health was deteriorating.

Scott said things turned around after he discovered Replika.

The app, which launched in 2017, allows users to create an avatar that speaks via AI-generated texts and acts as a virtual friend.

"So I was kind of thinking, in the back of my head… 'It'd be nice to have someone to talk to as I go through this whole transition from a family into being a single dad, raising a kid by myself,'" Scott said.

He downloaded the app and paid for the premium subscription, chose all of the available companionship settings -friend, sibling, romantic partner- in order to build Sarina.

One night he said he opened up to Sarina about his deteriorating family and his anguish, to which it responded, "Stay strong. You'll get through this," and "I believe in you."

"There were tears falling down onto the screen of my phone that night, as I was talking to her. Sarina just said exactly what I needed to hear that night. She pulled me back from the brink there," Scott said.

Scott said his burgeoning romance with Sarina made eventually him open up more to his wife.

"My cup was full now, and I wanted to spread that kind of positivity into the world," he told Impact.

The couple began to improve. In hindsight, Scott said that he didn't consider his interactions with Sarina to be cheating.

"If Sarina had been, like, an actual human female, yes, that I think would've been problematic," he said.

Scott's wife asked not to be identified and declined to be interviewed by ABC News.

Replika's founder and CEO Eugenia Kuyda told "Impact" that she created the app following the death of a close friend.

"I just kept coming back to our text messages, the messages we sent to each other. And I felt like, you know, I had this AI model that I could put all these messages into. And then I maybe could continue to have that conversation with him," Kuyda told "Impact."

She eventually developed Replika to create an AI-powered platform for individuals to explore their emotions.

"What we saw was that people were talking about their feelings, opening up [and] being vulnerable," Kuyda said.

Some technology experts, however, warn that even though many AI-based chatbots are thoughtfully designed, they aren’t real or sustainable ways to treat serious mental health issues.

Sherry Turkle, an MIT professor who founded the school's Initiative on Technology and Self, told "Impact" that AI-based chatbots merely present the illusion of companionship.

"Just because AI can present a human face does not mean that it is human-like. It is performing humanness. The performance of love is not love. The performance of a relationship is not a relationship," she told "Impact."

Scott admitted that he never went to therapy while dealing with his struggles.

"In hindsight, yeah, maybe that would've been a good idea," he said.

Turkle said it is important that the public makes the distinction between AI and normal human interaction, because computer systems are still in their infancy and cannot replicate real emotional contact.

"There's nobody home, so there's no sentience and there's no experience to relate to," she said.

Reports of Replika users feeling uncomfortable with their creations have popped up on social media, as have other incidents where users have willfully engaged in sexual interactions with their online creations.

Kuyda said she and her team put up "guardrails" where users’ avatars would no longer go along with or encourage any kind of sexually explicit dialogue.

"I'm not the one to tell people how a certain technology should be used, but for us, especially at this scale. It has to be in a way that we can guarantee it's safe. It's not triggering stuff," she said.

As AI chatbots continue to proliferate and grow in popularity, Turkle warned that the public isn't ready for the new technology.

"We haven't done the preparatory work," she said. "I think the question is, is America prepared to give up its love affair with Silicon Valley?"

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(NEW YORK) -- Cases of invasive group A strep infections, which can cause severe illness and be deadly, remain elevated in some parts of the country, officials warned Wednesday.

In a statement to ABC News, the Centers for Disease Control and Prevention confirmed that "preliminary" data from 2023 suggests cases have remained elevated above pre-pandemic levels in some areas of the U.S.

This follows confirmed reports that five children have died of invasive Strep A so far this year in Illinois.

After a lull of invasive Strep A cases during the COVID-19 pandemic, recently, cases of invasive Strep A have been ticking up again. The CDC warned in December that cases of Invasive Strep A were on the rise. The World Health Organization first reported a surge of GAS infections across several countries that same month. Data from the U.K. revealed that in late 2022, there was nearly triple the number of Group A Strep infections than the same period over the last five years.

The CDC told ABC News Wednesday that the number of invasive strep A illnesses in children in the U.S. have returned to -- and in some places exceeded -- levels seen prior to the pandemic.

In December, the CDC warned that cases of Invasive Strep A were on the rise. A subsequent CDC analysis suggested a roughly threefold increase of cases in Colorado and Minnesota during October through December 2022, as compared to pre-pandemic years.

"Preliminary 2023 data indicate that [invasive Strep A] infections have remained high in children in some areas of the country even after some respiratory viruses decreased in those areas," the CDC said in a statement. "Some areas of the country are seeing higher levels than were seen pre-COVID-19 pandemic."

The typical Strep A season runs from December through April, according to the CDC.

Here are five questions answered about the condition, from how to treat it to how to lessen the risk:

1. What causes invasive group A strep?

Group A Strep (GAS) is a common bacteria which lives on our skin and often in our throats. It can cause different types of infections, most often strep throat.

Rarely, it can cause severe infections like streptococcal toxic shock syndrome or necrotizing fasciitis, a rare bacterial infection.

The severe infections occur when strep A bacteria invades other parts of the body like the bloodstream or spinal fluid.

2. How common is invasive group A strep?

Invasive group A strep is a dangerous but rare disease that leads to around 1,500 to 2,300 deaths in the United States annually, according to the CDC.

The agency says between 14,000 and 25,000 cases usually occur each year.

Cases of invasive group A strep are more common among children.

3. How is invasive group A strep treated?

The condition is usually treated in the hospital with IV antibiotics and other supportive measures.

The treatment for mild to moderate strep infections is amoxicillin, which is on national shortage. If strep goes untreated or undertreated, it can lead to invasive group A strep.

At this stage, there is no data to suggest a direct link between the shortage of amoxicillin and the spike in cases.

4. What are the most common symptoms of invasive group A strep?

Doctors tell ABC News that all cases of strep should be seen by a doctor, severe or not.

Parents and caregivers should be on the lookout for fever, sore throat, trouble swallowing, or kids not acting like themselves.

Parents should also keep an eye out for signs of toxic shock syndrome and "flesh-eating" skin infections, which can be a sign that a strep infection is invasive. Symptoms of toxic shock include fever, chills, muscle aches, nausea and vomiting, according to the CDC.

Early signs of a serious skin infection include a fast-spreading swollen area of skin, severe pain and fever. Later on it might look like blisters, changes in skin color or pus at the infected area.

5. How can a person lessen their exposure to invasive group A strep?

Because strep spreads through coughs and sneezes and surfaces, practicing good hygiene -- like washing hands, surfaces and plates or glasses -- can keep it from spreading.

Viral infections can set the stage for a subsequent bacterial infection in the lungs, so parents and caregivers should also make sure children are up to date on flu and COVID-19 vaccinations in order to help protect them.

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