Children's Health
Well-Child Visits Suffer From Time Squeeze: Study
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Longer well-child visits for babies and toddlers make for happier parents because doctors can fit in more advice and answer more questions, a new study finds.
But most well-child visits last less than 20 minutes and pediatricians are getting even more time-crunched as health care systems look to cut extra expenses any way they can, researchers write in Pediatrics.
“The disability rates for children continue to increase, and the nature of disability is changing,” with more kids getting diagnosed with behavioral and developmental problems, lead author Dr. Neal Halfon, from the University of California, Los Angeles Center for Healthier Children, Families and Communities, told Reuters Health.
Little fingers, big trouble: Yale study sheds light on child self-unbuckling
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It can be quite jarring for a parent or caregiver to look in the rearview mirror while driving and see their child roaming around the backseat free of their safety restraints. A study on child self-unbuckling by Yale School of Medicine researchers reveals that most children who first unbuckle were age three and under and that many children unbuckle while the vehicle is in motion—putting them at a 3.5-fold increased risk for serious injuries.
“We found that young children might acquire the motor skills to unbuckle from restraints before developing the cognitive ability to understand the necessity of automotive restraints,” said Lilia Reyes, M.D., clinical fellow in Yale School of Medicine’s Department of Pediatrics, Section of Emergency Medicine, who will present the results of the study at the Pediatric Academic Societies meeting in Denver, Colo. on May 1.
“This pilot study elucidates a potential safety hazard in child motor vehicle restraint that needs to be addressed,” said Reyes, who points to National Highway Traffic Safety Administration data showing that motor vehicle collisions are the leading cause of death among 4- to 8-year-olds.
Movement + academics = success
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When schools cut physical education programs so students can spend more time in the classroom, they may be missing a golden opportunity to promote learning, according to research to be presented Sunday, May 1, at the Pediatric Academic Societies (PAS) annual meeting in Denver.
The study adds to growing evidence that exercise is good not only for the body but also the mind. It also shows that physical education and academic instruction need not be mutually exclusive.
Researchers Kathryn L. King, MD, and Carly J. Scahill, DO, pediatric residents at the Medical University of South Carolina Children’s Hospital, led by William S. Randazzo, MD, FAAP, and James T. McElligott, MD, sought to determine how implementing a daily physical activity program that incorporated classroom lessons would affect student achievement. First- through sixth-graders at an academically low-scoring elementary school in Charleston, S.C., took part in the program 40 minutes a day, five days a week. Prior to initiation of the program, students spent 40 minutes per week in physical education classes.
Vitamin E helps diminish a type of fatty liver disease in children
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A specific form of vitamin E improved the most severe form of fatty liver disease in some children, according to a study funded by the National Institutes of Health. Results appear in the April 27 issue of the Journal of the American Medical Association. A previous study found vitamin E effective in some adults with the disease.
Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease among U.S. children. NAFLD ranges in severity from steatosis (fat in the liver without injury) to nonalcoholic steatohepatitis or NASH (fat, inflammation, and liver damage). Fatty liver increases a child’s risk of developing heart disease and liver cirrhosis. The only way to distinguish NASH from other forms of fatty liver disease is with a liver biopsy. Weight loss may reverse the disease in some children, but other than dietary advice, there are no specific treatments. Excess fat in the liver is believed to cause injury by increasing levels of oxidants, compounds that damage cells.
Most children with fatty liver disease are overweight and resistant to insulin, a critical hormone that regulates energy. Boys are more likely affected than girls, as are Hispanic children compared to African-Americans and whites.
Playing music as a child helps you stay sharp in old age
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Endless hours of piano practice can be the bane of a child’s life - but there might be an added benefit of sticking with it.
A study has found that learning a musical instrument as a child could keep you sharp into old age.
Pensioners who had piano, flute, clarinet or other lessons as a youngster, did better on intelligence tests than others.
Breastfeeding tied to stronger maternal response to baby’s cry
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A new study from the Journal of Child Psychology and Psychiatry finds that mothers who feed their babies breast milk exclusively, as opposed to formula, are more likely to bond emotionally with their child during the first few months after delivery. The breastfeeding mothers surveyed for the study showed greater responses to their infant’s cry in brain regions related to caregiving behavior and empathy than mothers who relied upon formula as the baby’s main food source. This is the first paper to examine the underlying neurobiological mechanisms as a function of breastfeeding, and to connect brain activity with maternal behaviors among human mothers.
The fMRI-based findings suggest that breastfeeding and factors associated with breastfeeding, such has high levels of hormones (oxytocin, prolactin), stress, and culture may all play an important role for mothers’ brain activity and parenting behaviours during the early postpartum period. The research shows that up to three or four months after delivery some of the brain regions originally observed at one month postpartum (amygdala, putamen, globus pallidus, and superior frontal gyrus) continued to activate and were correlated with maternal, sensitive behavior among the same group of mothers.
The findings highlight the dramatic relationship between breastfeeding, brain activity and parenting behaviours during the early postpartum period.
Minimally invasive thyroid surgery effective in children
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Surgical approaches that reduce incision size and recovery time from thyroid surgery work well in children, physician-scientists report.
“It brings parents comfort to know it’s going to be a small incision, an outpatient surgery with no drains or staples on the skin. We just use some glue for the skin and the recovery is very rapid,” said Dr. David Terris, Chairman of the Department of Otolaryngology-Head and Neck Surgery at Georgia Health Sciences University.
The results should bring comfort as well with complication rates of minimally invasive thyroid surgery on par with the standard surgical approach that can leave a several-inch scar at the base of the neck. Terris and Dr. Melanie W. Seybt, endocrine-head and neck surgeon at GHSU, co-authored the study published in Annals of Otology, Rhinology and Laryngology.
Teens and young adults with cancer face unique challenges and require targeted care
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Adolescents and young adults are neither children nor adults and those affected by cancer require targeted care that crosses the boundaries between pediatric and adult oncology, according to several pioneers in this still-developing field of adolescent and young adult oncology. An illuminating roundtable discussion by these experts will be published in the premier issue of Journal of Adolescent and Young Adult Oncology, a multidisciplinary peer-reviewed publication of Mary Ann Liebert, Inc. (http://www.liebertpub.com). The Roundtable has been published ahead of the print issue and is available at http://www.liebertpub.com/JAYAO. The full issue will launch in April 2011.
“AYA cancer presents the medical community with several unique problems. First, it requires true collaboration between pediatric and medical oncologists as the age range crosses both disciplines. Next, our AYA cancer patients not only have cancer but are also often dealing with ongoing developmental and psychosocial issues at the same time; as such, we must be aware of how a cancer diagnosis interferes with their normal development. The Roundtable discussion helps put AYA cancer in perspective for those who have not yet considered the 15-39 year old cancer patient as a distinct and relevant patient group,” according to Editor-in-Chief Leonard S. Sender, MD, of the University of California, Irvine and CHOC Children’s Hospital.
The roundtable discussion, “Trailblazers in Adolescent and Young Adult Oncology,” was moderated by Archie Bleyer, MD, Medical Director of Clinical Research for the St. Charles Health System in Bend, Oregon. Participants were leading physicians of pediatric, adolescent, and young adult oncology who have helped mold and advance this area of specialization trace the history and driving forces behind programs and disease management strategies now in place that target this patient population. Representing the experiences and revolutionary changes that have taken place in the United States, England, and Canada, Dr. Bleyer was joined by Karen Albritton, MD, Director of the Adolescent and Young Adult Oncology Program at Cook Children’s Medical Center and University of North Texas Health Science Center in Fort Worth; Ronald Barr, MB ChB, MD, Professor of Pediatrics, Pathology and Medicine at McMaster University in Canada; Ian Lewis, MB ChB, Professor of Cancer Research in Children and Young People at Leeds Teaching Hospital in the United Kingdom; and Editor-in-Chief Leonard Sender, MD, Medical Director of the Cancer Institute at CHOC Children’s Hospital and Director of the Young Adult Cancer Program at the University of California, Irvine’s Chao Family Comprehensive Cancer Center in Orange, CA.
Childhood sexual abuse may be a risk factor for later psychotic illness
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An Australian study suggests that children who are sexually abused, especially if it involves penetration, appear to be at higher risk for developing schizophrenia and other psychotic disorders, according to a report in the November issue of Archives of General Psychiatry, one of the JAMA/Archives journals. Previous studies have established that abused children are more likely to develop depression, anxiety, substance abuse, borderline personality disorders, posttraumatic stress disorder and suicidal behavior, according to background information in the article. “The possibility of a link between childhood sexual abuse and later psychotic disorders, however, remains unresolved despite the claims of some that a causal link has been established to schizophrenia,” the authors write
Margaret C. Cutajar, D.Psych., M.A.P.S., of Monash University, Victoria, Australia, and colleagues linked data from police and medical examinations of sexual abuse cases to a statewide register of psychiatric cases. Rates of psychiatric disorders among 2,759 individuals who had been sexually abused when younger than age 16 were compared with those among 4,938 individuals in a comparison group drawn from electoral records.
Over a 30-year period, individuals who had experienced childhood sexual abuse had significantly higher rates than those in the comparison group of psychosis overall (2.8 percent vs. 1.4 percent) and schizophrenia disorders (1.9 percent vs. 0.7 percent).
Can breastfeeding transmit yellow fever after maternal vaccination?
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A five-week old infant most likely contracted a vaccine strain of yellow fever virus through breastfeeding, according to a case report published in CMAJ (Canadian Medical Association Journal) (pre-embargo link only)
“Until recently, avoidance of vaccination of breastfeeding women with yellow fever vaccine had been based on theoretical grounds only,” writes Dr. Susan Kuhn, with coauthors. “We report the probable transmission of vaccine strain of yellow fever virus from a mother to her infant through breastfeeding,” which supports current recommendations for breastfeeding mothers to avoid the vaccine.
The yellow fever vaccine is a live-virus vaccine that has been used since the 1940s.
Childhood Chronic Illness Affects Future Income, Education, Career
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Today, more children than ever survive serious chronic illness. Many thrive as young adults, but a large new study finds that for some, early illness can lead to fewer years of education, more joblessness and lower pay.
The good news is that when they grow up, these kids are just as likely to blossom socially, enjoy romantic relationships and get married as healthy kids, finds the study in the Journal of Adolescent Health online.
Researchers led by Gary Maslow, M.D., looked at two sets of interview data from the National Longitudinal Study of Adolescent Health. The more than 13,000 respondents were middle or high school students during the 1994-1995 school year.
Genetic clues to compulsive, self-injurious behavior in rare childhood disorder
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Research from the University of California, San Diego School of Medicine provides new clues for the compulsive behavior and cognitive defects associated with a rare childhood neurological disease called Lesch-Nyhan Disease (LND). Two pathways found to be defective in LND are known to be associated with other neurodegenerative disease, such as Alzheimer’s and Parknson’s diseases, suggesting common causes of cognitive and behavioral defects in these neurological disorders.
The research is published on-line today in the PLoS ONE.
“This study is important because it opens completely new and unexpected areas of research into the genetic cause of compulsive and self-injurious behavior in Lesch-Nyhan disease,” said principal investigator Theodore Friedmann, MD, professor of pediatrics at UCSD’s Center for Neural Circuit and Behavior and Rady Children’s Hospital-San Diego, a research and teaching affiliate of the UCSD School of Medicine.
Hold the Gas? Inhaled Nitric Oxide of No Benefit to Most Premature Babies
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A new Johns Hopkins Children’s Center study challenges the widespread practice of treating premature babies with nitric oxide gas to prevent lung problems, neurological damage and death. The research, based on analysis of 22 major studies of the effect of nitric oxide in babies born before 34 weeks of age, found no evidence of benefit in most infants.
Overall, the Hopkins review found that babies who received nitric oxide in the neonatal intensive care unit didn’t fare any better than those who didn’t. The babies who received the treatment were no less likely to die, develop chronic lung disease of prematurity, suffer cerebral palsy or have neurological or cognitive impairments, the researchers found.
The findings, to appear in the February issue of the journal Pediatrics, point against the routine use of inhaled nitric oxide in all premature babies and call for careful, case-by-case evaluation of each baby’s degree of brain and lung maturation to determine if nitric oxide would help, hurt or do nothing for a patient, the researchers say.
Mayo Clinic finds long-term prognosis is excellent for most children with seizures
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Mayo Clinic researchers studied more than 200 children with epilepsy and found that even if the cause of focal-onset seizures cannot be identified and they do not fit into a known epilepsy syndrome, long-term prognosis is still excellent. This study was presented at the American Epilepsy Society’s (http://www.aesnet.org/) annual meeting in San Antonio on Dec. 4.
Epilepsy (http://www.mayoclinic.org/epilepsy/) is a disorder characterized by the occurrence of two or more seizures. It affects almost 3 million Americans, and approximately 45,000 children under age 15 develop epilepsy each year in the U.S.
“This study is important because even if we cannot identify a cause of focal seizures in children and they do not fit into a known epilepsy syndrome, most of the children outgrow the seizures, and very few have seizures that are unable to be controlled by medication,” says Elaine Wirrell, M.D., (http://www.mayoclinic.org/bio/14986779.html) a Mayo Clinic epileptologist and an author of this study.
Mothers can prevent obesity in children
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From the Lempert Report: Moms already have a ton of responsibilities, and now results from a recent WomenTALK online survey found that most women underestimate their role in preventing obesity in their children.
The survey found that while 87 percent of women believe a parent’s weight affects a child’s risk of becoming obese, a little over a quarter of women actually assign that responsibility to themselves. Research has demonstrated that moms have a greater effect than dads on a child’s weight - yet another responsibility to give mom.
The results released earlier this month by Healthy Women, an independent online health information source for women, surveyed over 1,000 women. The results found that only 11 percent knew that a child’s risk of becoming obese more than doubled if the mother is obese during her first trimester of pregnancy.
