MedicalResearch.com Interview with: Adrianne Haggins, MD, MS
University of Michigan Health System
Department of Emergency Medicine
Ann Arbor, MI 48109-5303
MedicalResearch.com: What are the main findings of the study?Dr. Haggins: Since the implementation of the Children’s Health Insurance Program (CHIP) in 1997, the last national health care reform that broadly expanded insurance coverage, adolescent use of primary care and specialty care has increased substantially in comparison to no change seen among the comparison group (young adults, who were not covered). Broadening insurance coverage for adolescents did not result in a decrease in emergency department use, while ED use in the comparison group increased over time. (more…)
MedicalResearch.com Interview with:Dr. Elizabeth V. Asztalos, MD, M.Sc., FRCPC
Sunnybrook Health Sciences Centre
2075 Bayview Ave., Room M4 230
Toronto, ON M4N 3M5
MedicalResearch.com What are the main findings of the study?Answer: This study was focused to see if there were differences in the main neurodevelopmental outcomes of children whose mothers had participated in the original MACS trial. We found that there were no differences in the main outcomes of the trial as it related to the aspects of death and/or developmental. (more…)
MedicalResearch.com Interview with:Dr. Ali Rowhani-Rahbar PhD, MD, MPH
Kaiser Permanente Vaccine Study Center, Oakland, California
University of Washington
Department of Epidemiology Health Sciences
Seattle, WA 98195
MedicalResearch.com: What are the main findings of your study?Answer: We found that the magnitude of increased risk of fever and seizures
following immunization with the first dose of measles-containing
vaccines during the second year of life depends on age. Specifically,
the risk of seizures attributable to the vaccine during the 7 to 10 days
following vaccination was significantly greater among children 16-23
months of age (9.5 excess cases per 10,000 doses) than among children
12-15 months of age (4.0 excess cases per 10,000 doses). (more…)
MedicalResearch.com Interview with:
Dr Valerie Sung MBBS(Hons) FRACP MPH NHMRC PhD Candidate
Department of Paediatrics, University of Melbourne, and
Community Health Services Research, Murdoch Childrens Research Institute Paediatrician, Centre for Community Child Health
The Royal Children’s Hospital
Parkville | 3052 | Victoria Australia
MedicalResearch.com: What are the main findings of the study?Dr. Sung: The systematic review identified 12 studies (1825 infants) that investigated the use of probiotics to treat or prevent infant colic (excessive crying of unknown cause in babies less than 3 months old). Three of the 5 treatment trials concluded probiotics effectively treat colic in breastfed babies; one suggested possible effectiveness in formula-fed babies with colic, and one suggested ineffectiveness in breastfed babies with colic. The three effective trials used the probiotic Lactobacillus reuteri in breastfed babies only; in two of these trials, the mothers were on a dairy-free diet. Five of the 7 prevention trials suggested probiotics to be ineffective in preventing colic.
MedicalResearch.com Interview with: Dr. Elisabeth Jeppesen MPH, PhD-fellow
National Resource Center for Late Effects after Cancer Treatment, Department of Oncology, Oslo University, Hospital, The Norwegian Radiumhospitalet, Oslo, Norway
mobil +47 951 05271 Wisit: Ullernchaussen 70 (Radiumhospitalet)
MedicalResearch.com: What is the background of this study?
Answer: Each year a considerable number of parents with children younger than 18 years of age are affected by cancer in a parent. Cancer in one of the parents might represent a potentially traumatic event and thereby may be a risk factor for psychosocial problems in the offspring. So far, teenagers’ psychosocial responses to parental cancer have only been studied to a limited extent in controlled trials. Using a trauma theory perspective many studies have shown significant direct associations between parental cancer and psychosocial problems in teenagers. However, the literature also indicates that most children and teenagers have normal stress reactions to such events. In order to identify the need for eventual prevention and intervention among teenagers exposed to such a stressor, we need more empirical knowledge of their psychosocial situation.
MedicalResearch.com Interview with: Ketil Stordal
National Institute of Public Health
MedicalResearch.com:What are the main findings of the study?Answer: The study identified 324 children with celiac disease from a cohort of 82 000. Start of gluten in the diet later than 6 months was associated with a 27% increased risk of celiac disease compared to those starting during the 5th or 6th month of life. Breastfeeding was not protective; the duration of breastfeeding was slightly longer among children with celiac disease (10.4 vs 9.9 months) and breastfeeding at the time of gluten introduction was not associated with the later risk of celiac disease. The participating mothers had submitted detailed data since pregnancy including infant feeding practices, and these were collected before onset of the disease.
MedicalResearch.com Interview with:Elias Iosifidis, MD, PhD
Pediatric Infectious Disease Fellow
Aristotle University of Thessaloniki
MedicalResearch.com: What are the main findings of the study?Dr. Iosifidis: A large outbreak of VRE colonization was found in neonates hospitalized in an intensive care unit (Neonatal Intensive Care Unit, NICU) after the implementation of an active surveillance program. Both high incidence of VRE colonization (or “colonization pressure”) and antibiotic use promoted VRE spread according to the results of the case control study. No proven sources of VRE were found (in local hospital or even in local livestock). A multifaceted management was implemented and included enhanced infection control measures, active surveillance cultures, cohorting of colonized patients, daily audits and optimization of antibiotic therapy. Although the outbreak had a biphasic pattern (monoclonal first wave followed by a polyclonal second wave) strict adherence to the aforementioned bundle of actions was proved essential for reducing VRE colonized cases. During the study period no new VRE infection occurred in neonates.
MedicalResearch.com Interview with:Tanya Froehlich, MD, MS
Division of Developmental and Behavioral Pediatrics
Cincinnati Children's Hospital Medical Center
3333 Burnet Avenue, MLC 4002
Cincinnati, OH 45229
MedicalResearch.com: What are the main findings of the study?Dr. Froehlich: In a national sample of 2 to 5 year olds, the likelihood of psychotropic prescription peaked in the mid-2000s (at 1.5%), then stabilized in the late 2000s (to 1.0%). Increased psychotropic use in boys, white children, and those lacking private health insurance was documented.
MedicalResearch.com Interview with: Shaon Sengupta, MD MBBS MPH
Division of Neonatology, Department of Pediatrics
Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
MedicalResearch.com: What are the main findings of the study?Dr. Sengupta: In this study we looked at all full-term neonates, which are defined as those born between 37 weeks 0 days to 41 weeks 6 days.
Early term deliveries (37–38 weeks) are a significant part of all full-term deliveries, but are not the norm.
In our study, 27% of neonates were born early term (37-38 weeks) while almost 62% were born at or after 39 weeks (term neonates). Similar data has been reported by other established sources of vital statistics.
While traditionally, full term neonates are perceived to be a homogenous low-risk group, the findings from our study urge the pediatrics/neonatal provider to recognize early term (37-38 weeks) neonates as a higher risk group. They have significantly higher risk of NICU admission, respiratory morbidity, hypoglycemia, need for IV fluids and antibiotics.
MedicalResearch.com Interview with:Fern R. Hauck, MD, MS
Spencer P. Bass, MD Twenty-First Century Professor of Family Medicine
Director, International Family Medicine Clinic
Department of Family Medicine
University of Virginia, PO Box 800729
Charlottesville, VA 22908-072
Co-author of "14 Ways to Protect Your Baby from SIDS"
MedicalResearch.com: What are the main findings of the study?Dr. Hauck:We looked at data from the Infant Feeding Practices Study II, which followed mother from pregnancy through the first year of infant life. Mothers received several surveys that asked about infant feeding and bedsharing (sleeping with their infant in the same bed or other sleep surface). We found that mothers who bedshared for the longest time had the longest duration of breastfeeding compared with mothers who did not bedshare or bedshared for shorter times. Breastfeeding duration was also longer among mothers who were better educated, were white, had previously breastfed another child, had planned to breastfeed this baby, and had not returned to work in the first year after the baby was born.
MedicalResearch.com Interview with:Dr. Martha Iwamoto, MD, MPH
Centers for Disease Control and Prevention, Atlanta, Georgia;
MedicalResearch.com: What are the main findings of the study?Dr. Iwamoto: We have been successful in decreasing invasive MRSA infections among infants younger than 3 months, mostly due to declines in hospital –onset infections in NICUs. However, more needs to be done among pediatric patients older than 3 months, especially those in the community settings and without recent healthcare exposures.
MedicalResearch.com Interview withSelma Salihovic, Doctoral student
Center for Developmental Research
MedicalResearch.com: What are the main findings of the study?Dr. Salihovic: Although previous research has examined the stability of psychopathic traits, our study offer a more nuanced perspective on development. Rather than asking whether psychopathic traits simply increase or decrease in adolescence, we asked about patterns of change for youths with different initial level of psychopathic traits. In this way, we could tease apart those youths with extreme levels from those with low and more transient levels, and follow their unique trajectories over four years. We could see that even among the youths with the highest levels there was a decreasing trend in two out of three core aspects of psychopathy. Although the degree of change was small, it was still a naturally occurring pattern for these youths, which raises the question whether an intervention designed to reduce these levels would have provided even a steeper decrease.
MedicalResearch.com Interview with:Gianluca Gini, PhD and Tiziana Pozzoli, PhD
Department of Developmental and Social Psychology
University of Padua, Padua, Italy
MedicalResearch.com: What are the main findings of the study?Answer: Results of this meta-analysis show that bullied children are twice as likely as non-bullied children to experience psychosomatic symptoms (e.g., headache, stomachache, backache, abdominal pain, dizziness, sleeping problems, poor appetite, bedwetting, skin problems, vomiting), especially in samples that included an higher proportion of boys. Importantly, the same result was found not only with cross-sectional studies but also in a meta-analysis of six studies that employed a longitudinal design.
MedicalResearch.com Interview with:Ronald J. Iannotti, PhD
Prevention Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
Trends in Physical Activity, Sedentary Behavior, Diet, and BMI Among US Adolescents, 2001–2009 MedicalResearch.com: What are the main findings of the study?Dr. Iannotti: Although average BMI percentile increased from 2001 to 2005 it did not increase from 2005 to 2009. This is consistent with some recent studies that suggest the increase in overweight and obesity may be leveling off. We suggest that we may be 'bending the curve'. During the same period, physical activity and consumption of fruits and vegetables increased while television watching and consumption of sweets and sweetened beverages decreased. We cannot say whether television watching was replaced with more time spent on computers but we did not find an increase in computer use from 2005 to 2009.
MedicalResearch.com Interview with:Svetlana Popova, M.D., M.P.H., Ph.D.
Senior Scientist, Social and Epidemiological Research,
Centre for Addiction and Mental Health
Assistant Professor, Epidemiology Division
Dalla Lana School of Public Health, University of Toronto
Assistant Professor, Factor-Inwentash Faculty of Social Work, University of Toronto
Graduate Faculty Associate Member, Institute of Medical Science, University of Toronto
CAMH, 33 Russell Street, Room # T507
Toronto Ontario, Canada M5S 2S1
MedicalResearch.com: What are the main findings of the study?Dr. Popova: We conducted a systematic literature review and meta-analysis of internationally published and unpublished studies that reported the prevalence of FAS and/or FASD in all types of child care systems (e.g., orphanage, foster care, boarding school, adoption centre, or child welfare system).
The primary objective was to estimate a pooled (combined) prevalence for FAS and FASD in various child care systems using data from existing studies that used an Active Case Ascertainment method (when researchers/clinicians actively seek and diagnose FASD cases).The available data was analyzed byusing a standard statistical technique (called meta-analysis).
This study revealed that the vast majority of existing studies report that the prevalence of Fetal Alcohol Spectrum Disorder (FASD) in the various child-care settings in the different countries is extremely high.
Our analysis of these studies demonstrated that the pooled prevalence of FAS in child care settings (6%) was found to be approximately 9-30 times higher than the prevalence of FAS in the general population of North America, which is reported to range from 2 to 7 cases per 1,000 individuals in the USA and 1 per 1,000 in Canada. Thus, children in care represent a high-risk population for FASD.
MedicalResearch.com Interview with:Dr. Elsie Taveras
Massachusetts General Hospital for Children
Division of General Pediatrics, Department of Pediatrics
100 Cambridge St, 15th Floor
Boston, MA 02114
MedicalResearch.com: What are the main findings of the study?Dr. Taveras: The main findings of the study were that, overall, the body mass index of children in the intervention group dropped an average of 0.18, while it rose 0.21 in the control group. Children in the intervention group were sleeping about 45 minutes longer than children in the control group. Time spent watching television on weekends dropped about an hour per day in the intervention group, leading to a significant difference from the control group, which increased weekend TV viewing. Both groups had a small reduction in weekday TV viewing, with a greater decrease in the intervention group, as well.
David R. Fulton, M.D. Associate Cardiologist-in-Chief for Administration
Tommy Kaplan Chair in Cardiovascular Studies
Chief, Cardiology Outpatient Services
Department of Cardiology
Children's Hospital Boston
Boston, MA 02115
MedicalResearch.com: What are the main findings of this study?Dr. Fulton: The main findings of this study demonstrated that using a quality improvement methodology (SCAMPs), a diverse population of children and adolescents with chest pain could be managed with relative uniformity and cost effectiveness in a multi-center collaborative. Only 2 patients of the 1016 children who formed the basis for this review were shown to have a cardiac etiology. The clinicians were able to screen and reach a diagnostic conclusion in a large segment of this population using history, physical examination and ECG.
Professor Sheena Reilly PhD FASSA
Associate Director, Clinical and Public Health Research
Murdoch Childrens Research Institute
Professor of Speech Pathology
Department of Paediatrics, University of Melbourne
Royal Children’s Hospital
Flemington Road Parkville Victoria 3052 Australia
MedicalResearch.com: What are the main findings of the study?Prof. Reilly: Stuttering was more common than previously thought. The cumulative incidence of stuttering by four years old was 11%, which is more than twice what has previously been reported. Developmental stuttering was associated with better language development, non-verbal skills with no identifiable effect on the child’s mental health or temperament by four years of age.
MedicalResearch.com Interview with:Dr. Jonathan Silverman, MD
Department of Pediatrics
University of Washington in Seattle, Washington
MedicalResearch.com: What are the main findings of the study?
Dr. Silverman: We looked at the incidence of magnet foreign body injuries in children between 2002-2011, using a Consumer Products Safety Division surveillance database. We found an estimated 22, 581 cases over that period. Most strikingly, we found a rise in the incidence of magnet ingestions (in cases per 100,000 children/yr) from 0.57 (95% CI 0.22-0.92) in 2002-2003 to 3.06 (95% CI 2.16-3.96) in 2010-2011. The mean age for ingested magnets was 5, but for nasal magnets was 10. Multiple magnet ingestions and magnet injuries requiring hospital admission were much more common in the second half of the study period, corresponding with the rising popularity of small, high-powered, desktop magnet sets. However, due to limited detail from the database, we were unable to say with any certainty whether injuries were specifically due to these magnet sets.
MedicalResearch.com Interview with: Bjarke Feenstra, Ph.D.
Senior Research Scientist
Statens Serum Institut
Artillerivej 5, 2300 Copenhagen S
MedicalResearch.com: What are the main findings of the study?Dr. Feenstra: We discovered a new genome-wide significant locus for infantile hypertrophic pyloric stenosis (IHPS) in a region on chromosome 11 harboring the apolipoprotein (APOA1/C3/A4/A5) gene cluster and also confirmed three previously reported loci. Characteristics of the new locus led us to propose the hypothesis that low levels of circulating lipids in infants are associated with increased risk of IHPS. We addressed this hypothesis by measuring plasma lipid levels in prospectively collected umbilical cord blood from a set of 46 IHPS cases and 189 matched controls. We found that levels were on average somewhat lower in the children who went on to develop the condition.
MedicalResearch.com Interview with:Kirsten Ness, PT, PhD
Epidemiology and Cancer Control
MS 735, Room S-6013
St. Jude Children's Research Hospital
262 Danny Thomas Place
Memphis, TN 38105-3678
MedicalResearch.com: What are the main findings of the study? Answer: Even though they report similar levels of physical activity, children who were treated for cancer and who survive at least five years, on average, do not perform as well as their siblings on tests of physical performance. They have muscle weakness and decreased cardiopulmonary fitness.
MedicalResearch.com Interview with: Mark D. DeBoer, MD
Associate Professor of Pediatrics
Division of Pediatric Endocrinology
University of Virginia Health System
P.O. Box 800386
Charlottesville, VA 22908
MedicalResearch.com: What are the main findings of the study?Dr. DeBoer: Preschool and kindergarten children drinking SSB (compared to infrequent/non-drinkers) were more likely to be obese and among 2 year-olds had more unhealthy weight gain over the next 2 years. SSB consumption is thus linked to higher weight status in children age 2-5 years.
MedicalResearch.com Interview with: Gary A. Smith, MD, DrPHCenter for Injury Research and Policy, The Research Institute at Nationwide Children’s Hospital, Columbus, Ohio;
The Ohio State University College of Medicine, Columbus, Ohio; and
Child Injury Prevention Alliance, Columbus, OhioMedicalResearch.com: What are the main findings of the study?Dr. Smith: During the nine-year study period, more than 12,000 children were treated each year in U.S. emergency departments for injuries from choking on food, which equals 34 children each day. Hard candy caused the most choking episodes (15 percent), followed by other candy (13 percent), meat, other than hot dogs (12 percent), and bones (12 percent). These four food types alone accounted for more than half of all the choking episodes in the study.
MedicalResearch.com Interview with: Dr. Bernard Rosner
Harvard School of Public Health
Professor in the Department of Biostatistics
Department of Biostatistics
Channing Laboratory 180 Longwood Avenue
Boston, Massachusetts 02115
MedicalResearch.com: What are the Main Findings of this study?Dr. Rosner: The risk of elevated blood pressure (BP) among children has increased 27% over a 13-year period based on a study among 11,636 children ages 8-17 seen in the NHANES study from 1988-2008. In NHANES III (1988-1994) the risk was 15.8% among boys and 8.2% among girls. In NHANES 1999-2008 (1999-2008) the risk was 19.2% among boys and 12.6% among girls.
Important risk factors for elevated BP were BMI, waist-circumference and sodium intake.
Risk approximately doubled for children in the highest age-sex-specific quartile of BMI vs. children in the lowest quartile
Risk approximately doubled for children in the highest age-sex-specific quartile of waist circumference vs. children in the lowest quartile
Risk increased 36% among children with dietary Na intake > 3450 mg/day vs. children with intake <2300 mg/day. Na intake was normalized per 2000 calories.
There were large increases in both mean BMI and mean waist circumference over the 13-year period, especially for girls.
MedicalResearch.com Interview with Jill M. Norris, MPH, PhDColorado School of Public Health, University of Colorado, Aurora
MedicalResearch.com: What were the most significant findings? How do they relate to what was already known about this subject?Dr. Norris: One of the most intriguing findings is that if mothers are still breast-feeding when they introduce gluten-containing foods to their baby, they may reduce the risk for T1D. This is similar to a finding from a Swedish study that found that breast-feeding while introducing gluten-containing foods may reduce the risk for celiac disease, an autoimmune condition that has several similarities with T1D.
In children at increased genetic risk for T1D, our data suggest that parents should wait to introduce any solid foods until after the 4 month birthday. And when the baby is ready, solid foods should be introduced by the 6 months birthday or soon thereafter, preferably while the mother is still breast-feeding the baby, which may reduce the risk of T1D.
MedicalResearch.com Interview with: Virender K. Rehan, MD
Los Angeles Biomedical Research
Institute (LA BioMed).
MedicalResearch.com: What are the main findings of the study?Dr. Rehan: This is the first study to show that the active ingredient in Indian spice
turmeric provides long term protection against neonatal lung damage that
leads to chronic lung disease of prematurity.
MedicalResearch.com Interview with Batool Haider, MD, MS, DSc candidate
Departments of Epidemiology and Nutrition
School of Public Health
Anaemia, prenatal iron use, and risk of adverse pregnancy outcomes: systematic review and meta-analysisMedicalResearch.com: What are the main findings of the study?Dr. Haider: The main findings of the study are that iron use in the prenatal period increased maternal mean haemoglobin concentration by 4.59 (95% confidence interval 3.72 to 5.46) g/L compared with controls and significantly reduced the risk of anaemia (relative risk 0.50, 0.42 to 0.59), iron deficiency (0.59, 0.46 to 0.79), iron deficiency anaemia (0.40, 0.26 to 0.60), and low birth weight (0.81, 0.71 to 0.93). The effect of iron on preterm birth was not significant (relative risk 0.84, 0.68 to 1.03). Analysis of cohort studies showed a significantly higher risk of low birth weight (adjusted odds ratio 1.29, 1.09 to 1.53) and preterm birth (1.21, 1.13 to 1.30) with anaemia in the first or second trimester.
Exposure-response analysis indicated that for every 10 mg increase in iron dose/day, up to 66 mg/day, the relative risk of maternal anaemia was 0.88 (0.84 to 0.92) (P for linear trend<0.001). Birth weight increased by 15.1 (6.0 to 24.2) g (P for linear trend=0.005) and risk of low birth weight decreased by 3% (relative risk 0.97, 0.95 to 0.98) for every 10 mg increase in dose/day (P for linear trend<0.001). Duration of use was not significantly associated with the outcomes after adjustment for dose. Furthermore, for each 1 g/L increase in mean haemoglobin, birth weight increased by 14.0 (6.8 to 21.8) g (P for linear trend=0.002); however, mean haemoglobin was not associated with the risk of low birth weight and preterm birth. No evidence of a significant effect on duration of gestation, small for gestational age births, and birth length was noted.
MedicalResearch.com Interview with: Dr. Ezio Bonifacio, Ph.D.
Professor, Preclinical Stem Cells/Diabetes
Center for Regenerative Therapies Dresden
Technische Universität Dresden
MedicalResearch.com: What are the main findings of the study?Dr. Bonifacio: Children who develop multiple islet autoantibodies are destined to develop diabetes. Only a minority will be diabetes-free 15 years after developing islet autoantibodies. This is regardless of whether they have a family history of type 1 diabetes. Progression to diabetes after seroconversion varied from weeks to decades, and 20% of children had diabetes within 2 years from seroconverting. Progression was fastest in children who developed their islet autoantibodies before age 3 years.
MedicalResearch.com: Were any of the findings unexpected?Dr. Bonifacio: Unexpected is probably not the right word. The Eisenbarth model of chronic disease proposes that diabetes will happen some time after autoimmunity and the findings show the reality of it. Perhaps the unexpected finding is that it is not always chronic and that for a number of children, intervention would need to be applied quickly.
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