Louise-Anne McNutt, PhD
Associate Director, Institute for Health and the Environment
University at Albany, State University of New York
Jessica Nadeau, PhD
Epidemiologist, University at Albany, State University of New York
Medical Research: What are the main findings of the study?
Response: The study found that about 25% of infants consistently deviated from the routine vaccine schedule recommended by the American Academy of Pediatrics (AAP). Alterations included either consistently refusing a recommended vaccine or reducing the number of vaccines given at each visit.
These deviations are generally associated with intent to use an alternative vaccination schedule.
Infants who did not follow the AAP recommended schedule were more likely to be unprotected against vaccine preventable diseases for a longer period of time. Only 1 in10 infants vaccinated on an alternative schedule were up-to-date at 9 months of age.
MedicalResearch.com Interview Invitation
Dr Ken Ong, Programme Leader & Paediatric Endocrinologist
MRC Epidemiology Unit, University of Cambridge
Box 285 Institute of Metabolic Science
Cambridge Biomedical Campus, Cambridge
Medical Research: What are the main findings of this report?
Dr. Ong: We found that genetic factors that predict adult obesity were associated with faster weight gain and growth during infancy – the findings indicate that the biological mechanisms that predispose to later obesity are already active from birth.
MedicalResearch.com Interview with:
Georg Loss, PhD
Dr. von Hauner Children’s Hospital
Ludwig Maximilians University of Munich
Munich, Germany
Medical Research: What are the main findings of the study?
Dr. Loss: In this large population based cohort study we observed that consumption of fresh unprocessed cow’s milk protected from respiratory infections, febrile illness and inflammation of the middle ear during the first year of life. The risk of developing these conditions was reduced by up to 30%, and the effect was diminished if the milk was heated at home before consumption. Conventionally pasteurized milk retained the ability to reduce the risk of febrile illness, while exposure to the higher temperatures used in UHT (Ultra-heat-treatment) processing eliminated the effect altogether. Importantly, the positive impact of fresh milk could be clearly separated from the confounding effects of other elements of the children’s nutrition. Furthermore, infants fed on unprocessed milk were found to have lower levels of the C-reactive protein, which is a measure of inflammation status.
MedicalResearch.com: Interview with:
Jonathon Maguire MD MSc FRCPC
Pediatrician and Scientist Department of Pediatrics
Li Ka Shing Knowledge Institute
St. Michael’s Hospital University of Toronto
Medical Research: What is the background for this study? What are the main findings?
Dr. Maguire: One of the main health benefits of cow’s milk is vitamin D. We were interested to know if non-cow’s milk supports children’s vitamin D blood levels as well as cow’s milk.
Dr. Huiyun Xiang, MD, MPH, PhD
Center for Injury Research and Policy
The Ohio State University College of Medicine, Columbus, Ohio
Jeb Phillips, BA
Project Specialist, Injury Research and Policy Staff
Nationwide Children’s Hospital, Columbus, Ohio
Medical Research: What are the main findings of the study?
Response: From 2002-2012, a child younger than 6 years old experienced an out-of-hospital medication error every 8 minutes. That’s a total of 696,937 during the study period, or 63,358 per year. Almost all happened at the child’s residence. The rate and number of errors decreased with increasing age.
Analgesics were the mostly commonly involved medications (25.2%), followed by cough and cold medications (24.6%). More than 1 in 4 (27%) of the errors happened when a child inadvertently took or was given medication twice. Errors also happened when children took or were given an incorrect dose, when medication measurements were confused, and when the wrong medication was taken or given.
MedicalResearch.com Interview with:
Jeff R. Temple, PhD
Associate Professor and Psychologist
Director, Behavioral Health and Research
Department of Ob/Gyn
UTMB Health Galveston, TX 77555-0587
Medical Research: What are the main findings of the study?
Dr. Temple: Through previous research, we know that teen sexting is related to actual sexual behaviors, but we did not have any information on the temporal link between these two behaviors.
In short, we found that teens who sexted had 32% higher odds of being sexually active over the next year relative to youth who did not sext – this was even after controlling for history of prior sexual behavior, ethnicity, gender, and age. We also found that active sexting (actually sending a naked picture to another teen) mediated the relationship between passive sexting (asking for or being asked for a sext) and sexual behaviors. In other words, while sending a sext was predictive of subsequent sexual behavior, asking for/being asked for a sext was only associated with sexual behavior through its relationship with active sexting.
MedicalResearch.com Interview,
Sara Sammallahti, MA
Institute of Behavioral Sciences
University of Helsinki, Finland.
Medical Research: What are the main findings of the study?
Answer: Not only did we find that faster growth right after preterm birth is
associated with better neurocognitive abilities - we also showed that
these effects persist into adulthood, that they are seen across a wide
spectrum of abilities, and that head growth very early on seems
especially relevant in predicting long-term outcomes. These
associations were found when we examined 103 young adults who were
born prematurely and with very low birth weight (under 1500 grams).
MedicalResearch.com Interview with:
Dr. Lorraine Yeung
Division of Birth Defects and Developmental Disabilities
National Center on Birth Defects and Developmental Disabilities, CDC
Medical Research: What are the main findings of the study?
Dr. Yeung: In this report, we looked at the percentages of children who received various recommended clinical preventive services. We found that millions of infants, children, and adolescents in the U.S. did not receive key clinical preventive services.
This report provides a baseline snapshot of the use of 11 key clinical preventive services before or shortly after the Affordable Care Act went into effect. A focus of the Affordable Care Act is on improving prevention of illness and disability and it does so by requiring new health insurance plans to provide certain clinical preventive services at no additional cost — with no copays or deductibles. This is important because we know increasing the use of these services can improve children’s health and promote healthy lifestyles that will enable them to reach their full potential.
Some of the important findings in this report were:
In 2007, parents of almost eight in 10 (79 percent) children aged 10-47 months reported that they were not asked by healthcare providers to complete a formal screen for developmental delays in the past year.
In 2009, more than half (56 percent) of children and adolescents did not visit the dentist in the past year and nearly nine of 10 (86 percent) children and adolescents did not receive a dental sealant or a topical fluoride application in the past year.
Nearly half (47 percent) of females aged 13-17 years had not received their recommended first dose of HPV vaccine in 2011.
Approximately one in three (31 percent) outpatient clinic visits made by 11-21 year-olds during 2004–2010 had no documentation of tobacco use status; eight of 10 (80 percent) of those who screened positive for tobacco use did not receive any cessation assistance.
Approximately one in four (24 percent) outpatient clinic visits for preventive care made by 3-17 year olds during 2009-2010 had no documentation of blood pressure measurement.
MedicalResearch.com Interview with:
Lex W Doyle MD BS MSc FRACP
Professor of Neonatal Paediatrics
Department of Obstetrics and Gynaecology
The Royal Women’s Hospital
Parkville, Victoria, Australia
Medical Research: What are the main findings of the study?
Dr. Doyle: From collectively pooling data from five large trials carried out around the world over the past 20 years, we know that magnesium sulfate given under strict medical protocols in hospital to women threatening to deliver preterm reduces the risk of cerebral palsy in their children in early childhood. Following from this knowledge, magnesium sulfate is now given routinely to women, under strict medical conditions, who are threatening to deliver very early in Australia, and in other parts of the world, to try to prevent cerebral palsy in their child. What we do not know is if magnesium sulfate used this way has any longer-term effects on the brain or on other important outcomes.
One of the initial studies that contributed to the overall evidence about cerebral palsy was carried out in Australia and New Zealand and completed more than 10 years ago. Over 1000 women and their babies were enrolled in that study and although the rate of cerebral palsy was not substantially reduced by magnesium sulfate in our study, we showed that there were fewer children at 2 years of age who were not walking in the group whose mothers were given magnesium compared with those whose mothers were given placebo. With this knowledge, and given the unknown longer-term benefits or risks, we re-evaluated the children from our study at school-age, between 6-11 years of age. We thoroughly evaluated their brain function, including movement and co-ordination, thinking ability, behaviour, and school progress, as well as general health and well-being. The basic message from our longer-term study is that magnesium sulfate, as used in our trial, does not have any substantial benefits or harms on brain or cognitive function, or any other outcome at school age.
MedicalResearch.com Interview with:
Dr. Jun Li, MD, PhD, MPH
Epidemiology and Applied Research Branch
Division of Cancer Prevention and Control
National Center for Chronic Disease Prevention and Health Promotion
Medical Research: What are the main findings of the study?
Dr. Li: Using the 2001 to 2009 National Program of Cancer Registries (NPCR) and Surveillance, Epidemiology, and End Results (SEER) data, which represent 94.2% of the US population, we identified 120,137 pediatric cancer cases with an incidence rate of 171 cases per million children and adolescents.
Overall cancer incidence rates were stable from 2001-2009. However, we found rates were increasing significantly at 1.3% per year in African American children and adolescents. This increase might be partially attributed to the rise among renal tumors and thyroid cancer. We also found rising incidence in thyroid cancer and renal carcinoma among children and adolescents.
As has been previously established, pediatric cancer is more common in males, in white, in adolescents, and in the Northeast. Leukemia is the most common pediatric cancer, followed by central nervous system (CNS) neoplasms, and then lymphomas.
MedicalResearch.com: Interview with:
Dr. Steve Turner
Child Health, Royal Aberdeen Children's Hospital
Aberdeen,UK
Medical Research: What are the main findings of the study?
Dr. Turner: There is evidence that being small for a given gestational age is associated with a broad range of what could be loosely considered “disadvantageous” outcomes in early childhood, eg increased risk for wheeze, increased blood fat levels, increased blood pressure and low bone mineral density. Many of these outcomes are subclinical – ie unless they were measured no-one would be any the wiser – and what remains to be determined is whether as these individuals grow up these subclinical measurements become important. Follow up may take many years, decades for outcomes such as coronary artery disease and type II diabetes.
MedicalResearch.com Interview with:
Dr. Ralph Joseph Diclemente PhD
Behavoral Sciences & Health School Of Public Health
Emory University Atlanta Georgia
Medical Research: What are the main findings of the study?
Dr. DiClemente: In our study of 701 African American girls we observed significant and durable reductions in laboratory-confirmed sexually transmitted infections (50% reduction in chlamydial infections and a 60% reduction in gonorrhea) among girls in our intervention group relative to the comparison condition over a 36-month follow-up period. In addition, we observed significant increases in condom use during sex and reductions in sex while using drugs or alcohol. The key finding is the durability of the results - 3 years in the life of an adolescent is a long period.
MedicalResearch.com interview with:
Dr. Shannon MacDonald PhD
Department of Pediatrics, University of Calgary, Calgary and
Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
Medical Research: What are the main findings of the study?
Dr. MacDonald: We found that vitamin K was refused by only a very small number of parents in our study population (0.3%) but that the number appears to be increasing (almost doubling in the past 7 years). The parents that refused vitamin K for their child were more likely to be those that delivered at home and/or with a midwife. We also found that parents who refused vitamin K for their child were also much more likely to go on to refuse all vaccinations by 15 months of age.
MedicalResearch.com Interview with:
Dr Prakesh S Shah MSc, MBBS, MD, DCH, MRCP, FRCPC
Professor, Departments of Paediatrics and HPME
Mount Sinai Hospital and University of Toronto
CIHR Applied Research Chair in Reproductive and Child Health Services and Policy Research
Director, Canadian Neonatal Network
Toronto Ontario Canada M5G 1X5
Medical Research: What are the main findings of the study?
Dr. Shah: The main findings of our study are that by embracing collaborative quality improvement program in 25 of 28 Neonatal ICUs in the country, we were able to show significant reduction in adverse outcomes of necrotizing enterocolitis, severe retinopathy of prematurity and nosocomial infections among preterm neonates born at less than 29 weeks of gestation. This resulted in significant overall reduction of composite outcome of mortality or severe morbidities and improved overall outcomes over 3 years of study period.
MedicalResearch.com Interview with:
Suzanne Schuh, MD, FRCP(C), FAAP, ABPEM
Staff Paediatrician, Division of Paediatric Emergency Medicine
Senior Associate Scientist, Research Institute, Hospital for Sick Children
Professor of Paediatrics, University of Toronto
Medical Research: What are the main findings of this study?
Dr. Schuh: Our study shows that in previously healthy infants presenting to the Emergency Department with mild to moderate bronchiolitis (a viral lower respiratory tract disease producing breathing distress) who had their oxygen saturation measurements artificially elevated by a physiologically small amount experienced significantly reduced rate of hospitalizations within 72 hours compared to infants with unaltered oximetry readings.
Medical Research Interview with: Lara J. Akinbami, MD Infant, Child and Women's Health Statistics Branch National Center for Health Statistics Centers for Disease Control and Prevention Hyattsville, MD 20782. MedicalResearch.com: What are the main findings of the study? Dr. Akinbami : We analyzed national data to assess recent trends in racial disparities on childhood asthma...
MedicalResearch.com Interview with:
Jana Shaw MD, MPH, FAAP
Associate Professor of Pediatrics
Pediatric Infectious Diseases
SUNY Upstate Medical University
750 East Adams Street
Syracuse, NY 13210
Medical Research: What are the main findings of the study?
Dr. Shaw: In this study, we looked at exemptions to school immunization requirements in the US during 2009-2010 school year. We found that private schools have higher rates for all types of exemptions (medical, religious, and personal belief/philosophical). In addition, states that permitted personal belief exemptions had higher rates of exemptions overall compared to states that did not allow them.
MedicalResearch.com Interview with:
Sharon Levy, M.D., M.P.H.
Director, Adolescent Substance Abuse Program
Assistant Professor in Pediatrics
Boston Children’s Hospital
Medical Research: What are the main findings of the study?
Dr. Levy: We found that questions that asked about the frequency of alcohol, tobacco and drug use accurately triaged adolescents into "risk categories". In other words, kids who reported using alcohol or marijuana "once or twice" last year were unlikely to have a substance use disorder, those who reported "monthly" use were very likely to meet diagnostic criteria for a "mild" or "moderate" substance use disorder while those who reported use weekly or more were very likely to meet diagnostic criteria for a "severe" substance use disorder.
MedicalResearch.com Interview with:
Pete Dodd (BA, BSc, MMath, PhD)
Research associate in health economic modelling
Health Economics and Decision Science
ScHARR
Regent Court Sheffield
Medical Research: What are the main findings of the study?
Dr. Dodd: We found that over 650,000 children under the age of 15 developed tuberculosis in the 22 highest burden countries in 2010, with around 7.6 million becoming infected with the bacillus and more than 50 million harboring latent infection.
Our work points to a much larger gap between notifications and incidence in children compared to adults.
MedicalResearch.com Interview with:
David Olds, Ph.D.
Professor of Pediatrics and Director
Prevention Research Center for Family and Child Health
University of Colorado Department of Pediatrics
Aurora, Colorado 80045
Medical Research: What are the main findings of the study?
Dr. Olds: We’ve conducted a randomized controlled trial of a program of nurse home visiting for low-income women with no previous live firths during pregnancy and the first two years of the child’s life, with randomization of participants beginning in 1990. In our most recent follow-up of mothers and children in Memphis, those who received nurse-visitation were less likely to have died over a 2-decade period following the child’s birth than those in the control group. Death among mothers and children in these age ranges in the US is rare and extraordinarily important for what it tells us about the health of the population studied in this trial.
For children, the reduction in death was present for preventable causes, that is, sudden infant death syndrome, injuries, and homicide. All of the child deaths for preventable causes were in the control group, for whom the rate was 1.6%. None of the nurse-visited children died of preventable causes.
The reductions in maternal mortality were found for two nurse-visited groups combined for this report: one received prenatal and newborn visitation and a second received visitation during pregnancy and through child age two. Overall, mothers assigned to the control group were nearly 3 times more likely to die than those assigned to the two nurse-visited conditions. The relative reduction in maternal mortality was particularly pronounced for deaths linked to maternal behaviors -- suicide, drug overdose, injuries, and homicide; for these external causes of death, 1.7% of the mothers in the control group had died, compared to 0.2% of those visited by nurses.
MedicalResearch.com Interview with:
Dr. Daniel Agardh M.D., Ph.D
Department of Pediatrics
Diabetes and Celiac Disease Unit
Skåne University Hospital
Malmo, Sweden,
MedicalResearch: What are the main findings of the study?
Dr. Agardh: In this study, we stratify the risk of celiac disease among children according to their HLA genotype and country of residence. We confirm that HLA-DQ2/2 genotype is the major risk factor for early celiac disease, but also show how the risk differs between the participating countries despite of sharing similar HLA risk. This points to the direction of an interaction between HLA and the environment that eventually lead to an autoimmune response in genetic susceptible children.
MedicalResearch.com Interview with:
Johanna Petzoldt
Institute of Clinical Psychology and Psychotherapy
Chemnitzer Straße
Dresden, Germany
MedicalResearch: What are the main findings of the study?
Answer: We investigated 286 mother-infant couples from the Maternal Anxiety in Relation to Infant Development (MARI) Study from Dresden (Germany) via standardized interview and questionnaire. We found a robust relation from maternal lifetime anxiety disorders as early as prior to pregnancy to excessive crying in the offspring. Also, the association increased when considering incident anxiety disorders during pregnancy and after delivery.
MedicalResearch.com Interview with:
Frank H. Morriss, Jr., MD, MPH
Professor of Pediatrics - Neonatology
University of Iowa Carver College of Medicine
MedicalResearch: What are the main findings of the study?
Dr. Morriss: Our aim was to assess the association between surgery performed during the initial hospitalization of very low- birth-weight infants and subsequent death or neurodevelopmental impairment at 18-22 months’ corrected age. We conducted a retrospective cohort analysis of patients who were prospectively enrolled in the National Institute of Child Health and Human Development Neonatal Research Network Generic Database from 1998 to 2009. Surgery was classified by the expected anesthesia type as either major surgery that likely would have been performed under general anesthesia; or minor surgery, that is, procedures that could have been performed under non-general anesthesia and in general were shorter in duration. There were 2,186 major surgery patients and 784 minor surgery patients and more than 9,000 patients who did not undergo surgery.
We found that any surgical procedure increased the adjusted risk of death or neurodevelopmental impairment in low birth weight infants by about 30%. Not all surgical procedures were associated with increased risk, however. Compared with those who did not undergo surgery, patients who were classified as having major surgery had a risk-adjusted odds ratio of death or neurodevelopmental impairment of 1.52 (95% confidence interval 1.24-1.87). However, those who were classified as having minor surgery had no increased adjusted risk. Among survivors who had major surgery compared with those who did not undergo surgery the risk-adjusted odds ratio for neurodevelopmental impairment was 1.56 (95% confidence interval 1.26-1.93), and the risk-adjusted mean Bayley II Mental Developmental Index and mean Psychomotor Developmental Index values were significantly lower.
MedicalResearch.com: Interview with
Kay Wang
Academic Clinical Lecturer
Nuffield Department of Primary Care Health Sciences
University of Oxford, Oxford, UK
MedicalResearch: What are the main findings of the study?
Dr. Wang: We have found evidence of recent whooping cough infection in 1 in 5 school age children who see their doctor with a persistent cough and in 1 in 6 children who have been fully vaccinated against whooping cough. We have also shown that whooping cough can still cause clinically significant cough in fully vaccinated children.
MedicalResearch.com Interview with:
Kay W. Chang, MD
Associate Professor of Otolaryngology and Pediatrics
Stanford University
Department of Otolaryngology
Lucile Packard Children's Hospital at Stanford
Division of Pediatric Otolaryngology
MedicalResearch: What are the main findings of the study?
Dr. Chang: At 18 months after surgery, weight percentiles in the study group increased by a mean of 6.3 percentile points, and body mass index percentiles increased by a mean of 8.0 percentile points. The greatest increases in weight percentiles were observed in children who were between the 1st and 60th percentiles for weight and younger than 4 years at the time of surgery. An increase in weight percentile was not observed in children who preoperatively were already above the 80th percentile in weight.
MedicalResearch.com Interview with:
Michelle A. Mendez, PhD
Assistant Professor
Department of Nutrition
University of North Carolina at Chapel Hill
Gillings School of Public Health
Chapel Hill, NC
MedicalResearch: What are the main findings of the study?
Dr. Mendez: Using national surveillance data to examine trends in energy intake among children, we found that there was an initial decline in intakes from 2003-4 through 2007-08, which mirrored evidence that child obesity in the US may have begun to decline in that period. Subsequently, however, in 2009-10, energy intake increased in older children aged 12-19y, and reached a plateau in children aged <11y. This shift is consistent with reports that, particularly in older children, the downward trend in obesity levels may have been reversed in recent years.
MedicalResearch.com Interview with
Dr. Christopher Wildeman PhD
Associate Professor of Sociology
Faculty fellow at the Center for Research on Inequalities and the Life Course (CIQLE), and at the Institution for Social and Policy Studies (ISPS) at Yale University.
MedicalResearch.com: What are the main findings of the study?
Dr. Wildeman: There are four key findings in the study.
First, the cumulative risk of having a confirmed maltreatment report any time between birth and age 18 is much higher than most people would have thought. Fully 1 in 8 American children will experience this event at some point.
Second, the risk of experiencing this event is highly unequally distributed, with Black and Hispanic experiencing it much more than Hispanic, White, and (especially) Asian children. Between 1 in 4 and 1 in 5 Black children will have a confirmed maltreatment report at any time in their childhood. For Native American, the risk is about 1 in 7.
Third, the risk of maltreatment is quite similar for boys and girls.
Finally, the highest risks of child maltreatment are in the first few years of life, suggesting that interventions aiming to diminish maltreatment should focus on parents with very young children.