High School Students Increasingly Specializing in One Sport

MedicalResearch.com Interview with:

Michael G. Ciccotti, MD Professor of Orthopaedic Surgery Rothman Institute Chief of Sports Medicine, and Director of the Sports Medicine Fellowship Thomas Jefferson University

Dr. Michael Ciccotti

Michael G. Ciccotti, MD
Professor of Orthopaedic Surgery
Rothman Institute
Chief of Sports Medicine, and
Director of the Sports Medicine Fellowship
Thomas Jefferson University

MedicalResearch.com: What is the background for this study? 

Response: No doubt sports plays a huge role in the United States and all over world with millions of young people between the ages 6 and 18 participating in an organized sport on a regular basis.

Over the past decade, there has been a tremendous focus on youth single sport specialization (SSS), with pressure from coaches, parents and the athletes themselves to participate in one sport year round. Many participants, coaches and parents believe that early specialization may allow the young athlete to become better and progress more quickly in their sport, perhaps allowing them a greater chance of becoming a professional athlete. This drive toward early specialization has been fueled by popular icons i.e. Tiger Woods (golf) and Lionel “Leo” Messi (soccer) as well as by media hits such as Friday Night Tykes (young football players) and The Short Game (7-year old golfers). The pop-psych writer, Malcolm Gladwell, whose The 10,000 Hour Rule (in his book Outliers) holds that 10,000 hours of “deliberate practice” are needed to become world-class in any field may have also encouraged the specialization trend.

There is little doubt that youth sports may encourage a lifelong interest in a healthy lifestyle as well as improved self-esteem and social relationships. The flip side is that extreme training and singular focus on a sport can lead to stress on the developing musculo-skeletal system, a pressure to succeed at all costs, reduced fun, burnout and sometimes social isolation.

The dilemma we are beginning to scratch the surface of is does single sport specialization enhance the likelihood of getting to an elite level and does it increase the risk of injury? There is a growing sense in the medical community that SSS raises injury risk without enhancing progression to a higher level.

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Acute Kidney Injury Is A Frequent Complication of Pediatric Diabetic Ketoacidosis

MedicalResearch.com Interview with:

Constadina Panagiotopoulos, MD, FRCPC Department of Pediatrics, Endocrinology & Diabetes Unit British Columbia Children’s Hospital Vancouver, British Columbia, Canada

Dr. Panagiotopoulos

Constadina Panagiotopoulos, MD, FRCPC
Department of Pediatrics, Endocrinology & Diabetes Unit
British Columbia Children’s Hospital
Vancouver, British Columbia, Canada

MedicalResearch.com: What is the background for this study?

Response: I decided to conduct this study after observing a few cases of severe acute kidney injury (AKI) in children hospitalized with diabetic ketoacidosis (DKA) (with two patients requiring dialysis) while on call in the 18 months prior to initiating the study. While caring for these patients, I scanned the literature and realized that aside from 2 published case reports, there had been no large-scale systematic studies assessing AKI in children with DKA. It immediately became apparent to me that managing patients with AKI and DKA was more challenging. On presentation to hospital, many of these children with DKA present quite volume depleted but fluid management is conservative because of the risk for cerebral edema.

One of the most important management strategies for acute kidney injury in patients with DKA is early detection and correcting volume depletion in a timely manner to prevent further injury. I discussed my observations and these clinical cases with pediatric nephrologist and co-investigator Dr. Cherry Mammen, a pediatric AKI expert, and he confirmed my initial literature review findings. Thus, we decided to conduct this study to better understand the scope of the problem and any associated risk factors.

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Physical Activity In Decline For Most Kids By School Age

MedicalResearch.com Interview with:
Professor John J Reilly
University of Strathclyde Glasgow
Physical Activity for Health Group
Scotland, UK 

MedicalResearch.com: What is the background for this study?

Response: There is Concern that levels of physical activity among modern children are typically very low, well below the amounts recommended for their physical & mental health, well-being, and academic attainment.

It has been assumed for many years that physical activity levels begin to become a problem at adolescence, and this adolescent decline in activity is especially marked in girls.

MedicalResearch.com: What are the main findings?

1. Physical activity- in our sample of 545 individuals studies at ages seven, nine, 12, and 15 using activity monitors for six to seven days at each time point- was already low and was in decline from age seven, well before adolescence.

2. The physical activity decline was not especially marked at adolescence, or in girls.

3. In a minority of boys (19% of boys) and girls (12% of girls) physical activity was maintained at a relatively high level from age seven to 15 years. these are interesting exceptions to the general pattern.

MedicalResearch.com: What should readers take away from your report?

Response: We should no longer see girls,or adolescents, as the only high risk groups for low physical activity; the entire population is at high risk.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: Efforts to promote or maintain physical activity need to start well before adolescence, and should not just focus on girls. Physical activity seems to be in decline in most children by the time they start school. We need to address more research and policy effort at lifestyles of younger children of both sexes.

We also need to direct more research effort at the interesting minority in both sexes who maintained a relatively high physical activity from age seven to 15 years. We don’t know why they were different to the rest – for example, were they more engaged in sport ? – and understanding why and how they differed from the rest of the population would help us develop strategies for preventing the age-related decline in physical activity in future.

There are no conflicts of interest to declare. The work was funded by the UK MRC and the Scottish Government Chief Scientist Office.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Farooq MA, Parkinson KN, Adamson AJ, et al

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

More Medical Research Interviews on MedicalResearch.com

 

 

paul.gallagher@strath.ac.uk

 

Poor Sleep In Early Childhood Linked to Later Cognitive and Behavioral Problems

MedicalResearch.com Interview with:

Dr. Elsie M. Taveras, MD MPH Chief, Division of General Pediatrics Director, Pediatric Population Health Management Director, Raising Healthy Hearts Clinic

Dr. Taveras

Dr. Elsie M. Taveras, MD MPH
Chief, Division of General Pediatrics
Director, Pediatric Population Health Management
Director, Raising Healthy Hearts Clinic
MassGeneral Hospital for Children

MedicalResearch.com: What are the primary findings of this study and why are they important?

Response: The primary findings of this study are that children who get an insufficient amount of sleep in their preschool and early school age years have a higher risk of poor neurobehavioral functioning as reported by their mothers and independently by their teachers at age 7. These behaviors included poorer executive function and more hyperactivity/inattention, emotional symptoms, conduct problems, and peer relationship problems.

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Many Summer Camps Need More Training On Food Allergy Treatment

MedicalResearch.com Interview with:
Margaret T. RedmondMD
Nationwide Children’s Hospital
Columbus, Ohio 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Food allergies are becoming more prevalent and can cause a life threatening reaction if not managed correctly. Much of the previous focus has been on food allergy in the school setting and little was known about the camp setting.

Analysis of survey data from camp directors, medical personnel and staff reveal that there are deficiencies of training and policy at camps that could place food allergic campers at increased risk of reaction. A prospective registry of epinephrine administration from 51 camps revealed an increased rate of epinephrine administration compared to school data. Continue reading

Mouse Allergens Drives Asthma Symptoms In Many Children

MedicalResearch.com Interview with:

Elizabeth C. Matsui, MD MHS Professor of Pediatrics, Epidemiology, and Environmental Health Sciences Johns Hopkins University Baltimore, MD 21287

Dr. Matsui

Elizabeth C. Matsui, MD MHS
Professor of Pediatrics, Epidemiology, and Environmental Health Sciences
Johns Hopkins University
Baltimore, MD 21287 

MedicalResearch.com: What is the background for this study?

Response: We designed this study after our previous work indicated that mouse allergy was common among low-income children living in some urban neighborhoods in the US, that these children also had high levels of mouse allergen exposure in their homes, and that children who are both allergic to mice and exposed to high levels of mouse allergen are at greater risk of asthma symptoms, emergency room visits and hospitalization.   Given this background, we designed a randomized clinical trial to determine if an intensive professionally delivered mouse intervention was better than education about mouse control in reducing asthma symptoms and lowering home mouse allergen levels.

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Pediatric Asthma Costs Over $5 Billion Per Year In Health Care Expenses

MedicalResearch.com Interview with:

Patrick W. Sullivan, Ph.D. Professor Regis University School of Pharmacy Denver, CO 80221

Dr. Sullivan

Patrick W. Sullivan, Ph.D.
Professor
Regis University School of Pharmacy
Denver, CO 80221

MedicalResearch.com: What is the background for this study?

Response: Asthma is one of the most common chronic disorders among children. It affects 7.1 million children in the U.S. Of these, 4.1 million children suffered an asthma attack in 2011. An asthma attack is an acute period of extreme difficulty breathing. It can be life threatening and is always very frightening for children. Because asthma can be dangerous and frightening, it ends up costing a lot because patients need to go the doctor, hospital or take medications to try to control it.

Asthma also has a negative effect on the patient’s health and outlook about their health – both mentally and physically. Previous studies have focused on adults with asthma and have found that it is very expensive – it costs $18 billion in the U.S. to manage adults with asthma. Those studies also showed that adults with asthma have lower quality of life. However, there is not a lot of good evidence on the burden of asthma in children. This study was designed to quantify the cost and mental and physical health of children with asthma in the U.S.

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Neonatal Morbidity and 1-Year Survival of Extremely Preterm Infants

MedicalResearch.com Interview with:
Dr. Hans Jorgen Stensvold, M.D and
Dr. Arild Ronnestad, MD PhD
Neonatal Department, Oslo University Hospital and
the Norwegian Neonatal Network, Oslo, Norway

MedicalResearch.com: What is the background for this study?

Response:  Over the last decades, advances in perinatal care have led to improved survival of extremely preterm infants in most countries. Still, the decision to initiate or withhold active care for infants at the border of viability is challenging. Different attitudes and traditions in perinatal care influence the rates of stillbirths, admissions to intensive care and outcomes. Consequently, there is a continuous need for up-to-date results to guide caregivers and parents in decision making, and to evaluate current medical practices.

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Environmental Pyrethroids May Be Associated With Behavioral Problems in Children

MedicalResearch.com Interview with:
Professor Jean-Francois Viel
Department of Epidemiology and Public Health
University Hospital
Rennes, France

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The use of pyrethroid insecticides has increased substantially throughout the world over the past several decades, replacing organophosphate and carbamate insecticides, because of their chemical potency against many pests, their relatively low mammalian toxicity and their favorable environmental profiles. However, despite the neurotoxicity of these insecticides at high doses, the potential impact of environmental exposure to pyrethroid insecticides on child neurodevelopment has only just started to receive attention.

Using a longitudinal design (PELAGIE mother-child cohort), we were able to assess pyrethroid exposure (trough urine concentrations) both prenatally and during childhood (at 6 years of age). We showed that increased prenatal concentrations of one pyrethroid metabolite (cis-DCCA, a metabolite of permethrin, cypermethrin and cyfluthrin) were associated with internalising difficulties (children showing behaviours that are inhibited and over-controlled).

Moreover, for childhood 3-PBA (a common metabolite of up to 20 synthetic pyrethroid insecticides) concentrations, a positive association was observed with externalising difficulties (children showing behaviours that are under-controlled and having generally a more challenging temperament).

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Reduction in Radiation Has Reduced Second Tumors in Pediatric Cancer Patients

MedicalResearch.com Interview with:

Lucie Turcotte, MD, MPH University of Minnesota Masonic Children's Hospital Division of Pediatric Hematology-Oncology Assistant Professor Minneapolis, MN 55455

Dr. Lucie Turcotte

Lucie Turcotte, MD, MPH
University of Minnesota Masonic Children’s Hospital
Division of Pediatric Hematology-Oncology
Assistant Professor
Minneapolis, MN 55455

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We have observed dramatic improvements in the number of survivors of childhood cancer over the last 60 years. As more children are surviving, we have identified many important late health consequences of cancer therapy. One of the most devastating of these late health consequences is the diagnosis of a second cancer. As we have identified late effects, such as second cancers, we have modified therapy in an effort to prevent long-term sequelae of therapy, while still maintaining superior survival rates.

For this study, we utilized data from the Childhood Cancer Survivor Study (CCSS), which is a cohort of more than 23,000 survivors of childhood cancer from multiple centers in North America, who were initially diagnosed between 1970 and 1999. Our analysis focused on elucidating whether survivors diagnosed more recently were experiencing fewer second cancers, and determining whether a reduction in second cancers could be associated with treatment modifications.

The most important finding from this study is that the reductions in therapeutic radiation exposure that occurred between 1970-1999 resulted in a significant reduction in the second cancers experienced by survivors of childhood cancer.

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More Complications In Type 2 Than Type 1 Adolescent Diabetes

MedicalResearch.com Interview with:

Dana Dabelea, MD, PhD Conrad M. Riley Professor of Epidemiology and Pediatrics Director, Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center University of Colorado Anschutz Medical Campus Aurora, CO 80045

Dr. Dana Dabelea

Dana Dabelea, MD, PhD
Conrad M. Riley Professor of Epidemiology and Pediatrics
Director, Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center
University of Colorado Anschutz Medical Campus
Aurora, CO 80045

MedicalResearch.com: What is the background for this study?

Response: These recent increasing trends in type 1 and 2 diabetes diagnosed in young individuals raise the question of whether the pattern of complications differs by diabetes type at similar ages and diabetes duration. The SEARCH for Diabetes in Youth Stud, looked at five health complications and co-morbidities of diabetes, including: retinopathy, diabetic kidney disease, peripheral, arterial stiffness and high blood pressure. The researchers studied 1,746 adolescents and young adults with type 1 diabetes and 272 with type 2 diabetes diagnosed when < 20 years, with a similar average duration of 7.9 years and at a similar age of 21 years.

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Following Stroke, Children Face Behavioral and Emotional Difficulties

MedicalResearch.com Interview with:

Emily C. Maxwell, Ph.D. Pediatric Neuropsychology Bugher Fellow Division of Neurology Instructor | Department of Pediatrics University of Colorado School of Medicine Aurora, CO 80045

Dr. Maxwell

Emily C. Maxwell, Ph.D.
Pediatric Neuropsychology Bugher Fellow
Division of Neurology
Instructor | Department of Pediatrics
University of Colorado School of Medicine
Aurora, CO 80045 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Previous research has found increased psychological problems and significantly higher rates of psychiatric disorders after pediatric stroke. However, past studies have mainly used global indices, without comparison to age-based norms. Thus, little is known about the discrete symptomatology exhibited by these children and how discrepant these symptoms may be from normative expectations.

At the University of Colorado Denver and Children’s Hospital Colorado, we studied 50 patients who suffered an arterial ischemic stroke during childhood. The parents of these patients completed the Child Behavior Checklist, a questionnaire assessing emotional and behavioral problems. We found that children with stroke had higher symptoms of depression, anxiety, physical complaints, and behavioral difficulties compared to a normative sample of same-aged peers. Additionally, levels of anxiety were higher in children who had a stroke at an early age (before 6 years of age) compared to children who had a stroke at a later age (after 10 years of age).

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