Author Interviews, Education, Pediatrics / 06.08.2016

MedicalResearch.com Interview with: David C. Geary, Ph.D. Curators’ Distinguished Professor Thomas Jefferson Fellow Department of Psychological Sciences Interdisciplinary Neuroscience Program University of Missouri Columbia, MO MedicalResearch.com: What is the background for this study? What are the main findings? Response: In an earlier study, we found that children’s understanding of numbers and the relations among them (e.g., that 6 = 5 + 1 & 4 + 2 & 3 + 3…) at the beginning of 1st grade predicted their performance on math measures in adolescence, controlling IQ, working memory, family background and other factors. These are measures that predict employability and wages in young adults and thus is practically important. We were interested in understanding the very early quantitative knowledge that predicts children’s later number knowledge. We tested children on a variety of quantitative measures 2 years before they entered kindergarten and in kindergarten gave them the same type of number test that we used in the first study. We found that 3 year olds' cardinal knowledge was critical to their later understanding of number relations, controlling IQ and many other factors. Cardinal knowledge is their understanding of the quantities associated with number words. So, if you ask a child to give you 3 toys, and they give you a handful, they do not understand what ‘three’ means. Young children with poor knowledge of number words, we at risk for poor math outcomes in kindergarten, controlling other factors. (more…)
Author Interviews, Brain Injury, JAMA, Pediatrics / 02.08.2016

MedicalResearch.com Interview with: Danny G. Thomas, MD, MPH Department of Pediatrics, Emergency Medicine Children’s Hospital of Wisconsin Corporate Center Milwaukee, WI MedicalResearch.com: What is the background for this study? What are the main findings? Response: This was a secondary analysis of a randomized controlled trial of strict rest after concussion published last year. We wanted to find out how mental and physical activity levels related to symptom spikes or sudden increases in concussion symptoms. We found that one in three patients had symptoms spikes in recovery. Patients who had symptom spikes tended to have higher symptoms in the emergency department and throughout recovery. Most symptom spikes were not associated with an increase in physical and mental activity level the day prior. We did find that a sudden increase in activity like returning to school did increase the risk of having a symptom spike, but the good news is these symptom spikes seemed to resolve the following day and did not impact recovery by 10 days. (more…)
Accidents & Violence, Author Interviews, Cannabis, Pediatrics / 28.07.2016

MedicalResearch.com Interview with: Graeme Gordon CEO and Founder at SneakGuard - Home of Safe Responsible StorageGraeme Gordon CEO and Founder at SneakGuard - Home of Safe Responsible Storage MedicalResearch.com: What is the background for SneakGuard™? Response: SneakGuard™ creator and founder, Graeme Gordon recognized the urgent need to keep adventurous young snoopers from unintentionally ingesting cannabis. Founded in 2014, SneakGuard™ is a locking, vacuum and thermally insulated container that provides responsible storage of medications and cannabis, with the passion to protect, save and enhance everyday quality of life. Gordon explains “As a father of a 8 year old I understand how pressing it is for adults to protect children, teens, and even pets from unintended ingestion, so I created a unique storage unit to provide a solution.” (more…)
Author Interviews, Genetic Research, JAMA, Pediatrics, Surgical Research / 26.07.2016

MedicalResearch.com Interview with: Dr. Katherine Nelson MD Staff Paediatrician with the Paediatric Advanced Care Team at SickKids and PhD student University of Toronto MedicalResearch.com: What is the background for this study? Response: Trisomy 13 and 18 are rare genetic conditions that cause problems in multiple organ systems, including heart defects and severe neurologic impairment.  A majority of children with trisomy 13 and 18 die in the first days to weeks after birth, though a small number survive beyond one year.  For years, health care providers have debated the effectiveness and ethics of surgical interventions in these populations. (more…)
Author Interviews, Cannabis, JAMA, Pediatrics / 25.07.2016

MedicalResearch.com Interview with: George Sam Wang MD FAAP Assistant Professor of Pediatrics Section of Emergency Medicine, Medical Toxicology Department of Pediatrics University of Colorado Anschutz Medical Campus Children's Hospital Colorado MedicalResearch.com: What is the background for this study? Response: Many states have allowed medical and now recreational marijuana. The impact on pediatric population has not been fully described. MedicalResearch.com: What are the main findings? Response: Unintentional exposures presenting to our children's hospital and calls to our regional poison center significantly increased after our state allowed recreational marijuana. MedicalResearch.com: What should readers take away from your report? Response: Exposures in children are increasing in our state that allows medical and recreational Marijuana, many were edible products. Marijuana products should be treated like medications and household products in home and properly and safely stored. States looking to legalize marijuana need to consider safety rules and regulations during rule making processes. (more…)
Author Interviews, BMJ, Nutrition, Pediatrics / 21.07.2016

MedicalResearch.com Interview with: Sharon Carstairs PhD Student Public Health Research University of Aberdeen, Aberdeen MedicalResearch.com: What is the background for this study? Response: The introduction of solid foods is a key period when the milk diet is no longer able to meet all dietary needs, additionally it is a key time for food learning and development of eating preferences in a child’s life. It is vital that children are provided with nutritionally balanced foods as well as a variety of foods to meet dietary requirements and are exposed to different tastes and textures. Some parents provide home-cooked meals however, there is a large market of commercially available infant/toddler meals which can provide parents with a convenient alternative to home-cooking. (more…)
Author Interviews, Diabetes, JAMA, Pediatrics / 20.07.2016

MedicalResearch.com Interview with: Andy Menke PhD Social & Scientific Systems, Inc. Silver Spring, MD, 20910 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Limited information was available on the prevalence of diabetes among adolescents in the US, particularly the percentage that are undiagnosed and unaware of the condition. We found that 0.8% of adolescents 12-19 years of age had diabetes and 18% had prediabetes. Of those with diabetes, 29% overall were unaware of it and this increased to 40% among Hispanic adolescents and 50% among non-Hispanic black adolescents. (more…)
Author Interviews, Depression, JAMA, Mental Health Research, Pediatrics / 18.07.2016

MedicalResearch.com Interview with: Dr Carmen Pace MPsych (Clin Child) PhD AMACPA Clinical Psychologist and Research Fellow Murdoch Childrens Research Institute The Royal Children’s Hospital Flemington Rd Parkville, Victoria AUS MedicalResearch.com: What is the background for this study? Response: We know that mothers of very preterm infants (born prior to 32 weeks gestation) are at higher risk for psychological distress compared to mothers who have healthy full term infants. However, detailed longitudinal research looking at how symptoms evolve over the first weeks and months is limited, and fathers are largely neglected in the literature. We addressed these gaps by assessing symptoms of depression and anxiety in both mothers and fathers every two weeks for the first twelve weeks after birth, and again at six months. (more…)
Author Interviews, Education, Pediatrics, Technology / 18.07.2016

MedicalResearch.com Interview with: Lauren J. Myers, Ph.D. Assistant Professor Psychology Department Lafayette College Easton, Pennsylvania MedicalResearch.com: What is the background for this study? Response: Many families with young children use video chat to connect with family and friends--but what do children understand about the on-screen people and content of these interactions? The American Academy of Pediatrics discourages screen time for kids under 2 years because children who watch a lot of media often have poor language skills, and they miss out on other activities that would be more developmentally appropriate. However, in this study we wondered whether there is a difference between putting a baby in front of a television and having an interactive exchange via video chat. (more…)
Author Interviews, Flu - Influenza, JAMA, Pediatrics, Vaccine Studies / 07.07.2016

MedicalResearch.com Interview with: Marta C. Nunes, PhD DST/NRF:Vaccine Preventable Diseases Respiratory and Meningeal Pathogens Research Unit University of Witwatersrand Chris Hani Baragwanath Academic Hospital Soweto, South Africa MedicalResearch.com: What is the background for this study? Response: Young infants are at increased risk for influenza infection and hospitalizations associated with influenza infection. While active annual influenza vaccination is the most efficient mode for the prevention of influenza infection, current vaccines are poorly immunogenic and not licensed for use in infants (more…)
Author Interviews, JAMA, Pediatrics / 04.07.2016

MedicalResearch.com Interview with: Dr. Kirsten Herrick Ph.D. Division of Health and Nutrition Examination Surveys National Center for Health Statistics Centers for Disease Control and Prevention Hyattsville, Maryland MedicalResearch.com: What is the background for this study? What are the main findings? Response: The benefits of breastfeeding are well established: for children, it offers protection against infections and increases in intelligence; for nursing women, it protects against breast cancer and improves birth spacing. But there is no nationally representative information about whether there are differences in breastfeeding by birth weight (BW). Using data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2014, we estimated the proportion of infants ever breastfed (initiated), and those reporting any breastfeeding at 1 month, 4 months, and 6 months by birth weight categories and birth year cohorts. Our sample size was 13,859. (more…)
Accidents & Violence, Author Interviews, Pediatrics, Toxin Research / 28.06.2016

MedicalResearch.com Interview with: Thomas Swain, MPH Research Assistant, The Center for Injury Sciences, Division of Trauma, Burns and Surgical Critical Care, Department of Surgery University of Alabama at Birmingham Birmingham, AL 35294 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Case reports show that the number of laundry pod detergent related cases is increasing rapidly and children are disproportionately affected by pod detergent. Pod detergent is highly concentrated and contained in a water-soluble membrane. Prior research of pod laundry detergent did not include regular, non-pod detergent; this exclusion rendered cases and severity of cases between the two incomparable. This study, comparing regular laundry detergent and pod detergent, from 2012-2014 in the United States, using national data from emergency department visits, found that children under 5 accounted for 93.8% of pod detergent related exposures and 71.8% of non-pod exposures. Importantly, 71.8% of pod exposures were diagnosed as poisoning while 72.2% of non-pod exposures were diagnosed as contact dermatitis. Those exposed to pods were 4.02 times as likely to be hospitalized, a marker for severe injury, when compared to non-pod detergent (OR: 4.02; 95% CI: 1.96-8.24). (more…)
Author Interviews, Diabetes, Diabetologia, OBGYNE, Pediatrics / 27.06.2016

MedicalResearch.com Interview with: Lu Qi, MD, PhD, FAHA HCA Regents Distinguished Chair and Professor Director, Tulane University Obesity Research Center Department of Epidemiology Tulane University School of Public Health and Tropical Medicine New Orleans, LA 70112 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Prenatal malnutrition and other stresses may cause small newborn babies, who are more likely develop type 2 diabetes and other chronic diseases during adulthood. However, whether such relation is causal remains to be determined. Genetic associations provide a new approach to provide evidence for such causality. (more…)
Author Interviews, Mental Health Research, Pediatrics, Telemedicine / 23.06.2016

MedicalResearch.com Interview with: Mirna Becevic, PhD, MHA Assistant Research Professor University of Missouri - Department of Dermatology Missouri Telehealth Network MedicalResearch.com: What is the background for this study? Response: Psychiatry is, by far, the biggest utilizer of telemedicine services on the Missouri Telehealth Network (MTN). MTN supports an average of 4000 tele-psychiatry appointments every month, and 10% of those are provided by the University of Missouri Department of Psychiatry. Since we are all aware of the ever-increasing demand for child and adolescent psychiatry, but also the stigma that goes along with it, we wanted to examine more closely the actual usage of those services at the University of Missouri. (more…)
Anesthesiology, Author Interviews, Cognitive Issues, NYU, Pediatrics, Science / 23.06.2016

MedicalResearch.com Interview with: Guang Yang, Ph.D. Assistant Professor NYU Langone School of Medicine Alexandria Center for Life Sciences New York, NY 10016 MedicalResearch.com: What is the background for this study? How common is the problem of long-lasting behavioral deficits after repeated anesthesia exposure in neonates? Response: Each year, in the United States alone, more than 1 million children under 4 years of age undergo surgical procedures that require anesthesia. Many lines of evidence from animal studies have shown that prolonged or repeated exposure to general anesthesia during critical stages of brain development leads to long-lasting behavioral deficits later in life. The results from human studies are less clear, although some studies suggest a higher incidence of learning disabilities and attention-deficit and hyperactivity disorders in children repeatedly exposed to procedures requiring general anesthesia. To date, there has been no effective treatment to mitigate the potential neurotoxic effects of general anesthesia. (more…)
Author Interviews, OBGYNE, Pediatrics, Social Issues / 17.06.2016

MedicalResearch.com Interview with: Kelli A. Komro, MPH, PhD, Professor Director of Graduate Studies Behavioral Sciences and Health Education Jointly Appointed, Epidemiology Rollins School of Public Health Emory University Atlanta, GA 30322 MedicalResearch.com: What is the background for this study?  Dr. Komro: Epidemiologists have done a thorough job describing the income-health gradient, which shows a clear association between income and health. That is, as income increases, exposure to health risks and premature mortality decreases. Each step down on the income ladder decreases one’s health for many reasons related to material resources, physical environment exposures and social circumstances. The income to health association begins at birth, and more than one in four women giving birth in the U.S. are below the poverty level, putting nearly 1 million babies at risk each year. Low-income mothers are more likely to give birth prematurely, to have low birth weight babies, and to suffer the death of their infant during the post-neonatal period (28 to 364 days old). Given the importance of the income-health gradient, we set out to test the health effects of policies that are designed to increase economic security among low-income families. Our main question is: Do policies designed to reduce poverty and improve family economic security also improve health? One relevant policy is minimum wage laws. A federal minimum wage was first enacted in 1938. The real value (in 2015 dollars) of the federal minimum wage reached a high of $10.85 in 1968. The current federal rate is $7.25. Many cities and states have passed minimum wage laws that are higher than the federal rate, and currently there is a range of minimum wage increases under active public and policymaker discussion. Given that some states pass minimum wage standards and others do not, and that laws within states change over time, we took advantage of all the changes that have occurred to design a natural experiment. Our natural experiment examined the effects of state minimum wage laws on infant health. (more…)
Author Interviews, Pediatrics, Pediatrics, Toxin Research / 16.06.2016

MedicalResearch.com Interview with: Leland McClure, PhD Director in Medical Affairs for Quest Diagnostics Fellow of the American Board of Forensic Toxicology MedicalResearch.com: What is the background for this study? Dr. McClure: Quest Diagnostics is the leading provider of diagnostic information services, providing clinical lab testing to about one in three American adults each year. As a result, we've amassed the largest private clinical laboratory database in the United States, based on 20 billion data points from lab testing. Quest uses this data (in de-identified, HIPAA compliant form) to perform research -- called Quest Diagnostics Health Trends(TM) -- to reveal insights on important health issues to inform clinical patient management and health policy. Other Health Trends reports have focused on diabetes, pregnancy and influenza, among others. (more…)
Addiction, Author Interviews, Columbia, Pediatrics / 11.06.2016

MedicalResearch.com Interview with: Hannah Carliner, ScD MPH Post Doctoral Fellow in Substance Abuse Epidemiology Mailman School of Public Health Columbia University MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Carliner: We know from previous research that traumatic experiences in childhood can have far-reaching effects on the mental and physical health of adults, including increasing the risk for substance use disorders. There is a particularly strong body of evidence about this concerning exposure to child abuse and various other forms of family dysfunction and violence. However, no previous studies have examined a wider range of traumatic childhood experiences and their link to experimentation with different kinds of drugs in adolescence. While some studies have interviewed adults about initiation of drug use at this age, those results are not as reliable as interviewing teens directly. Using a nationally-representative sample of almost 10,000 non-institutionalized U.S. adolescents, we therefore determined that childhood trauma was associated with lifetime drug use in teens-- not only with clinically-significant disordered drug use, but even with just trying drugs one time. (more…)
Author Interviews, Depression, Lancet, Pediatrics / 10.06.2016

MedicalResearch.com Interview with: Andrea Cipriani, MD PhD Associate Professor Department of Psychiatry University of Oxford Warneford Hospital Oxford UK MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Cipriani: Major depressive disorder is common in young people, with a prevalence of about 3% in school-age children (aged 6–12 years) and 6% in adolescents (aged 13–18 years). Compared with adults, children and adolescents with major depressive disorder are still underdiagnosed and undertreated, possibly because they tend to present with rather undifferentiated depressive symptoms—eg, irritability, aggressive behaviours, and school refusal. Consequences of depressive episodes in these patients include serious impairments in social functioning, and suicidal ideation and attempts. Our analysis represents the most comprehensive synthesis of data for currently available pharmacological treatments for children and adolescents with acute major depressive disorder (5620 participants, recruited in 34 trials). Among all antidepressants, we found that only fluoxetine was significantly better than placebo. According to our results, fluoxetine should be considered the best evidence-based option among antidepressants when a pharmacological treatment is indicated for children and adolescents with moderate to severe depression. Other antidepressants do not seem to be suitable as routine treatment options. (more…)
Accidents & Violence, Author Interviews, CDC, Pediatrics / 09.06.2016

MedicalResearch.com Interview with: Laura Kann, PhD Chief, School-Based Surveillance Branch Division of Adolescent and School Health National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) Centers for Disease Control and Prevention (CDC) MedicalResearch.com: What is YRBSS? Dr. Kann: The Youth Risk Behavior Surveillance System (YRBSS) is the only surveillance system designed to measure the major health risk behaviors among our nation's high school students and to track those behaviors over time at the national, state, and local levels. Reports from this surveillance system have been released every two years since 1991. More information is available at: www.cdc.gov/yrbs. (more…)
Author Interviews, CDC, JAMA, Pediatrics, Weight Research / 08.06.2016

MedicalResearch.com Interview with: Cynthia L Ogden PhD, MRP Public Health, Nutrition and Dietetics CDC Atlanta MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Ogden: Monitoring trends in obesity prevalence is important because of the health risks associated with obesity and because obesity often tracks from childhood to adulthood. The most recent data before this point showed no increases overall in youth, men or women over the previous decade. We used the most recent nationally representative data with measured weights and heights from the National Health and Nutrition Examination Survey to look at trends in obesity prevalence. (more…)
Anesthesiology, Author Interviews, Cognitive Issues, Columbia, JAMA, Pediatrics / 08.06.2016

MedicalResearch.com Interview with: Lena S. Sun, MD E. M. Papper Professor of Pediatric Anesthesiology Professor of Anesthesiology and Pediatrics Executive Vice Chairman, Department of Anesthesiology Chief, Division of Pediatric Anesthesiology Columbia University Medical Center New York, New York 10032 MedicalResearch.com: What is the background for this study? Dr. Sun: The background for the study is as follow: There is robust evidence in both rodent and non-human primate studies that exposure of the developing brain leads to impairment in cognitive function and behavior later in life. The evidence from human studies derives mostly from retrospective studies and the results have been mixed. Some have demonstrated anesthesia in early childhood was associated with impaired neurocognitive function, while others have found no such association. Our study is the first to specifically designed to address the question of effects of general anesthesia exposure on cognitive function, comparing exposure with no exposure. (more…)
ASCO, Author Interviews, Brigham & Women's - Harvard, Cancer Research, Pediatrics / 06.06.2016

MedicalResearch.com Interview with: Katie Greenzang, MD Dana-Farber/Boston Children’s Cancer and Blood Disorders Center MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Greenzang: Advances made over the last several decades mean that more than 80 percent of children diagnosed with cancer will become long-term survivors. However, many of these survivors experience physical and cognitive late effects of the treatment that cured them. We surveyed 352 parents of children recently diagnosed with cancer to assess how well they understood their children’s risk of future limitations in physical abilities, intelligence, and quality of life. We found that an overwhelming majority of parents (92 percent) are very interested in learning about possible late effects, and most (86 percent) seek detailed information. Yet, parent and physician predictions of a child’s risk of experiencing late effects of treatment often don’t match. Among children identified by their oncologists as being at high risk for such challenges, only 38 percent of parents recognized this risk in physical abilities, 21 percent in intelligence, and 5 percent in quality of life. (more…)
Author Interviews, OBGYNE, Pediatrics, Vaccine Studies / 05.06.2016

MedicalResearch.com Interview with: Dr Paul T Heath MB BS, FRACP, FRCPCH Reader / Honorary Consultant Paediatric Infectious Diseases St George’s, University of London and Vaccine Institute London, United KingdomDr Paul T Heath MB BS, FRACP, FRCPCH Reader / Honorary Consultant Paediatric Infectious Diseases St George’s, University of London and Vaccine Institute London, United Kingdom MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Heath: Vaccinating pregnant women is an important and proven strategy for protecting young infants against tetanus, influenza and pertussis. Among the infants at highest risk for complications of these infections are infants born prematurely but it is generally believed that because antibody transfer from mother to baby is maximal in the 3rd trimester, babies born prematurely may miss out on the benefits of maternal vaccination. (more…)
Author Interviews, Cancer Research, Kaiser Permanente, Pediatrics / 03.06.2016

MedicalResearch.com Interview with: Andrea C. Wickremasinghe, MD Neonatologist Kaiser Santa Clara California MedicalResearch.com: What is the background for this study? Response: Neonatal jaundice is common and is often treated with phototherapy. Phototherapy is typically considered to be benign. In the past decade, phototherapy use has increased and it is sometimes started at bilirubin levels below recommended treatment thresholds. Beginning in the 1970’s, in-vitro and in-vivo studies have shown phototherapy to be associated with cellular changes implicated in the pathogenesis of cancer. Epidemiologic studies have yielded mixed results, with some studies showing associations between phototherapy and leukemia and other studies failing to show this association. In this study, we used a large statewide administrative dataset to investigate the relationship between neonatal phototherapy and cancer in the first year after birth. (more…)
ADHD, Author Interviews, BMJ, Heart Disease, Pediatrics / 01.06.2016

MedicalResearch.com Interview with: Nicole Pratt PhD Senior Research Fellow Quality Use of Medicines and Pharmacy Research Centre Sansom Institute, School of Pharmacy and Medical Sciences University of South Australia Adelaide South Australia MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Pratt: The cardiac safety of methylphenidate has been debated. This study aimed to measure the risk of cardiac events in a large population of children treated with these medicines. We found that there was a significantly raised risk of arrhythmia in time periods when children were treated with methylphenidate compared to time periods when they were not. While the relative risk of cardiac events was significant the absolute risk is likely to be low as cardiac events are rare in children. (more…)
Author Interviews, Diabetes, Diabetologia, Heart Disease, Pediatrics / 01.06.2016

MedicalResearch.com Interview with: Dr. Nina Berentzen PhD National Institute for Public Health and the Environment Bilthoven, the Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Berentzen: Cardiovascular disease and type 2 diabetes often occur together and share risk factors including an unhealthy diet, a lack of physical activity, and being overweight or obese. This study is the first to investigate the occurrence of both diabetes and CVD across two generations of parents and grandparents, and relate it to measurable risk factors in children. We found that one third of the 12-year-olds studied had a strong family history of one or both of cardiovascular disease (myocardial infarction and stroke) and type 2 diabetes. Children had a ‘strong family history’ if they had one affected parent, or at least one grandparent with early disease onset, or 3–4 grandparents with late disease onset. These children had higher levels of total cholesterol, and a higher ratio of total/HDL cholesterol than children with no family history of disease. (more…)
Author Interviews, Heart Disease, Infections, Pediatrics, Pediatrics, Weight Research / 01.06.2016

MedicalResearch.com Interview with: Markus Juonala, MD, PhD Murdoch Childrens Research Institute, Parkville Victoria, Australia MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Juonala: This is an epidemiological follow-up study investigating whether childhood infections and socieconomic status are associated with cardiovasular risk factor and early chances in vasculature. The main finding was that childhood infections were associated with obesity and impaired vascular function in adulthood among those individuals with low socioeconomic status. (more…)
Author Interviews, Brain Injury, Pediatrics / 31.05.2016

MedicalResearch.com Interview with: Kristy Arbogast, PhD Co-Scientific Director Center for Injury Research and Prevention The Children's Hospital of Philadelphia Research Professor Division of Emergency Medicine Department of Pediatrics University of Pennsylvania Philadelphia, PA 19104 MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Arbogast: The research team looked retrospectively at four recent years of data on children diagnosed with concussion at Children's Hospital of Philadelphia (CHOP) to determine how children access the health system for a concussion. For those 8,000 kids with a CHOP primary care provider, 82% entered the health system via a primary care location, 12% entered through the ER and 5% through a specialist. One-third of concussion diagnoses were to children under age 12. Many current counts of concussion injury among children are based on emergency room visits or organized high school and college athletics data. Thus, we are vastly underestimating child and youth concussions in the US. (more…)