Really Scary! Pediatric Pedestrian Fatalities 10x Higher on Halloween

MedicalResearch.com Interview with:
"Halloween Parade 2014" by GoToVan is licensed under CC BY 2.0Dr. John A. Staples, MD
Clinical Assistant Professor
University of British Columbia

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

Response: At this time last year, my co-author Candace Yip and I noticed an impressive number of advertisements for Halloween-themed parties at bars taped to lamp-posts. We wondered if the combination of dark costumes, dark evenings, alcohol and trick-or-treaters made the streets more dangerous for pedestrians.

To see if our hunch was correct, we examined 42 years of data on all fatal vehicle crashes in the United States between 1975 and 2016. We compared the number of pedestrian fatalities between 5 p.m. and midnight on Halloween with the number during the same hours on control days one week earlier and one week later. We found that 14 pedestrian deaths occurred on the average Halloween, while only 10 pedestrian deaths occurred on the average control evening. This corresponded to a 43% increase in the relative risk of pedestrian fatality on Halloween.

Among children aged 4 to 8 years of age, the risk of death was ten times higher on Halloween evening compared to control evenings. Risks were highest around 6pm, which is prime trick-or-treating time. Absolute risks were small and declined throughout the four decades of the study, but the relative risk increase on Halloween persisted throughout the entire study interval.  Continue reading

Mom’s Voice Makes a Better Smoke Alarm

MedicalResearch.com Interview with:

Gary Smith, MD, DrPH Director, Center for Injury Research and Policy Nationwide Children’s Hospital Columbus, OH

Dr. Smith

Gary A. Smith, MD, DrPH
Director, Center for Injury Research and Policy
Nationwide Children’s Hospital
Columbus, OH

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

Response: When residential fires happen at night while people are sleeping, deaths are more likely to occur. Smoke alarms are important for preventing these deaths, yet many young children don’t wake up to traditional high-pitch tone alarms. Children sleep longer and deeper than adults and require louder sounds to awaken than adults. For these reasons, children are less likely to awaken and escape a nighttime home fire. Continue reading

Program Can Help Parents Manage Kids’ Pain from Vaccines

MedicalResearch.com Interview with:

Dr. Anna Taddio BScPhm PhD Professor at the Leslie Dan Faculty of Pharmacy University of Toronto and Senior Associate Scientis The Hospital for Sick Children 

Dr. Taddio

Dr. Anna Taddio BScPhm PhD
Professor at the Leslie Dan Faculty of Pharmacy
University of Toronto and Senior Associate Scientis
The Hospital for Sick Children 

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

Response: In our prior research, parents have reported they are not educated about how to soothe their infants during painful procedures like vaccinations and that they want to know how they can help. Parents also reported that concerns about their infant’s pain affects their decision-making around vaccination. We therefore set out to target parents for education about how to soothe their infants.

We picked the hospital setting because almost all parents are in the hospital for some period of time following the birth of an infant and already routinely receive education about healthy baby topics. Providing information about pain management was easy to add. We found that about 1 out of 10 parents that were given this information acted on it. 

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

Response: No parent wants to see their child in pain and a parents’ desire to reduce pain is supported when we provide them with evidence-based strategies to use. These strategies are easy to use, and not only decrease unnecessary infant suffering, they also help parents. Parents are less anxious about their children getting vaccinations. Attending to infant distress is also important for healthy infant development. Targeting parents at the time of birth also ensures that parents will use and advocate for better pain care for their children across different  medical settings and throughout the lifespan.

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

Response: We need to find ways to reach more parents so that they can use this information to help their children. We also need to follow parents over time and teach them about the strategies that are helpful for children of different ages. Finally, we need to study how better pain management practices impacts on vaccination rates.

Citation:

Effectiveness of a hospital-based postnatal parent education intervention about pain management during infant vaccination: a randomized controlled trial Anna Taddio BScPhm PhD, Vibhuti Shah MD, Lucie Bucci MA, Noni E. MacDonald MD, Horace Wong MSc, Derek Stephens MSc

CMAJ 2018 October 22;190:E1245-52. doi: 10.1503/cmaj.180175

Oct 22, 2018 @ 9:53 pm

The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

Vaccines Prevent Disease and Death – Why Are Some US Children Not Vaccinated?

MedicalResearch.com Interview with:
"Vacuna influenza / Flu vaccine" by El Alvi is licensed under CC BY 2.0Kathryn M. Edwards, M.D.
Sarah H. Sell and Cornelius Vanderbilt Chair in Pediatrics
Professor of Pediatrics
Vanderbilt University School of Medicine

Dr. Edwards discusses the statement from the Infectious Diseases Society of America (IDSA) regarding the Centers for Disease Control and Prevention’s new data on child vaccine rates across the United States.

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

Response: To monitor the uptake of vaccines the CDC conducts a National Immunization Survey each year.  This survey is conducted by random-digit dialing (cell phones or landlines) of parents and guardians of children 19-35 months of age.  The interviewers ask the families who provides the vaccines for their children and if these providers can be contacted to inquire about the immunizations received.  The overall response rate to the telephone survey was 26% and immunization records were provided on 54% of the children where permission was granted.  Overall 15, 333 children had their immunization records reviewed.

When comparing immunization rates for 2017 and 2016, the last two years of the study, several new findings were discovered.

First the overall coverage rate for 3 doses of polio vaccine, one dose of MMR, 3 doses of Hepatitis b, and 1 dose of chickenpox vaccine was 90%, a high rate of coverage.  Children were less likely to be up to date on the hepatitis A vaccine (70%) and rotavirus vaccine (73%). Coverage was lower for children living in rural areas when compared with urban areas and children living in rural areas had higher percentages of no vaccine receipt at all (1.9%) compared with those living in urban areas (1%).

There were more uninsured children in 2017 at 2.8% and these children had lower immunization rates.  In fact 7.1% of the children with no insurance were totally unimmunized when compared with 0.8% unimmunized in those with private insurance. Vaccine coverage varies by state and by vaccine. Continue reading

Girls More Likely To Develop Post-Concussive Symptoms After Head Injury

MedicalResearch.com Interview with:

Dr. Ewing-Cobbs PhD Professor in the Department of Pediatrics McGovern Medical School University of Texas Health Science Center at Houston Harriet and Joe Foster Chair in Cognitive Neuroscience

Dr. Ewing-Cobbs

Dr. Linda Ewing-Cobbs PhD
Professor in the Department of Pediatrics
McGovern Medical School
University of Texas Health Science Center at Houston
Harriet and Joe Foster Chair in Cognitive Neuroscience

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

Response: Children may have long-lasting psychological and physical symptoms after an injury. Post-concussive symptoms (PCS) are nonspecific cognitive, physical, and mood symptoms such as difficulty concentrating, headache, and irritability. These symptoms occur in approximately 15 to 30% children after mild traumatic brain injury (TBI). Although PCS often resolve within one month, some children experience symptoms for longer periods of time.

Continue reading

Genetic Locus Linked to Migraine Risk in African American Children

MedicalResearch.com Interview with:
"DNA model" by Caroline Davis2010 is licensed under CC BY 2.0Hakon Hakonarson, MD, PhD
Corresponding Author
Xiao Chang, PhD
Lead Author
The Center for Applied Genomics
Children’s Hospital Philadelphia
PhiladelphiaPennsylvania

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

Response: Migraine is a genetic disorder characterized by recurrent and intense headaches often accompanied by visual disturbances. Genome-wide association studies (GWASs) are a powerful hypothesis-free tool for investigating the genetic architecture of human disease. Currently, multiple GWASs have been conducted on European adults with migraine that have successfully identified several migraine susceptibility genes involved in neuronal and vascular functions.

Considering the prevalence of migraines varies across ethnicities, the genetic risk factors may be different in patients of African ancestries and European ancestries. In addition, if migraine presents at an early age (childhood), it may reflect elevated biological predisposition from genetic factors or increased susceptibility to environmental risk factors.

We performed the first GWAS to investigate the susceptibility genes associated with migraine in African-American children. The main out come was that common variants at the 5q33.1 locus in the human genome are associated with migraine risk in African-American children. The genetic underpinnings at this locus responsible for this finding are less relevant in patients of European ancestry.  Continue reading

One Type of ART in HIV-Positive Pregnant Women Likely Increases Risk of Neurological Problems in Children

MedicalResearch.com Interview with:

Claudia Syueping Crowell, MD Lead author of the study Assistant professor of pediatrics University of Washington and  Seattle Children's Hospital

Dr. Syueping Crowell

Claudia Syueping Crowell, MD
Lead author of the study
Assistant professor of pediatrics
University of Washington and
Seattle Children’s Hospital

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

  • This research was conducted as part of the SMARTT (Surveillance Monitoring for ART Toxicities) study, which is an observational cohort study of HIV exposed uninfected children with the overall aim of studying the long-term safety of fetal and infant exposure to prophylactic antiretroviral (ARV) therapy.
  • This particular analysis was conducted in response to prior studies that showed an increased risk of seizures and other neurologic conditions in children who were exposed to ARVs in utero.
  • The aim of our study was to determine if in utero exposure to any particular ARV is associated with the diagnosis of neurologic conditions later in infancy and childhood.
  • In our cohort of 3747 HIV-exposed uninfected children we found 237 children who had neurologic conditions, 16 of whom were exposed to efavirenz in utero and 4 of whom were exposed to dolutegravir in utero.
  • The most common neurologic diagnoses were microcephaly, febrile seizures, non-febrile seizures and eye related disorders.
  • When comparing various antiretroviral medications, we found that children of women whose ART regimen included efavirenz were more likely to be diagnosed with a neurologic condition than children of women whose ART regimen did not include efavirenz (9.6% vs. 6.2%). This translated to a 60% higher risk of being diagnosed with a neurologic condition in the efavirenz exposed group after controlling for other risk factors.
  • We also found a suggestion of an association between in utero dolutegravir exposure and later diagnosis of a neurologic condition but the number of children exposed to dolutegravir was small (number of exposed children = 94). 

Continue reading

Most Overweight or Obese Children Will Stay So

MedicalResearch.com Interview with:

Antje Körner, M.D Center for Pediatric Research University Hospital for Children and Adolescents University of Leipzig Germany

Dr. Körner

Antje Körner, M.D
Center for Pediatric Research
University Hospital for Children and Adolescents
University of Leipzig
Germany

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

Response: We were interested to find out, when (at what age) obesity in children emerges, whether there is something such as an critical age.

There are many opinions on that but very few well-powered studies. We tracked weight/BMI development of more than 51,000 children from infancy to adolescence. We see, that it is clearly early childhood – the preschool years when obesity sets in in the children. If a child is obese at one or up to two years of age, chances are about 50:50 to return to normal weight; with 3 years of age, most children with overweight or obesity will stay so, almost 90%.

When we look at it dynamically, we see the strongest increase in excessive weight between 2 and 6 years of age in those adolescents who are obese. Even after that young age there is steady further increase in additional weight gain, hence worsening of obesity. 

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

Response: Our intention is to raise awareness that obesity sets in at that very young age. Often you hear of “innocent puppy fat” in the very young children, which will grow away. According to our data you cannot rely on returning to normal weight as soon as 3 years of age.

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

Response: Therefore, we have to think more in means of prevention. This early childhood is the age where habits are formed. Hence every day life should be structured in a healthy way and environment should favour a healthy life style. 

Citation:

Acceleration of BMI in Early Childhood and Risk of Sustained Obesity

Mandy Geserick, M.Sc., Mandy Vogel, Ph.D., Ruth Gausche, M.B.A., Tobias Lipek, M.D., Ulrike Spielau, M.Sc., Eberhard Keller, M.D., Roland Pfäffle, M.D., Wieland Kiess, M.D., and Antje Körner, M.D.

October 4, 2018
N Engl J Med 2018; 379:1303-1312
DOI: 10.1056/NEJMoa180352

Oct 5, 2018 @ 12:41 pm

The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

 

Parents Need To Talk Frequently To Their Children About Sexual Safety

MedicalResearch.com Interview with:

Laura M. Padilla-Walker, PhD Professor, School of Family Life Associate Dean, College of Family, Home, and Social Sciences Brigham Young University

Dr. Padilla-Walker

Laura M. Padilla-Walker, PhD
Professor, School of Family Life
Associate Dean, College of Family, Home, and Social Sciences
Brigham Young University

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

Response: The current study included approximately 500 teens that we followed for 8 years starting at approximately age 14.

In this particular study, we explored how parent-child sex communication regarding sexual safety changed from ages 14-18, and then how this change was associated with children’s sexual outcomes at age 21. Though we would hope and expect that parents would discuss sexual safety with their children at increasing levels as children age, findings from this study suggested low and unchanging levels of parent-child sex communication over time. In other words, parents are talking very little to their children about sexual safety, and how much they talk to children isn’t changing from age 14 to 18.

In addition, mothers reported significantly higher levels of sex communication than did children and fathers, suggesting that mothers think they talk about sexuality more than children think they do. Though this is an issue of perception, what the child perceives is generally a more important predictor of positive outcomes. Mothers also reported talking with their sons less than their daughters, though sex communication with sons increased over time and by age 18 mothers reported the same (relatively low) levels of sex communication with both daughters and sons.

That being said, initial levels and positive change in parent-child sex communication was associated with safer sex at age 21, suggesting that parents SHOULD talk with their children more and at increasing levels over time, because these factors are associated with positive child outcomes.

Continue reading

Breastfeeding May Alter Gene That Influences How Children Deal With Stress

MedicalResearch.com Interview with:

Barry M. Lester, PhD Center for the Study of Children at Risk Warren Alpert Medical School, Brown University Women and Infants Hospital of Rhode Island Providence, Rhode Island;

Dr. Lester

Barry M. Lester, PhD
Center for the Study of Children at Risk
Warren Alpert Medical School, Brown University
Women and Infants Hospital of Rhode Island
Providence, Rhode Island;
 

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

Response: We know from rodent studies that maternal care or nurturing behavior can change the rat pups physiologic response to stress. More nurturing behavior makes it easier for rat pups to relax after stress. Not only that, these changes are permanent, they last into adulthood and there is evidence that these changes can be passed on to the next generation. With animal studies you can unlock the mechanism for this in ways that you can’t do with humans and we know from the rodent studies that the mechanism for these changes has to do with changes in gene activity.

Nurturing behavior controls a specific gene that regulates the infant’s physiological response to stress. In other words, we are looking at maternal behavioral programming of a gene that can make, in our case, a human infant less physiologically reactive to stress.

The physiological reactivity to stress that we studied was the production of the stress hormone cortisol. Cortisol is part of the body’s flight or fight reaction, the body’s major response to stress and too much or too little cortisol can be harmful and is related to a wide range of mental and physical health disorders in children and adults. The concerns about separating immigrant children from their parents that we read about every day in the paper are based on this same physiological system, where brain structures that control cortisol production are damaged by the stress of separation. 

Continue reading

Almost 2 Million Children Suffer Traumatic Brain Injury Each Year

MedicalResearch.com Interview with:

Juliet Haarbauer-Krupa, PhD Senior Health Scientist Division of Unintentional Injury Prevention CDC

Dr. Haarbauer-Krupa

Juliet Haarbauer-Krupa, PhD
Senior Health Scientist
Division of Unintentional Injury Prevention
CDC

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

  • Traumatic brain injury in children results in a large number of emergency department visits each year and can result in long term difficulties
  • The purpose of this study was to estimate lifetime prevalence of TBI in children based on a nationally representative sample of U.S. parents/adults and to describe the association between TBI and other childhood health conditions.
  • CDC researchers examined the National Survey of Children’s Health, a cross-sectional telephone survey of U.S. households, to provide a national estimate of TBI in children.

Continue reading

“Head CT Choice” Educates Parents of Children with Mild Head Injury

MedicalResearch.com Interview with:

Erik P. Hess MD MSc Professor and Vice Chair for Research Department of Emergency Medicine UAB Medicine | The University of Alabama at Birmingham Birmingham Alabama 35249

Dr. Hess

Erik P. Hess MD MSc
Professor and Vice Chair for Research
Department of Emergency Medicine
UAB Medicine
he University of Alabama at Birmingham
Birmingham Alabama 35249

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

Response: 450,000 children present to U.S emergency departments each year for evaluation of head trauma.  Physicians obtain head computed tomography (CT) scans in 37%-50% of these patients, with less than 10% showing evidence of traumatic brain injury and only 0.2% that require neurosurgical treatment.

In order to avoid unnecessary CT scans and to limit radiation exposure, the Pediatric Emergency Care Applied Research Network (PECARN) developed clinical prediction rules that consist of 6 readily available factors that can be assessed from the history and physical examination.  If none of these risk factors are present, a CT scan is not indicated.

If either of 2 high risk factors such as signs of a skull fracture are present, CT scanning is indicated.

If 1 or 2 non-high risk factors are present, then either CT scanning or observation are recommended, depending on considerations such as parental preference, clinician experience and/or symptom progression.

In this study we designed a parent decision aid, “Head CT Choice” to educate the parent about the difference between a concussion – which does not show up on a CT scan – and a more serious brain injury causing bleeding in or around the brain.  The decision aid also shows parents their child’s risk for a serious brain injury – less than 1% risk in the majority of patients in our trial – what to observe their child at home for should they opt not to obtain a CT scan, and the advantages and disadvantages of CT scanning versus home observation.

In our trial, we did not observe a difference in the rate of head CT scans obtained in the ED but did find that parents who were engaged in shared decision-making using Head CT Choice were more knowledgeable about their child’s risk for serious brain injury, has less difficulty making the decision because they were clearer about the advantages and disadvantages of the diagnostic options, and were more involved in decision-making by their physician.  Parents also less frequently sought additional testing for their child within 1 week of the emergency department visit.

Continue reading

Could a Low-Gluten Diet During Pregnancy Protect Offspring from Diabetes?

MedicalResearch.com Interview with:
Knud Josefsen, senior researcher
Bartholin Institute, Rigshospitalet,
Copenhagen K, Denmark

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

Response: In a large population of pregnant women, we found that the risk of the offspring being diagnosed with type 1 diabetes before the age of 15.6 years (the follow up period) was doubled in the group of women ingesting the highest amounts of gluten (20-66 g/day) versus the group of women ingesting the lowest amounts of gluten (0-7 g/day). For every additional 10 grams of gluten ingested, the risk for type 1 diabetes in the child increased by a factor of 1.31.

It the sense that it was a hypothesis that we specifically tested, we were not surprised. We had seen in animal experiments that a gluten-free diet during pregnancy protected the offspring from diabetes, and we wanted to see if we could prove the same pattern in humans. There could be many reasons why we would not be able to show the association, even if it was there (sample size, low quality data, covariates we could not correct for and so on), but we were off course pleasantly surprised that we found the association that we were looking for, in particular because it is quite robust Continue reading

Mouth Microbiome Linked to Childhood Obesity

MedicalResearch.com Interview with:

Dr. Sarah J.Carnahan Craig PhD

Dr. Carnahan Craig

Dr. Sarah J.Carnahan Craig PhD
Postdoctoral Scholar
Makova Lab
Biology Department
Center for Medical Genomics
Penn State University

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

Response: This study stems from a long standing collaboration with pediatrician, Ian Paul at Penn State Hershey Medical School (and a co-author on this paper). Ian is very interested in understanding and preventing childhood obesity. It also is part of a much larger, collaborative study objective, lead by Ian and Leann Birch (another co-author), to understand social/behavioral contributors to childhood obesity, how a responsive parenting intervention can prevent childhood overweight/obesity, and the biological factors that contribute to the disease. This is an important research area as childhood obesity is a public health problem — one in three children are overweight or obese. A fuller understanding of factors that contribute to childhood obesity, how to identify children who are at risk for developing childhood obesity, and methods to prevent childhood obesity are of critical importance.

MedicalResearch.com: What are the main findings?

Response: The main finding from this paper is that the oral microbiota (the collection of bacteria that live in the mouth) are significantly related to young child growth patterns. The surprising part of this finding was that we observed this result with the oral microbiota and not the gut microbiota. The oral microbiota (in comparison to the gut microbiota, which has been associated with obesity in many previous studies) are largely understudied, especially in young children. The gut microbiome we found to be strongly influenced by diet; when the two are considered together, there is a significant relationship with child growth patterns.

Additionally, our team developed novel statistical methods to use child growth curves as a more comprehensive outcome rather than an outcome of weight at a single time point (i.e. it uses more of the information about how a child is growing). These methods allow us to better detect the relationship between child growth and the microbiota; they increase our power. 

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

Response: Readers should take away that there are many factors that contribute to obesity and obesity prevention – along with a healthy diet and exercise, biological factors, such as the microbiota for instance, could potentially be an important consideration. Additionally, we’re in the early stages of truly understanding how these microbes influence health. Importantly, we are unable to make any kind of causal conclusions – meaning we don’t know if the microbes are influencing the growth patterns, is health/environment influencing the microbes, or is it both directions.  

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

Response: One of the limitations of this study is that it looks at the microbiota at a single time point, at two years after birth –  this is a dynamic community, so we are really only seeing a snapshot of what is happening. Additionally, the study is retrospective in that the microbiota is sampled at two years and the growth trajectory is made of measurements from birth through two years. Because of this, we might be missing important dynamics happening earlier in life. A more comprehensive study would be to sample the microbiota at all the time points you are sampling growth, health, and other information — this is a study we are currently doing. We hope that by building on this study and examining the microbiota (both oral and gut) longitudinally and in concert with the social, environmental, and health data that we will be closer to a fuller understanding, which could potentially identify children who are most at risk of developing childhood obesity and be prime candidates for obesity intervention programs.  

Citation: 

Sarah J. C. Craig, Daniel Blankenberg, Alice Carla Luisa Parodi, Ian M. Paul, Leann L. Birch, Jennifer S. Savage, Michele E. Marini, Jennifer L. Stokes, Anton Nekrutenko, Matthew Reimherr, Francesca Chiaromonte, Kateryna D. Makova. Child Weight Gain Trajectories Linked To Oral Microbiota Composition. Scientific Reports, 2018; 8 (1) DOI: 10.1038/s41598-018-31866-9

Sep 19, 2018 @ 9:27 pm

 

 

 

The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

 

Steep Increase in Adversity-Related Hospital Admissions for Teenage Girls

MedicalResearch.com Interview with:

Dr Ruth Blackburn PhD  UKRI Innovation Fellow UCL Institute of Health Informatics

Dr Ruth Blackburn PhD 
UKRI Innovation Fellow
UCL Institute of Health Informatics 

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

Response: In England one child in every classroom is admitted to hospital with an adversity related injury (i.e. violence, intentional self-injury, or drug or alcohol misuse) between the ages of 10 and 19 years. These young people are more likely than their classmates to be re-admitted to hospital or to die within 10 years.

We investigated how the rate of hospital admissions with an adversity related injury has changed over time among young people aged 10-24 years, using administrative data for National Health Service hospitals in England.

We found that between 2012 and 2016, rates of admission with an adversity related injury (including intentional self-injury) increased steeply for girls, with the biggest increase (6% per year) among 15-19 year olds. During the same time period, rates of admission with an adversity related injury decreased in boys aged 15-24 years (4-5% per year) but increased slightly for 10-14 year olds (3% per year).  Continue reading

CDC Identifies Risk Factors for Adverse Childhood Experiences

MedicalResearch.com Interview with:

Melissa T. Merrick, PhD Behavioral Scientist,  Surveillance Branch, Division of Violence Prevention CDC

Dr. Merrick

Melissa T. Merrick, PhD
Behavioral Scientist,
Surveillance Branch, Division of Violence Prevention
CDC

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

Response: Childhood experiences build the foundation for health throughout a person’s life. Adverse childhood experiences (ACEs) are potentially traumatic experiences, which occur in childhood. Exposure to ACEs, especially for young people without access to safe, stable, nurturing relationships and environments, can impact health in many ways, including increased risk of chronic disease, engagement in risky behaviors, limited life opportunities, and premature death.

Continue reading

Prenatal Exposure to Air Pollution May Affect Newborn’s Thyroid Function

MedicalResearch.com Interview with:

Carrie Breton ScD Associate Professor and Director of the MADRES Center  Division of Environmental Health Los Angeles, CA 90032

Dr. Breton

Carrie Breton ScD
Associate Professor and Director of the MADRES Center
Division of Environmental Health
Los Angeles, CA 90032

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

Response: I am interested in how the environment can influence our very early development, starting in the womb. I have studied the health effects of air pollutants on children for several years and wanted to focus now on the earliest windows of susceptibility.  Thyroid hormones play a critical role in fetal growth and development. We knew we could get information on newborn thyroid levels from the California Department of Public Health’s newborn screening program therefore look at this question in our study population.

We found that exposure to high levels of PM2.5 and PM10 throughout most of pregnancy affected TT4 levels in newborns. Continue reading

More Than 2 Million High School Students Have Used Marijuana in an E-Cigarette

MedicalResearch.com Interview with:

Katrina Trivers, PhD, MSP Lead author and lead epidemiologist Office on Smoking and Health CDC

Dr. Trivers

Katrina Trivers, PhD, MSP
Lead author and lead epidemiologist
Office on Smoking and Health
CDC

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

Response: Although we’ve seen considerable declines in the use of regular cigarettes among U.S. youth over the past several decades, the tobacco product landscape is evolving, and the use of other tobacco products have become increasingly popular. For example, as of 2014, e-cigarettes have become the most commonly used tobacco product among US youth. During 2011-2015, e-cigarette use increased 900% among U.S. high school students before declining in 2016. No change was observed in 2017, with about 2 million youth, including 12% of high school students and 3% of middle school students, reporting they had used e-cigarettes in the past 30 days.

This is a public health concern because the use of any form of tobacco product is unsafe among youth, irrespective of whether it’s smoked, smokeless, or electronic. The U.S. Surgeon General has concluded that the aerosol emitted from e-cigarettes is not harmless. It can contain harmful ingredients, including nicotine, carbonyl compounds, and volatile organic compounds known to have adverse health effects. The nicotine in these products is of particular concern given that nicotine exposure during adolescence can cause addiction and can harm the developing adolescent brain.

In recent years, many youth have also been using other psychoactive substances in e-cigarettes, including cannabinoids and other illicit drugs. This could have been fueled, in part, by shifts in the social acceptability and access to cannabis as several states have or are considering legalized cannabis sales for adults. A previous CDC study found that in 2015, almost 1 in 3 students reported using e-cigarettes with non-nicotine substances. However, it wasn’t possible to identify what exactly those substances were based on the question. Given the high concurrent use of tobacco and other substances, including cannabis, a more detailed question was added to a future survey to assess the use of cannabis in e-cigarettes among U.S. youth. This study presents the findings from that question.

Continue reading

When Should Children in Pediatric Intensive Care Receive Parenteral Nutrition?

MedicalResearch.com Interview with:

Sascha Verbruggen, MD, PhD Pediatric intensivist Erasmus MC-Sophia Children's Hospital

Dr. Verbruggen

Sascha Verbruggen, MD, PhD
Pediatric intensivist
Erasmus MC-Sophia Children’s Hospital

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

Response: In critically ill children treated in the pediatric intensive care unit (PICU) are often difficult to feed. The subsequent macronutrient deficit was found to be associated with impaired outcomes in the PICU. Furthermore, being undernourished in the PICU has also been associated with poor outcome of critical illness in children.

These associations formed the basis for guidelines recommending initiation of parenteral nutritional support early when enteral feeding is insufficient. However, the multicenter randomised controlled trial (RCT) ‘Pediatric Early versus Late Parenteral Nutrition in Critical Illness’ (PEPaNIC), including 1440 critically ill children, showed that withholding PN for one week (Late-PN) resulted in fewer new infections and reduced the duration of PICU stay as compared to initiating PN at day 1 (Early-PN). However, withholding PN for one week in critically ill children, who are already undernourished upon admission to the PICU, raised concerns among experts.

Therefore we set out to investigate the impact of withholding supplemental PN in a subgroup of critically ill children who were acutely undernourished upon admission to the PICU.  Continue reading

Vaccines Against Rotavirus Gastroenteritis Decreased Infections Even in Unvaccinated Kids

MedicalResearch.com Interview with:

Chuanxi Fu, MD.PhD. Professor of Epidemiology, School of Public Health Zhejiang Chinese Medical University Associate editor, Human Vaccines & Immunotherapeutics

Dr. Chuanxi Fu

Chuanxi Fu, MD.PhD.
Professor of Epidemiology, School of Public Health
Zhejiang Chinese Medical University
Associate editor, Human Vaccines & Immunotherapeutics 

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

Response: Since 2000, the Lanzhou lamb rotavirus vaccine has been exclusively licensed in China for voluntary rotavirus gastroenteritis prevention, however, the effects of the vaccination on population health, including any indirect impact to unvaccinated individuals have not been evaluated.

In the study enrolled 33 407 patients with rotavirus gastroenteritis from 2007 to 2015 seasons in southern China shows vaccination effects in which the median age at onset increased by 4 months, and onset, peak, and cessation of incidence were delayed. The incidence rate ratio among children younger than 4 years and among children ineligible for vaccination decreased as citywide vaccination coverage increased, and the adjusted odds ratio for rotavirus gastroenteritis among unvaccinated infants decreased in areas with higher vaccination coverage.  Continue reading

10% of US Kids Diagnosed with ADHD

MedicalResearch.com Interview with:

Wei Bao, MD, PhD Assistant Professor, Epidemiology College of Public Health University of Iowa

Dr. Wei Bao

Wei Bao, MD, PhD
Assistant Professor, Epidemiology
College of Public Health
University of Iowa

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

Response: ADHD is common in children, with the rate of 5% as said in the American Psychiatric Association states in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.

In this study, we showed that the rate of diagnosed ADHD in US children and adolescents aged 4 to 17 years was 10.2% in 2015-2016, up from 6.1% in 1997-1998. 

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

Response:  Simply saying, a common condition becomes even common. Now, one in ten US kids have ADHD.

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

  • First, continue to monitor the trend through health survey and surveillance program.
  • Second, figure out the reasons for the increase, especially, identify potentially modifiable environmental risk factors for ADHD, because that may lead to an effective prevention.
  • Third, provide adequate resources for the diagnosis and treatment of affected individuals in the future.

No disclosures 

Citation:

Xu G, Strathearn L, Liu B, Yang B, Bao W. Twenty-Year Trends in Diagnosed Attention-Deficit/Hyperactivity Disorder Among US Children and Adolescents, 1997-2016. JAMA Network Open. 2018;1(4):e181471. doi:10.1001/jamanetworkopen.2018.1471

Sep 5, 2018 @ 12:55 pm

The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

 

No Premature Menopause Found in Adolescents Who Receive HPV Vaccine

MedicalResearch.com Interview with:

Allison L. Naleway, PhD Senior Investigator Associate Director, Science Programs Center for Health Research Kaiser Permanente

Dr. Naleway

Allison L. Naleway, PhD
Senior Investigator
Associate Director, Science Programs
Center for Health Research
Kaiser Permanente

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

Response: Reports of premature menopause after human papillomavirus (HPV) vaccination have received a lot of media attention, including on social media, but these reports were based on a small number of isolated cases. Large studies have demonstrated the safety of HPV vaccination, but parental safety concerns—including potential impact on future fertility—are often cited as one reason for lower HPV coverage.

Rates of HPV vaccination have lagged behind coverage rates for other recommended adolescent vaccinations, such as tetanus-diphtheria-acellular pertussis and meningococcal conjugate. (Based on national coverage estimates from 2016, 65% of 13–17 year-old females received at least one HPV vaccination and only 49.5% were up to date with the series, compared to about 88% of adolescents who received Tdap.)

We conducted a study of nearly 200,000 young women to determine whether there was any elevated risk of primary ovarian insufficiency (POI) after HPV or other recommended vaccinations.  Continue reading

Interventions Reduced Childhood Lead Levels, But Did Not Improve Neurobehavioral Outcomes

MedicalResearch.com Interview with:

Joseph M. Braun, MSPH, PhD  Associate Professor of Epidemiology Epidemiology Master's Program Director  Brown University School of Public Health

Dr. Braun

Joseph M. Braun, MSPH, PhD
Associate Professor of Epidemiology
Epidemiology Master’s Program Director
Brown University School of Public Health

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

Response: Childhood lead poisoning continues to be a problem in the United States and residential lead hazards are the major source of Pb exposure in young children. However, no studies have attempted to prevent exposure to lead hazards through primary prevention. Thus, we randomized 355 pregnant women to a comprehensive residential intervention and followed their children for up to 8 years to determine if childhood lead poisoning and associated cognitive deficits and behavior problems can be prevented.

Continue reading

Breast Milk Can Contain THC From Cannabis For Almost a Week

MedicalResearch.com Interview with:

“Cannabis sativa” by Manuel is licensed under CC BY 2.0

cannabis

Christina Chambers, PhD, MPH
Principal investigator
Professor in the Department of Pediatrics
UC San Diego School of Medicine
Drector of clinical research at Rady Children’s Hospital
San Diego 

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

Response: Although cannabis is one of the most common recreational drugs used by pregnant and breastfeeding women, there is little current research regarding potential exposure of the breastfed infant.  As a result, pediatricians are lacking concrete evidence to help support advice to breastfeeding mothers who use cannabis.  This is particularly important as cannabis products available today are substantially more potent than products available in years past.

Our group in the Department of Pediatrics at the University of California San Diego (UCSD) Center for Better Beginnings was interested in first determining how much if any of the ingredients in cannabis actually transfer into breastmilk and how long these metabolites might stay in the milk after the mom’s last use.  We invited mothers who are participating in our UCSD Human Milk Research Biorepository from across the U.S. and Canada to respond to questions about use of cannabis products over the previous 14 days and to provide a breast milk sample.

Fifty mothers participated in the study.  Samples were analyzed by investigators from the UCSD Skaggs School of Pharmacy.

Our major finding was that low, but measurable levels of THC, the main psychoactive ingredient in cannabis, were found in about 2/3 of the samples.  Although the number of hours after mother’s last use of cannabis that THC was still measurable varied widely, the longest time since mother’s last use that THC was still present was about 6 days.  Continue reading

Low Birth Weight Associated With More Diabetes and Hypertension in Adulthood

MedicalResearch.com Interview with:
“Chinese baby laying on a bed” by simpleinsomnia is licensed under CC BY 2.0Wanghong Xu, MD, PhD

Professor of Epidemiology
School of Public Health
Fudan University

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

Response: The Developmental Origins of Health and Disease (DOHaD) hypothesis proposes that cardiovascular diseases and other chronic conditions in adulthood may be a consequence of an unfavorable intrauterine life, a relationship that is further modified by patterns of postnatal growth, environment, and lifestyle.

Based on the two large-scale cohort studies, the Shanghai Women’s Health Study and the Shanghai Men’s Health Study, we observed nonlinear associations for birth weight with baseline body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR), and low birth weight was linked with lower BMI, smaller WC, but larger WHR and WHtR.

An excess risk of T2DM and hypertension was observed for low birth weight (<2500 g) versus birth weight of 2500-3499 g since baseline and since birth. The results support the DoHad hypothesis, and indicate the importance of nutrition in early life on health in Chinese population.  Continue reading