Adult Illness and Death Risk Increased by Respiratory Disease During Childhood

Respiratory disease in childhood increases the risk of illness and premature death in adulthood, according to a study published in the journal, Thorax.

Between 1948 and 1968 10,000 male graduates of Glasgow University supplied researchers with details of childhood illnesses, including bronchitis, asthma and pneumonia, plus their weight, height and blood pressure.

When survivors of the original study were traced between 1998 and 2002, 4044 men out of 8410 replied. Victims of bronchitis, pneumonia asthma in early childhood were 57% more likely to die of respiratory disease than those who had not suffered from these illnesses as children. And they were more than twice as likely to die of chronic obstructive pulmonary disease, emphysema and bronchitis.

Men who had had bronchitis were also 38% more likely to die of cardiovascular disease. Respiratory illness during childhood was also associated with a higher risk of assorted respiratory problems in adulthood, ranging from the relatively minor to the severe.

Source: Thorax,/em> 2008; doi 10.1136/thx.2007.086744

Industry Standards Needed for Children’s Flu Vaccine, Says Report

Evaluating and establishing industry standards for flu vaccines for hospitalized children could help prevent additional hospitalizations and complications from influenza, according to a study published in a recent issue of Pediatrics.

A research team led by Danielle M. Zerr, MD, MPH, medical director of infection control at Seattle Children’s Hospital and associate professor of Pediatrics at the University of Washington School of Medicine (UWSOM), monitored the number of times children with influenza had been hospitalized, and summarized their findings in an article entitled "Hospital-Based Influenza Vaccination of Children: An Opportunity to Prevent Subsequent Hospitalization."

It was found that 23% of the children admitted to hospital with influenza had a previous hospitalization during the most recent flu season. This suggests that providing in-hospital vaccinations when the children were at highest risk for influenza could reduce the rates of childrens’ influenza during the flu season.

Approximately 14,000 children were hospitalized with influenza—and 170,000 were hospitalized with influenza or a respiratory illness—during a 5-year period (2001–2006) when discharge data provided by the Pediatric Health Information System (PHIS) database was analyzed. The data was checked to see how many children had a previous hospitalization during the most recent flu season.

Researchers found approximately 16% of those hospitalized with influenza and 23% of those hospitalized with influenza and another underlying condition had previous hospital admissions during the vaccination season.

"This information will help pediatricians recognize hospitalization as an important opportunity to vaccinate the highest-risk children, and may hopefully prompt the development of hospital-based flu vaccine programs," said Zerr.

The study looked at five years of hospital discharge data from the Pediatric Health Information System (PHIS) database from 2001 through 2006 to determine how many children hospitalized with influenza or respiratory illness had a previous hospitalization during the most recent flu-vaccine season. PHIS is an administrative database developed by the Child Health Corporation of America (CHCA), used by 42 free-standing pediatric hospitals. Subjects included newborns through age 18. A previous hospitalization during flu vaccination season was considered if it occurred in the two weeks to six months prior to the influenza admission and between September 1 and March 1. Approximately 14,000 cases of children hospitalized with influenza and 170,000 hospitalized with influenza or a respiratory illness were reviewed.

Source: Pediatrics, February, 2008

Childrens’ Brain Development Not Affected By Amalgam Fillings

Dental amalgam fillings do not adversely affect brain development in children, or their neurological status, according to a recent report published in the Journal of the American Dental Association. Dental amalgam contains elemental mercury, plus silver, copper, tin, and zinc to form a stable alloy, and has long been used to save dacaying teeth.

A seven year study of 507 Portuguese children, aged 8 through 12 years, who had received amalgam or resin-based composite fillings, conducted routine neurological tests for hard and soft neurological damage to the children, and for the presence of tremor.

There was no difference between the two groups of children after seven years with regard to the presence or absence of tremor. Neither was there any difference in the presence, absence or severity of soft signs. And since these were healthy children, any neurological sot signs diminished as they grew older.

"Even at the levels of amalgam exposure in this study (a mean of 7.7-10.7 amalgam surfaces per subject across the seven years of follow-up)," the authors write, "[we] conclude that exposure to mercury from dental amalgam does not adversely affect neurological status.

"These data indicate the absence of a generalized negative effect on children’s nervous system functions stemming from the presence of dental amalgam," they continue, "and while we cannot rule out potential adverse reactions in individual children, we found no indications of any."

Source: American Dental Association (ADA)

Heart Disease Appears Early in Obese Children

A new study published in the Winter 2007 issue of the Journal of Cardiometabolic Syndrome finds that early signs of heart disease  appear in obese children or in children at risk for obesity.

"Based on this study, these subtle markers can help us predict who could be at risk for heart disease and heart attacks," said Angela Sharkey, M.D., associate professor of pediatrics at Washington University School of Medicine and a pediatric cardiologist at St. Louis Children’s Hospital.

Nationally, 19% of children in the 6 to 11 age group and 17% of children aged 12 to 19 are overweight, which amounts to an epidemic says the Centers for Disease Control (CDC). Being overweight during childhood means a higher risk of adult obesity, with the possibility of diabetes, elevated blood pressure and heart disease.

Dr. Sharkey and Dr. Steven M. Lorch of the University of Texas Health Science Center at Houston reviewed data from 168 children aged 10 to 18 who suffer from heart murmur, chest pain, acid reflux or hiogh blood cholesterol. CDC guidelines for BMIA indicated that 33 patients were obese, 20 had a BMIA putting them at risk for obesity, and 115 were considered normal.

The obese children’s hearts were evaluated by Drs. Sharkey and Lorch using a new tissue Doppler imaging technique called vector velocity imaging. This tracks the movement of the heart’s muscular wall: changes in the rate of motion of heart muscle were averaged within each group and compared to the normal rate of motion.

"In the patients who are obese, the rate of motion of heart muscle changed," Sharkey said. "As a child’s BMIA increases, we see alterations in both the relaxation and contraction phase of the heartbeat. Many of these changes that have been seen in adults were assumed to be from long-standing obesity, but it may be that these changes start much earlier in life than we thought."

The results of the study, said Dr. Sharkey, help physicians in counseling patients and parents about the risks of obesity and the importance of achieving a normal weight.

"Even in teenagers, obesity leads to decreased myocardial performance and abnormal diastolic function," she said.

Source: Washington University in St. Louis

Many Doctors Inadequately Trained for Prescribing Medicine to Children

Research published in Archives of Disease in Childhood suggests that inadequate training among healthcare professionals increases the risk of prescribing errors for childrens’ medicines. Children are especially vulnerable to mistaken prescribing because formulations are not designed specifically for them, and doses have to be individually figured.

Existing research revealed that junior doctors did not know what to prescribe for chest infections or anaphylaxis. The authors were able to find only two studies relevant to the teaching of prescribing skills, and these showed that the error rate fell after the introduction of specific techniques; but the conclusions did not show which had been most effective.

The survery generated a response rate of 57%, with 319 out of 559 questionnaires returned. They showed that training in the avoidance of mistakes in prescribing childrens’ medications was brief, and primarily veral with little practical training.

Eleven centers taught doctors how to complete a drug chart, with another seven reviewing common errors. Only one center offred a computer-based prescribing course showing the correct calculaton of drug doses. In thirteen centers the training amounted to a presentation by specialist pharmacists, of between 30 and 60 minutes, while another ten centers simply gave trainees an induction pack with written information. Only three centers tested prescribing competency.

This research may not present a complete picture of current prescribing training, say the authors, but meanwhile there are no national standards on the teaching of prescribing medicines for children. So that finding which teaching methods are most effective in reducing errors, if any, has geat mportance.

Source: (em>First Arch Dis Child 2007; doi: 10.1136/adc.2007.127761

Insufficient Sleep Could Lead to Overweight Kids

Research findings from the University of Michigan C.S. Mott Children’s Hospital indicate that kids who don’t get enough sleep may be at increased risk of being overweight.

A study researching the connection between length of sleep and weigh for third and sixth grade children showed that kids who got less than 9 hours sleep per day were at greater risk of being overweight—regardless of their gender, race, socioeconomic status, or home environment quality.

The study showed that sixth graders short on sleep were more likely to be overweight. Third graders who got fewer hours of sleep—regardless of their BMI—were more likely to become overweight in sixth grade. The findings of this study appear in the November issue of the journal Pediatrics.

"Many children aren’t getting enough sleep, and that lack of sleep may not only be making them moody or preventing them from being alert and ready to learn at school, it may also be leading to a higher risk of being overweight," says study lead author Julie C. Lumeng, M.D., assistant research scientist at the U-M Center for Human Growth and Development. "This study suggests that an increased risk for overweight is yet another potential consequence of short sleep duration, providing an additional reason to ensure that children are receiving adequate sleep, primarily through enforcing an age-appropriate bed time."

Data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development on reported sleep problems, sleep duration and BMI for 785 elementary school children, aged 9 to 12, was reviewed . 50% were male, 81% were white, 18% were overeight in the sixth grade. The overweight sixth grade lids slept fewer hours than those were not overweight, with boys in the majority of overweight sixth grade children.

"Even more important," Lumeng says, "is emerging research that shows a connection between sleep disruption and the hormones that regulate fat storage, appetite and glucose metabolism. Short sleep duration alters carbohydrate metabolism, and leads to impaired glucose tolerance, which can affect a person’s weight. Circadian rhythms, too, affect the body’s leptin, glucose and insulin levels."

So weight gain may not be a result of sleep’s effect on behavior, notes Dr. Lumeng, but rather sleep’s effect on hormone secretion in the body, specifically leptin and grehlin.

The National Sleep Foundation recommends these basic daily sleep requirements for children, adolescents, pre-teens and teens:

  • Preschoolers: 11-13 hours
  • Elementary school students: 10-12 hours
  • Pre-teens: 9 – 11 hours
  • Teens: 8 ½ – 9 hours

In addition to Lumeng, co-authors from the U-M Center for Human Growth and Development are Deepak Somashekar, B.S., and Niko Kaciroti, Ph.D.; Danielle Appugliese, MPH, with the Data Coordinating Center, Boston University; and Robert F. Corwyn, Ph.D., and Robert H. Bradley, Ph.D., with the Center for Applied Studies in Education, University of Arkansas.

The study was supported by the American Heart Association Fellow-to-Faculty Transition Award, and the American Heart Association Midwest Affiliate Grant-in-Aid.

Reference: Pediatrics, November 2007, Vol. 120, Issue 5.

Childcare by Mothers with Low Education Levels More Likely to Lead to Aggresive Child Behavior

In a recent study of mothers with low education levels and their children, those kids receiving regular care from adults other than their mothers during their preschool years were found to exhibit less physical aggression, such as hitting, kicking or biting.

"The origin of physical aggression problems can be traced back to early childhood, and studies have specifically shown that maternal characteristics, especially low levels of education, are among the best predictors of high physical aggression from early childhood to adolescence," the study’s authors write.

Sylvana M. Cote, Ph.D. of the University of Montreal and colleagues studies 1,795 infants, a cross-section of all children born in Montreal in 1997 and 1998. Mothers were asked to provide information on family, parent and child characteristics from when the child was 5 months to 60 months, including details of adult non-maternal care provided, including daycare centers, family arrangements or other non-maternal care provided regularly during preschool years.

Overall, 1,691 children were followed for the whole study, of which 111 (6.6 percent) received no non-maternal care before preschool, 234 (13.8 percent) received some type of non-maternal care beginning before age 9 months and 1,346 (79.6 percent) received non-maternal care beginning at age 9 months or after.

Children whose mothers had a low education level (i.e., did not have a high school diploma) were less likely to receive daycare. However, those children who did receive non-maternal care had lower levels of physical aggression, and the association was statistically significant among children who started day care before age 9 months.

Children of mothers who graduated from high school were at lower risk of developing physical aggression problems, and non-maternal care had no additional effect on their behavior.

The study’s authors conclude that "provision of non-maternal care services to children of mothers with low levels of education could substantially reduce their risk of chronic physical aggression, and that the protective impact is more important if children begin to receive these services before age 9 months… Because the children most likely to benefit from non-maternal care services are those less likely to receive them, universal programs involving the provision of non-maternal care should include special measures encouraging the use of non-maternal care services among high-risk families."

The study was supported by the Quebec Government Ministry of Health and Fond, Quebecois de la Recherche sur la Societe et la Culture, Canada’s Social Science and Humanities Research Council, Canadian Institutes for Health Research, St-Justine Hospital’s Research Center and the University of Montreal.

Source: Arch Gen Psychiatry. 2007;64(11):1305-1312.

Teaching Kids Hand Washing Habits to Avoid Flu

A new study, presented at the American Public Health Association’s Annual Meeting & Exposition in Washington, D.C. shows that with a little effort, kids can be taught to make hand-washing a lifetime habit.
A sample of 492 children in grades 1 through 6 was coached by a teacher, with role-playing and education on hand hygiene and a visual demonstration of its effectiveness. The coaching resulted in a lasting increase in the frequency of hand hygiene among elementary school-aged children.
The researchers suggest that with parent volunteers and the limited funds available, the school nurse could train the volunteers to teach a hand hygiene method, using germ-simulating lotion. The teachers could then prompt students to wash their hands before lunch, setting the example by washing their own hands.
"With flu season right around the corner, now is a great time to be having a conversation about what schools can do to encourage kids to develop the habit of washing their hands," said Michelle Snow, RN, MSPH, SHR, lead researcher on the study. "Our research shows that for a very low cost and just a little bit of effort, we can have an impact on a behavior that is important for our children’s health, not just now, but throughoutmtheir lives."
Source: American Public Health Association (APHA)

It’s Official! Feds Nix Cold and Cough Meds for Kids Under Six

After weeks of speculation, the Food and Drug Administration (FDA) took the additional step of recommending that cold and cough medicines used by parents for generations no longer be administered to children under six.

While the resolution of the FDA is "not binding," it will surely impact how such medications are marketed, displayed and used.

The recommendation applies to medications containing any of the following ingredients: decongestants, antitussives (against cough) and antiistamines.

Not only to the over-the-counter medicines for cough and colds apparently not work for kids, but there are documented incidents of the meds leading to death in the recipient kids (generally due to parental misuse).

In a separate action, the American Academy of Pediatrics recently backed a petition by pediatricians urging banning such medications from kids under six.

Source: FDA


Eliminate Your Kid’s Backpack – Try a “Wheelie” Instead

Even before they hit middle school, kids are cramming more and more pounds into their backpacks. What started out as a place to carry lunch, a few notepads and a mathematics text has turned into a portable library.

Unfortunately, your child’s back wasn’t designed to carry a day’s worth of textbooks, lunch and supplies.
Even with a backpack properly carried on both shoulders, more and more kids are complaining of back pain.

The solution? Talk to your child’s teachers about cutting the textbook load. And consider buying one of the newer backpacks that come with wheels. No longer the realm of "geeks," they’re the right fashion statement for the upwardly mobile student.