Conscientiousness in childhood is a predictor of adult smoking behaviour

Conscientious children are less likely to smoke in later life and the personality trait could help explain health inequalities, indicates a study published in the Journal of Epidemiology & Community Health.It is well known that people belonging to lower socio-economic groups have lower life expectancy and more health problems than those who are in higher groups, and certain health behaviours, such as smoking, follow a similar pattern, suggesting they could be partly responsible for health inequalities.Recently, certain personality traits have been found to be associated with health outcomes and health behaviours and to follow a similar social gradient to smoking and health outcomes. In particular, conscientiousness, the tendency to be self-controlled, dutiful, reliable and achievement oriented, has been linked to longer life expectancy and certain health behaviours. However, it is has not been clear whether conscientiousness is a cause or consequence of social inequalities.

Read the rest of the article at http://www.medicalnewstoday.com/releases/291395.php.

Studies show young people ‘wish they were better informed about sex’

Researchers investigating how young men and women learn about sex found that a gap exists between the type of sex education young people want and what they receive.The researchers also identified differences between how men and women learn about sex and relationships. The two studies, published in BMJ Open, utilized data from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3) – the largest scientific study of its kind in the UK.”The terrain young people have to navigate as they are growing up has changed considerably over the past 20 years and it will inevitably continue to do so,” says study author Dr. Clare Tanton. “This means that while we need a more structured approach towards sex and relationships education, we must also be able to adapt to these changing needs.”In one of the two studies, data from Natsal-3 for 3,869 participants, conducted between 2010 and 2012, was compared with data from surveys conducted in 1990-1991 and 1999-2001, in order to assess how sources of information about sex may have changed over time.

Read the rest of the article at http://www.medicalnewstoday.com/articles/290528.php.

Warning on use of melatonin for children’s sleep

Sleep researchers at the University of Adelaide are warning doctors and parents not to provide the drug melatonin to children to help control their sleep problems.Melatonin is a hormone produced in the body with the onset of darkness. It plays an important role in fine tuning people’s circadian rhythms, such as the timing of sleep onset, as well as other biological processes.In a paper published in the Journal of Paediatrics and Child Health, Professor David Kennaway, Head of the Circadian Physiology Laboratory at the University of Adelaide’s Robinson Research Institute, warns that providing melatonin supplements to children may result in serious side effects when the children are older.”The use of melatonin as a drug for the treatment of sleep disorders for children is increasing and this is rather alarming,” Professor Kennaway says.

Read the rest of the article at http://www.medicalnewstoday.com/releases/290010.php.

 

An ‘ambulance’ for the brain

Chemists at IRB Barcelona patent and present a shuttle capable of transporting molecules into the brain; this achievement could facilitate the treatment of diseases with no therapy available.The brain is protected by a barrier of cells that tightly regulates the transport of substances into this organ in order to prevent infection. The essential protective function of this barrier is also a red light for 98% of drug candidates for the treatment of the central nervous system. Iin Angewandte Chemie, scientists at the Institute for Research in Biomedicine (IRB Barcelona) have presented a shuttle able to cross the blood-brain barrier and transport various substances into the brain. The team of chemists at IRB Barcelona is now studying its application for specific medical conditions. Together with clinical researchers, they are preparing treatments for glioblastoma–the most aggressive brain cancer in adults–, Friedreich’s Ataxia–a hereditary neurodegenerative disease–, and a type of paediatric brain cancer.”It is estimated that 20% of humans at some time will need a treatment that targets the brain,” explains Meritxell Teixidó, associate researcher at IRB Barcelona and leader of this line of investigation, “and for many diseases there are some good candidate drugs but none have the capacity to reach their target and thus there is a subsequent loss of potential. Our shuttle offers a solution to an urgent clinical need”. The work has been carried out in IRB Barcelona’s Peptides and Proteins Lab. Directed by Ernest Giralt, also senior professor of the UB, this lab is one of the few leading labs worldwide devoted to these kinds of developments.

Read the rest of the article at http://www.medicalnewstoday.com/releases/289111.php.

Concentrating on word sounds helps reading instruction and intervention

UB researcher’s findings point to the value of word sounds over visual processing during reading instruction or when diagnosing and treating reading disorders.A neuroimaging study by a University at Buffalo psychologist suggests that phonics, a method of learning to read using knowledge of word sounds, shouldn’t be overlooked in favor of a whole-language technique that focuses on visually memorizing word patterns, a finding that could help improve treatment and diagnosis of common reading disorders such as dyslexia.For more information read here http://www.medicalnewstoday.com/releases/288698.php

 

30-minute naps may boost infants’ learning and memory development

It seems like young infants spend most of the day sleeping, and according to the National Sleep Foundation, they do. On average, infants aged 3-11 months have around one to four naps a day, each lasting 30 minutes to 2 hours. Now, a new study finds these daytime naps may be key to a child’s development, helping them remember newly learned skills and behavior.

 

The researchers, including Dr. Jane Herbert of the University of Sheffield in the UK and investigators from Ruhr University Bochum in Germany, publish their findings in the Proceedings of the National Academy of Sciences.

The association between sleep and the brain among adults is well studied. Last September, Medical News Today reported on a study claiming lack of sleep in adults may reduce brain volume, affecting the ability to retain new information, while another study foundshortness of sleep may speed up brain aging.

But according to Dr. Herbert and colleagues, very little was known about how sleep aids a child’s brain development, even though the majority of their time is spent sleeping.

As such, the team set out to assess how sleep affected the learning and memory skills of 216 healthy infants aged 6 and 12 months.

The best learning time for infants is just before a nap

For their study, the researchers made two visits to each infants’ home – either straight after they had slept or just before they were expected to fall asleep.

On the first visit, the researchers conducted a learning task, which involved showing the infants how to remove and play with a mitten that had been placed on a hand puppet.

On the second visit – either 4 or 24 hours later – the researchers monitored how the infants reacted to seeing the mitten-wearing hand puppet again. Specifically, they wanted to see whether the infants would try to remove and play with the mitten, indicating they had processed and remembered these actions from the learning task.

The researchers found that infants who had at least a 30-minute nap within 4 hours of the learning task remembered to remove and play with the hand puppet’s mitten on the second visit. Infants of the same age who did not nap after the learning task, however, were not able to perform these actions, suggesting they did not remember the learning task.

After 24 hours, infants who had napped after the learning task continued to show much better memory recall than those who had not napped.

Infants who napped for less than 30 minutes after the learning task did not display better memory recall, indicating that less than 30 minutes sleep is not enough time for infants’ brains to consolidate new information.

Commenting on the results, Dr. Herbert says:

“These findings are particularly interesting to both parents and educationalists because they suggest that the optimal time for infants to learn new information is just before they have a sleep.

Until now, people have presumed that the best time for infants to learn is when they are wide awake, rather than when they are starting to feel tired, but our results show that activities occurring just before infants have a nap can be particularly valuable and well-remembered.”

She adds that engaging in educational activities with children just before bedtime, such as reading a story, could significantly help their learning and memory development.

Next, the team plans to investigate whether sleep increases the amount of new information an infant can retain and whether it boosts memory quality.

Last month, MNT reported on a study suggesting shortness of sleep alongside sleep-related breathing problems may increase the risk of a child becoming obese by the age of 15 years.

Written by Honor Whiteman

http://www.medicalnewstoday.com/articles/287935.php

 

New guidelines for screening in preschoolers presented in Optometry and Vision Science

All children should undergo vision health screening between age 36 and 72 months – preferably every year – using evidence-based test methods and with effective referral and follow-up, according to recommendations published in the January issue of Optometry and Vision Science, official journal of the American Academy of Optometry. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

The National Expert Panel to The National Center for Children’s Vision Health makes recommendations for vision health screening in preschool-aged children, including specific guidance for screening tests and the screening process. The recommendations are available as open access articles on the journal website.

Vision Health Screening in Preschoolers: Recommendations and Best Practices

Preschool-aged children need screening for early detection of vision problems, particularly refractive error (vision problems requiring glasses), amblyopia (“lazy eye”), and strabismus (a disorder of eye alignment). Prompt diagnosis and referral to an eye care professional (optometrist or ophthalmologist) has major implications for school readiness and child development.

The recommendations are intended to guide the development of vision health screening programs in school and community settings, performed by appropriately trained lay screeners or nurses. The National Expert Panel was made up of leading professionals in optometry, ophthalmology, pediatrics, public health, and related fields.

The Panel recommends vision health screening or comprehensive eye exams for all children, between age 36 months and before age 72 months. Annual screening is defined as “best practice”; screening at least once after age three years is an “accepted minimum standard.”

Certain children – including those with recognized eye or vision abnormalities, developmental disorders, and other high-risk groups – need immediate referral to an eye care professional, rather than screening. The Panel also outlines recommendations for rescreening or referral in young children who are unable or refuse to complete screening.

Recommendations for Tests, Training, and Procedures

The guidelines specify acceptable screening methods, along with definitions of pass/fail screening results. The Panel identifies two “best practice” screening tests: visual acuity testing with eye charts and instrument-based testing using equipment called an autorefractor. The acuity test recommendations call for testing of one eye at a time, using specific types of vision charts and test distances. Specific models of autorefractors with adequate supporting evidence are identified.

The guidelines also address the training and certification of screeners, requirements for space, equipment and supplies, and recording and reporting of the results to the family, health care providers, school, and state agencies.

The January issue also presents an additional National Expert Panel report with recommended measures and definitions for determining vision health screening rates and appropriate follow-up for preschool-aged children. Another report proposes the establishment of integrated health information systems to help ensure quality eye care for children at the local, state, and national levels.

After publication, the recommendations will be periodically updated and posted on the on the website of The National Center for Children’s Vision Health: http://nationalcenter.preventblindness.org/. The website also offers supporting materials and demonstrations of the vision health screening process for communities and organizations seeking to establish screening programs.

“Unfortunately, many children receive neither appropriate screening to help identify those who need immediate eye attention, nor a comprehensive examination by an eye care professional prior to beginning school,” comments Anthony Adams, OD, PhD, Editor-in-Chief of Optometry and Vision Science. “These National Expert Panel reports are an important starting point for identifying vision health screening procedures and tests and definitions of expected performance measures to be tracked across the country. They also advocate the establishment of integrated health information systems, with the goal of ensuring that children with problems identified on screening tests receive appropriate, comprehensive eye examinations and follow-up care.”

Adapted by MNT from original media release

http://www.medicalnewstoday.com/releases/286986.php

 

 

Pain relief for kids in the ER without a needle

Children in emergency departments can safely be treated for pain from limb injuries using intranasal ketamine, a drug more typically used for sedation, according to the results of the first randomized, controlled trial comparing intranasal analgesics in children in the emergency department. The study was published online recently in Annals of Emergency Medicine (“The PICHFORK (Pain in Children Fentanyl OR Ketamine) Trial: A Randomized Controlled Trial Comparing Intranasal Ketamine and Fentanyl for the Relief of Moderate to Severe Pain in Children with Limb Injuries”).

“This is great news for emergency physicians and their young patients, especially those who may not tolerate other intranasal pain medications such as fentanyl,” said lead study author Professor Andis Graudins, MD, of Monash University in Clayton, Victoria, Australia. “For children in pain and distress, the option of treating their pain without a needle is a huge benefit as well. The intranasal option using fentanyl is accepted already for children, but the safe use of ketamine is new.”

Researchers compared pain relief resulting from ketamine and fentanyl, both delivered intranasally, for children 3 to 13 years old whose pain from isolated limb injuries registered seven or higher on a 10 point scale. Median baseline pain rating was eight out of ten. After 30 minutes, the median reductions in pain for ketamine were 4.45 and for fentanyl were 4.0. The pain reduction was maintained in both groups at 60 minutes. Satisfaction for ketamine was slightly higher at 83 percent. Fentanyl had a 72 percent satisfaction rating.

Adverse events were reported more frequently for ketamine (78 percent of patient) than for fentanyl (40 percent of patients), but they were all mild (dizziness or drowsiness were common).

“Ketamine is a great alternative for injured children in the ER who may not be able to tolerate opiates, like fentanyl,” said Prof. Graudins. “And being able to deliver pain-relief with minimal upset, such as that triggered in some children by even the sight of needles, is a great boon to our youngest patients.”

http://www.medicalnewstoday.com/releases/286526.php

 

 

Racial disparities in ear infection treatment may contribute to antibiotic overuse

Black children are less likely to be diagnosed with and less likely to receive broad-spectrum antibiotics for ear infections than white children are, a new study has found. But the discrepancy in prescribing fewer broad-spectrum antibiotics means black children actually are more likely to receive care that aligns with the recommended guidelines for treating ear infections.

Two explanations for the observed disparities in care are overtreatment and overdiagnosis in white children, and undertreatment and underdiagnosis in black children. Addressing behaviors that contribute to these findings may cut down on differential care and antibiotic overuse, both significant public health concerns.

Led by researchers at the University of Utah, Emory University, and the Centers for Disease Control and Prevention (CDC), the study appears online in Pediatrics.

“These findings raise the possibility that physicians bring with them to the exam room cultural and racial biases that influence how they make a diagnosis and prescribe antibiotics,” says senior author Adam Hersh, M.D., Ph.D., assistant professor of pediatrics at the University of Utah School of Medicine.

Examination of medical records from across the nation shows that when children were brought to the doctor for upper respiratory infections that commonly lead to ear infections, 30 percent fewer black children (African-American and other black racial backgrounds) were diagnosed with ear infections compared to other children (95 percent white, 5 percent of other non-black racial backgrounds). Once diagnosed with an ear infection, black children were 20 percent less likely to receive a prescription for broad-spectrum antibiotics.

The results indicate that, whether intentional or not, black children are more likely to receive care that aligns with current ear infection treatment guidelines, which specifically recommend a prescription of narrow-spectrum antibiotics, rather than broad-spectrum antibiotics, as first-line treatment. What’s more, fewer ear infection diagnoses among black children suggest that in some cases, ear infections may be overdiagnosed in other children.

“These findings may indicate racial differences in the diagnosis of otitis media,” says first author Katherine Fleming-Dutra, M.D., pediatric emergency fellow at Emory University and Children’s Healthcare of Atlanta. “Additionally they may reflect inappropriate treatment of otitis media with the use of broad-spectrum antibiotics in a majority of U.S. children.”

Guidelines for treating ear infections have been updated in recent years in an effort to confront antibiotic overuse. Ear infections can be difficult to accurately diagnose, and it can be hard to distinguish bacterial from viral infections. Physicians sometimes err on the side of prescribing antibiotics when the diagnosis is uncertain, even though they are ineffective against viral infections. Overprescribing antibiotics, and unnecessary use of broad-spectrum antibiotics, can lead to adverse side effects such as severe diarrhea, and development of antibiotic-resistant bacteria.

“The use of antibiotics is the single most important driver of antibiotic resistance. Further, ear infections lead to more antibiotic prescriptions in the United States than any other diagnosis,” says co-author Lauri Hicks, D.O., medical director of Center for Disease Control’s Get Smart: Know When Antibiotics Work program. “By increasing our knowledge base about antibiotic prescribing behaviors, we can develop tools and interventions to improve antibiotic prescribing.”

The results were derived from a sample of 15,694 doctor visits for respiratory infections and 4,178 visits for ear infections made by children age 14 years and younger between the years 2008 to 2010. The samples extrapolate to a national estimate of 23.5 million, and 6.4 million annual visits, respectively.

Though not directly addressed by the study, one explanation for disparities in treatment are biases toward children and families of different races. “Overtreatment and overdiagnosis could result from the possibility that in some circumstances, parents may expect an antibiotic prescription, or physicians may perceive that they do,” says Hersh. “Physicians may tailor their diagnosis based on these perceptions of patient expectations.”

Another explanation, underdiagnosis of ear infection and undertreatment with broad-spectrum antibiotics, could result from a number of factors including differences in how frequently parents of black children seek care for their children with respiratory infections, or return for follow-up visits. Racial differences in the reported rate of medication allergies could also influence the choice of antibiotics.

The authors found that equal proportions of black children and children of other races made visits to the doctor for respiratory infections, suggesting that lower rates of ear infection diagnoses in black children are not the result of decreased access to care. But limitations to the analysis include an inability to determine whether the visits were first or follow-up visits, and whether patients had allergies, both of which could impact treatment.

“It is important to understand why certain children are not getting guideline-recommended antibiotics so that we can focus public health efforts to help providers improve their diagnosis and selection of antibiotics for children with otitis media,” says Fleming-Dutra.

http://www.medicalnewstoday.com/releases/285552.php

 

Picture courtesy to articles.mercola.com

 

 

Can depression and guilt in preschool years change the brain?

New study published in JAMA Psychiatry suggests that children who were diagnosed with depression between the ages of 3-6 have a smaller brain region involved in emotion than those who were not depressed.

 

The researchers – led by Andrew Belden, assistant professor of child psychiatry at Washington University School of Medicine in St. Louis, MO – say their findings could help predict the risk of future depression, giving them an “anatomical marker” to use for those at high risk.

The area of the brain they focused on is the right anterior insula; each side of the brain has an insula, a key brain area involved in emotion, perception, self-awareness and cognitive function.

To conduct their study, the team followed 306 children for 3 years as they aged from 3-6, as part of the Preschool Depression Study. They assessed the children for depression and guilt each year.

In addition, all children had MRI brain scans every 18 months from the ages of 7-13.

In total, 47 were diagnosed with depression during their preschool years, and 82 were confirmed to not be depressed. Of those with depression, 55% showed signs of pathological guilt, while 20% of the non-depressed children had “excessive guilt.”

The researchers explain that pathological guilt can be a symptom of clinical depression and other psychiatric disorders, such as anxiety, obsessive-compulsive disorder and bipolar disorder.

“A child with pathological guilt can walk into a room and see a broken lamp, for example,” Belden says, “and even if the child didn’t break it, he or she will start apologizing. Even after being told he or she is not at fault, the child will continue to apologize and feel bad.”

But he adds that the important question is whether depressed children are more prone to guilt or whether children prone to guilt are more likely to be depressed.

Kids with smaller right insula more likely to be depressed when older

Results of the long-term study revealed that children with a smaller right insula were more likely to experience repeated bouts of clinical depression as they got older.

The team also found that this same brain structure is smaller in children diagnosed with pathological guilt during the ages of 3-6, which provides evidence that too much guilt is a symptom of depression – related to the size of the insula.

“That’s not a complete surprise,” says Belden, “because for many years now, excessive guilt has consistently been a predictor of depression and a major outcome related to being depressed.”

Belden adds:

“Arguably, our findings would suggest that guilt early in life predicts insula shrinkage. I think the story is beginning to emerge that depression may predict changes in the brain, and these brain changes predict risk for recurrence.”

So what does this mean for preschoolers with depression? The researchers note that though some children experience depression and recover, never experiencing another episode, other children experience chronic depression. As such, Belden says it is important to identify those at risk for the latter trajectory of depression.

Study is ongoing

Other studies have shown that the insula is also smaller in depressed adults, compared with their non-depressed peers.

And a previous study from the Washington University School of Medicine team showed that preschool children with depression were 2.5 times more likely to be clinically depressed in elementary and middle school, compared with their non-depressed peers in preschool.

In order to assess longer-term results, the researchers plan to continue their study for 5 more years, when the study subjects will travel through adolescence – a high-risk period in terms of depression.

Belden also has hopes to follow them into adulthood. “On the immediate horizon is a look at the effects of some things that become more common during adolescent years as kids hit a high-risk time for substance and alcohol abuse and other problems that co-exist with clinical depression,” he says.

For now, however, their latest study is the first to examine changes in the anterior insula as a potential biomarker for the trajectory of childhood major depressive disorder, results of which could help psychiatrists better understand the course of depression throughout an individual’s life.

Medical News Today recently reported on a study that suggested stressed girls with a family history of depression may age faster than those without a family history of the illness.

Written by Marie Ellis

http://www.medicalnewstoday.com/articles/285359.php