NEW YORK (Reuters Health) - Letting kids sleep a little longer may help improve their behavior and make them less restless in school, according to a new study.
On the flip side, cutting back on kids' time asleep seems to make them more likely to cry, lose their temper and become frustrated, according to the researchers, who published their findings in the journal Pediatrics on Monday.
'You can think about it from a lot of different angles. What we are showing here is that it can go both ways in terms of behavior and academic performance,' said Reut Gruber, of Montreal's McGill University and Douglas Research Center, who led the study.
While Gruber's team is not the first to link sleep and behavior, few studies have looked at whether more sleep actually leads to better behavior in school children.
For the study, they recruited 33 children between seven and 11 years old to be followed over two weeks.
For the first week, the researchers monitored how long the kids slept - about 9.3 hours, which is short of the 10 hours suggested by the U.S. National Institutes of Health.
The children were then split into two groups for the second week.
One group's parents were told to add an hour to their kids' usual time asleep, while the other group was told to cut their kids' sleep by an hour.
Half of the children did lose an hour of sleep each night, but the other group was only able to add about 30 minutes.
Still, that half hour seemed long enough for teachers to notice an improvement in the kids' behavior.
After the first week of monitoring, the teachers answered questions that rated the children's emotions, moodiness and restlessness at school on a scale from zero to 100, with higher scores indicating worse behavior and scores above 60 signaling a behavioral problem.
The baseline score for both groups of kids before the sleep manipulation began was about 50.
After a week of the experimental sleep changes, teachers - who did not know which group any of the children were in - rated the kids again.
The children who got that extra 30 minutes of sleep during the second week scored, on average, about 47, meaning their behavior had improved.
Meanwhile, teachers rated the kids who lost an hour of sleep each night at about 54, indicating their behavior had gotten worse.
Neither of those changes signals an extreme difference in the children's behaviors, said Gruber. But, she added, it would be enough of a difference to make the teachers notice.
Unsurprisingly, the parents of those who got an extra 30 minutes of sleep also said their children weren't as tired throughout the day, while the opposite was true for parents in the other group.
ELIMINATE INTERFERENCES
'The thing that was surprising was how little sleep extension could affect functioning on a day-to-day basis,' said Dr. Umakanth Khatwa, sleep lab director at Boston Children's Hospital in Massachusetts, who was not involved with the new study.
Gruber told Reuters Health that while the study only included 33 kids, it was still able to show more sleep leads to better behavior.
However, the researchers do write that not all of the study's participants were blinded as to which children lost or gained an hour of sleep, because the parents had to be in the know. That may have influenced the parents' reporting of sleepiness throughout the day, they say.
Gruber said that it can be hard for parents to add time to their kids' sleep schedule, but she said one of the keys is to eliminate interferences, such as late-night sports practice.
Khatwa agreed. 'A lot of practices are going into evening now. And by the time you're done, your body is riled up and you need time to wind down,' he said.
Gruber said one way to add the extra sleep could be to add 15 extra minutes of sleep at night and in the morning.
'Once it becomes a routine, the children won't really care about it,' she said.
But Khatwa said it's also important for parents to know their children's specific sleep needs.
'I don't want parents to take this and force their kids to sleep longer. Parents need to have realistic expectations,' he added. 'You need to let them sleep long enough so they can function normally.'
Gruber said that it's important for schools to educate children that getting enough sleep is just as important as eating right and getting enough exercise.
SOURCE: http://bit.ly/RwOI3p Pediatrics, online October 15, 2012.
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Tuesday, October 16, 2012
Monday, October 15, 2012
Kids with ADHD have dimmer prospects: study
NEW YORK (Reuters Health) - Children with ADHD symptoms tend to fare worse as adults than do kids without problems in school, according to the longest follow-up study of the disorder to date.
They have less education and lower income, on average, and higher rates of divorce and substance abuse, according to findings released today in the Archives of General Psychiatry.
'A lot of them do fine, but there is a small proportion that is in a great deal of difficulty,' said Rachel Klein, a professor of child and adolescent psychiatry at NYU Langone Medical Center in New York. 'They go to jail, they get hospitalized.'
Klein and her colleagues followed 135 white men who had been rated hyperactive by their school teachers back in the 1970s and referred to the hospital. According to Klein, the children did not have aggressive or antisocial behaviors and would have been diagnosed with attention deficit hyperactivity disorder today.
They all came from ordinary middle-class homes, Klein said, and had 'well-meaning' parents. When the boys were 18, the researchers established a comparison group of age-matched white boys who had visited their medical center for unrelated reasons and had not had any problems at school.
Based on interviews done when the men were 41 years old, on average, Klein's team found that those who'd had ADHD symptoms as kids left school 2.5 years before the comparison group. Only four percent had higher degrees versus 29 percent of their peers.
In both groups, salaries went as high as $1.5 million a year. But in the comparison group, the average salary was about $175,000, compared to $93,000 in the troubled children.
More than one in five of the hyperactive boys were diagnosed with ADHD three decades later, versus one in 20 in the comparison group. And about a third had been in jail at some point - about three times the comparison rate.
They were also more likely to be divorced, abuse drugs and be labeled with antisocial behavior disorder. However, they weren't more likely to have mood or anxiety disorders.
SLIPPERY SLOPE
It's not clear from the study that ADHD, per se, puts people at risk. But Klein said it's likely to be a slippery slope, with ADHD-linked impulsiveness making youngsters more likely to use drugs and spiral downward into crime and other antisocial behaviors.
'When you see signs of antisocial behavior you really have to step in,' she told Reuters Health. 'You have to keep treating these kids as long as they face problems.'
It's estimated that between three and seven percent of school-aged children in the U.S. have ADHD, according to the Centers for Disease Control and Prevention.
Fewer than half will have lasting problems; for the rest, the outlook is better.
'The ones who had made it through adolescence were no different from ordinary kids,' Klein said. 'Most of them are married, most of them are employed. I think that is a silver lining.'
J. Russell Ramsay, who studies ADHD at the University of Pennsylvania's Perelman School of Medicine, pointed out that although the kids fared worse than the comparison group, they still were within the normal range in many cases.
'We are not talking about awful outcomes necessarily,' Ramsay, who was not involved in the research, told Reuters Health.
'There are different outcomes for different individuals with ADHD based on severity and complexity,' he added. 'This is sort of a reminder to pay attention to the unique needs of the child, the educational environment and the home environment.'
Treatment options include both stimulant medications such as Ritalin or Adderall and behavioral coping strategies that can help address a child's specific difficulties.
'The going phrase is that pills don't teach skills,' said Ramsay. 'It is really an individualized treatment planning decision.'
SOURCE: http://bit.ly/K3aQdr Archives of General Psychiatry, online October 15, 2012.
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They have less education and lower income, on average, and higher rates of divorce and substance abuse, according to findings released today in the Archives of General Psychiatry.
'A lot of them do fine, but there is a small proportion that is in a great deal of difficulty,' said Rachel Klein, a professor of child and adolescent psychiatry at NYU Langone Medical Center in New York. 'They go to jail, they get hospitalized.'
Klein and her colleagues followed 135 white men who had been rated hyperactive by their school teachers back in the 1970s and referred to the hospital. According to Klein, the children did not have aggressive or antisocial behaviors and would have been diagnosed with attention deficit hyperactivity disorder today.
They all came from ordinary middle-class homes, Klein said, and had 'well-meaning' parents. When the boys were 18, the researchers established a comparison group of age-matched white boys who had visited their medical center for unrelated reasons and had not had any problems at school.
Based on interviews done when the men were 41 years old, on average, Klein's team found that those who'd had ADHD symptoms as kids left school 2.5 years before the comparison group. Only four percent had higher degrees versus 29 percent of their peers.
In both groups, salaries went as high as $1.5 million a year. But in the comparison group, the average salary was about $175,000, compared to $93,000 in the troubled children.
More than one in five of the hyperactive boys were diagnosed with ADHD three decades later, versus one in 20 in the comparison group. And about a third had been in jail at some point - about three times the comparison rate.
They were also more likely to be divorced, abuse drugs and be labeled with antisocial behavior disorder. However, they weren't more likely to have mood or anxiety disorders.
SLIPPERY SLOPE
It's not clear from the study that ADHD, per se, puts people at risk. But Klein said it's likely to be a slippery slope, with ADHD-linked impulsiveness making youngsters more likely to use drugs and spiral downward into crime and other antisocial behaviors.
'When you see signs of antisocial behavior you really have to step in,' she told Reuters Health. 'You have to keep treating these kids as long as they face problems.'
It's estimated that between three and seven percent of school-aged children in the U.S. have ADHD, according to the Centers for Disease Control and Prevention.
Fewer than half will have lasting problems; for the rest, the outlook is better.
'The ones who had made it through adolescence were no different from ordinary kids,' Klein said. 'Most of them are married, most of them are employed. I think that is a silver lining.'
J. Russell Ramsay, who studies ADHD at the University of Pennsylvania's Perelman School of Medicine, pointed out that although the kids fared worse than the comparison group, they still were within the normal range in many cases.
'We are not talking about awful outcomes necessarily,' Ramsay, who was not involved in the research, told Reuters Health.
'There are different outcomes for different individuals with ADHD based on severity and complexity,' he added. 'This is sort of a reminder to pay attention to the unique needs of the child, the educational environment and the home environment.'
Treatment options include both stimulant medications such as Ritalin or Adderall and behavioral coping strategies that can help address a child's specific difficulties.
'The going phrase is that pills don't teach skills,' said Ramsay. 'It is really an individualized treatment planning decision.'
SOURCE: http://bit.ly/K3aQdr Archives of General Psychiatry, online October 15, 2012.
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Saturday, October 13, 2012
Low Income Kids Prescribed Medication to Boost Academic Performance
This news article is brought to you by ADVANCED DATING ADVICE - where latest news are our top priority.
Medication Prescribed to Low-Income Kids to Boost Academic Performance
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Thursday, October 11, 2012
Drug shortage led to spike in kids' infections
NEW YORK (Reuters Health) - When there was a shortage of a drug used to prevent IV-related infections in kids, the frequency of those infections increased almost ten-fold at one Michigan hospital, a new study shows.
Known as ethanol lock therapy, the preventive drug is given to kids with bowel problems who require an IV feeding line because their intestines don't absorb enough nutrients.
Those children are at higher risk of infection to begin with because their gut bacteria don't have as much practice killing off germs, researchers said.
Luitpold Pharmaceuticals, then the sole supplier of ethanol, or dehydrated alcohol, voluntarily stopped manufacturing the drug between April and September, 2011 after scrutiny of pharmaceutical facilities by the U.S. Food and Drug Administration.
The details of the production halt were not made public.
Up until early 2011, kids being treated at C.S. Mott Children's Hospital in Ann Arbor were given daily ethanol lock therapy in their catheters to prevent infection. But with the shortage, that was cut back to weekly prophylaxis for most young patients.
The new study, published this week in Pediatrics, covers eight children ranging in age from 22 months to 18 years who'd been diagnosed with necrotizing enterocolitis or other intestinal conditions requiring an IV line.
When ethanol was readily available, there was an average of one catheter-related infection per child every four years.
But when the dosing frequency dropped, seven of the eight children developed catheter-related infections in just a few months. Six of them needed to be hospitalized as a result and spent more than two weeks in the hospital, on average. Treating them cost over $100,000 per patient, and two of the youths ended up in the intensive care unit.
'We definitely had concerns that rationing (ethanol) or decreasing the amount of time we used it could lead to an increase in infection,' said lead author Dr. Matthew Ralls, from Mott and the University of Michigan Medical School.
But the researchers said the spike in infections was far greater than what they'd expected.
'We had basically a complete failure in prophylaxis,' Ralls told Reuters Health. 'We reverted back to the numbers from before we even used ethanol.'
He said he and his colleagues hope that in the future, the FDA can come to an agreement with companies that are the sole producers of important drugs to only shut down some of their production facilities at any given time, for example.
'This had a profound effect on these kids,' Ralls said. 'Some of the complications were pretty devastating for some of these children.'
A press officer at the FDA said the agency hadn't reviewed the new study.
But, Sarah Clark-Lynn told Reuters Health in an email, 'the FDA is working hard with pharmaceutical companies to prevent and resolve drug shortages. Drug shortages (are) a top priority issue for the FDA and we are working hard to help assure that patients in the United States have access to the high quality medications they need.'
She added that another company, Akorn Pharmaceuticals, is now manufacturing ethanol lock therapy. 'We do not anticipate any further shortage issues at this time for this drug,' she said.
Luitpold did not respond to a request for comment.
SOURCE: http://bit.ly/TCaBQi Pediatrics, online October 8, 2012.
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Known as ethanol lock therapy, the preventive drug is given to kids with bowel problems who require an IV feeding line because their intestines don't absorb enough nutrients.
Those children are at higher risk of infection to begin with because their gut bacteria don't have as much practice killing off germs, researchers said.
Luitpold Pharmaceuticals, then the sole supplier of ethanol, or dehydrated alcohol, voluntarily stopped manufacturing the drug between April and September, 2011 after scrutiny of pharmaceutical facilities by the U.S. Food and Drug Administration.
The details of the production halt were not made public.
Up until early 2011, kids being treated at C.S. Mott Children's Hospital in Ann Arbor were given daily ethanol lock therapy in their catheters to prevent infection. But with the shortage, that was cut back to weekly prophylaxis for most young patients.
The new study, published this week in Pediatrics, covers eight children ranging in age from 22 months to 18 years who'd been diagnosed with necrotizing enterocolitis or other intestinal conditions requiring an IV line.
When ethanol was readily available, there was an average of one catheter-related infection per child every four years.
But when the dosing frequency dropped, seven of the eight children developed catheter-related infections in just a few months. Six of them needed to be hospitalized as a result and spent more than two weeks in the hospital, on average. Treating them cost over $100,000 per patient, and two of the youths ended up in the intensive care unit.
'We definitely had concerns that rationing (ethanol) or decreasing the amount of time we used it could lead to an increase in infection,' said lead author Dr. Matthew Ralls, from Mott and the University of Michigan Medical School.
But the researchers said the spike in infections was far greater than what they'd expected.
'We had basically a complete failure in prophylaxis,' Ralls told Reuters Health. 'We reverted back to the numbers from before we even used ethanol.'
He said he and his colleagues hope that in the future, the FDA can come to an agreement with companies that are the sole producers of important drugs to only shut down some of their production facilities at any given time, for example.
'This had a profound effect on these kids,' Ralls said. 'Some of the complications were pretty devastating for some of these children.'
A press officer at the FDA said the agency hadn't reviewed the new study.
But, Sarah Clark-Lynn told Reuters Health in an email, 'the FDA is working hard with pharmaceutical companies to prevent and resolve drug shortages. Drug shortages (are) a top priority issue for the FDA and we are working hard to help assure that patients in the United States have access to the high quality medications they need.'
She added that another company, Akorn Pharmaceuticals, is now manufacturing ethanol lock therapy. 'We do not anticipate any further shortage issues at this time for this drug,' she said.
Luitpold did not respond to a request for comment.
SOURCE: http://bit.ly/TCaBQi Pediatrics, online October 8, 2012.
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Wednesday, October 10, 2012
Three Ohio cities deemed best in U.S. for working moms: Forbes
NEW YORK (Reuters) - Women seeking the best place to work and raise children in the United States may want to head to Ohio, where three of its cities have been voted among the 10 best for working mothers.
Columbus topped the ranking by Forbes, edging past New Orleans and Hartford, Connecticut and their surrounding areas. Cincinnati and its suburb of Middletown came in fourth, just ahead of Providence and neighboring towns in Rhode Island.
With a population of 1.8 million, Columbus scored high marks for its higher than average salaries for women, who make up 44 percent of the city's workforce.
The city also boasts a jobless rate of 5.7 percent, much lower than the national 7.8 percent, and good schools and childcare, according to Forbes.
'Pairing the excellent unemployment rate with an affordable but impressive quality of living makes the city an attractive locale for savvy working moms,' Forbes said.
Another Ohio city, Cleveland, came in seventh, while Buffalo, New York, which topped the list last year, dropped to eighth place.
New Orleans' affordable childcare and higher per-pupil spending helped to propel it into the top 10. Families in the city, known as the Big Easy, pay about $5,900 annually for childcare, while New Yorkers have to budget more than double that amount - roughly $13,000.
Although working mothers are paid among the highest salaries in Boston and Washington D.C., both cities dropped out of the top 10 this year because the cost of living and childcare are above average, according to Forbes.
And like New York, where people spend as much as 80 minutes commuting each day, workers in Boston and the nation's capital also have lengthy trips back and forth to work.
To compile the list, Forbes ranked the cities on job opportunities and earning potential, cost of living, commuting times, cost of childcare, quality of schools, crime rates and healthcare.
It used data from various sources including the U.S. Bureau of Labor Statistics, the FBI Uniform Crime Report, the National Association of Child Care Research and Referral Agencies and the ACCRA Cost of Living Index.
The full list can be found at http://www.forbes.com/sites/meghancasserly/2012/10/10/the-best-cities-for-working-mothers-2012/
(Reporting by Patricia Reaney; editing by Jill Serjeant and Richard Chang)
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Columbus topped the ranking by Forbes, edging past New Orleans and Hartford, Connecticut and their surrounding areas. Cincinnati and its suburb of Middletown came in fourth, just ahead of Providence and neighboring towns in Rhode Island.
With a population of 1.8 million, Columbus scored high marks for its higher than average salaries for women, who make up 44 percent of the city's workforce.
The city also boasts a jobless rate of 5.7 percent, much lower than the national 7.8 percent, and good schools and childcare, according to Forbes.
'Pairing the excellent unemployment rate with an affordable but impressive quality of living makes the city an attractive locale for savvy working moms,' Forbes said.
Another Ohio city, Cleveland, came in seventh, while Buffalo, New York, which topped the list last year, dropped to eighth place.
New Orleans' affordable childcare and higher per-pupil spending helped to propel it into the top 10. Families in the city, known as the Big Easy, pay about $5,900 annually for childcare, while New Yorkers have to budget more than double that amount - roughly $13,000.
Although working mothers are paid among the highest salaries in Boston and Washington D.C., both cities dropped out of the top 10 this year because the cost of living and childcare are above average, according to Forbes.
And like New York, where people spend as much as 80 minutes commuting each day, workers in Boston and the nation's capital also have lengthy trips back and forth to work.
To compile the list, Forbes ranked the cities on job opportunities and earning potential, cost of living, commuting times, cost of childcare, quality of schools, crime rates and healthcare.
It used data from various sources including the U.S. Bureau of Labor Statistics, the FBI Uniform Crime Report, the National Association of Child Care Research and Referral Agencies and the ACCRA Cost of Living Index.
The full list can be found at http://www.forbes.com/sites/meghancasserly/2012/10/10/the-best-cities-for-working-mothers-2012/
(Reporting by Patricia Reaney; editing by Jill Serjeant and Richard Chang)
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Tuesday, October 9, 2012
Kids' surgery uses bone products not approved for children
NEW YORK (Reuters Health) - Nearly one in ten U.S. children undergoing spine fusion surgery get injections with bioengineered bone-growth proteins that have not been approved for that use by health regulators, researchers have found.
So-called 'off-label' use of medical therapies is legal, but has triggered concerns because its risks and benefits are not well understood. What's more, the orthopedic products add more than $4,000 in hospital charges for the surgery, according to a new study published on Tuesday in Journal of the American Medical Association.
For the full study, see: http://bit.ly/MvXYT6
'It is expensive, we don't know if it's effective, and we don't know what the long-term implications are,' said Dr. Emily Dodwell, a surgeon at the Hospital for Special Surgery in New York, who led the research.
Bone-growth proteins speed up bone formation and have been approved by the U.S. Food and Drug Administration for limited use in adults.
They have a troubled history.
Last year, a medical journal determined that doctors who were paid millions of dollars by Minneapolis-based Medtronic Inc had failed to report serious complications linked to the company's product Infuse, also known as bone morphogenetic protein-2 or BMP-2.
Those complications include increased cancer risk, sterility in men, infections, bone dissolution and worsened back and leg pain, among others.
While it's unclear whether children would experience similar side effects, a particular concern is how BMPs would interact with a still-growing skeleton, Dodwell told Reuters Health. Her study did not identify specific products.
There are also no good data on whether or not the products help youngsters, who are less likely to have healing problems than adults after spine surgeries, according to the new report.
At about 4,100 hospitals that are part of the national registry studied by the researchers, 9.2 percent of more than 8,000 spine fusions in people 18 years and younger involved BMPs.
'Most people would feel this is a high number,' Dodwell noted, although she stopped short of saying BMP should never be used in minors.
In cases where BMP was used, patients' hospital bills amounted to $47,136 on average, compared to $43,126 when surgeons didn't use the product.
There was no difference in the number of complications seen during the hospital stay in the two groups, although Dodwell and her colleagues cautioned that long-term complications are the main concern. She said her team is currently analyzing data from another registry to see how kids fare after they leave the hospital.
The researchers also found that doctors more frequently used BMP in the Midwest, which is home to Medtronic. Medtronic officials could not be immediately reached for comment.
(Editing by Ivan Oransky, Michele Gershberg and Andrew Hay)
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So-called 'off-label' use of medical therapies is legal, but has triggered concerns because its risks and benefits are not well understood. What's more, the orthopedic products add more than $4,000 in hospital charges for the surgery, according to a new study published on Tuesday in Journal of the American Medical Association.
For the full study, see: http://bit.ly/MvXYT6
'It is expensive, we don't know if it's effective, and we don't know what the long-term implications are,' said Dr. Emily Dodwell, a surgeon at the Hospital for Special Surgery in New York, who led the research.
Bone-growth proteins speed up bone formation and have been approved by the U.S. Food and Drug Administration for limited use in adults.
They have a troubled history.
Last year, a medical journal determined that doctors who were paid millions of dollars by Minneapolis-based Medtronic Inc had failed to report serious complications linked to the company's product Infuse, also known as bone morphogenetic protein-2 or BMP-2.
Those complications include increased cancer risk, sterility in men, infections, bone dissolution and worsened back and leg pain, among others.
While it's unclear whether children would experience similar side effects, a particular concern is how BMPs would interact with a still-growing skeleton, Dodwell told Reuters Health. Her study did not identify specific products.
There are also no good data on whether or not the products help youngsters, who are less likely to have healing problems than adults after spine surgeries, according to the new report.
At about 4,100 hospitals that are part of the national registry studied by the researchers, 9.2 percent of more than 8,000 spine fusions in people 18 years and younger involved BMPs.
'Most people would feel this is a high number,' Dodwell noted, although she stopped short of saying BMP should never be used in minors.
In cases where BMP was used, patients' hospital bills amounted to $47,136 on average, compared to $43,126 when surgeons didn't use the product.
There was no difference in the number of complications seen during the hospital stay in the two groups, although Dodwell and her colleagues cautioned that long-term complications are the main concern. She said her team is currently analyzing data from another registry to see how kids fare after they leave the hospital.
The researchers also found that doctors more frequently used BMP in the Midwest, which is home to Medtronic. Medtronic officials could not be immediately reached for comment.
(Editing by Ivan Oransky, Michele Gershberg and Andrew Hay)
This article is brought to you by RELATIONSHIP ADVICE.
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