[Reblog] The Doctor Is In: The arithmetic of children’s medicine

[Reblog]

The Doctor Is In: The arithmetic of children’s medicine

The Doctor Is In is an occasional series where JHU Press authors discuss the latest developments and news in health and medicine.

Guest post by Edward A. Bell, Pharm.D., BCPS

Do you know how to properly measure and administer medicine to your child? Arecent study presented at the Pediatric Academic Societies annual meetingsuggests that parents with low reading and math skills may not.

This study is similar to others in that it describes how common and easy it is for parents to err when determining and measuring liquid medication doses for their children. A multitude of factors contribute to the potential for these errors, including misinterpretation of medications and their strengths and miscalculation of a child’s specific dose by his or her weight. What is interesting about this study is that it evaluated a unique aspect of how parents determine medication doses for their children—the parents’ reading and math skills. Nearly one-half of the parents (41%) made a dosing error, demonstrating that the process of giving a dose of liquid medication to an infant or child can be somewhat complicated and that errors can be easy to make. According to anarticle on ScienceDaily, “parents’ math scores, in particular, were associated with measuring mistakes, with parents who scored below the third grade level on the math test having almost a five times increased odds of making a dosing error.”

Health care providers—including physicians, pharmacists, and nurses—should not assume that all parents can accurately administer medicine to their child, and should adequately educate parents on how to do so.

Edward A. Bell is a pediatric pharmacist and a professor of clinical sciences at Drake University College of Pharmacy and Health Sciences and the Blank Children’s Hospital and Clinics, Des Moines, Iowa. His book A Parent’s Guide to Children’s Medicines, is forthcoming this summer.

The information provided in this blog post is not meant to substitute for medical advice or care provided by a physician, and testing and treatment should not be based solely on its contents. Instead, treatment must be developed in a dialogue between the individual and his or her physician. This post has been written to help with that dialogue. The services of a competent medical professional should be obtained whenever medical advice is needed.

Related resources

• Giving Medication to Children(Food and Drug Administration)
• Got a Sick Kid? Don’t Guess. Read the Label(Food and Drug Administration)
• Also available in Spanish
• Medicine and Your Child: How to Give Your Child Medicine(American Academy of Family Physicians)

Related articles

• Parents’ Poor Math Skills May = Medication Errors (nlm.nih.gov)
• Over-the-Counter Medicine: Kids Aren’t Just Small Adults (education.com)
• Parents – Dosing Tips for Kids and Cough and Cold Remedies (education.com)
• Acetaminophen overdoses common but preventable: MDs (ctv.ca)

Johns Hopkins University Press Blog

The Doctor Is In is an occasional series where JHU Press authors discuss the latest developments and news in health and medicine.

Guest post by Edward A. Bell, Pharm.D., BCPS

Do you know how to properly measure and administer medicine to your child? A recent study presented at the Pediatric Academic Societies annual meeting suggests that parents with low reading and math skills may not.

This study is similar to others in that it describes how common and easy it is for parents to err when determining and measuring liquid medication doses for their children. A multitude of factors contribute to the potential for these errors, including misinterpretation of medications and their strengths and miscalculation of a child’s specific dose by his or her weight. What is interesting about this study is that it evaluated a unique aspect of how parents determine medication doses for their children—the parents’ reading and…

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Training Caregivers Not To Underestimate The Abilities Of People With Alzheimer’s Disease, Promoting Independence

 

This article resonates with me.
When my father was dying, it was a struggle not to help too much..and to make sure he made the decisions he was capable of, and physically moved on his own as much as possible.

Last week, as part of my volunteering at a senior residential center, I took a resident shopping. Although she had recently returned from the hospital, I did insist she go into the store with me (I was thinking exercise, she doesn’t move around much) …on the pretense that although she had a list, that would be the only way she would be assured she’d get what she needed.
She did manage! and thankfully wasn’t in pain (at least she didn’t complain).
As a volunteer at our local Area Office on Aging, it is challenging to offer options, but allow the clients to make their own decisions. Active listening is hard at times, but it does pay off in the end.

 

From the 21 July 2012 article at Medical News Today

Family members or professional caregivers who do everything for older adults withAlzheimer’s disease may just be wanting to help, but one University of Alberta researcher says that creating excess dependency may rob the patients of their independence and self-worth.

U of A psychologist Tiana Rust, who recently completed her doctoral program, says her research indicated that caregivers adopted a “dependency support script,” assuming control of tasks they believed patients seemed no longer capable of doing for themselves. She says this model shows that the caregivers’ beliefs, rather than the person’s real abilities, drove their interactions with the patients. Her research also showed that the caregivers’ actions were also seemingly incongruous with their values of wanting to treat patients with respect and promote their independence.

With an aging Canadian population, the number of people suffering from the disease is expected to increase over the next 20 years, she says. Thus, changing behaviour becomes critical – and she’s hoping her U-of-A based research will help spark that change.

“When we create this excess dependency that doesn’t need to be there, this is a problem,” said Rust. “1.1 million Canadians are projected to have dementia by 2038. So, if we’re able to maintain and promote independence to the degree permissible by the disease, that’s important.”

Help not necessarily wanted ….

 

Related articles

• Helping Alzheimer’s Patients Stay Independent (eurasiareview.com)
• The Alzheimer’s Caregiver™ – Bridges the Gap between Research and Caregiving (alzheimersspeaks.wordpress.com)
• Newly Released Report, Women and Alzheimer’s Disease, The Caregiver’s Crisis Finds 82% of Women Caring for Alzheimer’s Patients, Primarily at Home (prnewswire.com)
• Changes in walking may indicate Alzheimer’s disease (foxnews.com)
• New Study Shows The Stress of Working, Caring (caregiving.com)
• What Does Alzheimer’s disease and a Box of Cracker Jacks Have in Common? (alzheimersspeaks.wordpress.com)
• Caregivers need relief, respite from Alzheimer’s, too (miamiherald.com)

 

People May Be Motivated To Carry Out Unspeakable Acts By Social Identification Rather Than Obedience

 

The Milgram experiment: The experimenter (E) persuades the participant (T) to give what the participant believes are painful electric shocks to another participant (L), who is actually an actor. Many participants continued to give shocks despite pleas for mercy from the actor. (Photo credit: Wikipedia)

 

After reading this article, a few thoughts came to mind…

 

The importance of empathy, especially in identifying with the powerless and those different from us.
The importance of religion/spirituality in fostering community and service to others, especially to those who do not hold our beliefs.

 

From the 21 July 2012 article at Medical News Today

 

What makes soldiers abuse prisoners? How could Nazi officials condemn thousands of Jews to gas chamber deaths? What’s going on when underlings help cover up a financial swindle? For years, researchers have tried to identify the factors that drive people to commit cruel and brutal acts and perhaps no one has contributed more to this knowledge than psychological scientist Stanley Milgram.

Just over 50 years ago, Milgram embarked on what were to become some of the most famous studies in psychology. In these studies, which ostensibly examined the effects of punishment on learning, participants were assigned the role of “teacher” and were required to administer shocks to a “learner” that increased in intensity each time the learner gave an incorrect answer. As Milgram famously found, participants were willing to deliver supposedly lethal shocks to a stranger, just because they were asked to do so.

Researchers have offered many possible explanations for the participants’ behavior and the take-home conclusion that seems to have emerged is that people cannot help but obey the orders of those in authority, even when those orders go to the extremes.

This obedience explanation, however, fails to account for a very important aspect of the studies: why, and under what conditions, people did not obey the experimenter.

In a new article published in Perspectives on Psychological Science, a journal of the Association for Psychological Science, researchers Stephen Reicher of the University of St. Andrews and Alexander Haslam and Joanne Smith of the University of Exeter propose a new way of looking at Milgram’s findings.

The researchers hypothesized that, rather than obedience to authority, the participants’ behavior might be better explained by their patterns of social identification. They surmised that conditions that encouraged identification with the experimenter (and, by extension, the scientific community) led participants to follow the experimenters’ orders, while conditions that encouraged identification with the learner (and the general community) led participants to defy the experimenters’ orders.

As the researchers explain, this suggests that participants’ willingness to engage in destructive behavior is “a reflection not of simple obedience, but of active identification with the experimenter and his mission”. …

…According to the authors, these new findings suggest that we need to rethink obedience as the standard explanation for why people engage in cruel and brutal behavior. This new research “moves us away from a dominant viewpoint that has prevailed within and beyond the academic world for nearly half a century – a viewpoint suggesting that people engage in barbaric acts because they have little insight into what they are doing and conform slavishly to the will of authority,” they write.

These new findings suggest that social identification provides participants with a moral compass and motivates them to act as followers. This followership, as the authors point out, is not thoughtless – “it is the endeavor of committed subjects.”

Looking at the findings this way has several advantages, Reicher, Haslam, and Smith argue. First, it mirrors recent historical assessments suggesting that functionaries in brutalizing regimes – like the Nazi bureaucrat Adolf Eichmann – do much more than merely follow orders. And it simultaneously accounts for why participants are more likely to follow orders under certain conditions than others. …

 

Related articles

 

• Social Identification, Not Obedience, Might Motivate Unspeakable Acts (psychologicalscience.org)
• Social identification, not obedience, might motivate unspeakable acts (eurekalert.org)
• Not Obedience But Followership (psychologicalscience.org)
• Social identification, not obedience, might motivate unspeakable acts (medicalxpress.com)
• Social identification, not obedience, might motivate unspeakable acts (sciencedaily.com)
• The Stanley Milgram Films on Social Psychology | Now Available (alexanderstreet.typepad.com)
• Sam Sommers: When Good People Behave Badly (huffingtonpost.com)
• When Good People Behave Badly (psychologytoday.com)
• A scientific study of unethical behavior (southofheaven.typepad.com)
• Milgram’s Experiment on Obedience to Authority (dawnmarie4.wordpress.com)
• Social Engineering (vaticproject.blogspot.com)
• What are the similarities and differences between conformity, compliance, and obedience? (pavlovscouch.com)

 

City Street Pollution Reduced By Up To 8 Times More Than Previously Believed By Green Plants

 

 From the 22 July 2012 article at Medical News Today

Trees, bushes and other greenery growing in the concrete-and-glass canyons of cities can reduce levels of two of the most worrisome air pollutants by eight times more than previously believed, a new study has found. A report on the research appears in the ACS journal Environmental Science & Technology. ..

..The study concluded that judicious placement of grass, climbing ivy and other plants in urban canyons can reduce the concentration at street level of NO2 by as much as 40 percent and PM by 60 percent, much more than previously believed. The authors even suggest building plant-covered “green billboards” in these urban canyons to increase the amount of foliage. Trees were also shown to be effective, but only if care is taken to avoid trapping pollutants beneath their crowns…

 

Related articles

• Green plants reduce city street pollution up to 8 times more than previously believed (esciencenews.com)
• Plants reduce city street pollution 8 times more than thought (news.bioscholar.com)
• Green plants reduce city street pollution up to eight times more than previously believed (phys.org)
• Green plants reduce city street pollution up to eight times more than previously believed (terradaily.com)
• Green plants reduce city street pollution up to 8 times more than previously believed (eurekalert.org)
• The Creation of ‘Green Streets’ Could Cut UK Pollution By Up To 30% (inhabitat.com)
• ‘Green streets can cut pollution’ (bbc.co.uk)
• Trees And Bushes Cut City Pollution (futurepundit.com)
• Green Walls Could Reduce Air Pollution in Urban Areas by 30% (news.softpedia.com)
• Anti-pollution protesters halt construction of copper plant in China (bfreenews.com)

 

Beneficial Bacteria May Help Ward Off Infection

 

English: Template for Template:Food safety (Photo credit: Wikipedia)

 

From the 19 July 2012 article at Science News Daily

 

While many bacteria exist as aggressive pathogens, causing diseases ranging from tuberculosis and cholera, to plague, diphtheria and toxic shock syndrome, others play a less malevolent role and some are critical for human health.

In a new study, Cheryl Nickerson and her group at ASU’s Biodesign Institute, in collaboration with an international team including Tom Van de Wiele and lead author Rosemarie De Weirdt at Ghent University, Belgium, explore the role of Lactobaccilus reuteri — a natural resident of the human gut — to protect against foodborne infection.

Their results demonstrate that this beneficial or probiotic organism, which produces an antimicrobial substance known as reuterin, may protect intestinal epithelial cells from infection by the foodborne bacterial pathogen Salmonella….

…

Bacterial Blizzard

A swarm of some hundred trillion bacteria occupies the human body, outnumbering human cells by about 10 to 1. Among these are members of the genus Lactobacilli, some of which have been associated with therapeutic, probiotic properties, including anti-inflammatory and anti-cancer activity.

The current study zeros in on Lactobacillus reuteri — one of the more than 180 species of Lactobacilli. The group investigated the potential of this bacterium to inhibit the early stages ofSalmonella infection, seeking to identify plausible mechanisms for such inhibitory effects.

Intestinal infections by non-typhoidal Salmonella strains induce diarrhea and gastroenteritis, and remain a leading source of foodborne illness worldwide. Such infections are acutely unpleasant but self-limiting in healthy individuals. For those with compromised immunity however, they can be deadly and the alarming incidence of multi-drug resistant Salmonellastrains has underlined the necessity of more effective therapeutics.

The use of benign microorganisms offers a promising new approach to treating infection from pathogens like Salmonellaand indeed, L. reuteri has been shown to help protect against gastrointestinal infection and reduce diarrhea in children.

Safeguarding cells

The origin of L. reuteri’s protective role still remains unclear, and the present study investigated whether reuterin, a metabolite produced by L. reuteri during the process of reducing glycerol in the gut, could be one of the keys to protection. While it has been speculated that reuterin acts by regulating immune responses or competing with Salmonella for key binding sites, the current study represents the first in vitro examination of host-pathogen interactions using human intestinal epithelium in the presence of reuterin-producing L. reuteri.

 

Related articles

• Probiotics (slideshare.net)
• Genome Project for Food Pathogens Launched by FDA (bespacific.com)
• Tummy Troubles, Colic, and Mama’s Diet (scienceofmom.com)
• FDA plans database for identifying foodborne germs (sfgate.com)
• Genome Project for Food Pathogens Launched (fda.gov)
• Toward an alternative for antibiotics to fight bacterial infections? (eurekalert.org)
• Seeking An Alternative For Antibiotics To Fight Bacterial Infections (medicalnewstoday.com)
• The Surprising Viruses in Our Gut [The Weizmann Wave] (scienceblogs.com)