[News release] Are temper, anxiety, homework trouble medical issues? Many parents don’t realize it

From the 18 May 2015 University of Michigan news release

Just half of parents of school-aged children would discuss anxiety or temper tantrums that seemed worse than peers

ANN ARBOR, Mich. — Parents often bring their school-aged children to check-ups or sick visits armed with questions. What should he put on that rash? What about her cough that won’t go away?

IntBehavioralHealth_050515.fw_.png

But when children’s temper tantrums or mood swings are beyond the norm, or they are overwhelmed by homework organization, do parents speak up?

Today’s University of Michigan C.S. Mott Children’s Hospital National Poll on Children’s Health finds that many parents of children age 5-17 wouldn’t discuss behavioral or emotional issues that could be signs of potential health problems with their doctors. While more than 60 percent of parents definitely would talk to the doctor if their child was extremely sad for more than a month, only half would discuss temper tantrums that seemed worse than peers or if their child seemed more worried or anxious than normal. Just 37 percent would tell the doctor if their child had trouble organizing homework.

The most common reason for not sharing these details with their children’s doctors? Nearly half of parents believed that these simply were not medical problems. Another 40 percent of parents say they would rather handle it themselves and about 30 percent would rather speak to someone other than a doctor.

“Behavioral health and emotional health are closely tied to a child’s physical health, well-being and development, but our findings suggest that we are often missing the boat in catching issues early,” says Sarah J. Clark, M.P.H., associate director of the National Poll on Children’s Health and associate research scientist in the University of Michigan Department of Pediatrics.

…

[News release] The infant gut microbiome: New studies on its origins and how it’s knocked out of balance

The infant gut microbiome: New studies on its origins and how it’s knocked out of balance.

From the 15 May news release

IMAGE: BÄCKHED ET AL. ASSESSED THE GUT MICROBIOMES OF 98 SWEDISH MOTHERS AND THEIR INFANTS DURING THE FIRST YEAR OF LIFE. CESSATION OF BREAST-FEEDING WAS IDENTIFIED AS A MAJOR FACTOR IN DETERMINING GUT MICROBIOTA MATURATION, WITH… view more 

CREDIT: BÄCKHED ET AL./CELL HOST & MICROBE2015

A fecal sample analysis of 98 Swedish infants over the first year of life found a connection between the development of a child’s gut microbiome and the way he or she is delivered. Babies born via C-section had gut bacteria that showed significantly less resemblance to their mothers compared to those that were delivered vaginally.

The study, which appears May 11 in Cell Host & Microbe‘s special issue on “The Host-Microbiota Balance,” also found nutrition to be a main driver of infant gut microbiome development–specifically the decision to breast-feed or bottle-feed.

“Our findings surprisingly demonstrated that cessation of breastfeeding, rather than introduction of solid foods, is the major driver in the development of an adult-like microbiota,” says lead study author Fredrik Bäckhed of The University of Gothenburg, Sweden. “However, the effect of an altered microbiome early in life on health and disease in adolescence and adulthood remains to be demonstrated.”

Gut bacteria are suspected to be a source of nutrients and vitamins for a growing infant. Our intestinal tenants are able to interact with normal cellular processes to, for example, produce essential amino acids. Understanding the role individual gut microbes play in metabolism, immunity, and even behavior is an active area of investigation.

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[News item] Each dollar spent on kids’ nutrition can yield more than $100 later

 

 

From the 8 December 2014 ScienceDaily article

Date: December 8, 2014

Source: University of Waterloo

Summary: There are strong economic incentives for governments to invest in early childhood nutrition, reports a new paper that reveals that every dollar spent on nutrition during the first 1,000 days of a child’s life can provide a country up to $166 in future earnings.

There are strong economic incentives for governments to invest in early childhood nutrition, reports a new paper from the University of Waterloo and Cornell University. Published for the Copenhagen Consensus Centre, the paper reveals that every dollar spent on nutrition during the first 1,000 days of a child’s life can provide a country up to $166 in future earnings.

“The returns on investments in nutrition have high benefit-cost ratios, especially in countries with higher income levels and a growing economy,” said Professor Susan Horton, of the School of Public Health and Health Systems and the Department of Economics at Waterloo.

Children who are undernourished during the first 1,000 days of their lives typically show stunted growth patterns by the age of three and have poorer cognitive skills than their well-fed peers. As adults they are less educated, earn lower wages and have more health problems throughout their lives.

“Height-for-age is a much better measure of health than weight-for-age. It is also predictive of economic outcomes,”

…

Currently, the World Health Organization is aiming to reduce stunting among children under age five by 40 per cent as part of its 2025 nutrition goals, and it is widely expected that the rate of stunting will also be included in its Sustainable Development Goals, which will be announced in 2015.

More information can be found at: http://www.copenhagenconsensus.com/post-2015-consensus/nutrition

[News item] Parents skipping needed care for children, pediatricians say | Association of Health Care Journalists

Parents skipping needed care for children, pediatricians say | Association of Health Care Journalists.

BY JOSEPH BURNS | NOVEMBER 26, 2014

High-deductible health plans (HDHPs) discourage families from seeking primary care for their children, according to the American Association of Pediatricians. The problem is so severe that the federal government should consider limiting HDHPs to adults only, the AAP said in a policy statement published in Pediatrics.

“HDHPs discourage use of nonpreventive primary care and thus are at odds with most recommendations for improving the organization of health care, which focus on strengthening primary care,” the association said in its statement. Under the Affordable Care Act, preventive services are covered in full without charge.

This is the second time in as many months that a report has shown consumers skipping needed care because of the cost. Last month, we reported that out-of-pocket health care costs force one out of every eight privately insured Americans to skip necessary medical treatment, according to the survey from the AP-NORC Center, “Privately Insured in America: Opinions on Health Care Costs and Coverage.” The Robert Wood Johnson Foundation funded the survey. In a report earlier this month, “Too High a Price: Out-of-Pocket Health Care Costs in the United States,” the Commonwealth Fund expressed similar concerns.

In an article about the policy statement, Alyson Sulaski Wyckoff, associate editor of Pediatrics, quoted Budd Shenkin, M.D., the lead author of the AAP’s policy statement on HDHPs, saying parents are so concerned about the cost of care that they don’t bring in their children when they should. “They’re reluctant to come in, they seek more telephone care, they’re reluctant to complete referrals, and they’re reluctant to come back for appointments to follow up on an illness,” he said.

For children with chronic conditions, foregoing care can exacerbate illnesses, said Thomas F. Long, M.D., chair of the association’s Committee on Child Health Financing. “If it’s going to cost them out-of-pocket money, they may say, ‘Well, it’s just a cold, I don’t need to see the doctor.’ And ‘just a cold, turns into ‘just pneumonia,’” he added.

The problem of delaying necessary care is one Paul Levy addressed in his blog, Not Running a Hospital, about HDHPs. “Beyond the sad impact on individual families in any given year, I fear that the economic backlash of these policies will be a deferment of needed health care treatments and a resulting future bulge of cost increases. We’re playing Whac-A-Mole here,” he wrote.

For the Commonwealth Fund, researchers found that among privately insured consumers across all income groups, low- and moderate-income adults were most likely to skip the health care they need because of high out-of-pocket costs.

It’s no surprise that adults with the lowest incomes were most likely to skip needed care, the fund reported. Among consumers earning less than $22,890 annually, 46 percent cited at least one example of skipping needed health care because of copayments or coinsurance: 28 percent did not fill a prescription; 28 percent skipped a medical test or follow-up treatment; 30 percent had a medical problem but did not see a doctor; and 24 percent did not see a specialist when needed.

When deductibles are high relative to income, consumers tend to skip care as well, and low- and moderate-income adults had the most trouble, the report showed. Consumers whose deductibles represent 5 percent or more of their income cited at least one example of skipping needed health care because of their deductible: 29 percent skipped a medical test or follow-up treatment; 27 percent had a medical problem but did not go to the doctor; 23 percent skipped a preventive care test; and 22 percent did not see a specialist despite their physician’s advice.

For an article in Modern Healthcare, Bob Herman covered this topic well. He cited the case of a woman in Indiana who was searching for a health plan on HealthCare.gov. A single, 40-year-old nonsmoker, this woman could choose from 29 plans and 24 of them were considered HDHPs, he wrote.

Under IRS rules, (PDF) an HDHP in 2015 is defined as one that has an annual deductible of at least $1,300 for an individual and $2,600 for a family coverage and annual out-of-pocket costs that do not exceed $6,450 for individual or $12,900 for a family.

The Commonwealth Fund report showed that 13 percent of consumers with private health insurance had plans with a deductibles equivalent to 5 percent or more of their income; that figure includes 25 percent of adults with low incomes and about 20 percent of adults with moderate incomes ($11,490 to $45,960 a year for a single person).

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[Press release] World’s Dangerous Neighborhoods Produce Aggressive Children

From a 22 January 2014 Duke University press release

Editor’s Note: The study is available at http://www.mdpi.com/2075-4698/4/1/45

DURHAM, NC – Children around the world who grow up in dangerous neighborhoods exhibit more aggressive behavior, says a new Duke University-led study that is the first to examine the topic across a wide range of countries.

Many U.S. studies have described a link between dangerous neighborhoods and children’s aggressive behavior. Authors of the new study wanted to determine whether the pattern held true in other cultures. To find out, researchers interviewed parents and children from 1,293 families in nine countries: China, Colombia, Italy, Jordan, Kenya, the Philippines, Sweden, Thailand and the United States.

The study appears online today in the journal Societies.

The researchers asked families a series of questions about dangers in their neighborhoods. Based on the answers, the researchers scored the neighborhoods according to their degree of danger.

To measure children’s aggressive behavior, researchers asked parents and children to complete a widely used child-behavior checklist that captures behaviors such as screaming and threatening people. The researchers sought answers from mothers, fathers and children for the surveys, in order to obtain a fuller portrait.

In neighborhoods that parents described as highly dangerous, children exhibited higher levels of aggressive behavior. This link held true across all nine countries studied, based on parents’ responses, said lead author Ann T. Skinner, a researcher with Duke’s Center for Child and Family Policy.

“This is an incredibly diverse set of countries from around the world, representing countries from the developing and the developed world and including individualistic and collectivist societies,” Skinner said. “In all the countries we studied, we see that living in a dangerous neighborhood may affect kids negatively.”

The study further suggests that perilous neighborhoods may affect children indirectly, through their parents. In all nine countries, when children reported living in more dangerous neighborhoods, harsh parenting practices were more common, as was child aggression. However, adults’ and children’s perceptions differed on that point. More research is needed to determine whether or not dangerous neighborhoods promote harsh parenting practices, Skinner said.

The research was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development grant RO1-HD054805, Fogarty International Center grant RO3-TW008141 and the intramural program of the NIH, NICHD.

 

 

 

Related articles (including other studies focusing on different factors)

• University of Montreal study: Aggressive behavior in toddlers may have genetic link
• Spanking Worsens Aggressive Behavior in Children
• Aggressive Toddler Behavior Have More To Do With Genes Than Environmental Factors

 

[News article] Malnourished Children Still Have Hope Beyond First 1,000 Days

English: World map showing % of children under the age of 5 under height. (Photo credit: Wikipedia)

 

From the 11 December 2013 ScienceDaily article

 

Children who are malnourished during their first 1,000 days (conception to age 2) often experience developmental setbacks that affect them for life.

To that end, philanthropic groups have funded massive global health initiatives for impoverished infants and pregnant women around the world. While money flows justifiably to this cause, programs for children past the 1,000-day mark are seen as having little hope, and garner less support.

But new research from Brigham Young University is finding that global health workers should not give up on impoverished children after that critical time frame.

In a longitudinal study of 8,000 children from four poverty-laden countries, BYU health science assistant professor Ben Crookston and colleagues found that the developmental damage of malnutrition during the first 1,000 days is not irreversible.

“The first 1,000 days are extremely critical, but we found that the programs aimed at helping children after those first two years are still impactful,” Crookston said.

Specifically, the study found that nutritional recovery after early growth faltering might have significant benefits on schooling and cognitive achievement.

The data for the study, which comes from the international “Young Lives” project led by the University of Oxford, tracked the first eight years of life of children from Ethiopia, Peru, India and Vietnam.

Initially, Crookston and his colleagues found what they expected with the data: Children who had stunted growth (in this case, shorter than expected height at 1 year of age) ended up behind in school and scoring lower on cognitive tests at 8 years of age.

However, kids who experienced “catch-up growth,” scored relatively better on tests than those who continued to grow slowly and were in more age-appropriate classes by the age of 8.

 

Read the entire article here

 

Related articles

 

• Malnourished children still have hope beyond first 1,000 days (eurekalert.org)
• Hospitals set rules for treating malnutrition (vietnamnews.vn)
• Three Steps to Ending Child Hunger (healthandcultureblog.wordpress.com)

 

[Reblog] Right amount of fat and protein, key to babies

A new research projects studies the nutrition of babies and infants as a means to improve dietary recommendations to young mothers

From the 10 December post at yours.com – European Research Media Center

The early childhood diet and that of the mother during pregnancy determines the health of a child later life. This is the claim that the EU-funded research project Early Nutrition is trying to substantiate by the time it is due to be completed in 2017. Hans van Goudoever, professor of paediatrics and chair of the department of paediatrics at VU University Medical Centre, Amsterdam, the Netherlands, talks to youris.com about his hopes to drastically improve the health of future generations by giving nutritional advice to pregnant women and young mothers.

Has the project produced any surprising results so far?
We have found a relation between nutrition in the first stages of life and a staggering amount of afflictions including obesity, heart diseases, high blood pressure, cholesterol levels, as well as connections to IQ.  And we are now close to practical application. For instance, we found that young infants with a low-protein diet are far less likely to suffer from obesity in later life. So we have developed bottle feeding with less protein and we are tested it on piglets. The results are excellent and tests on humans are about to start.

Why do we need to study early nutrition?
Epidemiological studies, which go back as far as 25 years, have shown that birth and infant weight have an effect on the occurrence of cardiac problems later in life. But that is just a description of a relation, not a scientific proof.  These days we want hard evidence.  One group of children will get nutrition type A, another group will get type B. Then, we’ll keep following them in order to prove there is a specific effect. That’s what the project is all about.

At what stage is it possible to influence child nutrition most?
Nutrition during pregnancy and the first months of life is key. Later on, there is still an influence but it gets smaller with time. After birth, the choice between breast feeding and bottle feeding is very easy, from a nutrition perspective. Breast feeding is at least ten miles ahead.  I know there are many reasons why sometimes breastfeeding is impossible; the mother may not have the opportunity, or she is taking medicines. But if at all possible every effort should be taken to choose breast feeding. It is logical after all. Bottle feeding is made from cow milk, and cows are different from people.

What advice could you give to mothers of very young children?
Above all, avoid excess proteins and fat. Special care should be taken to make sure babies have a diet wherein the protein and fat content is just right. Not too little, but certainly not too much.

If you have a normal diet, you do not need anything else. Just forget about extra vitamins and minerals, as long as your diet is balanced. That is not easy these days. The groups where we see the most problems include, quite often, the people from the lower social classes, who are rather difficult to reach with information or nutrition campaigns. What I do hope is that we can ultimately get the message across to the hard-to-reach public.

 

 

Read more: http://www.youris.com/Bioeconomy/Food/Hans_Van_Goudoever_-_Right_Amount_Of_Fat_And_Protein_Key_To_Babies.kl#ixzz2nAe3HEhk

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Bad boys: Research predicts whether boys will grow out of it — or not

From the University of Michigan press release at EurkAlert 

Contact: Diane Swanbrow
swanbrow@umich.edu
734-647-9069
University of Michigan

Bad boys: Research predicts whether boys will grow out of it — or not

ANN ARBOR — Using the hi-tech tools of a new field called neurogenetics and a few simple questions for parents, a University of Michigan researcher is beginning to understand which boys are simply being boys and which may be headed for trouble.

“When young children lie or cheat or steal, parents naturally wonder if they’ll grow out of it,” says Luke Hyde, a U-M psychologist who is studying the development and treatment of antisocial behavior.

Hyde, a faculty associate at the U-M Institute for Social Research (ISR) and assistant professor of psychology, is speaking at ISR on November 11 on how genes, experience and the brain work together to heighten or reduce the risks that normal childhood transgressions will develop into full-blown conduct disorders in adolescence and early adulthood. His talk is part of the ISR Research Center for Group Dynamics seminar series on violence and aggression, and is free and open to the public.

“The lifetime prevalence of conduct disorder is around 10 percent, and even higher in males and low-income populations,” says Hyde. “The total cost to society is enormous, since these behaviors are often chronic, lasting through adulthood.”

With colleagues at U-M, Duke University, the University of Pittsburgh, and other institutions, Hyde has been exploring the role of the environment and biology as they interact over time to shape behavior. In particular, he is using the techniques of a new field called neurogenetics, which combines genetics, neuroscience and psychology, to learn how genes and neural processes interact with harsh environments, including dangerous neighborhoods and harsh parents, and with a child’s own levels of empathy and personality traits, to increase the risk of antisocial behavior.

In one recent study, for example, Hyde and colleagues studied subjects with over-reactive amygdala responses . The amygdala is an almond-shaped part of the brain’s primitive limbic system involved in processing fear and other visceral emotions. It has been associated with impulsive, aggressive behavior, as well as anxiety disorders and depression.

“Previous research suggests that the amygdala becomes over-reactive probably as a result of both genetics and experience,” says Hyde. “And once the amygdala is over-reactive, people tend to behave in an anxious, over-reactive way to things they see as a potential threat.

“Our study found that this tendency is moderated by a person’s environment, including the social support they get. If they’re not getting support from family, friends, neighbors, or professionals, then the link between the amygdala and anxious behavior is much stronger.”

In another study, Hyde and colleagues showed that kids who are impulsive are only at higher risk of engaging in antisocial behavior if they live in dangerous neighborhoods.

He also identified specific items within childhood behavior checklists that can be used as early as the age of three to identify kids who will likely have worse trajectories for anti-social behavior compared to other children who have similar behavior problems, such as throwing tantrums.

These items assess observable behaviors that include whether the child is cruel to animals, doesn’t seem to feel guilty after misbehaving, is sneaky, lies, is selfish or won’t share, and won’t change his or her behavior as a result of punishment.

“The results of this test aren’t really meaningful until age three or three-and-a-half,” says Hyde. “Before that, many of these behaviors are fairly common, and don’t predict anything. But after age three, if children are still behaving in these ways, their behavior is more likely to escalate in the following years rather than improve.”

There is good news, though. Kids who scored high on this test benefitted just as much as other kids from interventions, according to Hyde. These interventions, often called parent management training, focus on giving parents better skills to manage child behavior problems, including training parents to spend more positive time with their kids, use time-outs instead of physical punishments, and reward good behavior by giving out stickers.

“Parents need to know that intervention works, especially if it’s done early,” says Hyde. “They need to go for help if they see signs of trouble. Clinical psychologists, among other professionals, have empirically supported treatments that are quite effective for children, especially in this age period.”

 

###

Funding for this research was provided by The National Institute of Drug Abuse, the National Institute of Mental Health, and the National Heart, Lung and Blood Institute.

Established in 1949, the University of Michigan Institute for Social Research (ISR) is the world’s largest academic social science survey and research organization, and a world leader in developing and applying social science methodology, and educating researchers and students from around the world. For more information, visit the ISR Web site at http://home.isr.umich.edu

 

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[Press release] Behavior problems in preschool and child care centers may be an issue of genes

From the 24 October 2013 EurkAlert

BEND, Ore. – A new study suggests that some children may be genetically predisposed to developing behavioral problems in child care and preschool settings.

Previous research has found that some children develop behavior problems at child care centers and preschools, despite the benefit of academic gains. It was never known, however, why some youngsters struggle in these settings and others flourish. The new study indicates that some children may be acting out due to poor self-control and temperament problems that they inherited from their parents.

The study’s lead author Shannon Lipscomb, an assistant professor of human development and family sciences at Oregon State University-Cascades, said the findings point to the reason that some children develop problem behavior at care centers, despite the best efforts of teachers and caregivers. The results are published online today in the International Journal of Behavioral Development.

“Assuming that findings like this are replicated, we can stop worrying so much that all children will develop behavior problems at center-based care facilities, because it has been a concern,” she said. “But some children (with this genetic predisposition) may be better able to manage their behavior in a different setting, in a home or smaller group size.”

Researchers from Oregon State University and other institutions collected data in 10 states from 233 families linked through adoption and obtained genetic data from birth parents as well as the children. They found that birth parents who had high rates of negative emotion and self-control, based on a self-reported temperament scale, were more likely to have children who struggled with behavioral issues such as lack of self-control and anger, in child care centers. They controlled for adoptive parent’s characteristics, and still found a modest effect based on the genetic link.

“We aren’t recommending that children are genetically tested, but parents and caregivers can assess a child’s needs and help them get to a setting that might be more appropriate,” Lipscomb said. “This study helps us to explain why some children struggle so much with large peer groups and heightened social interactions. It may not be a problem with a teacher or parent, but that they are struggling on a biological level.”`

 

###

 

Lipscomb is in OSU’s College of Public Health and Human Sciences. She is an expert on early childhood development and school readiness, and is particularly interested in adult influences on young children.

Researchers from the University of Oregon, Pennsylvania State University, University of Pittsburgh, University of California, Riverside, Yale Child Study Center, and Oregon Social Learning Center contributed to this study, which was supported by grants from the National Institutes of Health.

 

Related article by Lipscomb

Academic gains found among high risk kids in Head Start

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• Behavior problems in preschool and child care centers may be an issue of genes (eurekalert.org)
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[Reblog] The Environmental Factors That Influence Our Children’s Illnesses

POSTED ON OCTOBER 23, 2013 BY BABYGREENSERIES

 

© Ampyang | Dreamstime Stock Photos & Stock Free Images

In general, we know that most illnesses and diseases are caused by an interplay of genetics and environmental factors. While there is little we can do to alter genetic susceptibility, understanding what and how environmental factors exacerbate if not trigger illnesses and diseases can help you keep your child safe and healthy.

First, note that there are disease agents – chemical and biological – that your child is exposed to through ingestion, inhalation and dermal contact with soil, food, water and the air. That’s called direct exposure. The opposite, indirect exposure, involves contact with disease agents through interactions with parents and caretakers. For instance, if the father who works in the construction industry comes home and holds his baby, the baby may inhale industrial fumes from his work clothes or chemical residue from the father’s worksite may be transferred from the father’s skin to the baby. Through both modes, children absorb disease agents that alter hormones and disrupt metabolic processes thereby triggering a number of childhood illnesses. It’s also important to recognize that exploratory behavior for children includes putting objects in the mouth, hand-to-mouth contact, which increases the risk for exposure to environmental disease agents.

The chart below lists a number of common childhood illnesses, an associated environmental agent and potential direct and indirect sources of exposures. Use this list to determine if there are any sources of disease agents that you should keep away from your child.

Presenting Problem	Environmental                  Agent	Potential Exposures
Abdominal Pain	Lead	Batteries, smelting, painting, ceramics, enameling, welding, plumbing
Acute Psychoses	Lead Carbon disulfide mercury	Fungicide, maternal infection, wood preserving, removing paint from old houses, viscose rayon
Angina	Methylene chloride Carbon monoxide	Improperly vented indoor combustion sources, traffic exhaust, car repair, furnaces, water heaters, gas grill, foundry, wood finishing
Asthma	Formaldehyde Pet dander Tobacco smoke Toluene diisocyanate	Plastics, textiles, lacquer, playing with pets, polyurethane kits
Cardiac Arrhythmia	Fluorocarbons Solvents	Refrigerator repair, automobile emissions, cigarette smoke, paint thinners, propane gas
Dermatosis	Solvents Soaps Caustic alkali Metals	Plastics, metal cleaning, electroplating, machining, housekeeping, leather tanning
Headache	Carbon monoxide Solvents	Unvented kerosene, tobacco smoke, firefighting, dry cleaning, wood finishing, gas grill, water heaters, furnaces, automobile exhaust, improperly vented indoor combustion mechanisms
Hepatitis	Halogenated hydrocarbons	Healthcare workers, lacquer
Pulmonary Edema	Cadmium Nitrogen oxides Phosgene Halogen gases	Farming, welding, smelting, chemical operations

 

Related articles

• Air pollution a leading cause of cancer – UN agency (eco-business.com)
• Could Environmental Factors Be Playing A Role In Rise Of Kidney Disease? (greenerideal.com)
• Early-life exposure of frogs to herbicide increases mortality from fungal disease (sciencedaily.com)
• Smoking affects molecular mechanisms and thus children’s immune systems (eurekalert.org)
• Environmental factors ‘turn on and off’ cancer related genes (medicalxpress.com)

 

‘Saving Brains’ of kids in developing countries: Grand Challenges Canada funds 14 bold new ideas

Realize this is a long post.
Guess I opted to include the full press release largely because I served in Africa as a Peace Corps volunteer.
Kudos to the Canadian government and all who work to alleviate pain and foster development everywhere.
So good to see an ever growing list of health applications for cell phones. Below is an example of an application for community health workers. Also good to see one project involving fathers!

 

From the 23 October 2013 EurkAlert

10 projects nominated for grants up to $2 million; 10 projects awarded $270,000, including one to reduce harm to brains of pre-term babies caused by pain of multiple daily hospital needles, other procedures

Grand Challenges Canada, funded by the Government of Canada, today extended a total of $10.1 million to 14 bold, creative projects aimed at improving the early brain development of kids in low-resource countries.

Projects in Jamaica, Colombia, Bangladesh and Indonesia are scale-up award nominees (board-approved grants up to CDN $2 million, pending successful contract negotiations).

Seed grants of CDN $270,000 each are given to seven organizations overseas — in Vietnam (2 grants), Bangladesh, India, Kenya, Zambia and Peru. And three seed grants are given to Canadian organizations: the Hospital for Sick Kids, Toronto (two grants), and the University Health Network, Toronto.

All 14 projects will be implemented in developing countries: five in Africa, six in Asia and three in Latin America and the Caribbean.

“Impoverished brains result in impoverished countries,” says Dr. Peter A. Singer, CEO of Grand Challenges Canada. “For a wide range of sad, all-too-familiar and preventable reasons, an estimated 200 million children under 5 years old in the world’s 112 low- and middle-income countries will fail to reach their brain’s full development potential.”

“These projects illustrate well the success of our search for ‘bold ideas with big impact,’ pioneering new approaches worldwide to maximize the number of kids in low-resource countries who achieve and contribute to their fullest capabilities,” Dr. Singer added.

Says Mrs. Laureen Harper, honourary chairperson of the program: “The Grand Challenges Canada Saving Brains program is designed to help millions of children in developing countries who fail to reach their full development potential due to such factors as malnutrition, infection, birth complications, or a lack of nurturing and stimulation at an early age.”

Says the Honourable Christian Paradis, Canadian Minister of International Development and Minister for La Francophonie: “Our Government, under the leadership of Prime Minister Harper, is committed to advancing the health of the world’s most vulnerable mothers, newborns and children. We are proud to partner with Grand Challenges Canada to find innovative solutions to the most pressing global health challenges. The Saving Brains program is just one example of how innovation can help improve the lives of children in their earliest days. ”

Seed grant awards

Hospital procedures: mitigating harm of pain to brain development of a tiny preterm baby

The Centre for Global Child Health, Hospital for Sick Children (Toronto, Canada)

Working in Ghana, this project will introduce ways of alleviating pain for infants born prematurely and treated in special neonatal intensive care units (NICU)s — the tiniest of kids who experience moderate to severe pain several times daily due to diagnostic and therapeutic procedures such as blood sample collections and medicine injections.

Project leader Dr. Bonnie Stevens of Toronto’s Hospital for Sick Children says the severity of brain defects found later among children born preterm can be linked to the number of painful procedures experienced in the NICU.

“Higher volumes of painful procedures with inadequately managed pain have also been associated with cognitive, language and motor problems, and low academic achievement,” says Dr. Stevens. “Although the consequences of pain are known, procedural pain is frequently under-managed and under-prioritized.”

Worldwide, about 13 million infants are born preterm each year — a number growing steadily thanks to modern technologies. And even in North America, Europe and Australia, surveys show “neonates” are exposed to an average of 4 to 14 painful procedures daily, with only about 1 in 3 receiving pain relief.

Less is known about neonatal pain management in low- and middle-income countries, where the incidence of neonatal sickness and death is highest. However, a survey in Kenya showed that infants in seven special care newborn nurseries experienced, on average, four painful procedures daily, half of them injections and blood sample withdrawals. No form of analgesia was documented.

The project will introduce Ghanaian caregivers and parents to an integrated “Toolkit for Minimizing the Impact of Pain in Infants,” adapted from successful practices in Canada. Videos and other educational materials will detail simple, universally affordable, proven ways to mitigate procedural pain for an infant, such as:

 

• Sweet solutions (e.g., sucrose or glucose) administered orally prior to a painful procedure;

 

• Kangaroo care, where infants are held in skin-to-skin contact with a parent;
• Facilitated tucking, where infants are held in a fetal-like position to provide support and boundaries;
• Breastfeeding.

Combined, these interventions have a demonstrated cumulative pain-relieving effect.

“Inadequate resources are cited as the major impediment to pain management in infants as well as a lack of knowledge, severe staff shortages and formal training about pain. The proposed Toolkit intervention will address these issues,” says Dr. Stevens.

The project draws on existing partnerships between the University of Ghana School of Nursing, Korle Bu Teaching Hospital in Accra and Toronto’s Hospital for Sick Children, together training 1,000 pediatric nurses in Ghana over the next 10-15 years, supported by a Canadian government grant. Plans calls for the toolkit’s integration into the curriculum at the School of Nursing (where there is limited pain content) and its use scaled up to reach additional countries.

Says Dr. Stevens: “Decreasing the intensity of painful procedures in hospitalized infants using simple, inexpensive, evidence-based strategies has the potential to minimize both immediate stress and suffering, and the known longer-term impact of pain on the developing neonatal brain and cognitive deficits.”

Malaria in the womb: New malaria policies to protect early brain development in Malawi

University Health Network (Canada)

Each year, about 125 million pregnant women are at risk of placental malaria (PM) and about 25% of all pregnancies in sub-Saharan Africa are complicated by PM at delivery.

PM has profound maternal and fetal health consequences, including increased risk of anemia, preterm birth, fetal growth restriction and delivery of low birth weight infants. The impact of in-utero malaria exposure on fetal neurodevelopment is unknown, however researchers with the project team recently linked malaria-exposure in animals with persistent and long-term deficits in memory and behaviour.

Dr. Kevin Kain of the Toronto-based University Health Network, leader of this project in Malawi, says malaria exposure in the womb “may derail the developmental trajectory of generations of children.” And a shift in understanding — that malaria exposure may result not just in infant mortality and low birth weight but affects also long-term neurodevelopment “represents a change in paradigm that will initiate a re-evaluation of public health policies designed to protect women and children from the deleterious consequences of PM.”

Today’s approach to this problem — intermittent preventive treatment of pregnant women with sulfadoxine-pyrimethamine — is losing effectiveness due to rising drug resistance, resulting in persistent infections.

The new project involves a novel antenatal care policy that focuses resources on accurate point-of-care malaria diagnosis and effective case- management of infection to reduce the burden of malaria in pregnancy and protect early brain development.

The work is expected to provide “compelling evidence that will directly impact national and international policies on the prevention of malaria in pregnancy. If our findings support an intervention that leads to improved neurocognitive outcome for exposed infants, it will refocus public health policies towards protecting fetal brain development.”

Project collaborators include the University of Malawi, and the University of Liverpool, UK.

An Integrated Toolkit to Save Newborns’ Brains in Kenya

The Centre for Global Child Health, Hospital for Sick Children (Toronto, Canada)

The first month of life is a critical period in brain growth and development that can be affected in many ways, including from hypothermia and infection.

Reducing the number of these impediments to young brain growth is the aim of a toolkit created by Toronto’s Hospital for Sick Kids for use initially by mothers in Kenya.

Contents of the tool kit (which costs less than $5) include:

• A clean delivery kit to minimize infection at time of delivery
• A sterilizing gel that, applied to the umbilical stump, reduces certain severe infections by 75% and mortality from all causes by 25 to 40%;
• An emollient to promote skin integrity, helping to reduce infection and prevent hypothermia (and shown to reduce mortality in hospitalized preterm infants)
• A handheld scale to spot early warnings signaled by an infant’s weight, and a ThermoSpot to identify hypothermia and fever
• A mylar infant sleeve and reusable heating device to treat hypothermia

Information on infant stimulation, involving play and communication strategies proven beneficial to neurodevelopment in low birth weight newborns.

If any danger signals are found, community health workers will refer cases to appropriate health care.

“We believe that improved neurodevelopment outcomes at age 1 will translate into sustainable longer term gains in academic performance, employment, productivity, and ultimately more human capital,” says project leader Dr. Shaun Morris of the Hospital for Sick Kids.

Project collaborators include the Aga Khan University, Kenya.

Iron-fortified biscuits to reduce maternal and child anemia

St John’s Research Institute, Unit ofCBCI Society for Medical Education, Bangalore, (India)

Anemia — a low level of red blood cells causing a body’s reduced capacity to carry oxygen — results from micronutrient deficiencies, most often iron.

India has one of the highest rates of anemia globally: over 79% of children aged 6 to 8 months and 58% of the 26 million pregnant women each year. Some 17 million of these women have access to iron pills yet 11 million do not take them for the recommend time (adherence rate: 35%). Why? The pill is big and tastes metallic.

Yet iron deficiency anemia dramatically affects the health of a pregnant woman and her unborn baby, increasing risks of death and sickness during childbirth, including hemorrhage and low-birth weight. Long-term, iron deficiency anemia delays psychomotor development and impairs cognitive development in infants, preschool and school-aged children around the world.

Moreover, researchers say, the effects of anemia are, “not likely to be corrected by subsequent iron therapy… anemic children will have impaired performance in tests of language skills, motor skills, and coordination, reportedly equivalent to a 5 to 10 point deficit in IQ.”

Part of the answer may be an iron-fortified biscuit for use by pregnant women, indistinguishable in taste from popular Indian biscuits.

Coupled with marketing, project leaders say their new biscuit is more likely to be used by previously non-adherent pregnant women, and increase iron stores in newborns, “which translates to more sustainable and protected early brain development.”

“After extensive consumer research, the nutrition team led by Dr A.V. Kurpad and the project collaborators, Violet Health Inc have developed several prototypes specifically designed with the tastes and preferences of pregnant women in India,” says project leader Dr. Pratibha Dwarkanath of St John’s Research Institute, unit of CBCI Society for Medical Education.

“We estimate our solution to be more cost-effective than the iron pill, while reaching more anemic women and their children”

“After proof of concept, we anticipate a scaled trial in Karnataka within three years and reducing anemia in women and infants.”

Project collaborators include Violet Health, Inc., NY, and the Indian Institute of Management, India Bangalore.

Early childhood development in low-resource settings: There’s an app for that.

“CommCare” project empowers community health workers with new mobile software for health workers, parents and caregivers

Ugunja Community Resource Center (Kenya)

In an unprecedented effort, Kenya’s Ugunja Community Resource Center will empower community health workers in Western Kenya with field-tested, mobile phone software to individualize early child development care in the family home and monitor progress via the Internet.

Calling it “the world’s first mobile phone-based early childhood development software platform for low-resource settings,” project leader Aggey Omondi says the software suite will include “apps” for community health workers, for parents and for caregivers, offering practical advice, tools, educational aids and forms for assessing, fostering early childhood development, including cognitive development, nutritional support, management of common illnesses, and counselling on cognitive stimulation for parents and caregivers.

Equipped with mobile phones carrying the software, 30 community health workers will serve 1500households with at least one child under age 3, and 10 parents will receive mobile phones containing the relevant application.

The online monitoring program features a “dashboard” to help users visualize key process and performance indicators, as well as outcome metrics and an analytics suite to enable program managers to analyze trends.

Project collaborators include the Harvard Business School and Dimagi Inc. of Cambridge MA, the University of Pennsylvania and the Kenya Methodist University School of Medicine and Health.

Managing maternal depression and stimulating kids to promote neurodevelopment

International Centre for Diarrheal Disease Research (Dhaka, Bangladesh)

Almost 60% of kids in Bangladesh are at risk of poor development due to low body weight (22%) and undernutrition (41%), poverty, and sub-optimal stimulation due to low parenting knowledge.

The mother is usually the key childcare provider and her physical and mental health is a major predictor of child development, particularly in low and middle-income countries.

Using the service of home-based workers of community health clinics in rural Bangladesh, the International Centre for Diarrheal Disease Research will offer a combined intervention that includes both a “Thinking Healthy” program for mothers of children 6 to 12 months old with depressive symptoms and psycho-social stimulation for their children.

Says project leader Dr. Fahmida Tofail: “Previous projects have used only one or the other of the interventions — depression treatment or child’s psychosocial stimulation. In this approach, we address the mother and child together to produce an optimal child-friendly environment to maximize the investment.”

Project collaborators include the International Centre for Diarrheal Disease Research, Bangladesh, the University of the West Indies, and the Institute for Child Health at University College, London UK.

Community-based family coaching for children with developmental risks

Partners in Health / Socios En Salud Surcursal (Peru)

In Lima, Peru, researchers will demonstrate a standardized community-based screening and treatment program delivered by community health workers to 60 children (6 to 24 months old) at risk of neurodevelopmental delay (NDD).

The community health workers will identify and treat at-risk children and assist their caregivers, addressing multi-level problems. The intervention includes 1) coaching parents on how to stimulate their child’s to promote development, and 2) providing parents with social support and encouragement.

The kids and their primary caregivers will be randomly assigned to one of three interventions:

1. monthly nutritional support alone;
2. nutritional support plus 3 months of the intervention in the home; or
3. nutritional support plus 3 months of the intervention in group settings.

Among the impacts to be measured and evaluated:

• Changes in child development and parenting
• The child, caregiver, and household characteristics that predict who benefits most
• How intervention should be delivered for maximum effect (one-on-one or group settings)

Says project leader Leonid Lecca: “The vicious cycle of developmental delay and limited socioeconomic opportunity (manifested in poor academic performance and child labor) have major impact at the societal level, in terms of economic productivity and social inequality.”

Project collaborators include the Harvard Medical School and Children’s Hospital, the Brigham and Women’s Hospital, and the University of California San Francisco Medical School, as well as stakeholders in Rwanda and Haiti who will help explore how to adapt this model for global dissemination.

Learning Clubs for women’s health and infant development

Research and Training Centre for Community Development (Vietnam)

Vietnamese researchers point to eight major risks to optimal early childhood brain development around the time of birth in resource-constrained settings:

• Intrauterine growth restriction
• Stunting
• Iron deficiency anaemia
• Iodine deficiency
• Unresponsive caregiving
• Insufficient cognitive stimulation
• Maternal mental health problems, and
• Exposure to family violence

And these risks interact: the poorest women who have experienced intimate partner violence are at the highest risk of common mental disorders. And, even when all other factors are controlled, those who experience common mental disorders during pregnancy are less likely to participate in essential preventive health care, including the use of iodized salt to prevent iodine deficiency and taking iron supplements to counter anaemia

Risks continue in early infancy, both for mom and baby: a third of mothers have common mental disorders, 22% of infants are moderately or severely anemic and 7.4% are stunted. Six-month-old infants of mothers with antenatal common mental disorders have infant cognitive development scores on average significantly lower than infants of mothers without common mental disorders in pregnancy.

To date, interventions in these settings have focused on one or at most two of these risks, and outcomes for child development have been, at best, only partially effective.

Capitalizing on 15+ years of experience in rural Vietnam, this project led by Vietnam’s Research and Training Centre for Community Development in Hanoi aims to pioneer a low-cost program addressing all eight risks through a structured, universal program combining information, learning activities and social support with groups of women at the same life stage: Learning Clubs for Women and Infants.

Content will include interventions to address all eight risks early childhood brain development, recognizing and integrating consideration of each woman’s health and social circumstances during pregnancy and in the years in which they are providing primary child care.

The benefit envisioned: enhanced fetal, newborn and early infant development through improved maternal nutrition, mental health, birth outcomes, sensitivity and responsiveness in care-giving and feeding and reduced exposure to family violence.

We estimate that this comprehensive approach will reduce preterm birth, anaemia, stunting, rates of cognitive and social emotional development at age six months, with the effects maintained at least to age three among young children in rural Vietnam.

Project collaborators include the Jean Hailes Research Unit, Australia’s Monash University and the Department of Medicine, University of Melbourne.

What about Dad?

Fathers Involvement: Saving Brains in Vietnam

Hanoi School of Public Health (Vietnam)

Recent research has shown that children of a highly-involved male parent show increased cognitive competence, greater empathy, and less sex-stereotyped beliefs. They have higher IQs, stronger verbal skills, are more academically motivated and successful, have fewer emotional and behavioural problems, show better emotional regulation, better social and problem-solving skills and greater overall life satisfaction.

This project by Hanoi’s School of Public Health aims to mobilize more fathers in parenting and involve them directly in the cognitive and emotional development of their infants, and to indirectly enhance infants’ nutritional status by having fathers encourage mother’s breastfeeding exclusivity and duration.

Fathers will be exposed to:

• Multimedia messages about the importance of breastfeeding and father involvement
• Small group antenatal and postpartum education via community health centers
• Individual at-home counselling
• Light- hearted public fathering contests, organized with the assistance of the local Farmers Association, to praise and reward teams of fathers demonstrating good fathering knowledge and behaviours, and
• Fathers Clubs, developed in collaboration with the Labour trade union and Farmers Association to provide peer support.The project involves 400 couples (with 400 children) in Vietnam’s Hai Duong province.

“Father-infant involvement is an important emerging innovation in developing countries,” says project leader Dr. Tran Bich. “Evolving cultural norms have resulted in fathering roles that range from traditional expectations of father as primarily economic provider and head of the household to more contemporary involvement with mothers and children.”

Project collaborators include Canada’s Brock University, St. Catherines, and St. Jerome’s University, Waterloo.

A new category of community workers in Zambia dedicated to early childhood development

Zambia Centre for Applied Health Research and Development (Lusaka, Zambia)

Recent research on brain development suggests that no single risk or developmental stress causes most harm; the main problem is the accumulated impacts of multiple early childhood adversities. Single risk factor interventions are, therefore, unlikely to achieve the highest possible impact on child development.

This project of the Zambia Centre for Applied Health and Development is designed as a comprehensive, integrated, community-based child development program, rolled out in Zambia’s Choma District.

The key innovation, and a critical improvement over previous efforts: establishment of a new cadre of health workers with the sole, explicit mission to monitor and support all aspects of child development under the age of 2.

The newly-trained, community-based “child development agents” (CDA) will form a natural link between mothers and the larger health system, including community health workers.

The CDA will have three principal responsibilities:

• Monitor children’s nutritional status on a monthly basis through home visits, and ensure immediate treatment of moderate to severe malnutrition and acute infections (malaria, diarrhea, and pneumonia) through local CHWs or public health facilities as needed.
• Ensure all children receive the full health benefits as defined in national guidelines, including exclusive breastfeeding to 6 months of age, a complete set of vaccinations, vitamin A supplementation, growth monitoring, and deworming every 6 months starting at 12 months of age.
• Coordinate local selected volunteer mothers in running a home -based stimulation component similar in nature to the ones successfully implemented in Cambodia

CDAs will be supported with mobile health technology to ensure continuous and efficient communication, monitoring and close implementation of service protocols.

The mobile device will serve three principal functions:

• Provide weekly visit reminders and a list of health services for mothers and children who missed services or appointments
• Allow CDAs to communicate with local CHWs and health facility staff to ensure immediate treatment of acute health conditions
• Support CDAs with visual materials (videos) to compliment their weekly training with volunteer mothers

Each CDA will be responsible for 250 households, which corresponds to approximately 50 to 60 children under the age of 2 in their communities. CDAs will enroll eligible mothers and their child in the study, and then will be responsible for the health and development of the respective child up to 24 months of age. Each week, the CDA will be sent a list mothers and children who missed a scheduled services or appointments through an automated electronic system; list of children that should be visited in the respective week for the monthly nutrition and health follow-up well; and reminder of content of early childhood learning sessions to support child nurturing. They will be monitored by CDA supervisors on a regular basis, and will be given verbal feedback on their performance. In each month, the best 10% of CDAs will receive a symbolic “CDA of the month” award.

The project will directly benefit 225 children in the short term, and, the hope, all Zambian children in the long run. Its main targets: reduced stunting and improved child development at age 2.

Says project leader Dr. Davidson Hamer: “The program has the potential to transform how mothers think about child development and early education, and to increase maternal understanding of age-appropriate development and cognitive stimulation.”

Project collaborators include America’s Harvard School of Public Health, and the Center for Global Health and Development at Boston University, and Zambia’s Centre for Infectious Diseases Research and Ministry of Health, Child Health Unit.

Large-scale award nominees

Putting online a proven, early cognitive stimulation program to help those helping kids in developing countries

University of the West Indies (Kingston, Jamaica)

A package of low-cost materials proven to help early cognitive stimulation will be made available online to support in-home interventions by community workers in developing countries, thanks to this project led by Christine Powell, PhD, Senior Lecturer at the Tropical Medicine Research Institute, University of West Indies. The materials can be used despite limited training by any qualified person (NGO, international agency, local government department) and include a curriculum, training manuals, books, play materials, and training videos, all tailored to the children’s culture.

The curriculum being placed online is the product of years of work pioneering the foundation for early childhood development in low resource settings. The web-based package is expected to provide skills and materials for 10 countries to adapt and implement the home cognitive stimulation package.

Stimulation and nutrition for pre-schoolers in rural Colombia

Universidad de los Andes (Bogotá, Colombia)

While there are government-run programs in urban centers, to now rural kids in Columbia have had available only a home-based daycare system run by women with little if any formal training.

Providing an integrated, two-stage intervention for children from 6 months to 5 years old is the idea behind of a project led by Raquel Bernal of Colombia’s Universidad de los Andes.

In the first stage, facilitators of existing family (home-visiting) services for pregnant women and children up to 30 months old will be trained to promote effective mothering, including nutrition, child development, and interaction with the child.

In the second stage, local mothers running community nurseries will receive 160 hours of training in topics such as fostering child development and developmental milestones in children 24-60 months old, and activities to encourage executive functioning of the child brain. Crucially, both curricular improvements will be implemented along with regular coaching and monitoring visits by trained supervisors.

An estimated 4,800 children will have access to more supportive developmental experiences as a result of this project.

Nutrition and psychosocial stimulation to improve development of malnourished children in Bangladesh

International Centre for Diarrheal Disease Research (Dhaka, Bangladesh)

Early cognitive development will be promoted through this program to treat malnourished children in rural Bangladeshi health clinics, improving the knowledge and skills of both mothers and field staff in early cognitive development. The anticipated outcome: improved language skills among children, as well as better mental and psychomotor development.

The project takes advantage of a time when kids and their parents are interacting with health clinics to provide more than just calories. challenge is how to do it in a way that is feasible to deliver by health workers with lots big workloads. The anticipated outcome: improvements in language, mental, and psychomotor development for approximately 3,000 children.

Golden Generation Program for community-based early childhood development

University of Mataram (Mataram, Indonesia)

The Golden Generation Program will integrate early development, health and nutrition programs to promote thriving children, and includes strategies to:

• enhance staff capabilities in early childhood development centers in villages;
• deploy of specially-trained community workers to coach and certify couples in early childhood development; and
• engage a mobile real-time data platform to link providers and clients to track infant growth and development, and flag needed interventions.

Program impact will be assessed through a randomized trial involving 80 communities, covering approximately 30,000 couples and their infants over a 2-year period.

To foster long-term sustainability and ongoing program development, the Program will also establish community worker cooperatives and a Center for Early Childhood Development at the University of Mataram.

The program is a collaboration between the University of Mataram, the Provincial and District Governments of Nusa Tenggara Barat Province, the Summit Institute of Development and the Harvard School of Public Health.

 

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Saving Brains

The Grand Challenges Canada Saving Brains Program promotes fulfillment of human capital potential by focusing on interventions that nurture brain development in the first 1,000 days of life. The goal of the Saving Brains program is to unlock the potential of children by developing and scaling up products, services and policies that protect and nurture early brain development in an equitable and sustainable manner. Almost CDN $30 million has been committed to date. In addition to projects, the Saving Brains program is investing in an authoritative quantification of the economic impact and true costs of poverty-related risk factors for cognitive and human capital development.

Grand Challenges Canada invites global, regional and corporate partners committed to enabling innovation for early brain development to join us in Saving Brains.

Please visit grandchallenges.ca and look for us on Facebook, Twitter, YouTube and LinkedIn.

About Grand Challenges Canada

Grand Challenges Canada is dedicated to supporting bold ideas with big impact in global health. We are funded by the Government of Canada through the Development Innovation Fund announced in the 2008 Federal Budget. We fund innovators in low and middle income countries and Canada. Grand Challenges Canada works with the International Development Research Centre (IDRC), the Canadian Institutes of Health Research (CIHR) and other global health foundations and organizations to find sustainable long-term solutions through integrated innovation – bold ideas which integrate science, technology, social and business innovation. Grand Challenges Canada is hosted at the Sandra Rotman Centre.

http://www.grandchallenges.ca

About Canada’s International Development Research Centre

The International Development Research Centre (IDRC) supports research in developing countries to promote growth and development. IDRC also encourages sharing this knowledge with policymakers, other researchers and communities around the world. The result is innovative, lasting local solutions that aim to bring choice and change to those who need it most.

As the Government of Canada’s lead on the Development Innovation Fund, IDRC draws on decades of experience managing publicly funded research projects to administer the Development Innovation Fund. IDRC also ensures that developing country researchers and concerns are front and centre in this exciting new initiative.

http://www.idrc.ca

About Canadian Institutes of Health Research

The Canadian Institutes of Health Research (CIHR) is the Government of Canada’s health research investment agency. CIHR’s mission is to create new scientific knowledge and to enable its translation into improved health, more effective health services and products, and a strengthened Canadian health care system. Composed of 13 Institutes, CIHR provides leadership and support to more than 14,100 health researchers and trainees across Canada. CIHR will be responsible for the administration of international peer review, according to international standards of excellence. The results of CIHR-led peer reviews will guide the awarding of grants by Grand Challenges Canada from the Development Innovation Fund.

http://www.cihr-irsc.gc.ca

About the Department of Foreign Affairs, Trade and Development Canada

The mandate of Foreign Affairs, Trade and Development Canada is to manage Canada’s diplomatic and consular relations, to encourage the country’s international trade, and to lead Canada’s international development and humanitarian assistance.

http://www.international.gc.ca

About Sandra Rotman Centre

The Sandra Rotman Centre is based at University Health Network and University of Toronto. We develop innovative global health solutions and help bring them to scale where they are most urgently needed. The Sandra Rotman Centre hosts Grand Challenges Canada.

http://www.srcglobal.org

 

Related articles

• Simple Method May Help Predict Tiny Preemies’ Outlook (nlm.nih.gov)
• Indiana University study shines new light on consequences of preterm births (eurekalert.org)
• Study Identifies New Consequences of Preterm Births (counselheal.com)
• Testing for Neonatal Sepsis: The Next Generation of Biomarkers (promega.wordpress.com)
• Neonatal Pain-Related Stress and NFKBIA Genotype Are Associated with Altered Cortisol Levels in Preterm Boys at School Age (plosone.org)

 

[Repost] Household chaos may be hazardous to a child’s health

Remembering that the television was only on for about an hour weekday evening (after homework was done!), and Saturday mornings for cartoons. Also Sunday evenings.  Still  generally stick to this after all these years. Even without homework.
No angel, could be on the Internet less!!

From the 9 October 2013 EurekAlert article

Study links crowding, noise, lack of routine to worse outcomes

COLUMBUS, Ohio – Kindergarten-age children have poorer health if their home life is marked by disorder, noise and a lack of routine and they have a mother who has a chaotic work life, new research suggests.

The results show the importance of order and routine in helping preschoolers stay healthy and develop to the best of their potential, said Claire Kamp Dush, lead author of the study and assistant professor of human sciences at The Ohio State University.

“Children need to have order in their lives,” Kamp Dush said. “When their life is chaotic and not predictable, it can lead to poorer health.”

Kamp Dush said that the study involved mostly low-income families, and the results showed mothers who were more impoverished reported significantly higher levels of chaos.

“I don’t think that the findings would be different in a middle-class sample – chaos is bad for children from any background,” she said.

“But most middle-class families can avoid the same level of chaos that we saw in the most impoverished families. We’re not talking about the chaos of your kids being overinvolved in activities and the parents having to run them from one place to another. This harmful chaos is much more fundamental.”

Kamp Dush conducted the study with Kammi Schmeer, an assistant professor of sociology at Ohio State, and Miles Taylor, assistant professor of sociology at Florida State University. Their results appear online in the journal Social Science & Medicine.

Data came from the Fragile Families and Child Well-being Study, and included 3,288 mothers who were interviewed at their homes by a trained interviewer when their child was 3 and again when he or she was 5 years old. Most of the parents were unmarried and low-income.

The researchers used several measures of household chaos: crowding (more than one person per room), TV background noise (TV was on more than 5 hours a day), lack of regular bedtime for the child, and a home rated as noisy, unclean and cluttered by the interviewer.

The study also included a measure of the mother’s work chaos, which included stress caused by the work schedule, difficulty dealing with child care problems during working hours, lack of flexibility to handle family needs and a constantly changing work schedule.

The children’s health was rated by their mother at ages 3 and 5 as excellent, very good, good, fair or poor.

Results showed that higher levels of household chaos and mothers’ work chaos when their children were age 3 were linked to lower ratings of child health at age 5, even after taking into account initial child health and other factors that may have had an impact.

In addition, the researchers were also able to use a statistical technique to determine if the causality may have been reversed: in other words, if poor child health might lead to more household chaos. “It would be easy to see how having a sick child may make your household more chaotic, but that’s not what we found. We did clearly see, however, that a chaotic household at age 3 was linked to poorer health at age 5,” Kamp Dush said.

The most common source of household chaos was television noise, with more than 60 percent of mothers reporting the television was on more than five hours a day. Between 15 and 20 percent of households reported crowding, noise, and unclean and cluttered rooms.

About a third of the mothers had inflexible work schedules and 11 percent worked multiple jobs.

How does household chaos lead to sicker children? Kamp Dush noted that chaos has been linked to stress, and stress has been shown to lead to poorer health. Women with inflexible work schedules may not be able to take their children to the doctor when needed. And a dirty house may increase exposure to toxins and germs.

Kamp Dush emphasized that the findings shouldn’t be used to suggest that the parents are at fault for the chaos in their households.

“We’re not blaming the victims here – there is a larger system involved,” she said.

“These mothers can’t help it that their jobs don’t give them the flexibility to deal with sick kids. They can’t afford a larger house or apartment to deal with overcrowding. With their work schedules, they often don’t have time to keep a clean home and they don’t have the money to spend on organizational systems or cleaning services used by middle-class families to keep their homes in order.”

What these mothers and fathers need most is jobs that allow them to maintain regular schedules and have the flexibility to deal with sick children, Kamp Dush said. Having to maintain two jobs is also detrimental to keeping households free of chaos.

 

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Kamp Dush received support for this study from the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

 

 

 

 

August is National Immunization Awareness Month

The Centers for Disease Control and Prevention (CDC) has a whole Web site on Vaccines and Immunizations
Some highlights

• Vaccine Information for Parents
• Vaccines and Preventable Diseases
• Vaccine Side Effects and Safety

 

Related articles

• Healthcare Professionals Are Key to Boosting Adult Immunizations (nfid.wordpress.com)
• Doctors on Call: Vaccines have eliminated diseases — but our kids still need to be immunized (jacksonville.com)
• Back-to-school vaccinations: Are your kids up to date? (abclocal.go.com)
• Report: Teen HPV vaccination rate still lagging (mysanantonio.com)

 

Medication Health News

Are you up-to-date on your immunizations? August is National Immunization Awareness month, a public health campaign sponsored by the CDC to recognized the importance of vaccination and to bring awareness to vaccinations that are not meeting national goals. Vaccines are the best prevention for some serious often life-threatening illnesses. This campaign is targeting a different group each week during the month of August: students starting college, students k-12, adults 26+, and pregnant women and newborns. The CDC is providing educational materials to healthcare providers so that they can encourage their patients to get immunized. Accessibility to vaccines has improved now that many pharmacists can deliver adult vaccinations. Howis your pharmacy taking advantage of this campaign toimprove vaccination rates in adults?

For more information click here CDC

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Facebook medical advice isn’t what’s best for your child

From the 29 July 2013 KevinMD.com article

COURTNEY SCHMIDT, PHARMD | SOCIAL MEDIA | JULY 29, 2013

It happens about once a week. As I scroll through Facebook and peruse the latest happenings, I notice that someone (usually a mom of small children, like me) has posed a question to their Facebook friends about some type of health dilemma.

“Little Sally is cutting teeth, and she’s miserable. What can I give her to make her feel better?”

“Johnny has such a bad cough, and he can barely breathe. Anyone used Vick’s Vaporub on a baby before?”

“Took  Sam for his 4-month checkup today. Dr. says I should wait to start giving him baby food until 6 months, but I feel like he’s ready. Any moms have some advice?”

I’ve seen each of these health concerns voiced on Facebook along with many others. Various friends weigh in with their tidbits of advice or personal experience, and usually the mom will choose from those options and then report back about how that advice worked.

Here’s the problem: all health information isn’t created equal.

And crowdsourcing for medical advice isn’t likely to result in the best outcome for your child.

Although the Facebook community recommended several products for Sally’s mom to try to ease teething pain, they were likely unaware that many of these products are no longer recommended for infants because of serious health risks associated with their use.

While Johnny’s mom’s Facebook friends offered enthusiastic support for rubbing Vick’s VapoRub on his chest, feet, and even putting it under his nose, they didn’t know that this product can be harmful to children under two years of age.

Read the entire article here (which includes great Web sites for child health/medical information)

Related resources

• Caring for Your Baby and Young Child, 5th Edition: Birth to Age 5. Author: The American Academy of Pediatrics
• My Child Is Sick! Expert Advice for Managing Common Illnesses and Injuries. Author: Barton D. Schmitt, MD, FAAP
• Healthychildren.org
• Familydoctor.org includes health information for the whole family
• KidsHealth provides information about health, behavior, and development from before birth through the teen years.

How Marketing Has an Impact on Children’s Health

Related article

Best and Worst of Food Marketing to Our Children (Food, Facts, and Fads)

 

FTC Updates Report on Food Marketing to Children

The Federal Trade Commission (FTC) recently released a report entitled, “A Review of Food Marketing to Children and Adolescents,” which shows that food and beverage companies spent less in marketing targeted to children in 2009 than they did in 2006, and the food and beverages marketed to youth had very small improvements in nutritional quality during that period. Food companies spent $1.8 billion to advertise to children age 2 to 17 in 2009, down from $2.1 billion in 2006.

The report was an update to the FTC’s 2008 report, “Marketing Food to Children and Adolescents: A Review of Industry Expenditures, Activities, and Self-Regulation,” which documented the amount food companies spent on marketing targeted to youth in 2006.

The reduction can be attributed to a decline in advertising on traditional media such as TV, radio, and print; however, food companies increased their youth-targeted spending on other forms of marketing, including websites, internet advertising, viral/word-of-mouth marketing, product placements, movie and video ads, cross-promotion licenses, celebrity endorsements, events, and philanthropy. In addition, spending on food marketing to tweens and teens increased from 2006 to 2009.

“While there’s been progress in advertising to children age 2 to 11 on traditional media, children continue to see too many ads for products of questionable nutritional quality,” said Jennifer Harris, PhD, MBA, Rudd Center Director of Marketing Initiatives. “Companies have also shifted much of their spending toward a somewhat older child audience, including 12- to 14-year-olds, and into newer forms of marketing.”

“Industry has faced public and legal pressure as well as pressure from health experts to improve their practices,” said Kelly Brownell, PhD, Rudd Center Director. “The voluntary changes they made are only modest and they have stepped up marketing in some arenas. The pressure on industry to do more must continue.”

The FTC’s report was conducted as part of a Congressional inquiry into rising childhood obesity rates and aims to help public health experts, parents, and lawmakers understand the extent of food marketing to children.

 

Food Marketing to Youth: The Best and the Worst of 2012

Only $11.4 million was spent on marketing fruits and vegetables to youth in 2006, representing less than 1 percent of the $2 billion spent on all food marketing to youth, according to the National Fruit & Vegetable Alliance and Federal Trade Commission. Food and beverage companies use traditional forms of marketing, such as television advertising and promotions on product packages, but companies are increasingly using more unique and invasive techniques. The Rudd Center compiled a collection of thebest and worst examples of food marketing practices in 2012, including McDonald’s and Coca-Cola’s sponsorship of the Summer Olympic Games (worst) and Disney restricting junk food advertising to children (best).

 

Million Ideas

Lots of us hate to admit it, but marketing has a huge impact on what we buy, eat, and how we live our lives. While marketing and advertising affects all of us, children are especially impressionable. A good advertiser knows what will stick with kids, and they use every trick in the book. The junk food industry is no exception, and marketers understand that getting their message to children leads to big business. To show just how much of an impact marketing has on our children’s health, we reached out to teach.com and USC Rossier Online and borrowed their infographic, “Targeting Children With Treats.”

A huge thanks to Teach.com and USC Rossier Online for sharing the infographic!

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Childhood Poverty, Stress, May Shape Genes And Immune System

From the 22 October 2012 article at Medical News Today

A University of British Columbia and Centre for Molecular Medicine and Therapeutics (CMMT) study has revealed that childhood poverty, stress as an adult, and demographics such as age, sex and ethnicity, all leave an imprint on a person’s genes. And, that this imprint could play a role in our immune response. …

..

Known as epigenetics, or the study of changes in gene expression, this research examined a process called DNA methylation where a chemical molecule is added to DNA and acts like a dimmer on a light bulb switch, turning genes on or off or setting them somewhere in between. Research has shown that a person’s life experiences play a role in shaping DNA methylation patterns. ..

..

“We found biological residue of early life poverty,” said Michael Kobor, an associate professor of medical genetics at UBC, whose CMMT lab at the Child & Family Research Institute (CFRI) led the research. “This was based on clear evidence that environmental influences correlate with epigenetic patterns.” ..

[youtube=[youtube=http://www.youtube.com/watch?v=JaNH56Vpg-A]]

http://www.youtube.com/watch?v=S6tSndex0CM&feature%5D

Related articles

• Genes, Immune System Shaped by Childhood Poverty, Stress (dogmaandgeopolitics.wordpress.com)
• Kobor, CMMT study shows genes and immune system shaped by childhood poverty, stress (aplaceofmind.ubc.ca)
• New Study: Stress Increases Risk of Mental, Physical Illness (baktoedenherbalproducts.wordpress.com)

 

Pre-Teen Health Disparities

Logo of the United States National Library of Medicine. (Photo credit: Wikipedia)

From the (NLM) Director’s comments page 

Greetings from the National Library of Medicine and MedlinePlus.gov

Regards to all our listeners!

I’m Rob Logan, Ph.D. senior staff National Library of Medicine for Donald Lindberg, M.D, the Director of the U.S. National Library of Medicine.

Here is what’s new this week in MedlinePlus.

Harmful health behaviors and experiences are significantly more likely among African-Americans and Hispanic-Americans than white fifth-graders, suggests a pioneering health disparities study recently published in The New England Journal of Medicine.

In a study of 5,119 randomly selected public school fifth-graders (and their parents) in three U.S. cities, 20 percent of African-American fifth-graders witnessed a threat or injury with a gun compared to 11 percent of Latinos and five percent of white youngsters.

Several of the study’s 16 measures consistently suggest unhealthy experiences were more likely to occur among African-American and Hispanic American fifth-graders while therapeutic actions were more likely to happen to white peers.

For example, while white fifth-graders exercised vigorously an average of four and a half days per week, Latino youngsters exercised about 3.77 days and African-American fifth-graders vigorously exercised about three and a half days each week. All the above differences are statistically significant.

The authors assessed other unhealthy experiences including victimization by peers and unhealthy behaviors such as alcohol use. The authors evaluated other therapeutic behaviors including bike-helmet use…

Continue reading the transcript here

OR

Listen to the message here   –>podcast100812.mp3

Related articles

• New Study Shows School has Large Role in Kids’ Health Disparities (cityconnectsblog.wordpress.com)

Information Connections – website for parents of children with developmental disabilities and chronic diseases

 

From the web page at the National Network of Medical Libraries

Connect with Information Connections

By Nalini Mahajan
Director, Medical Library
Marionjoy Rehabilitation Hospital

Information Connections is a website for parents of children with developmental disabilities and chronic diseases with a special focus on Autism, Cerebral Palsy, Attention Deficit Hyperactivity Disorder, Down Syndrome, and Traumatic Brain Injury. The informative website was developed and launched by the Marianjoy Medical Library with funding from the National Network of Library of Medicine, Greater Midwest Region (NN/LM GMR) and is sponsored by Marianjoy Rehabilitation Hospital. It is accessible to anyone from anywhere and it is free.

Since its initial launch in April 2011, InformationConnections.org has helped thousands of families seeking help on these topics. Website usage and feedback in our first year has been exceptional.

We would love to promote our Web site to everyone who could benefit from this wonderful resource and would appreciate any help from you. Please spread the word around; like us on Facebook, follow us on Twitter, feel free to blog about us, and place a link to us on your website. Our goal is to have 500 friends by the end of 2012. Once we reach the magic number of 500 friends, 3 winners be selected randomly and each will receive a $25.00 gift certificate.

This entry was posted on Wednesday, August 29th, 2012 at 12:45 pm and is filed under Consumer Health, Funding, News from the Region, Outreach. You can follow any responses to this entry through the RSS 2.0 feed. You can skip to the end and leave a response. Pinging is currently not allowed.

 

 

[Reblog] Maternal Health and the Status of Women

[Reblog]

Maternal Health and the Status of Women

Both globally and domestically, maternal health and the standing of women are inextricably linked. If women do not have the means and access to give birth safely, with trained and educated midwives, physicians and nurses, with appropriate prenatal education and care, it is often indicative of the standing of women in their communities and countries overall. Women’s inequality is also linked to the soaring population growth in developing countries, which will pose a range of new challenges for the next few generations.

Some may point to the United States as an anomaly, citing women’s increasing economic and financial independence, education, and leadership roles in America, while in terms of maternal health rankings, we remain pathetically far down the line for our resources (49 other countries are safer places to give birth than the U.S. – despite us spending more money on healthcare than anywhere else). Of course, the recent and incessant attacks on allowing women to access credible, accurate, up-to-date and comprehensive sexual and reproductive health education and services makes this statistic not entirely…surprising, shall we say.

So, I found the incredibly detailed and visually impressive infographic by the National Post, pulled from spectacular data and research done by Save the Children to be particularly fascinating. What they did was combine information on the health, economic, and education status of women to create overall rankings of the best and worst countries for women, splitting the countries into categories of more developed, less developed, and least developed, and the countries were ranked in relation to the other countries in their category (the divisions were based on the 2008 United Nations Population Division’s World Population Prospects, which most recently no longer classified based on development standing). While these divisions and the rankings can certainly be contentious and may incite some disagreement (nothing unusual there, these kind of rankings usually are), I thought the results were interesting. Some highlights – Norway is first, Somalia is last. The United States was 19th, and Canada was 17th (Estonia fell in between us and the Great White North) in the most developed. Israel is first in the less developed category, and Bhutan is first in the least developed category. The full report with data from Save the Children is also available, if you want to learn more about the information combined to make this image. Take a look:

[larger image at http://larkincallaghan.files.wordpress.com/2012/07/best-and-worst-places-to-be-a-woman.jpg]

A Woman’s Place – Courtesy of the National Post

One thing that I thought was particularly great was that the researchers combined women’s health and children’s heath data to create rankings specific to being a mother, when that category is sometimes only assessed based on access to reproductive care.The specific rankings of maternal health highlights largely mimics the overall standing of women, as seen here – Norway is number one, again, and Niger falls into last place:

Mother’s Index, Courtesy of Save the Children

I think these images and graphs are particularly moving given one of the top health stories coming out of the New York Times today, which showed that a recent Johns Hopkins study indicated meeting the contraception needs of women in developing countries could reduce maternal mortality (and thereby increase the standing of women in many of the nations doing poorly in the above ranking) globally by a third. When looking at the countries in the infographic that have low rates of using modern contraception and the correlation between that and their ranking in terms of status of women, it’s not surprising what the JH researchers found. Many of the countries farther down in the rankings have rates below 50%, and for those countries filling the bottom 25 slots, none of them even reach a rate that is a third of the population in terms of contraceptive use – which of course in most cases has to do with availability, not choice. Wonderfully, the Gates Foundation yesterday announced that they would be donating $1 billion to increase the access to contraceptives in developing countries.

Also of note, and in relation to maternal and newborn health, is a new study recently published by Mailman researchers that showed PEPFAR funded programs in sub-Saharan Africa increased access to healthcare facilities for women (particularly important for this region, as 50% of maternal deaths occur there), thereby increasing the number of births occurring in these facilities – reducing the avoidable (and sometimes inevitable) complications from labor and delivery, decreasing the chance of infection and increasing treatment if contracted. This has clear implications for children as well (and why I think this study relates to the National Post infographic and the NY Times article), since newborns are also able to be assessed by trained healthcare workers and potentially life-threatening conditions averted – including HIV, if the newborns have HIV+ mothers and need early anti-retroviral treatment and a relationship with a healthcare worker and system. And it goes without saying that if a new mother is struggling with post-delivery healthcare issues, including abscesses and fistulas, or was dealing with a high-risk pre-labor condition like preeclampsia, the child will have an increasingly difficult early life, perhaps even a motherless one.

Related articles

• The Best And Worst Places In The World To Be A Woman (fastcoexist.com)
• Maternal health: India likely to miss milennium goals, says UN (thehindu.com)
• Contraceptive Use Averts 272,000 Maternal Deaths Worldwide (jflahiff.wordpress.com)
• Mothers lose out (thehindu.com)
• 100,000 Women’s Lives Could Be Saved By Expanded Access To Contraception (thinkprogress.org)
• Rich countries pledge $2.6bn for family planning in global south (guardian.co.uk)
• Melinda Gates challenges Vatican by vowing to improve contraception (guardian.co.uk)
• Fulfilling Contraception Needs Could Lower Maternal Mortality Drastically, Study Says (nytimes.com)
• Maternal Mortality Rates Could Tank If We Meet Contraception Needs in Developing Countries [Contraception] (jezebel.com)

The conundrum between maturity and ADHD

Symptoms of ADHD described by the literature (Photo credit: Wikipedia)

I’ve often wondered if populations and sub-populations can be over-diagnosed or misdiagnosed.
At times this can happen with good intentions, sometimes I fear for the sake of profit….

From the 10 April posting by MATTHEW TOOHEY, MD at KevinMD.com

A recent Canadian study showed that the youngest children in each grade (born in the earliest month of the Canadian grade cutoff: December) were 30% more likely to be diagnosed with ADHD than the oldest children (born in January). For girls, who overall have a lower incidence of ADHD, the difference was even more pronounced: 70%.

Interestingly, the overall rate of ADHD diagnosis in the sampling of children from this Canadian study (900,000 children) was 6.9% for boys and 2.2% for girls. Rates of diagnosis here in the United States are much higher, creeping up on 10% of all children.

What does all of this mean? Well, you can look at this data many different ways, depending on your point of view and feelings about ADHD, but it stresses to me what seems to be common sense: many factors play into our expectations of what normal behavior should be.  It is often the school which prompts parents to have their child evaluated for attention problems and this comes from a comparison to other children in the class. A six year old may be significantly less mature or able to stay on task than a seven year old. Likewise, boys tend to have more trouble with the expectations of the school environment than girls in the younger grades….

Related articles

• Are kids being diagnosed with ADHD just for being young? [Medicine] (io9.com)
• Is Immaturity Being Mistaken for ADHD? (children.webmd.com)
• Youngest kids in classroom more likely to be diagnosed with ADHD: UBC study (news.nationalpost.com)
• Legal Drug-Pushing: How Disease Mongers Keep Us All Doped Up – John-Manuel Andriote – Health – The Atlantic (jflahiff.wordpress.com)
• Current psychiatric drugs are only marginally effective(jflahiff.wordpress.com)
• Seven Ways Medical Conflicts of Interest Are Disguised
  (jflahiff.wordpress.com)