Bicycle-Related Injuries, Childhood Obesity, Easing Pain – PediaCast 064

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Announcer: This is PediaCast.


Welcome to PediaCast, a pediatric podcast for parents, the News Edition. And now direct from BirdHouse Studios, here is your host, Dr. Mike.

Dr. Mike Patrick: Hi, everyone, and welcome to PediaCast. It#39;s Episode 64 for Thursday, October 18, 2007.

Day Care, Aggressive Toddlers and Easing Pain, of course, we#39;ll have a couple of others story for you as well. Well, let#39;s see. What do we have?

NFL players Combat Childhood Obesity, Update on Bicycle-related injuries , so those are the other stories. We have five of them coming your way.

Now most of you know that I#39;m kind of a sports fan, for specific sports. We don#39;t get to all of them.


I have been watching the baseball playoffs. And we#39;re fairly good Cleveland Indians fans. I don#39;t know, during the last season, the last few years. We haven#39;t really watched them too much.

My in-laws had season tickets to the Indians back in the 90s, when they were always right up there in contention and almost winning and they went to the Word Series one year. In fact, we went to one of those games in Cleveland.

So, anyway, we#39;ve been kind of on-again and off-again fans. Didn#39;t really follow them much this year but we have been watching the playoffs with the Indians versus the Red Sox. I am actually getting somewhere with this story.

But we#39;ve been watching it with the kids. I know there#39;s some special about October, watching baseball with the kids or staying up a little bit later watching the games. It#39;s really nice family moment.

There#39;s just one problem with it , enough of the erectile dysfunction commercials already.


I mean, I am so tired of seeing a quot;Cialisquot; commercial at every single commercial break. You#39;re sitting there with your family and they#39;re talking about , quot;With Cialis, you can be ready fast, or you can have up to 36 hours to relax and take your time. Ask your doctor if you are healthy enough to engage in sexual intercourse. And if you experience an erection lasting more than four hours,quot; , I mean, with every single commercial break.

OK, fine. You have to sit there in the living room with the kids. I may be a pediatrician but I#39;m a regular guy parent, too. It#39;s not the most comfortable thing hearing that, especially at every commercial break. [Laughter]

All right. We better move on. Don#39;t forget if there#39;s a topic you would like us to discuss or you have a lead on a new story or the interview of the century, or even if it#39;s just a regular interview, just let me know., click on the Contact link or you can email Our voice line is 347-404-KIDS. That#39;s 347-404-K-I-D-S.


And don#39;t forget the information presented in PediaCast is for general educational purposes only. We do not diagnose medical conditions or formulate treatment plans for specific individuals.

If you have a concern about your child#39;s health, call your doctor and arrange a face-to-face interview and hands-on physical examination.

Also, your use of this audio program is subject to the PediaCast Terms of Use Agreement, which you can find at

And with that in mind, we#39;ll be back with News Parents Can Use right after this break.

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Our News Parents Can Use Edition is brought to you in conjunction with News Partner, Medical News Today, the largest independent health and medical news website. You can visit them online at

Day care attendance early in life seems to protect infants and young children from later developing asthma, so says a recent study published in the Journal of Allergy and Clinical Immunology.

Researchers examined the relationship between the age at which day care attendance begins and the amount of immunoglobulin E or IgE in a child#39;s blood.

IgE is an antibody produced by the immune system and an indicator of allergic sensitivity. The study revealed that children who begin day care by age three months have low IgE levels, meaning they have low sensitivity to allergic triggers.


This translates to less chance of developing allergic nasal congestion and asthma. Furthermore, IgE levels of day care children remain low through age three. Children who stayed at day care facilities had significantly lower IgE levels than kids who stayed home.

The authors speculate regular exposure to microorganisms and environmental antigens from two different environments may play a role in immune development and supports the idea that there may be a critically short period of time when such exposure can guide the immature immune system to develop on a health path.

So there you have it , an apparent advantage to having your infant or toddler in a day care setting.

Sure they may get sick more often with colds and viruses, but as we#39;ve talked before , you know they#39;re going to get sick with those same cold viruses when they start regular school or as an older child or teenager.


Anyway, so we say day care centers are bad for babies, but here#39;s a study that shows maybe they have some advantage.

OK. Research looking at the development of aggressive behavior in toddlers may help to prevent anti-social and even criminal behavior in later life. This is according to scientists at the National Academy of Science in the United Kingdom.

Dr. Richard Tremblay, professor of Pediatrics, Psychiatry and Psychology at the University of Montreal will present research at the Scientific Meeting on the Neurobiology of Violence, highlighting that young children do not learn to be aggressive. Instead as they get older and their brains mature, they become less aggressive by learning to control their behavior.

Children learn to regulate the use of physical aggression during the pre-school years, making this time a critical period in which to intervene in order to prevent violence in later life. Those that don#39;t learn to control their behavior in early childhood stand a higher chance of becoming aggressive adults.


Dr. Tremblay said, quot;Developmental studies show that infants, aged three to four years old, are more physically aggressive than adults. Learning how not to be violent, which mostly takes place during the preschool years, is dependent on both genetic and environmental factors.quot;

This range from the type of parent#39;s care a child receives to whether kids are from mother smoked when pregnant. The research has shown, for example, that nicotine affects areas of a baby#39;s brain, which are responsible for emotional control.

The early years of human development are on fast forward and it is during this time period that physical aggression increases most dramatically. And environment plays a very important role and the extent to which physical aggression develops or is controlled.

Dr. Tremblay also says, quot;Physical aggression in children is a major public problem. It is not only an indicator of aggression in adulthood but it also leads to other serious behavioral problems, such as alcohol and drug abuse, violent crimes and continues the cycle of abusive parenting.quot;


Identifying factors which stopped children from becoming well socialized adults should help us design preventative measures, which are employed at a right time in a child#39;s development. This should put an appropriate emphasis on the behavior of the parents, as well as that of that child.

Furthermore, the research highlights the role that parents have in determining their children#39;s violent behavior. Children at highest risk of not learning to regulate physically aggressive tendencies have mothers with a history of anti-social behavior during their school years.

These mothers typically had children at an early age, often smoked during pregnancy and have low income combined with troubled family relationships. So it#39;s important to teach toddlers how to control their behavior because at some point, it may become too late to do so effectively.


A new study, conducted by researchers at the Center for Injury Research and Policy at Nationwide Children#39;s Hospital, concludes that bicycle-related injuries among children and adolescents in the U.S. maybe a more significant public health concern that previously estimated.

This study, published in the October issue of Injury Prevention, estimates that bicycle-related injuries among children and adolescents result in nearly $200 million in hospital inpatient charges annually.

Children and adolescent aged 20 years and younger compromised more than half of the estimated 85 million bicycle riders in the U.S. It has been long known that bicycle-related injuries result in more emergency department visits for children than any other recreational sport.

However, this study looks beyond emergency department visits to examine hospitalizations and estimates that approximately 10,700 children are hospitalized annually for a bicycle-related injury in the U.S., with an average length of stay of three days.


Bicycles are associated with more childhood injuries than any other consumer product, except the automobiles, said Dr. Gary Smith, Director of the Center for Injury Research and Policy and Faculty Member at the Ohio State University College of Medicine.

The high rate of hospitalization and use of health care resources identified in the study supports the need for increased attention to bicycle-related injuries.

This study is the first of its kind to analyze patient and injury characteristics associated with bicycling injuries utilizing a nationally representative sample.

Among the significant findings, motor vehicles were involved in approximately 30% of bicycle-related hospitalizations and the association with motor vehicles increased among older children.

Moreover, one-third of children hospitalized for a bicycle-related injury were diagnosed with traumatic brain injury, the statistic that is significant for its correlation to the number of injuries that maybe preventable through the use of bicycle helmets.


The findings from our study can be used to promote targeted prevention strategies to lessen the severity of injury and the number of deaths resulting from pediatric bicycle-related accidents, Smith said.

We know that bicycle helmets can reduce the risk of brain injury by up to 85%. We need to increase efforts to promote helmet use by children riding bicycles.

So parents, do your children wear helmets when they ride the bicycles? They should and you should, too.

The U.S. Department of Health and Human Services, the Ad Council and the National Football League will join to launch a new series of national public service advertisements designed to combat childhood obesity by encouraging physical activity among children.

The new ads, which feature NFL players Reggie Bush of the New Orleans Saints, Antonio Gates of the San Diego Chargers and Jason Whitten of the Dallas Cowboys, urge families to quot;get up and play an hour a day.quot;


The PSAs will be unveiled this morning during the NFL#39;s United Way Hometown Huddle Event in New Orleans, part of the NFL#39;s National Day of Service. The ads will also air during NFL games throughout the football season.

quot;A healthy amount of physical activity can be fun, and kids can do it with games , on the playing field or in other ways,quot; says Acting Surgeon General Dr. Steven Galson. quot;Seeing some of America#39;s elite athletes promoting these good health habits could encourage American kids and families to be active, too.quot;

To quot;Be a Playerquot; multimedia ad campaign, which encourages children to quot;get up and play an hour a day,quot; , I like that. It#39;s got a little ring to it, doesn#39;t it? It is an extension of the Health and Human Services Obesity Prevention Campaign that launched in 2004 in the Ad Council#39;s coalition for healthy children initiative.

The campaign message is also an important part of the NFL#39;s quot;Play 60quot; Youth Health and Fitness initiative, a multi-year campaign, which launches today to encourage youth to achieve 60 minutes of activity each day.


The public service announcements are available in both English and Spanish and were created pro bono by the NFL and Curious Pictures. The PSAs are being distributed to media outlets nationwide this week.

Per the Ad Council#39;s model, all of the new ads will air and run in advertising time and space donated by the media. To start, the PSAs will appear throughout NFL games beginning in the middle of October.

Additional media outlets including quot;USA Todayquot; and quot;Sports Illustratedquot; have committed to support the campaign during the next few months.

The new public service announcements aim to reach children ages 6 to 13 to communicate the message that physical activity is fun and easy, and you do not need to be an athlete to join organized sports or to join organized sports to stay healthy.

In addition to the NFL players, the ad introduced new animated NFL characters [Laughter] , aren#39;t they all little animated?


Mike quot;Good Mannersquot; McMannis, a referee who flags kids for quot;lazy penaltiesquot; and Wanda, a superhero-like cheerleader who joined the players and urging children to quot;get up and play an hour a dayquot;.

The characters will be featured in upcoming NFL youth fitness initiatives throughout the season. The new public service announcements encourage youth to visit and for fun interactive experiences to get healthy and be active.

Those sites include information to keep kids fit, including NFL player blogs , careful kids; moms, you may want to check those out first , also games, wallpapers and activities.

In addition to the new NFL spots, Ad Council continues to promote to quot;Be a Playerquot; physical activity message, along with communications focused on portion control and energy balance, through its quot;Coalition for Healthy Childrenquot;.


The coalition harnesses the combined strengths of major marketers, media, non-profit, and government partners to combat childhood obesity through the dissemination of consistent, research-based messages to parents and children.

This unique collaboration utilizes a national research study to evaluate progress and determine the effects of coalition members#39; initiatives.

For more information about the Childhood Obesity Prevention campaign and to learn how adults and children can learn to lead a healthier lifestyle, log on to and

And, of course, we#39;ll have links to those sites in the Show Notes at

A new system under development by a team of researchers at the University of Iowa will help children better cope with pain during medical procedures. The system works by using a Web-based software to advice nurses on the best way to distract children from the procedures that cause the pain.


The distractions could be anything from having a book read to them, watching a video, talking or playing a game. The research team, led by Professors Ann Marie McCarthy and Charmaine Kleiber in the University of Iowa College of Nursing developed the software after analyzing data from a multi-site research study that observed parents interacting and distracting their children, who are undergoing painful procedures.

The study helped the researchers determine how children cope with pain and what distractions worked best to keep their minds off of the discomfort.

Children between the ages of 4 and 10 at the University of Iowa Children#39;s Hospital participated in the study. Data was collected from 542 subjects, all of whom were having an IV line inserted while a video camera recorded the event.

The data was collected by having parents and children complete questionnaires and by analyzing video tapes of the procedures. Members of the research team reviewed the video and graded the children#39;s distress.


Children who experienced more pain and had more difficulty coping received the higher scores. Children were also able to report how painful the procedure was by using a scale with happy and sad faces on it.

quot;We#39;re now using that data to build software that would determine the best strategy for distracting a child from the procedure based on what we know about the child and the type of procedure,quot; said Nick Street, a Professor of Management Sciences who mined the data and is also working on the software.

The computer program will also determine the parent#39;s capacity for providing the distraction.

quot;Now parents are equally cut out for helping their children through medical procedures,quot; said Professor McCarthy.

Sometimes it might be best to bring in a distraction coach who has special training to keep the kids occupied.

A distraction coach , yes, folks, you heard me right. Some parents need a distraction coach. God, help them.


quot;The distraction,quot; she said, quot;are anything that captures the attention of the child so that they focus on the distraction and not on the procedure, such as reading a book, talking about school, coloring, or drawing.quot;

quot;In pain management one size doesn#39;t fit all,quot; McCarthy said. quot;Some children need intensive destruction, some might need none at all.quot; And some might ignore your distraction all together. That was my comment.

This software will tell the nurse what group each child should be in and what type of intervention to provide. McCarthy said the long-term health effects of making it easier for children to cope with pain could be profound.

quot;This is important because more than 4 million children require painful medical procedures and we know undergoing those procedures can affect health care decisions later in life,quot; said McCarthy.

quot;If we can provide the distraction, then the children are more likely to find the event to be less traumatic and are less likely to undergo serious psychological trauma.quot;

The next step in the research will begin in January, when researchers will pilot the software to determine what types of distractions work best with different parents and children.


Street said the software asks a brief series of questions of the children and their parents about such things as previous experiences with procedures and pain, parenting styles, and anxiety issues.

Based on the answers and the type of procedure, the software will suggest a distraction strategy to the nurse and recommend whether the parents should do the distracting, or a coach should be brought in.

McCarthy said researchers will observe 580 subjects over 30 months during the next phase of research. The children will be patients at the University of Iowa Children#39;s Hospital in Iowa City, Blank Children#39;s Hospital in Des Moines and Cardinal Glennon Children#39;s Hospital in St. Louis.

So if you like kids and you#39;ve always dreamed of becoming a distraction coach, you now know where to sign up.

All right. That wraps up our News Parents Can Use today and we#39;ll be back to wrap up the show right after this.

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As always thanks go out to Medical News Today for helping us out with today#39;s news show, also to Vlad over at

And don#39;t forget we have lots of other things other than just the podcast for you. The Pediascribe blog, you can get to it in the side bar of the Show Notes, or you can go directly to

And at Pediascribe , it#39;s a parenting blog done by my wife, Karen.


So if you haven#39;t checked that out, you should. She always has something interesting and usually somewhat funny [Laughter] to say. It#39;s not just parenting, some of it just life observations as well.

Reviews in iTunes are most helpful, if you haven#39;t done that yet. And we also have the poster page and the PediaCast shop , those are all at the website at

We#39;ll answer more of your questions tomorrow in our big Friday wrap up show.

And until then, this is Dr. Mike saying, stay safe, stay healthy and of course, stay involved with your kids.

So long, everybody!

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