Contact Lenses, Puberty In Girls, Prescription Painkillers – PediaCast 086

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Announcer 1: This is PediaCast.

Dr. Mike Patrick: Bandwidth for PediaCast is provided by: Nationwide Children's Hospital — For every child, for every reason.

[Music]

Announcer 2: 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's Episode 86 for Monday, November 26th, 2007 — Baby Social Skills, Contact Lenses, and Teenage Drug Use — plus a couple of other news stories for you, as well.

I hope everyone had a wonderful Thanksgiving weekend. I know, speaking for myself, I ate way too much. There are just too many dinners, too many places to go and too much food. Just wretched excess. And of course, I didn't really exercise during the entire four-day weekend, so that didn't help at all.

But we did a have a great time spending it with family. I even went on a big family bowling outing. Now, I have to tell you, I'm not a bowler.

[Laughter]

Dr. Mike Patrick: I come from a long line of bowlers. There are a lot of bowling people in my family. I'm not sure if I'm proud to admit that or embarrassed to, but I'm not one of them. They put me on a bumper lane with the kids and I didn't break 100. I know, that is really sad. I realized this, Wii bowling, I'm so much better at that. Bowling on the Wii, that's the way to go.

All right, we're going to talk about babies preferring helpful to unhelpful social types — it's kind of interesting. Even minute levels of lead cause brain damage in children. Contact lens wear improves how children and teens feel about their appearance and also their activity participation in sports. The impact of family conditions on puberty in girls and Canadian teens using prescription pain killers for recreational purposes — that's all coming up in our News Parents& Can Use segment right after the break.

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Don't forget, if there's a topic you would like to hear about or if you have a question for me — an interview or a research article, news or whatever, if it's just something you want to tell us about — just go to pediacast.org or click on Contact link. Or you can email pediacast@gmail.com or call the voiceline at 347-404-KIDS. That's 347-404-K-I-D-S.

Don't forget, the information presented in every episode of 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'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 pediacast.org.

And with that in mind, we will be back with News Parents Can Use right after this break.

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Dr. Mike Patrick: OK, I'm going to tell you right from the get-go here that I have a little bit of a sore throat. Now, fortunately, you can't catch it through my podcast. My point here is that I don't know if I'm going to make it to the entire news without taking a sip of water. So I'm going to do my best but, you know, if I have to take a pause and sip — and I'm not going back and editing it because I got too much to do tonight.

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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. And you can visit them online at medicalnewstoday.com.

A study led by Yale researchers in the United States revealed that babies less than one year old can tell the difference between helpful and unhelpful social types and show a preference for the helpful ones.& The study is the work of Kiley Hamlin, a graduate student at Yale University in New Haven, Connecticut and is published in the November 22nd issue of the journal, Nature. The researchers showed that babies aged six months and ten months who observed a puppet show could tell the difference between the helpful and unhelpful character, even though the events did not affect them directly.

After watching the show, the babies demonstrated a preference for the character who helped one of the puppets who was trying to climb a hill, and did not demonstrate a preference for the character who behaved in an unhelpful manner by hindering the progress of the climber. Hamlin said, "We knew babies were socially skilled, but we weren't aware they were so skilled they could track people by their behavioral tendencies or how they might treat someone else."

The babies watched a puppet show where a colored round wooden block with googly eyes tried to climb a steep hill with little success. There were two scenes: one where the climber puppet was helped by another good Samaritan puppet, who gave him a friendly push up the hill; and another where an evil puppet shoved the climber back down. After the puppet show, the babies were given the opportunity to reach out for either the helpful puppet or the unhelpful puppet. Nearly all the babies reached for the helpful one. The researchers said this suggested that babies were able to distinguish between the puppets. They also showed a tendency toward the positive helper.

Hamlin also added, "We were shocked by the strength of the response. We thought infants would be sensitive to the behavior of others, but didn't anticipate the extent of this." The researchers said the effect was not so strong when they removed the googly eyes from the puppets, suggesting the babies identified with them as characters only when the googly eyes were attached.

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Now, I just love saying that word — googly.

Researchers performed a second experiment where the babies watched another puppet show where the climber appeared to make friends with either the helpful or the unhelpful puppet. The older babies spent more time watching the show when the climber approached the unhelpful character, as though this was more surprising to them.

OK, that's definitely a jump.

[Laughter]

Dr. Mike Patrick:& You know, do you know that for sure? You don't know what's going through their heads.

OK. But anyway, Hamlin and colleagues concluded that these findings constitute evidence that pre-verbal infants assess individuals on the basis of their behavior toward others. This capacity may serve as the foundation for moral thought and action, and its early developmental emergence supports the view that social evaluation is a biological adaptation. The researchers said the results suggest that the older babies are able to make sophisticated conclusions about social interactions, attitudes and motives from observing the behavior of others. While there has been a lot of hearsay about parents knowing this, it had never been tested before.

Speculating on their findings, the researchers suggested the ability to choose between nice and nasty people could be innate. Having a hard wired tendency to favor helpful over unhelpful people could confer positive social advantage to a growing child. Hamlin said, "Just by spending more time with positive people, they might get a different set of learning inputs than if they spent time with negative people, and over time you can see that could have a real influence on their development."

OK, sip of water time here. Just bear with me.

OK. Sorry about that, I really am. But you know, it's a podcast. &

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Even small amounts of lead in children's blood — amounts well below the current federal standard — are associated with reduced IQ scores, that's according to a new six-year Cornell study. The study examined the effect of lead exposure on cognitive function in children whose blood-lead levels were below the Centers for Disease Control and Prevention's standard of 10 micrograms per deciliter or about 100 parts per billion. The researchers compared children whose blood-lead levels were between 0 and 5 with children in the five to ten range.

"Even after taking into consideration family and environmental factors known to affect a child's cognitive performance, blood-lead played a significant role in predicting non-verbal IQ scores," says Richard Canfield, a senior researcher in Cornell's Division of Nutritional Sciences and senior author of the study which was published in the journal, Environmental Health Perspectives. "We found that the average IQ scores of children with blood-lead levels of only 5 to 10 were about five points lower than the IQ scores of children with blood-lead levels less than 5. This indicates an adverse effect on children who have a blood-lead level substantially below the CDC standard, suggesting the need for more stringent regulations."

In the United States, over the last several months, nearly 50 specific products — including millions of toys for young children — have been recalled due to excessive lead in the paint, plastics and metal. "Our findings emphasize the very real dangers associated with low-level exposures, to which lead in toys can contribute," Canfield said. US children are exposed to lead primarily from household dust contaminated by deteriorating interior lead-based paint. In addition to toys, other potential sources include contaminated soil, imported food — especially those stored in lead-glazed pottery — and certain plastics, metallic and painted products.

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This most recent finding builds on the same research team's influential 2003 study, published in the New England Journal of Medicine, that reported adverse effects of blood-lead levels below 10 in a group of children followed from infancy to age five. "Our new findings are based on follow-up testing of the same children at age six using a more comprehensive IQ test to assess cognitive function. The results provide compelling evidence that low-level lead exposure has effects into the school-age years," add Todd Jusko, a University of Washington PhD candidate in epidemiology and co-author on both reports.

"Children living in poverty disproportionately suffer from elevated blood-lead levels," said statistician and co-author Charles Henderson, a Cornell senior researcher in human development. He also noted that even a small decline in an IQ score is likely to be reflected in aptitude test scores such as the SAT.

According to the CDC, about one out of every 50 children in the United States between ages one and five has a blood-lead level above 10& and about 10%& of children have blood-lead levels of 5 or higher. And, about 25% of US homes with children under the age of six do have lead-based paint hazards in the home.

"The bottom line," according to Canfield, "is that lead is a persistent neurotoxin that causes brain damage. The fact that lead has been found in millions of toys, even toys specifically designed for children to put into their mouths, presents an unacceptable risk. Our findings suggest the need to re-evaluate the current federal standards for lead in consumer products and the current definition of an elevated blood-lead level in children."
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Compared to glasses, contact lenses significantly improve how children and teenagers feel about their appearance and participation in activities, a newly-published study shows. These quality of life improvement measures following a switch from glasses to contacts indicate that children eight to 12 years of age who require vision correction should be given the option of being fitted with contact lenses, say study investigators. Researchers reported the results of the study in the November issue of Eye & Contact Lens, the official publication of the Contact Lens Association of Ophthalmologists.

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Teenagers are frequently fitted with contact lenses to correct refractive errors by eye care practitioners. But children younger than 13 are generally not given the option of contact lens wear, often because eye care practitioners or parents believe that children don't have the maturity to properly care for them. "But children as young as eight years old who need vision correction are as capable as teenagers at wearing and caring for soft contact lenses and should be presented with the option of contact lens wear when vision correction is required," says Dr. Jeffrey Walline from the Ohio State University College of Optometry and study leader of "The Contact Lens in Pediatrics Study".

This research demonstrates that both children and teenagers derive a number of quality of life benefits from contact lenses, which leads to greater satisfaction with their vision correction. "Contact lenses often provide a more convenient mode of correction for young wearers and the study demonstrates that both children and teenagers can adapt to contact lens wear and derive similar benefits," adds Dr. Mary Lou French, a private practitioner in Orland Park, Illinois. "With a wide variety of contact lenses available, eye care practitioners can work with young patients and their parents to determine what modality best fits each child's personality, maturity and lifestyle."

The Contact Lens In Pediatrics Study is the first clinical investigation to look at pediatric use of contact lenses. The study compared the function and quality of life benefits of contact lenses among first-time wearers ages eight to 17. Participants completed the Pediatric Refractive Error Profile survey at the baseline visit wearing glasses, and at the one-week and one-month visits while wearing contact lenses. This profile survey compares the vision-specific quality of life between children wearing contact lenses and children wearing glasses. The scores are calculated on a scale that ranges from zero or poor quality of life to 100 or excellent quality of life.

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Participants were also asked other questions like how they felt about wearing contact lenses during sporting events. Ninety-six percent of children and 93% of teenagers said they loved or liked to wear contact lenses during sports. When asked about their sporting performance, 59% of children and 62% of teens felt their performance was 'much better' or 'better' while wearing contact lenses.

When asked which they liked better, 71% of children and 79% of teenagers said they liked wearing contact lenses 'a little better' or 'a lot better' than glasses. Children said that they 'always' or 'usually' like to wear their contact lenses 77% of the time, and teens reported the same 85% of the time. After three months of contact lens wear, the children wore their contact lenses an average of 11 hours per day.

Other study parameters examined included short-term safety, vision correction, fitting and training time, and a series of questionnaires completed by patients and their parents. The three-month study was conducted at three sites — the Ohio State University College of Optometry, the New England College of Optometry and the University of Houston School of Optometry. The study was sponsored by Vistakon, a division of Johnson & Johnson Vision Care, who just happens to make contact lenses.

I'm all about full disclosure here, folks.

All right, early puberty in girls has been found to negatively affect these teenagers' health in areas such as mood disorders, substance abuse, adolescent pregnancy, and cancers of the reproductive system. Given these findings, it is critical to understand why certain adolescents are at increased risk for early puberty in order to develop effective early intervention and prevention strategies for high-risk youths. New research shows that greater support from mothers and fathers, as well as less marital conflict and depression can lead to later onset of puberty. The findings from researchers at the University of Arizona and the University of Wisconsin-Madison are published in the November-December 2007 issue of the Journal of Child Development.

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The researchers sought to test and extend a 1991 model, developed by researcher Jay Belsky and colleagues, of the role of family ecology in speeding up or slowing down puberty in girls. According to Belsky's theory, children's early experiences affect how they mature with certain stressors in and around the family creating conditions that speed puberty as well as sexual activity. These stressors include marital conflict, negativity and coercion in the parent-child relationship and a lack of support between parents and children. According to the theory, children adaptively adjust their sexual development in response to the conditions in which they live.

To test this theory, the researchers investigated the effects of stressors on the timing of children's development by examining families of 227 preschool children over a period of time. Specifically, they looked at the families' socioeconomic conditions, marital conflict, parental depression, and supportive versus coercive parenting through interviews with both mothers and fathers. The study followed the children through middle school, testing the first hormonal changes of puberty, which is the awakening of the adrenal glands, in a 120 of the children when they were in first grade, and the development of secondary sexual characteristics — such as breast budding and the growth of body hair — in 180 girls when they were in the fifth grade.

Children living in families with greater parental supportiveness from both mothers and fathers and less marital conflict and depression experienced the first hormonal changes of puberty later than other children, the researchers found. In addition, children whose mothers had started puberty later — a genetic factor — whose families were better off when the children were in preschool, whose moms gave them more support when they were in preschool, and who had lower Body Mass Index or BMI when they were in third grade developed secondary sexual characteristics later than their peers.

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"Consistent with the theory, quality of parental investment emerged as a central feature of the proximal family environment in relation to the timing of puberty," according to Bruce Ellis, associate professor of Family Studies and Human Development at the University of Arizona and the lead author of the study. "These results replicate and extend previous longitudinal studies indicating that higher levels of positive investment and support in family relationships in preschool predict lower levels of pubertal maturation in daughters in the seventh grade."

So, kids having good, great home environment with low stress and with a good parent-child relationship and less depression, if they're in that kind of environment, it looks like puberty is delayed a little bit. And the good thing about puberty being delayed a little bit is because early puberty is associated with problems — and lots of problems actually –& such as mood disorders, substance abuse, adolescent pregnancy and cancers of the reproductive system.

So, just a little summary there for you because it seem it was getting a little confusing in the middle.

All right, and finally, 21% of Canadian teenagers in grades 7 through 12 said in a survey that they had used prescription painkillers — opioid drugs — such as Tylenol number 3 and Percocet at least once during the previous twelve months for recreational purposes. The survey, carried out by the Centre for Addiction and Mental Health in Toronto interviewed teenagers in Ontario. Approximately three-quarters of these teenagers said they obtained the painkillers from their homes.

OxyContin was the only drug to show a significant, albeit small, increase in non-medical use since the previous survey. In 2005, 1% reported using it, compared to 2% in 2007.

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The surveyors were encouraged to find that there was no increase in the uptake of other drugs, saying that this may be because of effective health promotion initiatives that have been in place over a number of years. Louis Gliksman, Acting Chief of Research and study spokesperson, said "The reasons for the increase in OxyContin use are currently unknown, and we need to monitor this finding to determine whether it is a real trend or a one-time finding. However, the finding that 72% of the students report obtaining the drugs from home suggests that some intervention with families might be appropriate."

Students still opt for alcohol as their drug of choice, the report explains. Approximately 61% of all the students surveyed consume alcohol. About 26% of students binge drink, and in this report, binge drinking means consuming five or more alcoholic drinks in one session. Nineteen percent of students may be drinking hazardously — the same proportion as in 2005 — and drinking hazardously means doing so in a way that significantly raises your chances of having social, psychological and physical problems.

Not really specific there, is it?

Twenty-six percent of the students said they had consumed cannabis or marijuana at least once during the previous twelve months, a slight drop on previous years. And 14% of all students said they had consumed cannabis at least six times during the past twelve months. A higher number of students said they drove a car after using cannabis than those who had consumed alcohol. Just 5% of all the students said they smoked cigarettes regularly, while 72% had never tried a cigarette ever. In fact, the prevalence of daily smoking is at its lowest since 1977, when records began. Today, 12% of students smoke cigarettes regularly.

Gail Czukar, Vice President of Policy, Education and Health Promotion, said, "The survey indicates that it is not the illegal drugs, but rather the legal drugs such alcohol and prescription opioids, that are being used by Ontario's youth today. And our government's efforts to address substance use among youth need to be in sync with that reality if we want to improve the health of our young people."

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The survey also revealed 4% of students use over-the-counter sleeping medication, 3% use Jimson Weed, 1% use ADHD medicines for non-medical use. Speed or methamphetamine and crystal meth or crystal methamphetamine does not seem to have made any inroads into the student population. In fact, speed consumption dropped from 2% of all students in 2005 to 1% in 2007.

Three percent of students consumed cannabis every day during the four weeks prior to the survey. About 27,300 students in grades 7 through 12 were in that category. Approximately 28,700 students in Ontario which is 3% may have a cannabis dependence problem. Fifteen percent of all students said they got drunk at least once during the previous twelve months and 21% either sold, offered or were given drugs at school.

The survey, called the Ontario Student Drug Use and Health Survey, is Canada's longest running school survey of teenagers, describing drug use and changes since 1977.

So, you know, the reason I do this article, this particular one, is I think it's important. I mean, OK, it's Canada that we're talking about. I don't think the numbers are going to be all that different in the United States. I mean, can you believe that 21%, I mean a fifth of all kids, teenagers in grade 7 through 12 said that they had used prescription painkillers such as Tylenol number 3 and Percocet, at least once during the previous 12 months for recreational purposes. A fifth of all kids!

So some of you in the audience with teenagers, your kids are doing drugs. And do you know about it?

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OK, we're going to take a break and we'll come back and wrap up this part of the show right after this.

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Dr. Mike Patrick: All right, thanks to all of you for joining us today and listening to PediaCast, the News Edition. And especially, thank you for putting up with my throat clearing and sips of water and all these things. I really appreciate it.

Also, thanks go out to Nationwide Children's Hospital for providing the bandwidth for our program, Medical News Today for helping with content, and Vlad Studio at vladstudio.com for providing the artwork. And, of course, thanks to my family.

And speaking of my family, the PediaScribe blog post I'm highlighting today is called "If I'm Not Here, Look for Me in …" Karen talks about where in the world she would really like to live and recounts the effects of Ohio weather on her seasonal affective disorder.

Don't forget iTunes reviews are very important. We're set at 150 reviews as of the recording of this program. If you haven't taken the time to give us a review on iTunes, we would certainly appreciate it, because that does help with the numbers and with the exposure that we get. So we really appreciate that. Again, my personal goal is 200 reviews by the end of the year and time is running short. So, please, we need 50 more views. If you haven't done that, I'd appreciate it. And, for those of you who took the time to do it, a sincere thank you.

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We have full week lined up for you. We have answers to Listener Questions tomorrow. Then we're going to have an interview with an infant sign language instructor. I'm really excited about that one. We're going to do an in-depth show and another research roundup to round out the week. That's all contingent upon my throat not getting a lot worse. So, we'll see what happens.

And until hopefully tomorrow, when we answer more of questions, this is Dr. Mike saying stay safe, stay healthy and stay involved with your kids.

So long everybody!

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