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Letters: Now is the ideal time for a two-track approach to Covid-19

YOU report (HeraldScotland, May 5) that Professor Neil Ferguson, one of the UK government’s key advisers on the current lockdown restrictions, has resigned after breaching the government (and his own) strong advice on the need for social distancing.




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Camley's Cartoon on Saturday, July 27: New PM's spirit of blind optimism

Framed prints of Steven Camley's cartoons are available by calling 0141 302 6210.”




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Culturally Supportive Program for Black Boys Boosts On-Time Graduation Rates

The California district rolled out a culturally-specific program to support black male students, and the program has led to positive outcomes for students who had an opportunity to participate.




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Time for a spring clean of our statues to keep them relevant

It’s not that I would be without the pyramids. Nor do I think that the Taj Mahal is a waste of good stone. These tombs, monuments to the departed are treasures beyond price. But can you name the pharaohs or the Mughal empress whose death they mark? No, nor can I without the help of Google.




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How Homeschooling Is Sometimes Used to Conceal Child Abuse

Most states take a very hands-off approach to regulating home schooling, and some advocates worry that makes it attractive to neglectful and abusive parents.




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Pro Basketball Player Brings Entrepreneurship Program to Baltimore Schools

Rudy Gay's Flight 22 Foundation is partnering with ed-tech company EverFi to teach students how to create a successful business.




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Coronavirus: Testing times for us all

THE fact that Scotland’s testing figures have fallen well behind the strategy outlined by the First Minister on April 3 of “proportionately” matching those of the UK government is a cause for concern, and the reasons for it certainly merit examination, but it would be hasty to regard it as an indictment of overall policy.




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Babies as Young as 12 Months Get Nearly an Hour of Screen Time a Day, Study Finds

Babies as young as 12 months are exposed to nearly an hour a day of screen time, despite warnings from pediatricians to avoid digital media exposure for children under a year and a half, according to a new analysis.




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Culturally Supportive Program for Black Boys Boosts On-Time Graduation Rates

The California district rolled out a culturally-specific program to support black male students, and the program has led to positive outcomes for students who had an opportunity to participate.




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Galleries: Tim Stead saving part of the nation’s furniture

Celebrated artist and wood sculptor, Tim Stead, may be best known for public works such as the Millennium Clock in the National Museum of Scotland in Edinburgh, the furniture in Glasgow's Cafe Gandolfi and the North Sea Oil Industries Memorial Chapel in Aberdeen, but his masterpiece is closer to home.




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Now is the time to reinvent travel for our economic and environmental futures

MY after work walk on Wednesday was a zig zag, following the sun as she headed west.




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Restoring true joy to tsunami victims

Responding to God’s call to reach out to survivors of the 2011 tsunami in the Tohoko region, OM Japan starts a ministry called 4 Friends Network.




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A Prospective Study of the Effects of Optimism on Adolescent Health Risks

Optimism later in life is protective against a range of health problems. It has commonly been a focus in adolescent mental health promotion. Cross-sectional studies suggest a protective effect against adolescent health risks, but prospective studies have been lacking.

Optimism is somewhat protective against adolescent health risks; the strongest effect was seen against the onset of new depressive symptoms. Its protective effect against heavier substance use and antisocial behavior was modest and only for the highest categories compared to the lowest. Promoting optimism along with other positive aspects of psychological and emotional style has a role in mental health promotion that is likely to be enhanced if an intervention also addresses risk and protective factors in an adolescent's social context. (Read the full article)




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Intima-Media Thickness and Flow-Mediated Dilatation in the Helsinki Study of Very Low Birth Weight Adults

Adults born at very low birth weight (VLBW) (<1.5 kg) have higher blood pressure and higher fasting insulin levels than their peers born at term. However, they show no signs of endothelial dysfunction in childhood and in adolescence.

Adults born at a VLBW showed no endothelial dysfunction compared with term adults. They had, however, a thicker intima-media layer in relation to lumen size. More rapid growth during their first weeks of life was associated with better endothelial function. (Read the full article)




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Symptoms and Time to Medical Care in Children With Accidental Extremity Fractures

A delay in seeking medical care for children with significant injury often raises a concern about child abuse, but there are few data describing the range of responses children display after accidental fracture for providers to use in comparison.

This study presents the range of responses exhibited by children after accidental fractures and identifies factors associated with a delay in seeking medical care. No child was asymptomatic, although a minority did not manifest all expected responses after their injury. (Read the full article)




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US Estimates of Hospitalized Children With Severe Traumatic Brain Injury: Implications for Clinical Trials

Clinical trials in children with severe traumatic brain injury (TBI) are challenging. To date, no work has been published that permits clinical investigators to estimate the number and compositional features of sites from which to recruit children with severe TBI into clinical trials.

Children with severe TBI are infrequent. Less than 5% of all US hospitals discharged more than 78% of severe TBI cases. To maximize enrollment efficiency for future clinical trials, attention has to be paid to selecting appropriate hospital sites. (Read the full article)




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Cardiac Screening Prior to Stimulant Treatment of ADHD: A Survey of US-Based Pediatricians

Over the past decade, drug oversight committees and professional organizations have debated the evidence regarding cardiac screening to identify undiagnosed disorders associated with sudden cardiac death in youth with attention-deficit/hyperactivity disorder before beginning treatment with stimulants.

How practicing pediatricians have responded to this controversy is not known. We present results from a national sample of pediatricians regarding current attitudes, barriers, and practices for cardiac screening in youth with attention-deficit/hyperactivity disorder before prescribing stimulants. (Read the full article)




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Incidence and Timing of Presentation of Necrotizing Enterocolitis in Preterm Infants

Necrotizing enterocolitis (NEC) can present within the first week of life in term infants. In preterm infants, NEC usually appears after commencement of feeds and can occur between 2 and 3 weeks of life.

Among infants <33 weeks’ gestation, NEC appears to occur at mean age of 7 days in more mature infants, whereas onset of NEC is delayed to 32 days of age in smaller, lower gestational age infants. (Read the full article)




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Using US Data to Estimate the Incidence of Serious Physical Abuse in Children

Limited data exist about the frequency and incidence of serious injuries due to physical abuse of children. Data from Child Protective Services, which are published yearly, do not have information about severity.

This is the first study to provide US estimates on the occurrence of serious injuries due to physical abuse. The incidence was highest in infants on Medicaid. Such data can be used to track changes due to prevention. (Read the full article)




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Development of a Pragmatic Measure for Evaluating and Optimizing Rapid Response Systems

The availability of rapid response systems to assist deteriorating patients is the standard of care in children’s hospitals. Metrics for evaluating their effectiveness include cardiac and respiratory arrest rates, rare events that require years of data to show significant improvements.

A proximate outcome for in-hospital mortality among patients receiving rapid response system assistance was developed. This "critical deterioration" metric was eightfold more common than arrests and demonstrated criterion and construct validity, facilitating meaningful evaluation over shorter periods of time. (Read the full article)




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Maternal Caffeine Consumption and Infant Nighttime Waking: Prospective Cohort Study

Fetus and infants until 3 months of age are unable to metabolize caffeine, which crosses the placenta and in adults has a somnolytic effect. Little is known about the effect of caffeine consumption by pregnant or nursing mothers over infant sleeping.

In this setting where caffeine is largely consumed in pregnancy and by nursing mothers, heavy consumption (≥300 mg/day) did not increase the number of nighttime awakenings by their 3-month-old infants. (Read the full article)




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Pediatric-Specific Antimicrobial Susceptibility Data and Empiric Antibiotic Selection

Ideal empirical antibiotic choices are based on local susceptibility data. These choices are important for ensuring positive patient outcomes, but pediatric-specific data may not be available.

Antibiotic susceptibilities differ by age group within a tertiary-care hospital. Knowing these differences, pediatricians chose empirical antibiotic therapy more likely to be successful. Children with infectious diseases would benefit from reporting of pediatric-specific susceptibility results. (Read the full article)




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Timing of Measles Immunization and Effective Population Vaccine Coverage

Many children are vaccinated against measles with a delay. This may influence effective measles vaccine coverage even in countries with high overall immunization levels. Official vaccine coverage statistics do not usually report on the impact of timeliness of measles vaccination.

Delayed measles vaccination results in 48.6% effective coverage in children aged 6 months to 2 years when 84.5% of 25-month-olds are up-to-date for 1 measles vaccination. Analyzing patterns of measles vaccination could help to address low coverage in infants and toddlers. (Read the full article)




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Gender and Crime Victimization Modify Neighborhood Effects on Adolescent Mental Health

Adolescents living in lower-poverty neighborhoods have better mental health than youth in high-poverty contexts, but it is unclear if associations are causal. Furthermore, it is unknown why some youth benefit more than others from moving to more advantaged neighborhoods.

Using an experimental study that randomly assigned families to receive vouchers to move to lower-poverty neighborhoods, we found that recent violent crime victimization adversely modified the mental health effects of moving to better neighborhoods. (Read the full article)




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Cobedding and Recovery Time After Heel Lance in Preterm Twins: Results of a Randomized Trial

Skin-to-skin contact with mothers and fathers has been associated with lower pain reactivity and enhanced physiologic recovery after heel lance. The effect of skin-to-skin contact between preterm twins during cobedding on pain response has yet to be studied.

We demonstrate that cobedding significantly diminished time to recovery in preterm twins after heel lance but did not lower pain reactivity. (Read the full article)




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Office-Based Randomized Controlled Trial to Reduce Screen Time in Preschool Children

Interventions to reduce screen time in preschool-aged children are promising.

A screen time intervention in 3-year-old children implemented in the primary care setting did not reduce screen time or BMI. (Read the full article)




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Timing of the Introduction of Complementary Foods in Infancy: A Randomized Controlled Trial

In a previous randomized trial, infants from a low-resource country exclusively breastfed for 6 months had lower iron stores at 6 months compared with breastfeeding infants receiving solid foods. Randomized trials of exclusive breastfeeding in high-income countries are lacking.

In a high-income country, infants who receive complementary foods in addition to breast milk from 4 months of age had higher iron stores at 6 months compared with those exclusively breastfed for 6 months. (Read the full article)




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Age, Academic Performance, and Stimulant Prescribing for ADHD: A Nationwide Cohort Study

The impact of relative age at school entry on academic progress and the risk of being diagnosed with ADHD remains controversial. Stimulants are widely used as a therapeutic option for ADHD in the United States and increasingly in Europe.

Relative age among classmates affects academic performance among boys and girls into puberty, as well as children’s risk of being prescribed stimulants for ADHD. This should be taken into account when evaluating children’s performance and behavior in school to prevent unnecessary stimulant prescribing. (Read the full article)




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Lifetime Growth and Blood Pressure in Adolescence: Hong Kong's "Children of 1997" Birth Cohort

Most observational studies from Western populations suggest that blood pressure is positively associated with low birth weight and faster infant growth; however, it is unclear whether these associations are biologically based or contextually specific.

In a developed non-Western setting with relatively little socioeconomic patterning of size or growth, birth weight and infant growth had relatively limited impacts on early adolescent blood pressure, which was more strongly related to recent growth and current size. (Read the full article)




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Longitudinal Associations Between Teen Dating Violence Victimization and Adverse Health Outcomes

Although a number of cross-sectional studies have documented associations between teen dating violence victimization and adverse health outcomes, including sexual risk behaviors, suicidality, substance use, and depression, longitudinal work examining the relationship between victimization and outcomes is limited.

This study is the first to demonstrate the longitudinal associations between teen dating violence victimization and multiple young adult health outcomes in a nationally representative sample. Findings emphasize the need for screening and intervention for both male and female victims. (Read the full article)




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Weight-Based Victimization: Bullying Experiences of Weight Loss Treatment-Seeking Youth

Studies have linked bullying with BMI, with overweight and obese youth vulnerable to bullying and its negative psychological and health consequences. However, there has been little comprehensive assessment of weight-based victimization, especially in weight loss treatment–seeking samples of youth.

WBV is prevalent in treatment-seeking youth, who report victimization from peers (92%), friends (70%), parents (37%), and teachers (27%). Providers should discuss WBV in their assessment and treatment of pediatric patients who are overweight or obese. (Read the full article)




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Presleep Activities and Time of Sleep Onset in Children

Presleep activities (eg, television watching) have been implicated in the declining sleep duration of young people. However, previous research reported on selected presleep activities, raising the possibility that important activities in this period are not accounted for.

This is the first study in youth to construct the presleep period by using a use-of-time approach. Twin trajectories of higher screen time and lower nonscreen sedentary time/self-care were evident in late sleepers, with the opposite pattern occurring in early sleepers. (Read the full article)




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Population-Based Estimates of In-Unit Survival for Very Preterm Infants

Survival estimates for preterm infants are vital for counseling parents, informing care, and planning services. Widely use estimates of in-unit survival derived from a large UK population for infants born at <33 weeks’ gestational age have been available since 1999.

These survival charts have been updated and will be of use to clinicians, parents, and managers. An alternative method for graphical representation of survival probabilities is offered: contour survival plots. (Read the full article)




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Developmental Trends in Peer Victimization and Emotional Distress in LGB and Heterosexual Youth

Peer victimization predicts numerous health risks. Lesbian, gay, and bisexual (LGB)-identified youth report greater peer victimization than do heterosexual-identified youth. No longitudinal studies have been conducted on developmental trends of peer victimization and emotional distress among LGB and heterosexual youth.

We provide the first longitudinal evidence on developmental trends of peer victimization and emotional distress for LGB- and heterosexual-identified youth. The findings suggest peer victimization of LGB-identified youth decreases in absolute, but not necessarily relative, terms and contributes to later emotional distress disparities. (Read the full article)




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Chest Compression Quality Over Time in Pediatric Resuscitations

Rapid initiation of effective chest compressions (CCs) for patients in cardiac arrest improves outcomes, yet even trained rescuers fail to provide consistently effective CCs. Pediatric data on CC quality and objective measures of CC work are limited.

CC quality deteriorates similarly in pediatric and adult models, and overall work done to compress the pediatric chest is similar to that in adults. Power output during CC performance is analogous to that generated during intense exercise such as running. (Read the full article)




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Time and Risk Preferences and the Use of Asthma Controller Medication

College students with asthma tend to have worse health outcomes than their peers without asthma. Consistent use of controller medication could improve outcomes for these students, but a predictive model of appropriate use of controller medication is needed.

This study adds risk tolerance and time preference to previously studied factors of nonadherence with control medication. These preferences have substantial impacts on use of controller medication and the potential success of asthma education programs. (Read the full article)




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Chlorhexidine Cleansing of the Umbilical Cord and Separation Time: A Cluster-Randomized Trial

Chlorhexidine cleansing of the cord can reduce mortality in high-risk settings. Time to separation may increase with topical applications of chlorhexidine; 1 previous community trial quantified this increase and did not measure whether caretakers perceived the delay.

Single and multiple cleansing of the umbilical cord increases time to separation by ~50%, or an average of 2 to 2.5 days. Caretakers were able to detect this difference and expressed dissatisfaction, while still accepting the intervention. (Read the full article)




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Timing of Solid Food Introduction and Obesity: Hong Kong's "Children of 1997" Birth Cohort

Some Western studies show early introduction of solid food is associated with subsequent obesity. However, introduction of solid food and obesity share social patterning, making these observations vulnerable to residual confounding.

In a non-Western developed setting, there was no clear association of the early introduction of solid food with childhood obesity. Studies in populations with a different confounding structure may be valuable in clarifying and reconciling potentially confounded epidemiologic associations. (Read the full article)




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RCT of Timolol Maleate Gel for Superficial Infantile Hemangiomas in 5- to 24-Week-Olds

The systemic nonselective β-blocker propranolol hydrochloride is increasingly used as first-line management for infantile hemangiomas. Superficial nonulcerating lesions do not require systemic medications. Case series have suggested the efficacy of timolol; however, its safety has been questioned.

This randomized controlled trial indicates that timolol maleate 0.5% gel is a well-tolerated, safe, and effective treatment of superficial infantile hemangiomas. (Read the full article)




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Genetic and Environmental Influences on Daytime and Nighttime Sleep Duration in Early Childhood

Sleep patterns of adult monozygotic twins are more similar than those of dizygotic twins, showing moderate heritability and little effects of environmental influences. There have been very few genetically informative studies of sleep in preschool children and results appear inconsistent.

From previous studies, we investigated daytime and nighttime continuous sleep duration longitudinally. This is the first time that the etiologies of daytime and nighttime continuous sleep duration trajectories were studied in early childhood. (Read the full article)




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Discharge Timing, Outpatient Follow-up, and Home Care of Late-Preterm and Early-Term Infants

Infants born late-preterm and early-term are at higher risk of morbidity and mortality compared with term infants. Home care practices recommended for all infants include supine sleep position, no smoke exposure, and breastfeeding to optimize health outcomes.

Our study provides new findings on the timing of hospital discharge, outpatient follow-up, and home care of late-preterm and early-term infants compared with term infants in the United States. (Read the full article)




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Association of Fitness With Vascular Intima-Media Thickness and Elasticity in Adolescence

Atherosclerotic cardiovascular diseases are rooted in childhood. Vascular intima-media thickness (IMT) and elasticity are early surrogate markers of atherosclerosis. In adults, cardiorespiratory fitness is associated with enhanced arterial elasticity and decreased IMT.

Fitness was favorably associated with aortic IMT and elasticity in adolescents. The association was independent of several cardiometabolic risk factors. In fit adolescents, the increase in IMT during the preceding 6 years was smaller compared with low-fit peers. (Read the full article)




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Time Interval Between Concussions and Symptom Duration

Although concussion is increasingly being diagnosed in the pediatric population, little is known about what factors lead to prolonged postconcussive symptoms in children. In particular, the effect of previous history of concussion on recovery from a repeat injury is unclear.

Children with a history of previous concussion, particularly recent or multiple concussions, are at increased risk for prolonged symptoms after concussion. This suggests that repeat concussion, particularly within a vulnerable time window, may lead to longer duration of symptoms. (Read the full article)




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Estimating Overweight Risk in Childhood From Predictors During Infancy

Several risk factors for both overweight and obesity in childhood are identifiable during infancy.

A simple risk algorithm can be used to quantify risk of overweight in children. It can be used to help identify at-risk infants in a clinical setting to facilitate targeted intervention. (Read the full article)




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Late-Preterm Birth and Lifetime Socioeconomic Attainments: The Helsinki Birth Cohort Study

More than 70% of all preterm deliveries are late-preterm (34–36 weeks of gestation). Compared with those born at term, those born late-preterm have higher risk for medical and neurodevelopmental disabilities and suffer more often from mental and behavioral problems.

Late-preterm birth is associated with considerable lifetime socioeconomic disadvantages across the adult years. These disadvantages are not explained by childhood parental socioeconomic position. (Read the full article)




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Changes in Bedtime Schedules and Behavioral Difficulties in 7 Year Old Children

Links between clinically diagnosed sleep problems and adverse behavioral outcomes are well documented. However, in nonclinical populations, causal links between disrupted sleep and the development of behavioral difficulties are far from clear.

Seven-year-old children with nonregular bedtimes had more behavioral difficulties than children who had regular bedtimes. There were clear dose–response relationships, and the effects of not having regular bedtimes appeared to be reversible. (Read the full article)




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Narrow Vs Broad-spectrum Antimicrobial Therapy for Children Hospitalized With Pneumonia

Recent guidelines for the management of childhood pneumonia recommend narrow-spectrum antimicrobial agents (eg, ampicillin) for most children; however, few studies have directly compared the effectiveness of narrow-spectrum agents to the broader spectrum third-generation cephalosporins commonly used among children hospitalized with pneumonia.

By using data from 43 children’s hospitals in the United States, we demonstrate equivalent outcomes and costs for children hospitalized with pneumonia and treated empirically with either narrow- (ampicillin/penicillin) or broad-spectrum (ceftriaxone/cefotaxime) antimicrobial therapy. (Read the full article)




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Catheter Dwell Time and CLABSIs in Neonates With PICCs: A Multicenter Cohort Study

Peripherally inserted central catheters (PICCs) are essential to deliver life-saving treatment to neonates. Longer PICC dwell times may increase the risk of central line–associated bloodstream infections (CLABSIs) in neonates, but previous studies have yielded inconsistent results, likely due to different study designs, analytic methods, and small sample sizes.

The risk of CLABSIs increases during the 2 weeks after PICC insertion and remains elevated for the catheter duration. These data support daily review of PICC necessity, optimization of catheter maintenance practices, and consideration of novel strategies to prevent CLABSIs. (Read the full article)




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Adiposity and Different Types of Screen Time

Screen time has risen to unprecedented levels among youth. Greater television time is known to be associated with gains in pediatric adiposity, but few studies have examined the longitudinal relations of other forms of screen-based media with weight gain.

Among adolescents aged 9 to 19 years, television viewing was the type of screen time most consistently associated with gains in BMI. However, time with digital versatile discs/videos and video/computer games was also associated with gains in BMI among girls. (Read the full article)




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Comorbidity Clusters in Autism Spectrum Disorders: An Electronic Health Record Time-Series Analysis

Individuals with autism spectrum disorders have a higher comorbidity burden than the general pediatric population, including higher rates of seizures, psychiatric illness, and gastrointestinal disorders.

Comorbidities do not occur evenly. Our clustering analysis reveals subgroups characterized by seizure, psychiatric disorders, and complex multisystem disorders including auditory and gastrointestinal disorders. Correlations between seizure, psychiatric disorders, and gastrointestinal disorders are validated on a sample from a second hospital. (Read the full article)