Health news Watchdog barks at stories about health of children and dogs

An article published in Pediatrics, Respiratory tract diseases during the first year of life: effect of dog and cat contacts "is getting a lot of attention in the news, but more than misses what most of these stories generally Miss: you cannot prove cause and effect from an observational study.  And there are major limitations on research based on people keeping diaries and answer questionnaires.

The study concludes:

".. dog contacts may have a protective effect on the respiratory tract infections during the first year of life. Our findings support the theory that, during the first year of life, contacts are important, possibly leading to greater resistance to infectious respiratory diseases during childhood "

The Wall Street Journal reported:

"While the study controlled just under 400 babies, the researchers said that the results were statistically significant because it relied on questionnaires completed by parents. weekly" (Our reaction: huh?  This sentence makes no sense.  Statistical significance is not determined by filling out questionnaires from parents.)

WebMD reported:

"It is not clear why live with a dog makes a difference."  (Our reaction: it is not clear that living with a dog makes a difference. Making a difference means you have already proved the cause and effect and this study did not do it.)

HealthDay reported:

"Exhibition of cats also showed a protective effect, but was not as strong as the effect of exposure of the dog". (Our reaction: no protective effect was created in this observational study.)

None of these news organizations earlier and any of the following mentioned the limitations of observational studies and that it is not possible to establish a causal relationship.  Reuters Health nor the Los Angeles Times, or CNN. (90 minutes later Addendum: Nor CBS.  Or TIME.com. Neither the Toronto Star. )

From our early morning sweep, just a news story of my HealthNewsDaily the MSNBC.com included what we were looking for:

"The relationship between pets and less infections held even when the researchers took into account factors known to affect infection rates of infants, how to breastfeed and number of brothers. Still, the researchers acknowledged that it could not account for all factors and noted that they found a correlation, not a relationship of cause and effect. "

That wasn't so hard, was it?

Our usual reminder: journalists and consumers must read our booklet, "the language fits the evidence?  Association Versus causation. "

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Health Tip: Keep Magnets Away From Children

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(HealthDay News) -- Small magnets that dislodge from toys or products for adults pose choking and ingestion hazards. If swallowed by young children, they can lead to choking or serious injury to the stomach and digestive tract.

The American Academy of Pediatrics mentions these guidelines for parents to help prevent magnet-related injuries:

Never allow very young children to play with or touch objects that contain magnets.Carefully watch older children who play with such toys.Don't purchase large sets of magnets, in groups of more than 100, because it's difficult to keep track of any that are missing.Make sure teens understand the serious dangers of using magnets as fake piercings.

-- Diana Kohnle Copyright © 2012 HealthDay. All rights reserved.

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In search of lost sleep: Secular trends in the sleep time of school-aged children and adolescents

a Health and Use of Time (HUT) Group, University of South Australia, GPO Box 2471, Adelaide SA 5000, Australiab Sansom Institute for Health Research, University of South Australia, GPO Box 2471, Adelaide SA 5000, Australiac School of Health Sciences, University of South Australia, GPO Box 2471, Adelaide SA 5000, AustraliaReceived 7 January 2011. Revised 18 March 2011. Accepted 18 March 2011. Available online 25 May 2011.View full text Sleep deficits are associated with a wide range of detrimental physical and mental health outcomes. There is concern that children are not getting enough sleep, and that sleep duration has been declining. However, evidence is sparse.

A systematic review of world literature was conducted to locate studies reporting the sleep duration of children aged 5–18 years. Monte Carlo simulation was used to generate pseudodata from summary data, which were combined with raw data and analysed by linear regression of sleep duration on year of measurement at the age × sex × day type × country level.

Data were available on 690,747 children from 20 countries, dating from 1905 to 2008. From these data, 641 regressions were derived. The sample-weighted median rate of change was -0.75 min nightly per year, indicating a decrease of more than 1 h per night over the study period. Rates of change were negative across age, sex and day type categories, but varied according to region, with Europe, the USA, Canada and Asia showing decreases and Australia, the UK and Scandinavia showing increases.

Over the last 103 years, there have been consistent rapid declines in the sleep duration of children and adolescents.

prs.rt("abs_end");Sleep duration; Children; Adolescents; Trends

Figures and tables from this article:

Fig. 1. PRISMA flowchart for the search.

View Within ArticleFig. 2. Funnel plots of changes in sleep duration (Y-axis, min/year) against the span of years for each regression, and the total sample size for each regression (X-axes). The dashed line is the sample-weighted median rate of change (-0.75 min/year).

View Within ArticleFig. 3. Box plots showing sample-weighted rates of change for age (Fig. 3a), sex (Fig. 3b) and day type (Fig. 3c) sub-groups. The dashed line is the sample-weighted median rate of change (-0.75 min/year). k = number of regressions assessed; SD = standard deviation; IQR = interquartile range.

View Within ArticleFig. 4. Box plots showing sample-weighted rates of change for different regions. The dashed line is the sample-weighted median rate of change (-0.75 min/year). k = number of regressions assessed; SD = standard deviation; IQR = interquartile range.

View Within ArticleFig. 5. Box plots showing sample-weighted rates of change for different year periods. The dashed line is the sample-weighted median rate of change (-0.75 min/year). k = number of regressions assessed; SD = standard deviation; IQR = interquartile range.

View Within ArticleTable 1. Search strategy used for each database.

View Within ArticleTable 2. Rates of change (minutes per day per year) in sleep duration according to sex, age, day type and geographical location.

Significant differences were found across age groups (with the exception of 13–15 and 16–18 year-old age categories), sexes, regions and between different day types (P < 0.05).k = number of regressions assessed; n = sample size; SD = standard deviation; IQR = interquartile range.

View Within ArticleCopyright © 2011 Elsevier Ltd. All rights reserved.

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Does treatment of SDB in children improve cardiovascular outcome?

Available online 29 May 2012

In Press, Corrected Proof — Note to users

The Ritchie Centre, Monash Institute of Medical Research, Monash University, Melbourne, AustraliaReceived 9 December 2011. Revised 20 April 2012. Accepted 20 April 2012. Available online 29 May 2012.View full text Sleep disordered breathing (SDB) is a common disorder in both adults and children and is caused by the obstruction of the upper airway during sleep. Unlike adults, most cases of paediatric SDB are due to the presence of enlarged tonsils and adenoids, thus the main treatment option is adenotonsillectomy (T&A). It is well known that obstructive sleep apnoea in adults increases the risk for hypertension, coronary artery disease and stroke, and there is now mounting evidence that SDB also has a significant impact on the cardiovascular system in children with reports of elevated blood pressure, endothelial dysfunction and altered autonomic cardiovascular control. As there is now substantial evidence that elevated blood pressure in childhood is carried on to adulthood it is important to know if treatment of SDB improves cardiovascular outcomes. Studies in adults have shown that treatment of SDB leads to improvements in cardiovascular function, including a reduction in pulmonary artery pressure, systemic blood pressure and endothelial dysfunction. However, studies exploring the outcomes of treatment of SDB in children on the cardiovascular system are limited and varied in their methodology and outcome measures. As a number of cardiovascular disturbances are sequelae of SDB, early detection and management could result in the reduction of elevated blood pressure in children, and consequently a reduction in cardiovascular morbidity in adulthood. The aim of this review is to summarise the findings of studies to date which have investigated the cardiovascular outcomes in children treated for SDB and to make recommendations for future management of this very common disease.

prs.rt("abs_end");Adenotonsillectomy; Blood pressure; Cardiovascular; Children; Hypoxaemia; Inflammation; Obstructive sleep apnoea; Sleep disordered breathing; Treatment

Figures and tables from this article:

Fig. 1. The effects of treatment on the cardiovascular consequences of obstructive sleep apnoea in children. The tick indicates studies that show improvement in the cardiovascular outcome with treatment, the question mark indicates study results are conflicting or that the treatment effects are unknown. OSA indicates obstructive sleep apnoea; RV, right ventricle; BP, blood pressure. Adapted from Bhattacharjee et al., 2009.49

View Within ArticleTable 1. Summary of studies investigating the effect of treatment on cardiovascular outcomes in children treated for SDB.

AHI – apnoea hypopnoea index; ApoB – apolipoprotein B; BP – blood pressure; BNP – brain natriuretic peptide; CRP – c-reactive protein; DBP – diastolic blood pressure; ET-1 – endothelin-1; HR – heart rate; IL-6 – interleukin 6; IL-10 – interleukin 10; LV – left ventricular; mo – month; N/A – not available; NIPPV – non-invasive positive ventilation; NOB – non-obese group; NT-proBNP – N-terminal pro-B-type natriuretic peptide; OB – obese group; ODI – oxygen desaturation index; OSA – obstructive sleep apnoea; P – prospective; PR – pulse rate; PRV – pulse rate variability; PS – primary snoring; R – retrospective; RV – right ventricular; S – primary snoring; SBP – systolic blood pressure; SD – standard deviation; SDP – sleep disordered breathing; T&A – adenotonsillectomy; w – week; y – year.

View Within ArticleCrown copyright © 2012 Published by Elsevier Ltd. All rights reserved.

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Sleep in special needs children: The challenge

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Sleep in attention-deficit/hyperactivity disorder in children and adults: Past, present, and future

Sun Young Rosalia Yoona, b, , , , Umesh Jainb, e, , Colin Shapiroa, c, d, f, a Institute of Medical Sciences, University of Toronto, Canadab Child, Youth and Family Service, Centre for Addiction and Mental Health, 352-250 College Street, Toronto, ON, M5T 1R8, Canadac Division of Patient Based Clinical Research, Toronto Western Research Institute, Canadad Youthdale Child and Adolescent Sleep Centre, CanadaReceived 5 April 2011. Revised 1 July 2011. Accepted 5 July 2011. Available online 26 October 2011.View full text The understanding that sleep can give rise to, or exacerbate symptoms of attention-deficit/hyperactivity disorder (ADHD), and that good sleep hygiene improves attention and concentration tasks has sparked interest in the investigation of possible etiological relationships between sleep disorders and ADHD.

Studies indicate that 30% of children and 60–80% of adults with ADHD have symptoms of sleep disorders such as daytime sleepiness, insomnia, delayed sleep phase syndrome, fractured sleep, restless legs syndrome, and sleep disordered breathing. The range and diversity of findings by different researchers have posed challenges in establishing whether sleep disturbances are intrinsic to ADHD or whether disturbances occur due to co-morbid sleep disorders. As a result, understanding of the nature of the relationship between sleep disturbances/disorders and ADHD remains unclear.

In this review, we present a comprehensive and critical account of the research that has been carried out to investigate the association between sleep and ADHD, as well as discuss mechanisms that have been proposed to account for the elusive relationship between sleep disturbances, sleep disorders, and ADHD.

prs.rt("abs_end");Sleep architecture; Sleep disturbances; Sleep disordered breathing; Restless legs; Periodic limb movements; ADHD; Circadian cycle

Figures and tables from this article:

Table 1. Studies of sleep disturbances in children with ADHD with subjective methods.

ADHD = Attention-deficit/hyperactivity disorder, ADHD-C = ADHD of the combined subtype, ADHD-H/I = ADHD of the hyperactive/impulsive subtype, ADHD-I = ADHD of the inattentive subtype, BD = bipolar disorder, CD = conduct disorder, DEP = major depressive episode, C(P/T)RS-R:S = Conner’s (parent/teacher) rating scale-revised: short forms, GAD = generalized anxiety disorder, IQ = intelligence quotient, LD = learning disability, MPH = methylphenidate, OCD = obsessive compulsive disorder, ODD = oppositional defiant disorder, PTSD = post-traumatic stress disorder, SAD = separation anxiety disorder, SD = standard deviation.

View Within ArticleTable 2. Studies of sleep disturbances in children with ADHD with objective methods.

AHI = Apnea hypopnea index, BD = bipolar disorder, CD = conduct disorder, DEX = dextro-amphetamine, DLMO = dim light melatonin onset, GAD = generalized anxiety disorder, LD = learning disability, MD = major depression, MPH = methylphenidate, MSLT = multiple sleep latency test, ODD = oppositional defiant disorder, PLMI = periodic limb movement index, RDI = respiratory disturbance index, REM = rapid eye movement, S1 = stage 1 sleep, SAD = separation anxiety disorder, SDB = sleep disordered breathing, SE = sleep efficiency, SOL = sleep onset latency, SOT = sleep onset time,TSP = total sleep period.

View Within ArticleTable 3. Studies of sleep disturbances in adults with ADHD with subjective methods.

ADHD = attention-deficit/hyperactivity disorder, ADHD-C = ADHD of the combined subtype, ADHD-H/I = ADHD of the hyperactive/impulsive subtype, ADHD-I = ADHD of the inattentive subtype, ASRS = adult self report scale, CSM = composite scale of morningness, EDS = excessive daytime sleepiness, ESS - Epworth sleepiness scale, IH = idiopathic hypersomnia, GAD = generalized anxiety disorder, MDD = major depressive disorder, MPH = methylphenidate, OCD = obsessive compulsive disorder, PTSD = post-traumatic stress disorder.

View Within ArticleTable 4. Studies of sleep disturbances in adults with ADHD with objective methods.

DEX = dextro-amphetamine, BRD = brief recurrent depression, MDD = major depressive disorder, MPH = methylphenidate, PSG = polysomnography, REM = rapid eye movement, SE = sleep efficiency, SOL = sleep onset latency.

View Within ArticleCopyright © 2011 Elsevier Ltd. Published by Elsevier Ltd. All rights reserved.

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