Sleep Patterns - Problems, Prevalence and Persistence in First Three Years of Life

Sleep problems in early childhood can be easily missed or recognized by parents and doctors. A short and flexible screening tool (like a questionnaire) may help the process of recognizing these children do that corrective measures can be instituted.Sleep is essential for daily functioning, sleep related issues are routinely addressed through anticipatory guidance in pediatric settings. However, research indicates that pediatric sleep problems may go undetected during routine clinical care. Although there is no gold standard for sleep assessment during infancy and early childhood, a study confirms the importance of focused screening for sleep problems during infancy and early childhood that goes further than merely asking if the child has problems sleeping.
This study was performed in United States in which 359 mother/child pairs participated.Sleep questionnaires were administered to mothers when children were 6, 12, 24, and 36 months old. Sleep variables included parent response to a nonspecific query about the presence/absence of a sleep problem and 8 specific sleep outcome domains: sleep onset latency, sleep maintenance, 24-hour sleep duration, daytime sleep/naps, sleep location, restlessness/vocalization, nightmares/night terrors, and snoring.
The sample was 64% white participants and 31% African American participants. In the 6- months survey point, the overall rate of parent-reported sleep problems and behaviors around sleep maintenance did not significantly differ by race or family income at any time point. However, there was differential attrition over time among African Americans and those in the lowest education and income groups. Those from lower-income families were reported to have longer sleep onset latency, shorter overall sleep duration, less independent sleep, and more snoring than were white children and those fromhigher-income families.
Reported napping/daytime sleep, vocalization/restlessness, and nightmares/night terrors differed by race or family income at only one time point. Nightmares/ night terrors and restlessness/ vocalization were significantly associated with parent report of a sleep problem from 12 to 36 months of age.
While the presence of a nonspecific sleep problem was reported by roughly 10% of parents at each time point, parent report of a sleep problem was significantly associated with snoring only at 12 months and with the location of a child’s sleep only at 24 months. Parent report of a sleep problem was significantly associated with longer sleep onset latency across all age ranges, as well as poorer sleep maintenance and shorter sleep duration at 6 to 24months but less strongly at 36 months.
21% to 35% of those who were reported to have a sleep problem during infancy showed persistent sleep problems 1 to 2 1/2 years later. Night waking and shorter sleep duration were perceived as sleep problems by 6 months of age and then remained particular concerns for parents through 2 years of age. Also, across all time points, the majority of children (62.5%–81.9%) were sleeping in their own bed.
Parents did not seem to associate snoring with sleep problems as a result snoring could be completely overlooked during well-child visits, despite its known risk for morbidity. It is noteworthy that the failure of a parent to recognize and report problems related to these domains could lead to errors in clinical decision making. Like sampling error may have influenced prevalence estimates of sleep problems. All sleep measures were based on parent-report. Since there is no single validated instrument for assessing sleep problems in children aged 6 to 36 months, the data was pooled from 2 independent sleep questionnaires. Sleep problem and behavioral domains that were the focus of this study are culturally defined to varying degrees; study did not propose nor examine potential mechanisms underlying sleep problems.
Parent interpretation and report of a sleep problem during early childhood may be inconsistent with clinical criteria for diagnosing pediatric sleep disorders, especially when assessed via a nonspecific query. To clarify parental concerns about sleep during early development and ensure that clinically relevant sleep issues are not overlooked, it is recommended that sleep problems be screened by using a flexible family-centered approach while addressing specific sleep behaviors and symptoms that have known clinical significance.
Reference: Prevalence, Patterns, and Persistence of Sleep Problems in the First 3 Years of Life; Kelly Byars et al; Pediatrics 2012.

Anti-Molestation Device for Women Invented by Indian Schoolboy

An Indian schoolboy from Delhi claims that his invention is a device, which can help women fend off potential attackers.
The device, which can be worn like a wristwatch, delivers an electric shock once it touches the attacker's skin.Manu Chopra, 16, said that he wanted to "use science to provide safety to women on the street".
Parts of many Indian cities, including the national capital, are unsafe for women.
Many working women carry pepper spray to deter attackers.
The latest National Crime Records Bureau figures show that India recorded almost 22,000 rape cases in 2008, 18 percent up from 2004.
Chopra said that it was "shameful" that women consider it unsafe to go out of home at night.
"Even my sister is not allowed to go out when dark because it is unsafe," the BBC quoted the boy as saying.
"This is the state of the national capital.
Chopra, whose sister Kaanchi is 12, said that it took him about six days to make the device and he expects it to be up for sale for as little as 122 rupees.
The student of Delhi's GD Goenka School said the idea to work on the device came to him when he read about a national competition, organised by the National Innovation Foundation (NIF).
The foundation, set up by the government, awards children for their innovation and creativity.
The product is attracting a lot of attention and there is talk of its market launch.
But the foundation says it may take time as the "prototype needs to be refined further to be launched as a product" and tests need to be conducted to prove its efficiency.
The "anti-molestation device" is activated when it records a significant rise in nerve speed and pulse rate of the victim.
For it to be effective, the victim has to ensure the dial of the device touches an exposed part of the attacker's body.
"It gives a feeble shock to the molester, giving precious time to the victim to flee," Chopra added.
The device also has an inbuilt camera to record the image of the attacker.
Source-ANI

Ayurveda hospitals face major crisis in Kerala due to shortage of several important medicines

The Ayurveda hospitals in Kerala are facing major crisis as there are complaints of Ayurveda pharmacies running short of several important drugs and the resultant dwindling turnout of patients to these hospitals.
Medical Officers in the ayurvedic dispensaries and hospitals complain that their pharmacies are running short of many important drugs and the number of patients coming to the hospital is steadily decreasing. The situation blights the existence of these traditional medical institutions by forcing the patients to depend on allopathic hospitals and expensive methods of treatments.
Due to non-availability of drugs, patients have to purchase these medicines from private medical shops by giving huge prices. “Only economically stable patients can afford them, but it becomes difficult for the poor patients to do so,” said a medical officer belongs to Idukki district in Kerala.
Apart from the drug shortage, all the Indian medicine hospitals are working without sufficient staff such as pharmacists, nurses and attenders. According to the medical officers, government is showing no interest in Ayurveda hospitals and the sector itself is in a major crisis.
In a chat with Pharmabiz during the Ayurveda Medical Association’s state conference in Kozhikode in Kerala, the physicians of Ayurveda system said the hospitals are getting an allotment of Rs.75000 from government during three terms for procurement of medicines. Since the hospitals come under the local bodies, additional expenditures are incurred by the local Panchayats, most of whom do not have supportive attitude.
“The delivery of supply is done by Aushadhi, but we have to wait three to six months period to get it. Government or the local Panchayats do not take any step to avoid the delay. There is always shortage of the essential ‘Kashaayams’, tablets, 'Arishtams', ointment and powders. So we advise the patients to buy the medicines from outside. Recently, the government has given order to Aushadhi to deliver the supply within two months of the intent received,” said a doctor.
An ayurveda dispensary or hospital should have some essential Kashaayams including Rasnerandaathi, Punarnavaathi, Desamoola Kaduthrayam and Rasnaasthakam, but these medicines are not available in most of the hospitals in Kerala, said the doctors. In the case of tablets, shortage is there for Kaishoragugulu, Yogarajagugulu, Vettumaaran and Chandraprabha.
Arishtams such as Amruthaarishtam, Abhayaarishtam, Mustaarishtam and Vaashaarishtam, oils including Murivenna, Karpooradi thailam, Kottamchukkaathi and Pindathailam, ointments like Dhanwantharam, Sahacharaadi, and powders such as Taaleesapathraadi and Raasnaadi are also not available in any of the hospitals or dispensaries functioning across the state.
The members of AMAI said Kerala has about 800 Ayurveda dispensaries which are controlled by the local bodies. But in 256 Panchayaths, there are no dispensaries.
Meanwhile, when contacted, joint director of ISM admitted that there is pending of supply from Aushadhi and said the management of dispensaries and hospitals in the villages is under the control of local bodies whose duty is to procure the medicines on time. He said there is no budget allocation for purchase of medicines to these Ayush hospitals from the government.
Source:Pharmabiz

Shrinking Research Funding Resulting in Rising Problem of Scientific Plagiarism

Since scientific researchers are becoming fiercely competitive for scarce funding, scientific journals are increasing efforts to identify submissions that plagiarize the other’s work.
"We need a better system," said Harold Garner, executive director of the Virginia Bioinformatics Institute at Virginia Tech. Garner discussed the problem and solution in a Comment in the January 4, 2012 issue of Nature and in a January 19, 2012 radio interview with NPR's Leonard Lopate.
Garner, creator of eTBLAST plagiarism detection software, identified numerous instances of wholesale plagiarism among citations in MEDLINE. "When my colleagues and I introduced an automated process to spot similar citations in MEDLINE, we uncovered more than 150 suspected cases of plagiarism in March, 2009.
"Subsequent ethics investigations resulted in 56 retractions within a few months. However, as of November 2011, 12 (20 percent) of those "retracted" papers are still not so tagged in PubMed. Another two were labeled with errata that point to a website warning the papers are "duplicate" -- but more than 95 percent of the text was identical, with no similar co-authors."
But even when plagiarism is uncovered, it does not guarantee that the plagiarized articles will be retracted. In Garner's study, as noted in his Nature commentary, "Three of the 56 retracted papers are cited in books, including one citation after the retraction. Another eight were cited in other PubMed Central archived articles before retraction, and seven were cited after retraction."
Some researchers say plagiarism has become a pandemic in many large institutions and schools, and that there is an entire industry built on the business of copying the work of others for the purpose of developing theses content and technical papers.
Quelling the proliferation of scientific plagiarism by identifying and retracting plagiarized articles is not the only issue. Publication editors and researchers must agree on the definition of plagiarism as noted in Nature.
Said Garner, "Ultimately, plagiarism comes down to human judgment, similar to other questionable practices -- you know it when you see it."

Source-Eurekalert

Study Reveals Secret Behind Centenarians' Longevity

Researchers have found that genetic variants play a crucial and complex role in the exceptional longevity in centenarians.The findings of the study by researchers from the Boston University Schools of Public Health and Medicine, Boston Medical Center, IRCCS Multimedica in Milan, Italy, and Yale University are the corrected version of work originally published in Science in July 2010.

The new study includes additional authors who independently assessed and helped to produce a valid genotype data set, for which the same analysis as in the original paper was performed. It also contains an additional replication data set of subjects with an average age of 107.
Centenarians are a model of healthy aging, as the onset of disability in these individuals is generally delayed until they are well into their mid-90s.
Because exceptional longevity can run strongly in families, and numerous animal studies have suggested a strong genetic influence on life span, the researchers set out to determine which genetic variants play roles in human survival beyond 100 years of age.
They used a well-established Bayesian statistical method for determining which single nucleotide polymorphisms (SNPs, or genetic variants) could, as a group, be used to categorize subjects as centenarians versus controls, based solely upon the genetic information.
The predictive sensitivity of the model they developed, which contains 281 SNPs, increased with the age of the subject, supporting the hypothesis that genes play an increasingly strong role in survival in centenarians.
The model was able to predict exceptional longevity with 60 to 85 percent accuracy, depending on the average age of the replication sample that was used. The older the sample, the stronger the sensitivity.
Many of the 130 known genes associated with the SNPs in the prediction model have been shown by other gerontologists to play roles in age-related diseases and aging, said the study's lead researchers, Paola Sebastiani, PhD, professor of biostatistics at the BU School of Public Health, and Thomas Perls, MD, MPH, associate professor of medicine at the BU School of Medicine.
"This is a useful step towards meaningful predictive medicine and personal genomics," said Dr. Perls, a geriatrician at Boston Medical Center.
"When people can do this kind of analysis on whole genome sequences for traits that have important genetic components, the predictive value should be even better," he stated.
The corrected study, as did the original, found that subjects who shared the same profile of variations for genetic markers in the model appeared to share similar levels of risk for various traits or diseases associated with exceptional longevity-most notably, in their ages of survival.
The revised publication appeared in PLoS ONE.
Source-ANI

Olive Oil May Protect Against Liver Damage

Olive oil, an integral part of Mediterranean diet, is known to have numerous health benefits that protect against heart diseases and some cancers. It also modifies the immune and inflammatory responses of the body. A new study showed that extra virgin olive oil and its hydrophilic extract protect against oxidative damage of the liver.
An impaired antioxidant defence of the body is one of the major causes for the development of heart disease, cancer and premature degeneration of the nerve cells. A healthy human body maintains a balance between the generation of Reactive Oxidant Species (ROS) which cause oxidation, and the counteractive antioxidant defences. ROS are by-products of normal metabolic processes and accidental exposure to occupational chemicals like pesticides accelerate their production.
Ar ecent study reported that rats fed on a diet containing olive oil were protected from liver damage following exposure to a moderately toxic chemical called 2,4-Dichlorophenoxyaceticacid (2,4-D). 2,4-D is one of the most widely used herbicides that causes liver damage. It is known to produce oxidative stress, and/or deplete antioxidants.
In the study, rats fed on the herbicide 2,4-D were supplemented with either extra virgin olive oil, or one of its extracts (hydrophilic or lipophilic).
2,4-D caused significant liver damage in the rats. Intake of extra virgin olive oil or its hydrophilic fraction induced a substantial increase in antioxidant activity and decreased markers of liver damage. These two contained a high amount of phenols, which could contribute to the antoxidant effect. The lipophilic fraction, which was deprived of phenols, failed to produce a protective effect.
Authors of the study concluded that extra virgin olive oil and its hydrophilic extract protect against oxidative damage of liver cells. More detailed studies dealing with the effect of antioxidant compounds separately and/or their interactions could corroborate these results.
Reference: Effects of olive oil and its fractions on oxidative stress and the liver's fatty acid composition in 2,4-Dichlorophenoxyacetic acid-treated rats; Amel et al; Nutrition & Metabolism 2010.

Company combines genomics and digital tech for a health care revolution

Modern medical technology is revealing the secrets of the human genome at an accelerating rate, and also making it possible to give patients anywhere intensive monitoring once available only in the hospital.
But translating medical technology into medical practice has fallen far behind, says Samir Damani, a Scripps Clinic cardiologist. Damani has co-founded a company called MD Revolution to close that gap.
Damani said the company personalizes medicine to the individual, something that advances in genomics is supposed to provide, but hasn't materialized. Genomics refers to the complete set of DNA in an individual.
"Medicine lacks plasticity, and the average technology takes 15 to 20 years to (enter) clinical practice, and we can't afford to do that anymore," Damani said.
MD Revolution, which opened this month, offers customers intensive workups and tests to guide them in staying healthy, Damani said. These are developed with Damani's clinical experience with patients, augmented with a team of specialists and including everything from nutritional consulting to health apps for the iPhone.
Colleagues at the company include board member Nicholas Schork, director of bioinformatics and biostatistics at the Scripps Translational Science Institute, which combines personalized medical with digital technology..
Customers can select from three programs, called DNA-Fit, DNA-Select and, at the high end, DNA-3-Day. The cost ranges from roughly $2,000 to $10,000, depending on the choice of programs. Some of the cost goes to devices that customers are given to assess their progress and gather data that's emailed back to the office. For DNA Fit, for example, the devices include a heart monitor and iPod Touch.
MD Revolution also gives customers a report in electronic form on a USB drive. The genomic information is not linked to the medical records, Damani said, so it's kept confidential. Customers have the option to share this information with their regular doctors, if they choose.
Equipped
Once they've been examined initially, customers have the option of a virtual office visit via teleconferencing.
"You can meet with me through Skype on ITV or on Facetime on your iPhone," he said. "These are the kinds of technologies that are built into the practice."
While the programs aren't now covered by insurance, Damani said he expects they will eventually be, because they are scientifically valid approaches to preventing and managing health problems.
The programs include a scan of customers' DNA to find disease predispositions and how they metabolize drugs. The higher-end programs include a more complete genomic report, medical imaging, metabolic testing and more extensive monitoring of vital signs and activities.
Damani said the programs aren't meant to steal customers away from their regular doctors, but to help the patients stay healthy, and to help the doctors help their patients stay healthy.
For example, customers can get a personalized exercise regimen that's crafted to their own physiology. And the intensive examination can detect a wrong diagnosis.
Bringing in science
"My first patient was a 75-year-old gentleman who thought his heart was going to explode," Damani said. "He was diagnosed with Parkinson's disease but did not really have Parkinson's disease. He had a bad tremor and he had something called orthostatic hypotension, where he gets really light-headed because his blood pressure drops. We took him off the medication, but he had never really exercised at the level he should have."
Testing found that the man had a low metabolic rate, so he was given instructions on how to perform interval training. He also received a wrist monitor that tracked his heart rate. The patient emailed the information from the device to MD Revolution, so doctors could check on how he was responding to the exercise.
"There is a science to exercise, there is a science to nutrition, there is a science to genomics" Damani said. "There's a lot out there that's being under-utilized because our system doesn't allow us, as physicians, to use these because of time constraints. You cannot see 20 patients a day and be able to provide some of these tools."
Source:NCT