Monday, December 29, 2014

Earlier school start time can mean more car crashes

Start changing your child's sleep schedule back to school time. - JR

Teens with an earlier school start time get into more car crashes which can indicate these teens are sleep deprived due to the earlier school start time.

A new study suggests that teen drivers who start class earlier in the morning are involved in significantly more motor vehicle accidents than peers with a later high school start time. The results underscore the importance of the "Awake at the Wheel" campaign of the National Healthy Sleep Awareness Project.
Results show that the weekday crash rate for teen drivers during the 2009 to 2010 school year was about 29 percent higher in Chesterfield County, Va., where high school classes began at 7:20 a.m., than in adjacent Henrico County, Va., where classes started at 8:45 a.m. Similar results were found for the 2010 to 2011 school year, when the weekday crash rate for 16-17 year old teens in Chesterfield County was about 27 percent higher than for those in Henrico County. In contrast, there was no difference in adult crash rates in the two counties for either year. A secondary analysis evaluating the causes and types of crashes found that Chesterfield County adolescents had a significantly higher rate of run-off-road crashes, which is a common feature of drowsy driving accidents.
"There are more and more data suggesting that insufficient sleep is common in our teens and that early high school start times are a contributor to teens' reduced sleep," said principal investigator and lead author Dr. Robert Vorona, associate professor in the Division of Sleep Medicine at Eastern Virginia Medical School in Norfolk, Va. "Insufficient sleep appears to have deleterious consequences such as decrements in mood and increased risk taking, impaired academics and increased crash rates."
The results corroborate the findings of a previous study by Vorona's team that evaluated teen crash rates from 2007 to 2008. Results of the current study are published in the November issue of the Journal of Clinical Sleep Medicine.
"When high school classes begin early in the morning, we ask teens to shine when their biological clock tells them to sleep," said American Academy of Sleep Medicine President Dr. Timothy Morgenthaler, a national spokesperson for the Healthy Sleep Project. "Many do not get adequate sleep as a result. Smarter school start times, that are more consistent with sleep needs, will improve students' safety, overall health, mood and academic performance."
Recently the Healthy Sleep Project launched the "Awake at the Wheel" campaign to increase public awareness of the risks of drowsy driving. More details are available at
The study involved an analysis of data provided by the Virginia Department of Motor Vehicles. During both school years there were more than 520 motor vehicle accidents involving teen drivers in Chesterfield County and more than 320 teen crashes in Henrico County.
The American Academy of Sleep Medicine recommends that adolescents get a little more than nine hours of nightly sleep for optimal health and daytime alertness during the critical transition from childhood to adulthood. The AASM advises parents and local school boards to work together to implement high school start times that allow teens to get the healthy sleep they need to meet their full potential.
A new report from the AAA Foundation for Traffic Safety estimates that drowsy driving may cause 328,000 motor vehicle accidents and 6,400 fatal crashes on U.S. roads each year. Previous data analysis by AAA also shows that the prevalence of drowsy driving crashes is highest among drivers between the ages of 16 and 24 years.
Read more here

Age of Miracles and Wonders - Unraveling the Genetics of Neurodevelopmental Disorders

We are living in a time of revolutionary change - a time of miracles and wonders.

I get 2 major questions about genetic testing:

1) How likely is this to be positive? 
  • Years ago I would say (in quieter tones) ...well...may be 3%. 
  • The latest data shows a 45% yield in testing. 
2) How likely is this to impact care? 
  • In this series it was as high as 49%
Speaking professionally and personally, its very helpful to chase down neurodevelopmental problems. Ask your pediatric neurologist!


Unraveling the Genetics of Neurodevelopmental Disorders

Genetic sequencingUnraveling the Genetics of Neurodevelopmental Disorders
In order for 85 billion neurons to develop into a healthy human brain, distinct neural cells must proliferate, differentiate, migrate, and integrate successfully.1 It's not surprising then that neurodevelopmental disorders (NDDs) affect more than 3% of all children.2. Up to 45% of all NDDs, which include autism spectrum disorders (ASDs), intellectual disability syndromes, and syndromes of developmental delay have been linked to specific genes.3
Genetic sequencing has been a quantum leap forward in our ability to gather genetic data, allowing massive amounts of DNA to be sequenced rapidly. Today, tens of thousands of genetic variants can be filtered to identify gene mutations through a process that once took years to identify a small number of disease-causing mutations.1 “At our specialized site, we can sequence a whole genome in under 50 hours,” said Sarah E. Soden, MD, developmental pediatrician and associate professor at the University of Missouri-Kansas City School of Medicine.

NDDs Still Difficult to Diagnose

Even with state-of-the-art gene sequencing, molecular diagnosis of NDDs is challenging. Although many genetic variations have been identified for many NDDs, variable expressivity, reduced penetrance, and phenotypic complexity make molecular diagnosis difficult. Locus heterogeneity can lead to similar NDDs, and genotypic convergence can lead to an NDD or to a psychiatric disorder.3
“We suspect that at least 30% of ASDs are caused by de novo mutations. Half of the mutations we find may be false positives. They may be silent mutations, or they may code for a different disorder that may show up later,” said Michael Ronemus, PhD, research assistant professor at Cold Spring Harbor Laboratory in New York, and a lead author on a 2014 study on the genetics of autism spectrum disorders. The study, published in Nature, analyzed the genomes of 2,500 families in which a single child had an ASD, but neither parent nor any siblings had ASDs. The study identified about 400 de novo mutations that may contribute to ASDs.5
“Some genetic defects seen in ASDs are also seen in schizophrenia. We still have little knowledge of what causes de novo mutations or what triggers mutations to become active. We do know that mutations increase with paternal age,” said Ronemus.
“We all have some de novo mutations. Many of them are silent, and some of them may be advantageous. That's how evolution works. We still need clinical diagnosis to guide treatment. Fetal alcohol syndrome and prematurity also contribute to NDDs. The epidemiology of these disorders remains a moving target,” said Soden.

Whole Exome Versus Whole Genome Sequencing

One way to cut down on the complexity and the cost of gene sequencing is to sequence only the genes that code for proteins. The exome accounts for 1.5% of the whole genome, and are the genes most likely to cause significant developmental changes. They are the “low-hanging fruit” of molecular diagnosis. “The advantages of whole exome sequencing are less expense and more yield because these are the genes that code for amino acids. The disadvantage is that you may miss something,” said Ronemus.
Soden and her team of researchers used both exome and genome sequencing in 100 families of children with NDDs. The researchers were able to make a molecular diagnosis of an established NDD in 45 out of 100 families. Most importantly, a change in clinical care or clinical diagnosis was reported in 49% of the newly diagnosed families. The study, which was published in Genomics, also concluded that using these technologies at the time when symptoms first appear could shorten the time to diagnosis by 77 months.2


Thursday, December 25, 2014

Effect of longer, deeper cooling for newborns with neurological condition

 As a neonatal neurologist involved in the program at The Womans Hospital, its amazing to care for these babies in the NICU and to see them later in the office.

Sadly, there is a limit to the efficiacy of the treatment.


ScienceDaily: Your source for the latest research news

Effect of longer, deeper cooling for newborns with neurological condition

December 23, 2014
JAMA - Journal of the American Medical Association
Among full-term newborns with moderate or severe hypoxic ischemic encephalopathy (damage to cells in the central nervous system from inadequate oxygen), receiving deeper or longer duration cooling did not reduce risk of neonatal intensive care unit death, compared to usual care, according to a study in the December 24/31 issue of JAMA.
Hypoxic ischemic encephalopathy is an important cause of childhood neurodevelopmental deficits among infants born at full-term. Hypothermia (reduced body temperature) at 33.5°C for 72 hours reduces death or disability, according to background information in the article. Longer cooling and deeper cooling has been found to be neuroprotective in animal models.
Seetha Shankaran, M.D., of Wayne State University, Detroit, and colleagues conducted a study in which full-term infants were randomly assigned to four hypothermia groups: 33.5°C for 72 hours, 32.0°C for 72 hours, 33.5°C for 120 hours, and 32.0°C for 120 hours, to examine if longer duration and deeper cooling would improve outcomes at 18 to 22 months. Infants admitted to the neonatal intensive care until within 6 hours of birth were candidates for the study when seizures or moderate or severe encephalopathy was present. The trial was closed for safety and futility issues and included 364 infants (of 726 planned).
Mortality in the neonatal intensive care unit (NICU) was 7 percent for the 33.5°C for 72 hours group, 14 percent for the 32.0°C for 72 hours group, 16 percent for the 33.5°C for 120 hours group, and 17 percent for the 32.0°C for 120 hours group.
Among neonates with moderate hypoxic ischemic encephalopathy, death in the NICU occurred in 4 percent in the 72 hours group; 8 percent in the 120 hours group; 7 percent in the 33.5°C group; and in 5 percent in the 32.0°C group. Among neonates with severe hypoxic ischemic encephalopathy, deaths in the NICU occurred in 34 percent in the 72 hours group; 42 percent in the 120 hours group; 31 percent in the 33.5°C group; and in 44 percent in the 32.0°C group.
Safety outcomes were similar between the 120 hours group vs 72 hours group and the 32.0°C group vs 33.5°C group, except major bleeding occurred among 1 percent in the 120 hours group vs 3 percent in the 72 hours group. Futility analysis determined that the probability of detecting a statistically significant benefit for longer cooling, deeper cooling, or both for NICU death was less than 2 percent.

Wednesday, December 24, 2014

Concussions impact teen drivers

This article explains how concussions can impact teen drivers.

Researchers at Cincinnati Children's Hospital Medical Center are currently studying teenagers who have suffered concussions in order to help doctors determine when teen drivers are ready to get back behind the wheel of a vehicle.
A driving study is currently taking place that uses assessments of eye tracking within a driving simulator to evaluate potential impairments to reaction times following a concussion.
"This is the only pediatric driving study that I know of that's examining the behavior of concussed patients," said Dr. Adam Kiefer, assistant professor of pediatrics at Cincinnati Children's Sports Medicine. "We are looking for novel ways to assess these teens and to allow them to return to the road safely."
Cincinnati Children's Sports Medicine recently received a grant from the Ohio Department of Transportation to perform the study. Researchers are testing patients between the ages of 16-19 who have suffered a concussion within 7-10 days. They are comparing them to their peers of the same age who are healthy and driving.
They will collect the data over the next several months. The research team with expertise in sports medicine, behavioral medicine and neurology will then analyze the results.
"One of the biggest issues teens and adults face when dealing with concussions is a decreased ability to react quickly to objects in their environment," said Dr. Kiefer. "This can be a major problem, especially during driving, and that's why I think it's important for this type of research to be done."
Read more here

Sleep apnea? Learn to play a double reed instrument like the oboe or didgeridoo!

Sleep apnea? Learn to play the oboe or didgeridoo! JR

Risk of Obstructive Sleep Apnea Lower in Double Reed Wind Musicians

Christopher P. Ward, Ph.D.,1 Kaki M. York, Ph.D.,2 and John G. McCoy, Ph.D.3

Risk of Obstructive Sleep Apnea Lower in Double Reed Wind Musicians
Christopher P. Ward, Ph.D.,1 Kaki M. York, Ph.D.,2 and John G. McCoy, Ph.D.3
Author information ► Article notes ► Copyright and License information ►

Go to:
Study Objectives:

Obstructive sleep apnea (OSA) is caused by a collapse of the upper airway. Respiratory muscle training with a wind instrument (didgeridoo) in patients with moderate OSA has been previously shown to improve OSA symptomology. However, a survey of orchestra members did not indicate a difference in OSA risk between wind and non-wind instrumentalist. The present study examines whether playing of different wind instrument types may affect the risk of OSA.


A national sample of active musicians (n = 906) was surveyed through the internet. Participants' risk for OSA was determined by the Berlin Questionnaire. Additional survey items included questions about general health and musical experience.


A binary logistic regression was conducted to determine if OSA risk was predicted by gender, age, number of years playing instrument, number of hours per week playing instrument, and instrument type. Musicians who played a double reed instrument had a lower risk of OSA (p = 0.047) than non-wind instrumentalists. Additionally, in double reed instrumentalists, the number of hours spent playing the instrument predicted lower OSA risk (p = 0.020). The risk for OSA in other wind instruments (i.e., single reed, high brass, and low brass) was not significantly different from non-wind musicians.


Playing a double reed musical instrument was associated with a lower risk of OSA.


Ward CP; York KM; McCoy JG. Risk of obstructive sleep apnea lower in double reed wind musicians. J Clin Sleep Med 2012;8(3):251-255.

Tuesday, December 23, 2014

What is microchimerism? Scientists Discover Children’s Cells Living in Mothers’ Brains

What a cool topic.  JR

Scientists Discover Children’s Cells Living in Mothers’ Brains

The connection between mother and child is ever deeper than thought
The link between a mother and child is profound, and new research suggests a physical connection even deeper than anyone thought. The profound psychological and physical bonds shared by the mother and her child begin during gestation when the mother is everything for the developing fetus, supplying warmth and sustenance, while her heartbeat provides a soothing constant rhythm.
The physical connection between mother and fetus is provided by the placenta, an organ, built of cells from both the mother and fetus, which serves as a conduit for the exchange of nutrients, gasses, and wastes. Cells may migrate through the placenta between the mother and the fetus, taking up residence in many organs of the body including the lung, thyroid, muscle, liver, heart, kidney and skin. These may have a broad range of impacts, from tissue repair and cancer prevention to sparking immune disorders.
It is remarkable that it is so common for cells from one individual to integrate into the tissues of another distinct person. We are accustomed to thinking of ourselves as singular autonomous individuals, and these foreign cells seem to belie that notion, and suggest that most people carry remnants of other individuals. As remarkable as this may be, stunning results from a new study show that cells from other individuals are also found in the brain. In this study, male cells were found in the brains of women and had been living there, in some cases, for several decades. What impact they may have had is now only a guess, but this study revealed that these cells were less common in the brains of women who had Alzheimer’s disease, suggesting they may be related to the health of the brain.....
 Microchimerism is the persistent presence of a few genetically distinct cells in an organism. This was first noticed in humans many years ago when cells containing the male “Y” chromosome were found circulating in the blood of women after pregnancy. Since these cells are genetically male, they could not have been the women’s own, but most likely came from their babies during gestation....

Tuesday, December 16, 2014

Short sleep and breathing issues increases obesity risk in children

A child's risk of obesity is increased by sleeping for short amounts of time and breathing issues while sleeping.

Too little sleep has officially been linked to an increased risk of obesity, particularly among young children. Recent findings published in The Journal of Pediatrics reveals a high connection between sleep-related breathing problems and obesity.

For the study, researchers analyzed data from 1,900 children in England and followed the participants for about 15 years. Study results showed that those who got the least amount of sleep between the ages 5 and 6 had between a 60 percent and 100 percent increased risk of obesity by age 15.

"In recent years, lack of sleep has become a well-recognized risk for childhood obesity," said lead study author Karen Bonuck, Ph.D., professor of family and social medicine and of obstetrics & gynecology and women's health at Einstein, in a news release. "Sleep-disordered breathing, or SDB, which includes snoring and sleep apnea, is also a risk factor for obesity but receives less attention. These two risk factors had not been tracked together in children over time to determine their potential for independently influencing weight gain. Our study aimed to fill in that gap."

Furthermore, researchers found that children with the most severe sleep-disorder breathing (SDB) had the highest obesity risk. Children whose SDB levels peaked at around 5 to 6 years old still had a 60 to 80 percent increased risk of obesity, but fared better overall.

"If impaired sleep in childhood is conclusively shown to cause future obesity, it may be vital for parents and physicians to identify sleep problems early, so that corrective action can be taken and obesity prevented. With childhood obesity hovering at 17 percent in the United States, we're hopeful that efforts to address both of these risk factors could have a tremendous public health impact," Bonuck concluded.

A common cause of sleep-related breathing problems in children is oftentimes due to enlarged tonsils or adenoids, which can be removed with surgery if a problem occurs. Misalignment of jaws or teeth can also cause issues.

Read more here

Monday, December 15, 2014

Getting to bed early helps mental health

Going to sleep early can help a person's mental health.

There are many benefits of going to bed early- and now, a team of researchers have found how this teeny tiny habit could have a positive impact on not just your physical health, but mental health as well.

Researchers from Binghamton University have found a possible connection between sleeping disorders and anxiety. It has been found that depression, anxiety, stress and obsessive compulsive disorders may cause heavy psychological traffic that could have an individual clinging too much to the past.

This new study, which took into consideration one hundred young adults, asked them to fill out questionnaires and carry out certain computerized tasks while the researchers assessed the extent of their obsessive behavior and thinking and worrying with respect to it. The study subject included individuals having different sleeping habits- some of them were night owls, while others had regular sleeping hours.

They found that individuals who slept less or went to bed late had signs of negative thinking as compared to those who slept early. While repetitive negative thinking isn’t a disorder as such, it does increase the risk of several anxiety disorders including depression and stress.

While the reason behind this phenomenon is unclear, scientists are making assumptions to decode it all. They have noted that sleeping late at night tends to disrupt the biological clock of the body, which also plays a negative impact on the levels of certain chemicals in our body.

These kinds of irregular sleeping patterns tend to upset the chemical production in the brain as well as other organs, even if you manage to get your much needed 8 hours of sleep a day.

Read more here

Increase in concussions seen in Ontario's children

A study showed that concussions in Ontario's children significantly increased between 2003 and 2010.

The number of children and youth treated for concussions in both emergency departments and physician's offices in Ontario increased significantly between 2003 and 2010, with falls, hockey and skating injuries identified as the leading causes of pediatric concussion, according to a new joint study out of York University and the Institute for Clinical Evaluative Sciences (ICES).
The study," A population-based study of pediatric emergency department and office visits for concussions from 2003 to 2010," published in the journal Paediatrics & Child Health, analyzed all visits related to a concussion by school-aged youth (three to 18 years) in Ontario from 2003 to 2010.
"This study is the first to examine pediatric concussions evaluated in both emergency departments and physicians' offices," says York University Professor Alison Macpherson, the study's lead author. "By examining all of the pediatric concussions evaluated in multiple facilities, we were able to minimize the issue of under-reporting and obtain a more accurate number of concussions treated in Ontario."
Between 2003 and 2010, researchers found a total of 88,688 pediatric concussions were treated in either an emergency department or a physician's office, and there was a significant trend in both locations. The total rate of concussions per 100,000 increased from 466.7 to 754.3 (for boys), and from 208.6 to 440.7 (for girls) during the study period. The numbers also showed that over time more children were being evaluated in physician's offices than emergency departments.
When the sources of concussion were broadly examined, falls were found to be the most common cause of concussion in an emergency department, representing 34 per cent of all emergency department visits, followed closely by exposure to force (25.5 per cent) and motor vehicle collisions (12.3 per cent). When specific causes were examined in more detail, hockey and skating -- common sports in North America -- were the most common causes of concussions that were treated in an emergency department.
"Our findings reinforced that falls in general are the most common cause of pediatric concussions, and that evidence-based prevention initiatives to help reduce the incidence of concussion are warranted -- particularly in sports and recreation programs," says senior scientist and chief science officer at ICES, Dr. Astrid Guttmann, the study's senior author. "Sports-related concussions can be minimized by taking preventive action, such as reducing body checking in hockey or wearing a helmet while cycling."
Macpherson says that future studies can attempt to differentiate between the true incidence of concussions and an increase in those seeking a health evaluation due to increased awareness of concussion and subsequent health consequences.
Read more here

Monday, December 08, 2014

Sleep apnea in children and behavioral problems

This article explains the link between sleep apnea in children and behavioral problems such as ADD and ADHD.

Attention deficit hyperactivity disorder (ADHD) is the most-commonly diagnosed behavioral disorder in children. The current standard of care for youngsters with attention deficit disorder (ADD) and ADHD is prescription medication such as Adderall, Ritalin and Dexadrine. These medications may have concerning side effects such as reduced height and weight, cardiovascular effects, tics, evidence of carcinogenic and reproductive effects, and substance abuse.

Sadly, many of these children are being misdiagnosed. A child who exhibits behavior problems or difficulty paying attention at home or school may actually be suffering from another disorder, an underlying undiagnosed sleep-related breathing disorder known as obstructive sleep apnea (OSA).

Dr. Stephen Sheldon, professor of pediatrics at Northwestern University School of Medicine and director of the Sleep Medicine Center says, “There are a number of sleep disorders that if looked at, an attention deficit problem can be identified. If you take a large number of children that have attention deficit and you evaluate them for sleep-disordered breathing, about a fifth to a quarter of those youngsters will have pediatric obstructive sleep apnea.”

He continues, “The most important aspect of evaluating a child for ADHD or other attention problems is to do a sleep evaluation in every single child. One hundred percent of these children need a sleep evaluation.”


Nighttime symptoms of youngsters with sleep-related breathing disorders are: snoring, bruxism, mouth breathing, bed wetting, frequent awakenings, nightmares, insomnia and physically restless sleep. Resulting daytime symptoms and findings are neurocognitive impairment, headaches, hyperactivity, behavioral issues, tiredness and poor school performance.

Lack of sleep and/or poor-quality sleep affects a child’s physical and emotional health, cognitive function, behavior and academic success. Parents, teachers, counselors or anyone concerned with the growth and development, academic performance, or health and well-being of a child must have greater awareness of sleep issues. Sleep screening and interventions to improve sleep must become part of every child’s routine clinical exam.

Early diagnosis and treatment of pediatric OSA is vital if we are going to have an impact on the epidemic of OSA in our country. Today, research indicates that one in four adults in this country suffers from obstructive sleep apnea. Of these, 80 percent remain undiagnosed and untreated. Although there is a growing awareness and therefore an increase in the number of adults treated for OSA, the key is prevention and early intervention.

A YouTube video, “Finding Conner Deegan,” tells a mother’s story of her struggling son who was labeled a “troubled child” early in his life. Having exhausted every resource, potential diagnosis and treatment known to his medical community, there appeared no other options. But through his mother’s perseverance, love, relentless search and striving to understand her son, her prayers were answered. Conner, in fact, suffered from undiagnosed pediatric OSA. He simply couldn’t breathe!

Parents, teachers, counselors and doctors need to be made aware of the need to screen children for sleep-related breathing disorders and understand the significant role timely diagnosis and thorough treatment play in the healthy growth and development of our children.

Read more here

Sunday, December 07, 2014

Can your mattress type influence your sleep quality? Can your mattress reduce your back pain? Maybe.

A patient asked me if there is any evidence that a certain mattress type can help their pain. In doing a little research, I found some evidence (admittedly weak on when judged from an academic standpoint) that...

Yes...a NEW, medium firm mattress that conforms to your sleeping position MAY help.

Other articles show evidence for lumbar support while sleeping.


J Chiropr Med.
 2009 Mar;8(1):1-8. doi: 10.1016/j.jcm.2008.09.002.

Changes in back pain, sleep quality, and perceived stress after introduction of new bedding systems.



This study compared sleep quality and stress-related symptoms between older beds (>/=5 years) and new bedding systems.


A convenience sample of healthy subjects (women = 30; men = 29) with minor musculoskeletal sleep-related pain and compromised sleep, but with no clinical history of disturbed sleep, participated in the study. Subjects recorded back discomfort and sleep quality upon waking for 28 consecutive days in their own beds (baseline) and for 28 consecutive days (post) on a new bedding system using visual analog scales. Following baseline measures, participant's beds were replaced by new, medium-firm beds, and they again rated their sleep quality and back discomfort. Stress was assessed by a modified stress questionnaire.


Repeated-measures analysis of variance was used to treat sleep quality and efficiency and factored responses of the stress items. Results indicated that the subjects' personal bedding systems average 9.5 years old and were moderately priced. Significant (P < .01) improvements were found between pre- and posttest mean values in sleep quality and efficiency. Continued improvement was noted for each of the 4-week data gathering period. Stress measures yielded similar positive changes between pre- and posttest mean values.


Based on these data, it was concluded that, in this population, new bedding systems increased sleep quality and reduced back discomfort, factors that may be related to abatement of stress-related symptoms.

Subjective rating of perceived back pain, stiffness and sleep quality following introduction of medium-firm bedding systems.



To compare personal and new bedding systems between subjects with reported high and low base line sleep quality.


A convenience sample of healthy subjects (women = 30; men = 29) with no clinical history of disturbed sleep participated in the study. Subjects recorded perceived back discomfort and stiffness, sleep quality and comfort, and sleep efficiency upon waking for 28 consecutive days in their own beds (baseline) and for 28 consecutive days (post) on a new bedding system. Repeated measures analysis of variance was used to treat sleep data.


Analysis revealed significant differences between pre- and post means in all areas for both high and low sleep quality groups. Analysis of sleep efficiency also yielded significant differences between, but not among pre- and post means. Improvement of sleep comfort and quality became more prominent with time (from wk 1 to 4 post observation).


Similar significant benefits of new, medium- firm bedding systems can occur for those reporting both good and poor current sleep quality and variables such as age, weight, height, and body mass index are independent of such improvements.
Appl Ergon. 2010 Dec;42(1):91-7. doi: 10.1016/j.apergo.2010.05.004. Epub 2010 Jun 26.

Effect of prescribed sleep surfaces on back pain and sleep quality in patients diagnosed with low back and shoulder pain.


The purpose of this study was to assess sleep quality and comfort of participants diagnosed with low back pain and stiffness following sleep on individually prescribed mattresses based on dominant sleeping positions. Subjects consisted of 27 patients (females, n=14; males, n=13; age 44.8 yrs ± SD 14.6, weight 174 lb. ± SD 39.6, height 68.3 in. ± SD 3.7) referred by chiropractic physicians for the study. For the baseline (pretest) data subjects recorded back and shoulder discomfort, sleep quality and comfort by visual analog scales (VAS) for 21 days while sleeping in their own beds. Subsequently, participants' beds were replaced by medium-firm mattresses specifically layered with foam and latex based on the participants' reported prominent sleeping position and they again rated their sleep comfort and quality daily for the following 12 weeks. Analysis yielded significant differences between pre- and post means for all variables and for back pain, we found significant (p<0 .01="" 4="" 8-12="" additionally="" and="" are="" back="" based="" between="" both="" by="" chronic="" concluded="" days="" decreased="" differences="" discomfort="" experiencing="" first="" improvement="" in="" increase="" indeed="" indicating="" is="" it="" mattresses.="" mattresses="" mean="" nbsp="" new="" number="" of="" on="" p="" pain="" per="" physical="" poor="" position.="" possible="" posttest="" progressive="" quality="" reduce="" related="" replacing="" significantly.="" sleep="" sleeping="" stiffness="" surfaces="" that="" the="" those="" thus="" to="" was="" week="" weeks="" while="" with="">
Copyright © 2009. Published by Elsevier Ltd.

Thursday, December 04, 2014

Autism diagnoses may miss minority kids

Autism diagnoses may miss minority kids, a new study claims.

Black and Hispanic students are less likely to be identified as having autism than white students, a new study reveals.
Researchers analyzed autism identification rates at schools across the United States between 2000 and 2007. These rates reflect how many students have been identified by schools -- not necessarily a doctor -- as having autism.
Rates among black, Hispanic and white students increased in all states and the District of Columbia, but the overall increase was smaller than predicted by the U.S. Centers for Disease Control and Prevention.
Rates among black students climbed in all states except Alaska and Montana, and rates among Hispanic students increased in all states except Kentucky, Louisiana and the District of Columbia, the investigators found.
Rate increases among black and Hispanic students were much smaller than among whites, according to the study in the November issue of theJournal of Special Education.
"Nearly every state that had proportional representation of students in 2000 underidentified black and Hispanic students in 2007," Jason Travers, assistant professor of special education at the University of Kansas, and colleagues, wrote.
"Although there is no firm epidemiological evidence that race is predictive of autism, we found substantial racial differences in the ways U.S. schools identify students with autism," they added.
The findings suggest that black and Hispanic students may not be getting the same level of autism services as white students, the researchers said in a university news release.
The racial differences suggest a number of problems, including unequal access to autism services, according to Travers.
"These data depict what's going on in schools," he said in the news release. "Whether or not they match with clinical diagnoses, the numbers can be associated with a variety of costs. They tell us about the human costs, financial resources dedicated to services, administrative costs, community costs and many others."
Read more here

Magnets in helmets may help reduce concussions

This article explains how adding magnets to football helmets could help reduce concussions by using a magnet's the repulsive forces.

Adding magnets to football helmets could reduce the risk of concussions, new research suggests. When two players collide, the magnets in their helmets would repel each other, reducing the force of the collision.

“All helmet design companies and manufacturers have the same approach, which is to try to disperse the impact energy after the impact’s already occurred,” neuroscientist Raymond Colello said November 15 at the annual meeting of the Society for Neuroscience.

The magnets, he says, would put a brake on the impact before it happens.

The idea hasn’t been tested yet in helmets with real players, said Judy Cameron, a neuroscientist at the University of Pittsburgh. “But a lot of thought has gone into it, and the data that was shown about the ability of the magnets to actually repel each other looked extremely promising.” 

On the field, football players can run at nearly 20 miles per hour and can experience up to 150 g’s of force upon impact. Concussions readily occur at impacts greater than 100 g’s. Every year there are 100,000 concussions at all levels of play among the nearly 1.2 million people who play football in the United States.

Colello, of Virginia Commonwealth University in Richmond, is testing magnets made in China from the rare-earth element neodymium. They are the most powerful commercially available magnets and weigh about one-third of a pound each (football helmets weigh from 3.5 to 5.5 pounds). When placed one-fourth of an inch away from each other, two magnets with their same poles face-to-face exert nearly 100 pounds of repulsive force.

Colello tested his magnets with the same procedure that the National Operating Committee on Standards for Athletic Equipment uses to evaluate football helmets. He placed magnets on the front of a weight and let it drop from various heights onto another magnet. The heights Colello tested (between 6 inches and 4 feet) represent the impact forces athletes normally experience on the playing field.

“At 48 inches, if you dropped a standard helmet and it hit a stationary object, it would create 120 g’s of force,” says Colello. “With the magnets we drop that below 100 g’s.”

The magnets would complement existing helmet safety features. Colello speculates that adding magnets to a helmet would raise the price by $50 to $100. (Professional helmets today can cost several hundred dollars.) Amateur players, who will not experience impacts as crushing as pros do, could use helmets with cheaper, less powerful magnets.

Though the magnets do attract metallic objects, the National Football League prohibits athletes from wearing jewelry during games. Another safety concern is whether the magnets are dangerous to have near human heads. Colello says that a 30 minute- to one-hour MRI procedure produces magnetic fields 10 to 30 times as strong as those in helmet magnets.

Colello is now awaiting customized arc-shaped magnets that can be fitted inside helmets so he can begin field-testing them. First he will run crash-test dummy heads donning the helmets on a zip line; when the heads collide, accelerometers will measure the linear and rotational forces caused by the impact.

If the magnets make it through field tests, they could theoretically reduce the relative risk of concussions by up to 80 percent without changing the appearance or intensity of the game, Colello says.

Read more here