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Pediatrics, Research, Stanford News

Stanford brain tumor research featured on “Bay Area Proud”

Stanford brain tumor research featured on “Bay Area Proud”

Stanford physician-scientist Michelle Monje, MD, PhD, conducts research on a particularly heartbreaking form of brain tumor. Diffuse intrinsic pontine glioma, a brain cancer of school-aged children, has a five-year survival rate of just one percent. The prognosis has not improved in decades, in part because the tumor is rarely biopsied in living patients, making tumor samples that scientists might study very scarce.

However, for the last five years, Monje’s lab has been culturing cancer cells from tumors donated by the families of recently deceased patients. The cell cultures, which Monje has been sharing with scientists around the country, could give valuable information about how the cancer grows and what drugs might work to fight it.

Today, NBC Bay Area featured a Gilroy family who just donated their daughter’s tumor. After 6-year-old Jennifer Kranz passed away earlier this week, Monje’s team began working to grow the tumor cells.

“If I can stop another mother, another grandmother, another aunt from feeling the way I do right now, I will,” said Jennifer’s mother, Libby Kranz, in the NBC story.

“I think it is the definition of selfless to donate tissue in this way,” Monje told NBC.

Previously: Emmy nod for film about Stanford brain tumor research – and the little boy who made it possible, Big advance against a vicious pediatric brain tumor and New Stanford trial targets rare brain tumor

Parenting, Pediatrics, Research, Stanford News

Want to boost your child’s language skills? Talk directly to him (or her) from an early age

Want to boost your child's language skills? Talk directly to him (or her) from an early age

13499-fernald_newsIn a past entry published on Scope, my colleague Holly MacCormick spoke with Anne Fernald, PhD, an associate professor of psychology at Stanford, about her research showing that the amount of time parents spend speaking directly to their toddler can make an significant difference in the child’s language proficiency and vocabulary.

To further explore the link between children’s language skills and how often their caregivers talk directly to them, Fernald and colleagues launched a parent-education intervention study with low-income Spanish-speaking mothers in East San Jose. A recent Stanford Report story offers more details about the program and researchers’ preliminary findings:

This new program, called ¡Habla conmigo! (Talk with Me!), teaches Latina mothers how they can support their infants’ early brain development and helps them learn new strategies for engaging verbally with their children. Although they have data from only 32 families so far, the preliminary results are promising. Mothers in the ¡Habla conmigo! program are communicating more and using higher quality language with their 18-month-olds compared to mothers in a control group.

“What’s most exciting,” said Fernald, “is that by 24 months the children of more engaged moms are developing bigger vocabularies and processing spoken language more efficiently. Our goal is to help parents understand that by starting in infancy, they can play a role in changing their children’s life trajectories.”

Previously: Talk to her (or him): Study shows adult talk to preemies aids development, Stanford study shows importance of parents talking directly to their toddler and Study shows brain scans could help identify dyslexia in children before they start to read
Photo by Alan Bailey/Shutterstock

Cancer, Dermatology, Parenting, Pediatrics, Research

Want teens to apply sunscreen regularly? Appeal to their vanity

tanning_021314When it comes to encouraging teenagers to take measures to reduce their risk of skin cancer, new research suggests parents and health educators should emphasize how ultraviolet light causes wrinkles and other signs of premature aging.

In the study, researchers recruited high-school students and randomly assigned them to two groups. One set of participants watched a health-based video that highlighted skin-cancer risks, while the other group viewed a video focusing on the cosmetic changes due to ultraviolet light. Students completed questionnaires demonstrating their knowledge about ultraviolet light and use of sun-protective behaviors before and after watching the videos. According to a University of Colorado Cancer Center release:

… despite knowing the skin cancer risk from ultraviolet exposure, the group that had watched the health-based video showed no statistically significant increase in their sun-protective behaviors. On the other hand, the group that had been shown the appearance-based video reported a dramatic increase in the use of sunscreen.

“For teenagers, telling them [ultraviolet] exposure will lead to skin cancer is not as effective as we would hope. If our endgame is to modify their behavior, we need to tailor our message in the right way and in this case the right way is by highlighting consequences to appearance rather than health. It’s important to address now – if we can help them start this behavior when younger, it can affect skin cancer risk when older,” [says study co-author April Armstrong, MD.]

Previously: Beat the heat – and protect your skin from the sun, As summer heats up take steps to protect your skin, How ultraviolet radiation changes the protective functions of human skin, Medical experts question the safety of spray-on tanning products and The importance of sunscreen in preventing skin cancer
Photo by David van der Mark

Neuroscience, Parenting, Pediatrics, Research

Talk to her (or him): Study shows adult talk to preemies aids development

Talk to her (or him): Study shows adult talk to preemies aids development

preemie sleeping

When my little niece was born at 25 weeks’ gestation, she lived in a clear plastic incubator for the first several months out of the womb. Walled off in her own world, she grew and stabilized her health seemingly by the force of her own strong will, which still powers her as a 6-year-old. Unlike healthy full-term babies who can be snuggled, sung to and incorporated into the fold of a family’s daily life, preemies in the NICU may have less direct contact with their parents and other loved ones initially. But a recent study (subscription required) published in the journal Pediatrics has found that when adults spent more time talking to premature infants in the NICU, those babies score better on development tests at ages 7 and 18 months corrected age (actual age in weeks minus weeks premature).

Reuters Health article reports:

For the new study, the researchers recruited families of 36 babies that were medically stable but born before 32 weeks of pregnancy and kept in the NICU.

….

The babies in the study wore vests equipped with devices that record and analyze the conversations and background noises near the baby over 16 hours. The recordings were taken at 32 and 36 weeks of gestational age.

Overall, the babies were exposed to more talking at 36 weeks than at 32 weeks, but the actual amount of talk each baby was exposed to during the study periods varied from 144 words to over 26,000 words.

The study found an increased amount of parent talk in the NICU was linked to higher language and thinking scores when the babies were older. “I think we should pay attention to it, and try to understand it a little bit better and figure out what the causal mechanisms are,” Heidi Feldman, MD, PhD, a Lucile Packard Children’s Hospital Stanford physician who was not involved in the study, said of the findings.

Previously: The year in the life of a preemie – and his parentsUsing the iPad to connect ill newborns, parents and The emotional struggles of parents of preemies
Photo by singingbeagle

Behavioral Science, Nutrition, Parenting, Pediatrics, Public Health, Research

Fruit-filled Manga comics may increase kids’ consumption of healthy food

Fruit-filled Manga comics may increase kids' consumption of healthy food

kidsfruitMore than a decade into adulthood, I’m still drawn in to the worlds created by sugar-cereal commercials. Hypnotized by the swirling pattern of Cinnamon Toast Crunch and captivated by the magic of Lucky Charms, I can see how actual kids’ eating behavior could be influenced by cartoon messaging.

So I was interested to read about a pilot study in New York City public school children that examined how reading comics featuring healthy food could have an effect on snack choice.

Science 2.0 reports:

It comprised 57 youth, approximately 11 years of age, nearly 90% of whom were either Black/African American or Hispanic and 54% were female. The school districts in the study had greater percentages of students eligible for free lunch (79 and 96%, respectively) compared to the citywide average of 66%.

After reading either a Manga comic, titled “Fight for Your Right to Fruit,” or a non-health-related newsletter, children were given the choice between a healthy snack (oranges, grapes, apples, strawberries) or an energy-dense snack (cookies, potato chips, nacho chips, and cheese-filled crackers). 61% of children in the comic group chose a healthy snack after reading, opposed to just 35% of the control group.

Regarding the choice of Manga, a Japanese comic form featuring detailed artwork and storytelling, the study notes:

The Transportation-Imagery Model (TIM) explains how Manga comics may contribute to changes in health-related beliefs and behaviors. According to the TIM, persuasion of a story’s messages occurs because an individual is “transported” or immersed into the narrative world.15 The TIM also suggests that images are most impactful when they are embedded in a story, rather than provided in isolation.15 Thus, visual images relevant to the story’s messages, such as those incorporated in Manga comics, may further influence attitudes and beliefs.

The authors write, “Results suggest Manga comics may be a useful format to promote healthy snack selection in urban minority youth.” (Side note: Writing about this pilot study made me want to eat mangoes.)

The research was published in the Journal of Nutrition Education and Behavior.

Previously: Depictions of obesity in children’s moviesNo bribery necessary: Children eat more vegetables when they understand how food affects their bodies, Talking to kids about junk food ads, Health experts to Nickelodeon: Please stop promoting unhealthy food to our kids and Researchers find cartoons really do make food taste better (or so kids think)
Photo by North Charleston

In the News, Parenting, Pediatrics, Public Safety

Carseats save lives, but only if kids are buckled in

Carseats save lives, but only if kids are buckled in

carseatA new study shows failure to properly restrain children in carseats or a seatbelt remains a leading cause of death for children involved in motor vehicle accidents. As reported today on the Well blog, the death rate decreased from 2002 to 2011, but  thousands of children under 12 unfortunately died because they were not buckled in. Using a carseat or seatbelt could have saved many of those lives:

In 2011, 33 percent of children who died in motor vehicle accidents were not buckled in. While only 2 percent of children under age 1 rode unrestrained, 22 percent of those in that age group who died were unbuckled. An estimated 3,308 children under 4 are alive today because they were properly buckled in.

“We can do more to help protect our children on the road,” [lead author Erin K. Sauber-Schatz, PhD] said “We have to make sure that children are buckled into age- and size-appropriate seats and seatbelts on every trip, no matter how short the trip.”

Many hospitals, including Lucile Packard Children’s Hospital Stanford, offer car seat installations and inspections for new parents.

Previously: Precious cargo: Keeping kids safe in cars and planes
Photo by Kari Bluff

Cancer, Infectious Disease, Pediatrics, Public Health, Research, Sexual Health

Girls don’t have riskier sex after the HPV vaccine

Girls don't have riskier sex after the HPV vaccine

HPV vaccineWhen the first vaccines were introduced against the human papillomavirus, some people worried that this anti-cancer vaccine would give young women the wrong idea. The vaccines, which protect against common cancer-causing strains of HPV, don’t guard against other sexually transmitted infections or unwanted pregnancies. But some parents and physicians thought that vaccine recipients might forgo condoms more often, have more sexual partners or otherwise engage in riskier sexual behaviors than women who were not vaccinated.

However, a study published today in Pediatrics says that’s not the case. According to the new research, young women don’t change their sexual behaviors after receiving the HPV vaccine. The researchers asked more than 300 girls and women, aged 13 to 21, about their risk perception and their sexual behaviors when they received their first dose of the HPV vaccine. They followed the group over time, repeating the questions 2 and 6 months later, when the vaccine’s booster shots were delivered.

“Most participants in this study did not perceive that they had a lower risk for STIs other than HPV, and most believed that safer sexual behaviors were still important,” the study’s authors wrote. Later, they add, “These findings contribute to the growing literature suggesting that HPV vaccination is unlikely to alter sexual risk behaviors in young women.”

I asked Stanford’s Sophia Yen, MD, for her take on the results. Yen provides HPV vaccinations in her role as an adolescent medicine specialist at the Teen and Young Adult Clinic at Lucile Packard Children’s Hospital Stanford. “The findings are not surprising and re-emphasize what other studies have shown,” she told me, adding that she hopes the study will be repeated in males, since boys have now begun receiving the HPV vaccine, too.

In the meantime, Yen plans to continue using this and other scientific evidence to reassure parents about the value of the vaccine. “I hope that the findings of this study and its many other predecessors will become widely known to parents and other non-adolescent medicine specialists who see adolescents, and to policymakers,” she said. “Let’s prevent STDs and cervical cancer together.”

Previously: Study shows racial disparities in HPV vaccination, Packard Children’s adolescent and young-adult specialist offers tips for college-bound students, HPV-associated cancers are rising, HPV vaccination rates still too low, new national report says and Only one-third of teenage girls get HPV vaccine to prevent cervical cancer
Photo by wintersoul1

Genetics, Immunology, Pediatrics, Research, Stanford News

Researchers show how DNA-based test could keep peanut allergy at bay

Researchers show how DNA-based test could keep peanut allergy at bay

peanut butter cookies

Treating peanut allergy is an arduous process. The only option is a still-experimental therapy, known as oral immunotherapy, in which a patient consumes tiny, gradually increasing doses of peanut powder under a doctor’s supervision. After months or years of treatment, the patient can eat small amounts of peanuts in ordinary foods without provoking an allergic response.

People with severe peanut allergy may think the effort is worthwhile because it frees them from worry that a stray, peanut-containing cookie or stir-fry will trigger anaphylactic shock. But there’s a catch. To maintain this hard-won tolerance, patients who have completed oral immunotherapy are told they must eat peanuts every day for the rest of their lives. If they don’t, they may regain their allergy.

Now, Stanford researchers think they’ve come up with a better option: a potential blood test to see which patients can safely stop eating peanuts without losing their peanut tolerance. A new study led by Kari Nadeau, MD, PhD, found that differences in the DNA of certain white blood cells separated patients who kept their immune tolerance from those who lost it after oral immunotherapy. The study, published today in the Journal of Allergy and Clinical Immunology, followed 20 child and adult patients who completed two years of oral immunotherapy to treat their peanut allergies. They were asked to stop eating peanuts for three months. In that time, 13 regained their sensitivity to peanuts and seven stayed peanut-tolerant.

The researchers saw epigenetic differences between the groups – genetic changes that affect the structure of the chromosome but not the gene sequence itself. The differences could be detected in small blood samples with commonly-available lab equipment, pointing the way to a possible clinical test. FDA approval is needed before the test could be clinically used for this purpose.

From our press release about the study:

“It’s interesting that the change we saw is at the epigenetic level,” Nadeau said, referring to changes in gene activity and expression caused by factors other than DNA sequence. “This might help us tell people if they can safely go off of immunotherapy, or if they need to continue to eat the food every day.” The test could also help researchers determine whether some individuals would benefit from longer courses of immunotherapy, she added.

Interestingly, the new research answers some questions that physicians posed about another just-released study of oral immunotherapy for the treatment of peanut allergies.

Previously: Eating nuts during pregnancy may protect baby from nut allergies, Ask Stanford Med: pediatric immunologist answers your questions about food allergy research and A mom’s perspective on a food-allergy trial
Photo by Muy Yum

Mental Health, Parenting, Pediatrics

Study finds treatment for anxiety disorders among children and young adults inadequate

Study finds treatment for anxiety disorders among children and young adults inadequate

anxiety_teenNew research shows that less than half of children and young adults who are treated for anxiety disorders will achieve long-term relief from symptoms.

In the study (subscription required), researchers at Johns Hopkins Children’s Center and five other institutions conducted a long-term analysis of nearly 300 patients, ages 11 to 26,  treated with medication, cognitive behavioral therapy or a combination of the two. Individuals received treatment for three months and followed, on average, for six years. Results showed 47 percent were anxiety-free by the end of the follow-up period and nearly 70 percent required some form of occasional mental health treatment.

A story published today in U.S. News and World Report discusses the significance of the findings:

“The study underscores the chronic nature of psychiatric illnesses and illustrates the importance of the pressing need to study and support mental health treatments across the age and demographic spectrum,” said Dr. Aaron Krasner, adolescent transitional living program chief at Silver Hill Hospital in New Canaan, Conn. “Anxiety, a common condition by most epidemiologic estimates, is understudied and undertreated, especially in the pediatric population,” he said.

[Lead investigator Golda Ginsburg, PhD and her] team believe their findings also highlight the importance of close follow-up and monitoring of symptoms among children, teens and young adults who’ve been treated for anxiety, even if they seem to be getting better.

“Our findings are encouraging in that nearly half of these children achieved significant improvement and were disease-free an average of six years after treatment, but at the same time we ought to look at the other half who didn’t fare so well and figure out how we can do better,” Ginsburg, who is also professor of psychiatry at the Johns Hopkins University School of Medicine, said in a Hopkins news release.

“Just because a child responds well to treatment early on, doesn’t mean our work is done and we can lower our guard,” she added.

Previously: Anxious children’s brains are different from those of other kidsNew research tracks “math anxiety” in the brain and Fear leads to creation of new neurons, new emotional memories 

Behavioral Science, Neuroscience, Parenting, Pediatrics, Research

Study finds age at which early-childhood memories fade

Study finds age at which early-childhood memories fade

baby with balloonI have a clear memory of standing near a crêpe-paper-lined wall of my fourth-grade classroom and deciding that age 9 was the time kids got a grip on how things worked and became fully initiated into the world of adult-level thinking. (I had recently turned 9.) That hypothesis wasn’t confirmed but, let’s say, wouldn’t be struck down by the results of a recent study on childhood amnesia that suggests that 7 is the age that the earliest childhood memories – of events that happened before age 3 – fall away.

Researchers from Emory University recorded 83 3-year-olds being interviewed by their mothers about unique autobiographical events. From the study:

Different subgroups of children were tested for recall of the events at ages 5, 6, 7, 8, and 9 years. At the later session they were interviewed by an experimenter about the events discussed 2 to 6 years previously with their mothers (early-life events). Children aged 5, 6, and 7 remembered 60% or more of the early-life events. In contrast, children aged 8 and 9 years remembered fewer than 40% of the early-life events.

The authors found that children whose parents allowed them to direct the conversation, even to switch topics, recalled more than children whose parents kept them on topic.

A release describes more on the findings:

“One surprising finding was that, although the five-and-six year-old children remembered a higher percentage of the events, their narratives of these events were less complete,” [Emory University psychologist Patricia Bauer, PhD, the study's lead author] says. “The older children remembered fewer events, but the ones they remembered had more detail.”

Some reasons for this difference may be that memories that stick around longer may have richer detail associated with them and increasing language skills enable an older child to better elaborate the memory, further cementing it in their minds, Bauer says.

Young children tend to forget events more rapidly than adults do because they lack the strong neural processes required to bring together all the pieces of information that go into a complex autobiographical memory, she explains.

The study was published in the journal Memory.

Previously: We’ve got your number: Exact spot in brain where numeral recognition takes place revealedIndividuals’ extraordinary talent to never forget could offer insights into memory and Childhood-cancer survivors face increased risk of PTSD
Photo by Charlotte Morrall

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