Pediatric Research Podcast

Young children face unprecedented access to screens in the modern environment. It was recently estimated that children between the ages of 3-8 get almost 3 hours of screen use a day. The American Academy of Pediatrics (AAP) have recommendations for screen-based media use which focus on four variables: access to screens, frequency of use, content and grownup-child interaction, or “co-viewing". In this episode, we meet Early Career Investigator, Dr John Hutton, from Cincinnati Children's Hospital Medical Centre, who has created a composite measure of these variables, reflecting current modes of screen-based media use. 

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There is a growing body of evidence to suggest that early life stress can have detrimental effects on a child's physical and mental health. Hair cortisol concentrations are increasingly accepted as a cumulative measure of stressful experiences but they are understudied in preschool children. In this episode, we meet Professor Sunny Anand from Stanford University School of Medicine who developed a sensitive assay for hair cortisol concentrations. He and his team took hair samples from children aged 1-4 years in order to uncover psychosocial and demographic factors associated with this measure of physiological stress.

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In this episode, we meet Early Career Investigator, Dr Anna Tottman who during her time at the University of Aukland, Liggins Institute performed a retrospective cohort study looking at the relationship between neonatal nutrition and neurodevelopmental outcomes. Her research suggests that nutrition for preterm infants may need to be sex-specific. Take a listen!

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Preterm infants regularly need Packed red blood cell transfusions. This life-saving therapy can help prevent anaemia of prematurity and in turn, safeguard normal organ function. However, there is a risk that donor blood contains the heavy metals mercury (Hg), lead (Pb) and Cadmium (Cd) which are known developmental neurotoxicants and may be present in neurotoxic doses. In this episode we meet Alison Falck, Assistant Professor of Pediatrics at the University of Maryland School of Medicine who has studied the relationship between the donor concentration, number of transfusions and exposure in preterm infants. Her results may have implications for prescreening of donor blood.

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Medical Simulation is a powerful model for pediatric education. This type of experiential training is used to teach various skills including stressful medical tasks like resuscitation, without putting patients at risk. In order to better understand the behavior of healthcare providers during these situations, researchers have started to use eye-tracking technology. In this episode, we meet Early Career Investigator, Michael Wagner from the Medical University of Vienna, who during a fellowship at the Yale University, carried out a simulation-based study using eye-tracking glasses to explore the gaze behavior and subjective experience of care-givers during a neonatal resuscitation to assess the usability of this technology for training.

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Clinical studies have shown that newborns can experience up to 14 painful procedures each day of admission at the neonatal intensive care unit. There is evidence that these early experiences can cause changes to the developing nervous system affecting, amongst other things, nociception in adulthood. Preterm infants are at particular risk from repeated noxious procedures owing to the extensive developmental and functional changes taking place in the CNS at that time. In this episode, we meet Dr Nynke van den Hoogen, who during her time at Maastricht University, used an animal model to assess whether the number of neonatal noxious events has an affect on acute and long-term mechanical sensitivity.

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Cumulative exposure to psychosocial adversity in the early years of life can have an adverse effect on early child development (ECD).  Focus on ECD is growing globally, yet to date, the bulk of research on adverse psychosocial experiences and child development has taken place in high-income, Western countries, despite a large burden in developing countries. This month, we meet Early Career Investigator Dr. Annie Berens, a pediatric resident at the University of California San Francisco. She created the Childhood Psychosocial Adversity Scale, a novel measure of cumulative risk which has had its first application in Bangladesh. 

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A number of clinical variables are used to predict the likelihood of childhood epilepsy, however, additional predictors are needed to improve patient stratification for those at the highest risk of recurrent seizures. In this episode, we meet Adam Numis from the University of California San Francisco, who set out to assess the utility of circulating cytokines as a predictor of childhood epilepsy. He performed a longitudinal study of newborns at risk of neonatal encephalopathy, revealing an association between circulating levels of particular inflammatory cytokines and the later development of epilepsy.

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Neonatal encephalopathy (NE) is associated with substantial morbidity and mortality and affects around 1.5/1000 live term births. Predicting the severity and outcome of neonates with NE is therefore vital in order to provide the best care for neonates with NE, and a biochemical marker obtained at birth would therefore be useful to bolster the current scoring system. In this episode, Geoff Marsh speaks to Early Career Investigator Dr. Imran Nazir Mir, from the University of Texas, Southwestern Medical Center. He's just published a paper testing the utility of two potential candidate proteins for determining the presence and severity of hypoxic NE, and to understand where these molecules are synthesized and cleared.

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For term-born infants, low birth weight has been shown to correlate with a broad array of adverse cardiometabolic outcomes, and excess glucocorticoid exposure has been linked to these relationships. Also, intra-uterine growth restriction (IUGR) in term-born infants has been linked to subsequent increases in adrenal androgen activity. In this episode, we meet Kristi Watterberg, a professor of Pediatrics at the University of New Mexico who evaluated the relationship between preterm birth to salivary cortisol and dehydroepiandrosterone (DHEA) at age 6, and assessed the relationship of cortisol and DHEA with blood pressure and measures of adiposity. The results suggest interventions to improve the cardiometabolic outcomes of infants born extremely preterm.

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