March 9, 2016
Volume VII | Issue No. 10

Mediators of psychological well-being in adolescent boys
The Active Teen Leaders Avoiding Screen-Time (ATLAS) intervention (a 20 week school-based intervention designed to improve health behaviors in low income communities that consists of teacher professional development, enhanced school-sport sessions, researcher-led seminars, lunch-time physical activity mentoring sessions, pedometers for self-monitoring, etc.) was utilized in a cluster-controlled trial in 14 secondary schools (and 361 adolescent boys) in low income communities to assess 8th month post intervention psychological well-being.

Statistically significant improvements in autonomy needs satisfaction, recreational screen time and muscle fitness mediates the intervention's ability to enhance psychological well-being in adolescent boys.

Journal of Adolescent Health
Oral effects of Ursodeoxycholic acid on indirect hyper-bilirubinemia in neonates
Ursodeoxycholic acid is a metabolic bile acid byproduct of intestinal bacteria which has many functions and has been shown to decrease jaundice in primary biliary cirrhosis.

It appears from a double-blind randomized clinical trial of jaundiced neonates undergoing phototherapy that ursodeoxycholic acid significantly decreases indirect hyperbilirubinemia and reduces the time required for phototherapy.
Melatonin supplementation for children with Atopic Dermatitis (AD) and sleep disturbance
A randomized, double-blind, placebo controlled, cross-over study to evaluate the effectiveness of melatonin supplementation (3mg/day or placebo for 4 weeks) on AD severity and sleep variables indicates that the treatment is a safe and effective therapy to improve AD severity and sleep-onset.
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X-ray negative lateral ankle injuries - occult growth plate fracture or sprain?

Lateral ankle injuries without x-ray evidence of a fracture are common in childhood; often presumed to be a fracture involving the epiphysis (growth plate only or "Salter-Harris type I fracture of the distal fibula; SH1DF"). Management is usually by immobilization. Previous small studies suggest that many are "ankle sprains" and do not involve a bone fracture.

A prospective cohort study of 135 children evaluated ankle MRI's with clinical suspected SH1DF to assess its frequency and compare functional recovery to those diagnosed with an isolated ligament injury. Salter-Harris fractures of the distal fibula are rare in children with radiograph negative lateral ankle injury ( <3% ); most injuries are ligamentous,  (sprains) & comparable recovery occurs with a removable ankle brace.

Video Feature 
Optimizing Well-Being
Optimizing Well-Being
Touch-screen technology usage in toddlers
From a parental questionnaire of children 12 months to 3 years of age, it appears that 71% of toddlers have access to a touch-screen device - by 24 months most have the ability to unlock, swipe and actively look for specific features on the device.

Infection risk factors in Nuss bar (substernal metal bar) treatment of Pectus Excavatum (PE)

"PE is the most common chest wall deformity with an incidence of 1:400 births". Minimally invasive treatment utilizing a
Pectus Excavatum
Pectus Excavatum
substernal bar to elevate the sternum has become the most common method of surgical treatment.

A retrospective chart review of 854 patients treated with a Nuss bar for PE reveals:
  1. 3.5% develop cellulitis or infection.
  2. Preoperative antibiotics (cefazolin) decreases infection rate.
  3. Using a continuous peri-incisional pump for analgesia increases infection rate.
  4. Nuss bars can be retained in place in 90% of patients with infection.
Prenatal vs postnatal predictors of severity in Congenital diaphragmatic hernia (CDH) in infants.

A retrospective postnatally-based clinical prediction model was compared to fetal imaging-based predictors of mortally in 176 CDH patients.

Prenatal data suggests CDH survivors have higher lung volumes, lung-to-head ratios and lower degrees of liver herniation compared to nonsurvivors , with observed/expected-total fetal lung volume being the only independent prenatal predictor to describe 6 month mortality.

A postnatal prediction rule (see article) provides good discrimination between patients classified as low, intermediate and high mortality risk at 6 months of age.

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