On the Pulse

Exploring the gray area in the bioethics of clinical trials

Stethoscope

People are more comfortable with black and white, and less so with gray. This isn’t a reference to artwork, but rather the way that things work in the world. There is right and wrong, left and right, and one side of the fence, or the other.

“Gray” happens in medicine and quite frequently in the realm of bioethics, the study of ethical and moral implications of new biomedical discoveries, advances and new and not-so-new procedures. When clinicians grapple with whether an organ transplant should be performed over a family’s objections, for example, that is bioethics.

Alabama-led study under scrutiny

In March, a federal agency known as the Office for Human Research Protections notified the University of Alabama that it was not compliant with U.S. Department of Health and Human Services regulations for the protection of human research subjects. UAB was the lead investigator in this study, which included 23 institutions, among them Stanford, Duke, Emory and Yale.

HHS said the risks of the study, which compared the effect of two different oxygen levels in babies’ blood, were not properly communicated to the parents of some 1,300 infants in the permissions forms and that the risks included blindness, neurological damage and death. The study was conducted between 2004 and 2009, and results were published in 2010. Read full post »

Couple turns their big day into a big gift for kids

Marc and Shaquita_print Dishes, silverware, small appliances, sheets, towels. Home essentials like these appear on nearly all wedding gift registries. But for Shaquita Bell, MD, a primary care pediatrician at Seattle Children’s, and her fiance, Marc Stamm Boyer, giving their wedding guests a wish list of stuff for themselves just didn’t feel right.

“We are at a point in our lives where we have the things we need and the things we want,” says Boyer. “It seemed silly to say, ‘Hey, you know how we have all this silverware? We should totally get some more.’”

But knowing that guests might insist on giving a gift, they put their heads together to come up with another option: “registering” for donations to Seattle Children’s.

“If our guests want to spend money on our wedding, we’d rather it go toward something inherently good,” says Boyer. Read full post »

Summer routines help keep kids thinking and moving while school’s out

GirlReadingAs the song goes, school’s out for summer! Children across the country are putting another school year behind them and welcoming, with open arms, the long days of summer. But while summer might seem like the perfect time to put aside routines and schedules, Mollie Grow, MD, MPH, a pediatrician at Seattle Children’s Hospital, says a little structure is critical for kids’ growth and development.

Summer schedule may sound like an oxymoron, but kids need direction and routine, says Grow. Some children can experience a loss of cognitive ability during summer break, according to some studies. By encouraging mental stimulation throughout summer, parents can help children maintain math, reading and spelling skills. Research suggests a significant positive effect when children are enrolled in summer learning programs, compared to children who are not. Promote daily reading or math problems, select educational television programs and games and plan educational “field trips” with the family, like nature walks or trips to museums. Read full post »

More kids accidentally poisoned by legal marijuana, study finds

Medical marijuana

A Colorado study finds that more of the state’s children have accidentally ingested marijuana since medical marijuana was legalized. Suzan Mazor, MD, a pediatric emergency medicine physician at Seattle Children’s and a medical toxicologist at Children’s and the Washington Poison Center, says parents and doctors can expect to see similar effects in Washington state.

The study, published May 27 in JAMA Pediatrics, was conducted at a children’s hospital in Colorado, where medical marijuana was legalized in June 2001 and recreational use of marijuana was decriminalized in November 2012. The researchers saw a sharp increase in emergency department visits for marijuana ingestion after October 2009, when the federal government stopped prosecuting medical marijuana users who were conforming to their state’s laws.

Fourteen children between 8 months and 12 years old were evaluated and treated for accidental ingestions between October 2009 and December 2011. By comparison, there were no accidental marijuana ingestions between January 2005 and September 2009.

Mazor says it makes sense that as marijuana became more available in the community, children’s exposures to the drug increased. She suspects that researchers would see the same results in Washington state, which has similar laws. “More availability of any poison usually translates to more unintentional poisonings in kids.”

The emergency team at Children’s has already seen several cases of unintentional marijuana ingestion. “One child in particular was quite sedated, and was admitted to the pediatric intensive care unit after eating a homemade product containing marijuana,” says Mazor.

Read full post »

Building Hope expansion full, getting rave reviews one month after opening

Building Hope patient roomIt’s been one month since Seattle Children’s new cancer, critical and emergency care expansion opened to patients and the inpatient units are already full. The new Emergency Department (ED) on the ground floor of the building has also seen higher-than-normal patient volumes. Patients and staff are giving Building Hope high marks.

“It’s unbelievable to see it as a real building. It’s amazing that it’s so similar to the cardboard mockup we built three years ago,” says Mandy Hansen, Building Hope project manager. “There’s a great sense of pride about all the hard work that went into building a space that really supports our patients and families.”

New inpatient rooms already full

The new critical care and cancer care units in Building Hope filled up almost immediately after the building opened. Twenty patients moved into the new cancer unit on April 21, but volumes quickly grew. At times since the opening, all 48 beds in the unit have been full (up from 33 beds in the previous unit). Read full post »

Water safety tips for kids

Life jacketIf you’ve ever spent time with a toddler, you know how quickly they can move. One minute they’re standing next to you, the next they’re sampling from the dog’s bowl, drawing on the wall or crawling up the stairs. Elizabeth Bennett, drowning prevention expert with Seattle Children’s, says toddlers’ speed and curiosity can be especially dangerous when it comes to water.

“Water is a magnet for kids,” says Bennett. “The one- to four-year-old age group is at very high risk around the water.” Over 1,500 children and teens die every year in the U.S. from drowning. In Washington state, an average of 20 children and teens drown every year.

Bennett says families’ Memorial Day preparations should include a water safety refresher, because this is an especially dangerous time of year for drowning.

“People underestimate the power of the water, especially in the spring,” she says. “The water’s really cold right now, and the rivers are running high. The minute you go in the water, you’ll feel the effects of cold water shock. It’s critical that you are already wearing a life jacket, because your limbs will start to stiffen right away.”

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Camping safety tips for families

Camping kidsGet the tents out of storage, shake out the sleeping bags and head for the campgrounds. Temperatures are on the rise and nature is calling. But before you load up the minivan and head for the great outdoors, Michelle Terry, MD, a pediatrician at Seattle Children’s Hospital, has some tips to keep you and your family safe and well while camping. When you’re camping with small children, Terry advises parents to follow the three P’s – planning, preparation and precaution.

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Tips for kids’ mental health

MentalHealthPostWhen a child is sick, needs a vaccination or gets bumped or bruised, most parents don’t hesitate to make a trip to the doctor’s office. But what happens when a child’s feeling blue, overly anxious or struggling to focus in school? This month, in recognition of Mental Health Awareness Month, doctors offer tips for parents to keep kids mentally and emotionally well, and explain what to do when there’s a problem.

Carol M. Rockhill, MD, PhD, and Ian M. Kodish, MD, PhD, child and adolescent psychiatrists at Seattle Children’s Hospital, say first and foremost, we need to relearn the way we view mental health.

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College students just as worried about young kids’ Facebook use as parents

A team of our (smart) researchers from SMAHRT descended on Washington, D.C. last weekend for the Pediatric Academic Societies annual meeting. SMAHRT = Social Media and Adolescent Health Research Team, which is based at Seattle Children’s Research Institute. This week, we’ll feature some of their new research. Megan Moreno, MD, leads the group and is a senior author on all of the research studies. Some of the researchers are based at other academic institutions, demonstrating the collaborative spirit of SMAHRT.

Facebook homepage

As a researcher who is barely out of college myself, it’s interesting when I run focus groups with college students to ask them their opinions about Internet use, because I often share the same views. So when we asked college students what they think about younger generations using social media, their answers weren’t all that surprising to me. Basically, like many parents and pediatricians, college students are worried about the effects of early social media use.

As we all know, the use of social media is widespread and increasing in use among all age groups. While social media provides teenagers and young adults many benefits, including improving communication skills, being able to network with friends and family and staying informed about local and world news, it can also have risks, such as exposure to content that might not be age appropriate, cyberbullying, and even sexting (sending sexually explicit texts or pictures).

In order to gain a unique perspective on this issue, we asked college students to share their thoughts about the potential effects that social media may have on younger adolescents. We chose this population because college students are heavy users of social media and because the current generation of college students did not begin using social media until they were slightly older. We thought this would give them an interesting outlook on how it affects the generation below them.

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College students more likely to drink with peers who appear responsible on Facebook

A team of our (smart) researchers from SMAHRT descended on Washington, D.C. last weekend for the Pediatric Academic Societies annual meeting. SMAHRT = Social Media and Adolescent Health Research Team, which is based at Seattle Children’s Research Institute. This week, we’ll feature some of their new research. Megan Moreno, MD, leads the group and is a senior author on all of the research studies. Some of the researchers are based at other academic institutions, demonstrating the collaborative spirit of SMAHRT.

Study group

There are two predictions that are a near sure bet when discussing the daily lives of college students. First, Facebook is an omnipresent social tool for this age group. Nearly all students use it, and it has become an important part of how they form friendships.

Second, as you’ve read in other SMAHRT posts this week, alcohol is a big part of collegiate life, to the extent that binge drinking and other dangerous drinking behaviors are often seen as normal. Taking these two factors into account, a related phenomenon is that students often post about alcohol on Facebook.

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