An end to needle phobia: Device could make painless injections possible

"As many as 1 in 10 people experience needle phobia, which may have negative consequences, such as decreasing the rate of vaccinations and blood donation," said William McKay, M.D., lead author of the study. Credit: © uwimages / Fotolia

Imagine no tears during infant vaccines and no fear of the needle for those old enough to know what's coming. Such painless injections could be possible with a device that applies pressure and vibration while the needle is inserted in the skin, according to a study presented at the ANESTHESIOLOGY™ 2014 annual meeting.

"As many as 1 in 10 people experience needle phobia, which may have negative consequences, such as decreasing the rate of vaccinations and blood donation," said William McKay, M.D., lead author of the study and a professor of anesthesiology in perioperative medicine and pain management at the University of Saskatchewan, Saskatoon, Canada. 

"Our early research suggests that using a device that applies pressure and vibration before the needle stick could help significantly decrease painful sensations by closing the 'gate' that sends pain signals to the brain."

Researchers studied the use of pressure, vibration, and cooling or warming in 21 adults poked in the shoulder by a plastic needle that doesn't break the skin but produces needle-like pain. They tested different levels of pressure, vibration and temperature to determine the amount that provided the most benefit. The perception of pain was significantly decreased when a specific amount of pressure and vibration was applied to the site for 20 seconds prior to using the plastic needle. The addition of heat added a small benefit, but it wasn't significant. The study should be repeated in children, who may experience pain differently, said Dr. McKay. The addition of heat or cold might be more beneficial, he said.

While commercial devices that include some of these features are available, they could be improved by incorporating the additional features tested in this and other studies, he said. They could be used to prevent pain prior to providing intravenous (I.V.) treatment, the drawing or donating of blood, or administering vaccinations.

The concept likely works by distraction as well as employing the gate-control theory of pain, in which these sensations (pressure, vibration and potentially temperature) close the gate that allows the brain to register pain.

Source: American Society of Anesthesiologists (ASA)

Correct seat belt use saves children's lives

Nine out of ten children are seriously or fatally injured in traffic accidents because they are incorrectly restrained or because of loose objects in cars. Credit: Marianne Skjerven-Martinsen, NIPH

Nine out of ten children are seriously or fatally injured in traffic accidents because they are incorrectly restrained or because of loose objects in cars. Correct use of safety equipment will save more lives, according to a new study from the Norwegian Institute of Public Health (NIPH).

Why are some children seriously or fatally injured in traffic accidents while other children in the same vehicle walk away without physical injury? This is one of the main questions Dr Marianne Skjerven-Martinsen at the NIPH studied as part of her doctoral dissertation.

The study is part of the research project 'Barn i bil' (Eng: Children in cars), a collaboration between the NIPH and Oslo University Hospital. As part of the project, a roadside study of normal traffic on Norwegian high-speed roads also took place which showed that every third child was incorrectly restrained.

Correct seat belt use is crucial

By investigating traffic accidents in Norway, Skjerven-Martinsen and her colleagues documented that incorrect restraint and loose objects in cars play a significant role in the number of deaths and injuries among children.

The results show that:

• Accidents where children are seriously injured mainly occur on high speed roads, in weekend traffic and most often follow frontal collisions on roads without crash barriers between carriageways.
• More than 9 out of 10 children who were seriously or fatally injured in traffic accidents were incorrectly restrained or were hit by loose objects in the car.
• The most common error is that the seatbelt is misplaced, with the shoulder belt under the arm or behind the back, or the lap belt is placed too high on the abdomen.
• Loose objects also cause damage to passengers, often indirectly when heavy luggage shifts, displacing the rear seat where the child is sitting.
• Correctly secured children have a low risk of injury, even in a heavy collision.

Children over 4 years are injured most frequently and the most common injuries are to the head, face, chest and abdomen.

For younger children, the most common errors are loose or misplaced straps.

Learn from experience

"We see that adults want to protect their children but they may lack knowledge of what can happen if the equipment is not used properly. The aim of this study was to evaluate the incorrect usage of child restraint in the vehicle, related to the child's height, age and type of equipment. In this way, we can give advice to parents, authorities and particularly the motor industry," says Skjerven-Martinsen.

In her thesis, she also described how children of different ages should be secured to prevent serious injury in car accidents. The findings provide a scientific basis for targeted prevention.

Source: Norwegian Institute of Public Health

Link between prenatal antidepressant exposure, autism risk called into question

The authors note that, while genetic factors are known to play a substantial role in autism, exactly how that risk may be exacerbated by environmental factors is not well understood. While animal studies and investigations based on health records have suggested an increased risk associated with prenatal antidepressant exposure, others found no such association. Credit: © milosducati / Fotolia

Previous studies that have suggested an increased risk of autism among children of women who took antidepressants during pregnancy may actually reflect the known increased risk associated with severe maternal depression. In a study receiving advance online publication in Molecular Psychiatry, investigators from Massachusetts General Hospital (MGH) report that -- while a diagnosis of autism spectrum disorder was more common in the children of mothers prescribed antidepressants during pregnancy than in those with no prenatal exposure -- when the severity of the mother's depression was accounted for, that increased risk was no longer statistically significant. An increased risk for attention-deficit hyperactivity disorder (ADHD), however, persisted even after controlling for factors relating to a mother's mental health.

"We know that untreated depression can pose serious health risks to both a mother and child, so it's important that women being treated with antidepressants who become pregnant, or who are thinking about becoming pregnant, know that these medications will not increase their child's risk of autism," says Roy Perlis, MD, MSc, MGH Department of Psychiatry, senior author of the report.

The authors note that, while genetic factors are known to play a substantial role in autism, exactly how that risk may be exacerbated by environmental factors is not well understood. 

While animal studies and investigations based on health records have suggested an increased risk associated with prenatal antidepressant exposure, others found no such association. And since discontinuing antidepressant treatment significantly increases the risk of relapse -- including an increased risk of postpartum depression -- the current study was designed to clarify whether or not any increased autism risk could actually be attributed to the medication.

To investigate this possibility, the research team analyzed electronic health record data for children born at MGH, Brigham and Women's Hospital, or Newton Wellesley Hospital -- hospitals belonging to Partners HealthCare System -- for whom a diagnostic code for pervasive developmental disorder, a category that includes autism, was entered at least once between 1997 and 2010. They matched data for almost 1,400 such children with that of more than 4,000 controls with no autism diagnoses, born the same years and matched for a variety of demographic factors.

The children's information was paired with that of their mothers, noting any factors related to the diagnosis and treatment of major depression or other mental illness, including prescriptions for antidepressants and other psychotropic drugs. A similar analysis was done for almost 2,250 children with an ADHD diagnosis, compared with more than 5,600 matched controls with no ADHD diagnoses.

While prenatal exposure to antidepressants did increase the risk for either condition, in the autism-focused comparison, adjusting for factors indicating more severe maternal depression reduced the strength of that association to an insignificant level. Taking antidepressants with stronger action in the serotonin pathway, which has been suspected of contributing to a possible autism risk, did not increase the incidence of the disorder. In addition, the children of mothers who took a serotonin-targeting non-antidepressant drug for severe morning sickness had no increased autism incidence. Prescriptions for antipsychotic drugs sometimes used to treat severe, treatment-resistant depression, as well as psychotic disorders, did appear to increase the risk for autism. For ADHD, however, the increased risk associated with prenatal antidepressant exposure remained significant, although reduced, even after adjustment for the severity of maternal depression.

"There are a range of options -- medication and non-medication -- for treating depression and anxiety in pregnancy," says Perlis, an associate professor of Psychiatry at Harvard Medical School. "But if antidepressants are needed, I hope parents can feel reassured about their safety."

Source: Massachusetts General Hospital

Parental incarceration can be worse for a child than divorce or death of a parent

With more than 2 million people behind bars, the U.S. has the highest incarceration rate in the world. This mass incarceration has serious implications for not only the inmates, but their children, finds a new University of California-Irvine study. The study found significant health problems, including behavioral issues, in children of incarcerated parents and also that, for some types of health outcomes, parental incarceration can be more detrimental to a child's well-being than divorce or the death of a parent.

"We know that poor people and racial minorities are incarcerated at higher rates than the rest of the population, and incarceration adversely affects the health and development of children who are already experiencing significant challenges," said study author Kristin Turney, an assistant professor of sociology at UC Irvine.

When comparing children with similar demographic, socioeconomic, and familial characteristics, the study found that having a parent in prison or jail was linked to a greater incidence of attention deficit disorder/attention deficit hyperactivity disorder (ADD/ADHD), behavioral or conduct problems, learning disabilities, speech or other language problems, and developmental delays.

"The results suggest that children's health disadvantages are an overlooked and unintended consequence of mass incarceration," Turney said. "In addition, given its unequal distribution across the population, incarceration may have implications for racial and social class inequalities in children's health."

Turney will present the study at the 109th Annual Meeting of the American Sociological Association, and the research will appear in the September edition of the Journal of Health and Social Behavior.

"About 2.6 million U.S. children have a parent in state prison, federal prison, or jail at any given time," said Turney, who noted that "Sesame Street" recently introduced a Muppet named Alex, whose dad is in jail, as a way to address the stigma associated with having an imprisoned parent.

The likelihood of having an incarcerated parent is especially high in certain groups. "Among black children with fathers without a high school diploma, about 50 percent will experience parental incarceration by age 14, compared with 7 percent of white children with similarly educated fathers," Turney said.

Compared to divorce, parental incarceration is more strongly associated with both ADD/ADHD and behavioral problems in children; compared to the death of a parent, parental incarceration is more strongly associated with ADD/ADHD.

"These findings have important implications for health professionals," Turney said. 

"Physicians serving poor communities where incarceration is common may consider screening children for parental incarceration, as it is a risk factor that, in some cases, is more consequential than other forms of parental absence like divorce."

Turney's study used data from the 2011-2012 National Survey of Children's Health, a population-based and representative sample of 0- to 17-year-olds.

Source: American Sociological Association (ASA)

Ultrasound guides tongue to pronounce 'R' sounds

Using ultrasound technology to visualize the tongue's shape and movement can help children with difficulty pronouncing "r" sounds, according to research led by NYU Steinhardt assistant professor Tara McAllister Byun. Credit: Ramsay de Give / NYU Steinhardt

Using ultrasound technology to visualize the tongue's shape and movement can help children with difficulty pronouncing "r" sounds, according to a small study by NYU's Steinhardt School of Culture, Education, and Human Development and Montclair State University.

The ultrasound intervention was effective when individuals were allowed to make different shapes with their tongue in order to produce the "r" sound, rather than being instructed to make a specific shape. The findings appear online in the Journal of Speech, Language, and Hearing Research.

The "r" sound is one of the most frequent speech errors, and can be challenging to correct. For other sounds -- such as "t" or "p" -- speech pathologists can give clear verbal, visual or tactile cues to help children understand how the sound is created. "R" is difficult to show or describe in an easy-to-understand fashion.

In addition, most speech sounds are produced in the same way, but with "r," normal speakers use widely different tongue shapes to create the sound. The two primary strategies to create the "r" sound include a retroflex tongue shape, where the tongue tip is pointed up, and the bunched tongue shape, where the tongue tip is pointed down and body of tongue bunches up toward the top of the mouth.

Up to 10 percent of children have speech sound disorders, according to the National Institutes of Health. Some children respond well to conventional forms of speech therapy, but others have errors that persist despite their therapists' best efforts. A growing body of evidence suggests that treatment incorporating visual biofeedback, which uses various technologies to create a dynamic visual representation of speech, could fill this need.

"The idea that you could get around the challenges with 'r' sounds by showing children their tongues as they are talking is really appealing to clinicians," says Tara McAllister Byun, an assistant professor in NYU Steinhardt's Department of Communicative Sciences and Disorders and the study's lead author. "That's what ultrasound technology lets us do."

Linguists have used ultrasound in the past to study basic functions of speech, and in recent years, speech pathologists have begun exploring using ultrasound to treat children with speech errors. An ultrasound probe -- similar to ones used in cardiac and tissue imaging -- is held under the chin, and sound waves capture real-time images of the tongue. The images provide both the child and speech pathologist with information about the tongue's position and shape.

Using the ultrasound images as a guide, children learn how to manipulate their tongues, and speech pathologists advise them on how to make adjustments to better achieve different sounds.

Several case studies and small studies suggest that ultrasound biofeedback can successfully correct "r" speech errors. Byun and her colleagues set out to gather systematic evidence on the effectiveness of the treatment, studying eight children with difficulty pronouncing "r" sounds. Seven of the eight had previous speech therapy that was unsuccessful.

Four children participated in the initial eight-week study. They were taught to make a bunched tongue shape, guided by ultrasound, in an effort to better pronounce "r." The researchers saw only small improvements among the four participants.

However, while trying to create a bunched tongue, one child stumbled upon a retroflex tongue shape and was able to improve her "r" sound. As a result of her success, the researchers altered their study design to allow participants to choose their own tongue shape, with individualized guidance from speech language pathologists.

A different four children participated in the second study over an eight-week period. Using ultrasound to visualize their tongues, all four participants in the second study showed significant improvement in their "r" sounds.

"Our second study offers evidence that when flexibility is given to choose a tongue shape, rather than a one-size-fits all approach, ultrasound biofeedback treatment can be a highly effective intervention for children with trouble pronouncing 'r' sounds," Byun says.

The researchers noted that the two studies were not a controlled comparison, thus additional systematic research is needed before drawing strong conclusions about the importance of individualized tongue shapes.

Source: New York University

The biology of fun and playfulness

Dog and child (stock image). Credit: © Irina84 / Fotolia

Current Biology celebrates its 25th birthday with a special issue on January 5, 2015 on the biology of fun (and the fun of biology). In a collection of essays and review articles, the journal presents what we know about playfulness in dogs, dolphins, frogs, and octopuses. It provides insights on whether birds can have fun and how experiences in infancy affect a person's unique sense of humor.

"Fun is obviously--almost by definition--pleasurable, rewarding, but in a way that is distinct from the pleasures of satisfying basic needs, such as the drives to reduce thirst or hunger or to reproduce," says Current Biology Editor Geoffrey North. "The articles in this special issue consider examples of what appear to be fun and play in a broad range of animal species and the insights that can be gained into how the behaviors might contribute to evolutionary fitness."

How do we get our sense of humor?

Psychologists Vasu Reddy and Gina Mireault, of the University of Portsmouth and Johnson State College respectively, offer a comprehensive overview of how, in infancy, reactions to absurd behavior like pulling hair or blowing raspberries, as well as teasing others, offer a window into how aware young children are of others' intentions. "As [infants] discover others' reactions and, indeed, others' minds, they also discover the meaning of 'funny', a construct that varies across and within cultures, regions, families, and even dyads," write the authors. "Infants become attuned to the nuances in humour through their social relationships, which create the practice of contexts of humorous exchange." The scientists note that children with atypical patterns of development may exhibit different senses of humor compared to their peers.

Why do adult apes play?

Based on her observations of a wild bonobo community, primatologist Isabel Behncke of the University of Oxford makes the case that play in bonobo adults could be a key adaptation that underlies social bonding and intelligence. She describes how bonobos in the Wamba community of Central Africa naturally engage in chasing, hanging, and water games despite differences in age and sex. "Play makes individuals more adaptable because it makes them more social; and more successful in their sociality as a result of being more adaptable," Dr. Behncke writes. "Life-long play is a bridge between sociality and adaptability."

Does playfulness spur creativity?

Ethologist Sir Patrick Bateson of the University of Cambridge wants to know why playfulness is so connected to creativity in the realms of science, music, and business. Working with behavioral biologist Daniel Nettle, he asked over 1,500 people to rank their creativity and then provide up to ten potential uses for a jam jar or paperclip. Those who considered themselves the most playful were most likely to provide many uses for the items. 

"Play is an effective mechanism for encouraging creativity since creativity also involves breaking away from established patterns of thought and behavior," Dr. Bateson writes.

Source: Cell Press

Dance choreography improves girls' computational skills

Report lead author Shaundra Daily performs alongside her virtual character. Daily designs innovative new technologies that bring together sensors and machine learning with theories of human learning. Credit: Clemson University

Clemson researchers find that blending movement and computer programming supports girls in building computational thinking skills, according to an ongoing study funded by the National Science Foundation and emerging technology report published in journal Technology, Knowledge and Learning.

Even with increasing demands for computationally savvy workers, there is a lack of representation among women in science, technology, engineering and mathematics fields (STEM), the researchers say.

"We want more diverse faces around the table, helping to come up with technological solutions to societal issues," said Shaundra Daily, lead author on the report and assistant professor of computing at Clemson. "So we're working with girls to create more pathways to support their participation."

Virtual Environment Interactions (VEnvI) is software and curriculum for blending movement and programming, which offers a novel and embodied strategy of engaging fifth- and sixth-grade girls in computational thinking.

"We want to understand how body syntonicity might enable young learners to bootstrap their intuitive knowledge in order to program a three-dimensional character to perform movements," said Alison Leonard, report co-author and assistant professor of education at Clemson.

In the process of developing this emerging technology, the researchers conduct user-centered design research for creating choreography and the social context for a virtual character through which girls can be introduced to alternative applications in computing.

"We adopt the view that computational thinking is a set of concepts, practices and perspectives that draw upon the world of computing and applicable in many STEM fields," Daily said.

Students met with instructors and learned basic curriculum involving the elements of dance, choreography and Alice, an existing educational software that teaches students computer programming in a three-dimensional environment.

The researchers utilize movement choreography as both an engaging and a parallel context for introducing computational thinking. Compositional strategies in the choreographic process of ordering and reordering movement sequences also mirror computational practices of reusing and remixing.

"Executing one bit of code or movement one after the other exists in both programming and choreography. Likewise, loops or repeating a set of steps, also occur in both contexts," Leonard said.

The students moved and created pieces for their virtual characters to perform, bringing about connections between computational thinking and what their bodies are doing.

The findings indicate the active presentation of concepts and future scalability of their virtual environment VEnvI that will add to the rich landscape of emerging technologies geared toward more inclusive strategies to engage girls in computational thinking.

The researchers are designing the first control algorithm that links concepts from computational thinking to animation algorithms, thus creating and evaluating new animation algorithms working to ensure the quality of the resulting choreography.

This emerging technology has the potential to widen the scope of current technologies that seek to cultivate computational thinking for diverse designers, users and audiences, according to the researchers.

Source: Clemson University

Lead in teeth can tell a body's tale, study finds

Revealing information UF geology professor George Kamenov has published research that shows trace amounts of lead in modern and historical human teeth can give clues about where they came from. Credit: Ray Carson/UF Photography

Your teeth can tell stories about you, and not just that you always forget to floss.

A study led by University of Florida geology researcher George D. Kamenov showed that trace amounts of lead in modern and historical human teeth can give clues about where they came from. The paper will be published in the August issue of Science of The Total Environment.

The discovery could help police solve cold cases, Kamenov said. For instance, if an unidentified decomposed body is found, testing the lead in the teeth could immediately help focus the investigation on a certain geographic area. That way, law enforcement can avoid wasting resources checking for missing persons in the wrong places.

"We can use this pollution signal to figure out where these people came from," he said.
Lead is composed of four variants, called isotopes. The amount of those isotopes fluctuates in different rocks, soils and ores -- and, therefore, regions of the world.

Mining and other pollution-causing activities release that lead into the environment, and it accumulates in children's bodies as they grow because kids inhale dust and ingest soil when they put their hands in their mouths.

Tooth enamel, which develops during childhood, locks in the lead signals and preserves them.
"When you grow up, you record the signal of the local environment," Kamenov said. "If you move somewhere else, your isotope will be distinct from the local population."
Even different teeth can reveal certain facts.

First molar enamel is finished forming by age 3, so it provides information about birth and toddler years. Incisor and canine enamel starts later and finishes around age 5, so it gives insight into early childhood. The third molar enamel does not start forming until age 8, so it indicates late childhood residences.

Lead analysis can also tell what time period a body is from.

Modern and historical teeth have different signals, according to the study. The natural composition of lead changed over the past century because of mining and the use of leaded gasoline, so there's a clear distinction between modern and historical human exposure.

Using that information, archaeologists can identify early European bodies in New World areas.
"You can go back in time, look at archaeological sites and try to reconstruct human migration," Kamenov said.

But modern American teeth are like no others in the world, according to the study. Whereas available data for areas such as South America overlap with Europe, American teeth can be identified anywhere due to usage of ores with distinct isotope signals in the United States.
"What's in the environment goes into your body," Kamenov said

Source: University of Florida.