Because a woman’s birth canal is curved and only a little wider than a fetus’s head, a baby must proceed through the canal in a specific sequence of moves. A failure during the process, such as a head turned the wrong way at the wrong time, can result in difficult labor or dystocia.

Using the new software, called PREDIBIRTH, Dr. Olivier Ami and a team of researchers from the Department of Radiology at Antoine Béclères Hospital, Université Paris Sud, France, processed MR images of 24 pregnant women. The result was a three-dimensional (3-D) reconstruction of both the fetus and pelvis along with 72 possible trajectories of the baby’s head through the birth canal. The program scored each mothers likelihood of a normal birth based on these simulations.

“The mechanics of the human birth canal make for a very complicated delivery process compared to other mammals,” said Dr. Ami in a news release. “We now have computer-simulated childbirth to identify potential problems. The software simulates the properties of potential deliveries.”

For this study, the PREDIBIRTH scores were computed retrospectively and measured against delivery outcomes for the 24 women. Thirteen women had normal deliveries, which had been  scored as highly favorable by the simulator. Three women who had elective cesarean-section (C-section) were scored at high risk for dystocia.

Of the five women who had emergency C-sections, two involved heart rhythm abnormalities and had simulator scores of mildly favorable and favorable. Three involved obstructed labor, all of whom scored at high risk of dystocia. Three women delivered with vacuum extraction and had mildly favorable simulator scores.

Researchers say the results in predicting dystocia were highly accurate and are a notable improvement over pelvimetry, which measures the pelvis manually or by imaging to determine its adequacy for childbirth. While pelvimetry is commonly used, Dr. Ami said it’s not entirely reliable.

“A small pelvis may be able to deliver without problems, and a big pelvis might require mechanical help during childbirth,” he said. “This uncertainty raises the rate of C-sections.”

In the U.S., C-sections account for approximately one-third of all births. In France, the rate of mechanical problems is 30 percent, two-thirds of which are emergency procedures.

“An emergency C-section has six to seven times more morbidity and mortality than a planned C-section,” Dr. Ami said. “With this virtual childbirth software, the majority of C-sections could be planned rather than emergency, and difficult instrumental extractions might disappear in the near future.”

For more on  child safety issues, see the library of articles by Daytona Beach child injury attorney.

All of the child safety seats and booster seats tested in this study properly restrained the children across a varied weight range. Almost 1,000 children ages 1 to 8 who were involved in vehicle crashes were included in this study conducted by The Children’s Hospital of Philadelphia’s Center for Injury Research and Prevention.

Researchers say the results of this study show that the current range of child safety seats accommodates a wide range of children’s body sizes, including those who are heavier.

Considering that car crashes are the leading cause of death and injury for all children and that almost 32 percent of kids in the United States are categorized as obese or overweight, researchers wanted to explore the interaction between these two threats to children’s health, said Dr. Mark Zonfrillo, an attending emergency physician at The Children’s Hospital of Philadelphia.

Zonfrillos said the results of the study should help parents to see that their main  concern need only be following the American Academy of Pediatrics most recent car seat guidelines.

Current AAP guidelines call for children remaining rear-facing until at least the age of 2 or until they reach the height and weight limit for the rear-facing car seat.

Once they are moved to a forward-facing seat, children should be secured in a five-point harness until they reach the weight and  height limit set by the seat manufacturer. After that, children should then move up to a belt-positioning booster seat, which is the type of seat they should have until they are 4′9″ tall, a height usually reached  between ages 8 and 12.

Researchers say a good time to re-evaluate child safety seats is right after your children’s annual medical visits.

“Compare your child’s weight and height measurements to the manufacturer’s acceptable ranges on the seat’s labels or instructions,” says Zonfrillo, the father of a toddler. “There’s no ‘one-size-fits-all.’ If your older child moved to a booster seat at age 5, don’t necessarily assume it will be the same for his or her younger siblings.”

Pediatricians and family physicians also  play an important role in making sure children are well protected  as they ride in vehicles, the study’s authors say. When the children’s height and weight are evaluated during checkups, physicians should counsel the parents to evaluate their child’s measurements against their safety seat. Those with more complex questions should be referred to certified passenger safety technicians.

For more on child safety issues, see the library of articles by Daytona Beach child injury attorney.

“Respiratory hygiene education and the regular use of hand sanitizer can be an important adjunct to influenza vaccination programs to reduce the number of influenza A infections among children,” said study author Dr. Samuel Stebbins of the University of Pittsburgh.

In the recent study, five Pittsburgh elementary schools were assigned to receive five-step training “cough etiquette and hand hygiene” program. In the program, called “WHACK the Flu,” children were taught:

• (W)ash or sanitize your hands often.
• (H)ome is where you stay when you are sick.
• (A)void touching your eyes, nose, and mouth.
• (C)over your coughs and sneezes.
• (K)eep your distance from sick people.

Five other schools did not received any special hygiene training. During the school year, children who developed a flu-like illness were tested to see if they had influenza, and whether the cause was influenza A or B virus.

A total of 279 children with flu-like illness were tested but 104 confirmed cases of the flu were identified.

The program was a hit in getting kids to use hand sanitizer regularly. On average, students used hand sanitizer 2.4 times per day, compared to the previous four suggested times (on arrival at school, before and after lunch, and when leaving school).

Schools assigned to “WHACK the Flu” had a significant 52 percent drop in the rate of confirmed illness caused by influenza A. However, there was no major difference in the overall rate of laboratory-confirmed influenza, or in the rate of illness caused by influenza B.

Along with the decrease in influenza A, there was a 26 percent reduction in total school absences. The hygiene program was also linked to possible improvements in other school attendance measures, including a lower absentee rate during the flu season.

School-age kids are a significant source of influenza transmission, and were heavily affected by the 2009-10 influenza A H1N1 pandemic. Previous reports suggested using hand sanitizer can reduce absences and some causes of infectious diseases

While the “WHACK the Flu” program didn’t lower the overall influenza rate, it did achieve about a one-half reduction in influenza A and a one-fourth reduction in school absences.

The researchers aren’t sure why there was no decrease in influenza B — possibly because of “basic differences in the biology or epidemiology” of influenza B, or because it occurred later in the flu season and mainly in younger children.

The results show that a hygiene education program including hand sanitizer “can be implemented successfully on a large scale within urban schools to reduce absenteeism and the incidence of influenza A,” Dr Stebbins and coauthors write.

Researchers say their study supports current recommendations for respiratory hygiene — including hand sanitizer — during any type of flu outbreak, and as part of an overall influenza prevention strategy in schools.

For more on medical safety issues, see the library of articles by Daytona Beach child injury attorney.

These traumatic brain injuries (TBI) can affect a child’s ability to communicate with others and take care of day to day tasks, leading to a long-term reduction in the their quality of life.

The study’s findings show the need for prevention, said Dr. Frederick Rivara, author of this study and professor of pediatrics at the University of Washington School of Public Health in Seattle.

Parents can help prevent many of these head injuries, Rivara says, by using gates on all stairways and by making sure that children use bicycle helmets when riding and that they use seatbelts in vehicles. He said schools should also consider adopting different rules for football.

Rivara and colleagues conducted  a study of 729 children younger than 18 who were treated for a TBI at emergency rooms in Philadelphia and Seattle between March 1, 2007, and Sept. 30, 2008. The majority of the injuries resulted from falls and car crashes, the study’s authors noted. Few were related to assault or abuse.

Researchers also made comparisons to a separate group of 197 children who had visited the same emergency rooms with arm injuries during the same time.

Researchers looked at the resulting disability in health-related quality of life, adaptive skills, and participation in community and social activities at three months, one year and two years after the injury compared with their functioning prior to injury.

The children’s levels of  functioning prior to injury were determined through telephone interviews with parents in most cases. Researchers looked at whether the children had trouble concentrating or remembering, whether they were depressed and teased, how they played or interacted with others, and if they could do the things that other children do.

Researchers discovered that 85 percent of the children with head injuries had suffered mild trauma. While some had experienced deficits at three months,  only a few suffered lasting loss of daily life and social activities.

However, lasting effects were noted in those with mild injury who also suffered a brain hemorrhage and those who suffered a moderate or severe brain injury. Those children faced obstacles in day-to-day life, sports and school activities at the end of the two-year study observation.

The first three months after injury, there was a substantial decrease in the level of activities in which these children were able to participate. Their ability to participate in  these activities improved at 12 and 24 months but they were still significantly impaired.

Communication and day-to-day life abilities for children with severe TBI were lower at 3 months than at baseline and did not improve by 24 months. Children who met the definition of mild TBI but had an brain hemorrhage had lower quality-of-life scores at 3 months.

Researchers say those children with  problems after two years are unlikely to make significant improvement in their condition, however, data is still being collected on the children in this study.

For more on child medical issues, see the library of articles by Daytona Beach child injury attorney.

A record 31 seats have been designated Best Bets, meaning they correctly position a vehicle safety belt on a typical 4 to 8 year-old in almost any car, minivan, or SUV. Prices for these top-rated seats range from less than $15 to several hundred dollars.

In addition to the 31 Best Bets, another 5 seats are Good Bets, meaning they provide acceptable belt fit in most vehicles. Six boosters are not recommended because they don’t provide proper belt fit, and consumers are advised to avoid them.

Booster seats are for children who have outgrown forward-facing child restraints. A booster should elevate a child and route the lap and shoulder belts, which are designed for adults, in the correct position to restrain a child during a crash. Some boosters do this better than others.

The problem is that consumers can’t tell a good booster from a bad one just by comparing features or prices. The Institute’s booster seat ratings, initiated in 2008, are the only evaluations to tell parents which boosters do the best job of improving belt fit for children in the widest range of vehicles.

“A Best Bet means any of these top-rated boosters should work well in the family SUV or the babysitter’s sedan,” said Anne McCartt, the Institute’s senior vice president for research, in a news release.

Engineers evaluated 62 booster models in the latest round. Twenty-one of them show up twice in the lists. These are dual-use seats, which can work as highback or backless boosters. In the ratings, each dual-use model is considered to be 2 separate boosters for a total of 83 seats evaluated, 11 more than last year.

The biggest group of boosters falls into a middle category, designated “check fit.” These 41 seats may provide good fit for some children in some vehicles, but not as many as Good Bets or Best Bets. Parents are advised to make sure the lap belt lies flat across a child’s upper thighs and the shoulder belt crosses snugly over the middle of the shoulder. If not, a different seat is needed.

The focus of the Institute’s ratings is belt fit, not crash performance, and no crash tests are conducted as part of the evaluation. To assess belt fit, engineers use a test dummy representing an average-size 6 year-old. They measure how lap and shoulder belts fit the dummy in each booster under 4 conditions representing the range of belt configurations in real-world vehicles.

Boosters have improved a lot in recent years. In 2008 there were 10 Best Bets. That fell to 9 in 2009 but soared to 21 last year after manufacturers began using the Institute’s test protocols as they designed and updated their seats.

“Just 4 years into our ratings program, parents have a wide variety of top-rated seats to choose from,” McCartt says. “Still, boosters that don’t consistently provide good belt fit outnumber the ones that do, so consumers need to keep paying attention to this issue.”

One thing consumers need to be aware of is that most dual-use boosters have different ratings for each mode. For example, 14 dual-use boosters are Best Bets or Good Bets in highback mode but are designated check fit in backless mode. For one seat, the Evenflo Big Kid Sport, the opposite is true: It’s a Best Bet in backless mode and a check fit in highback mode.

The Harmony Dreamtime remains the only dual-use booster that’s a Best Bet in both modes, while the Combi Kobuk Air Thru is a Good Bet in both modes.

A notable newcomer to the Best Bet list is the BubbleBum, an inflatable seat that’s marketed for vacations, car pools, and taxis, as well as everyday use. When needed, it can be quickly inflated by blowing into a valve at the back of the seat.

Among booster manufacturers, Harmony Juvenile Products continues to be a standout. All 5 seats the Canadian company currently makes, counting the Dreamtime in both modes, are Best Bets. The company is discontinuing the dual-use Baby Armor, which was a Best Bet in highback mode but not recommended in backless mode.

Diono, which recently changed its name from Sunshine Kids, bumped an existing seat, the Monterey, from check fit to Best Bet by changing the shoulder belt guide. The new ranking applies when the dual-use seat is used in highback mode. The booster remains a “check fit” in backless mode. Consumers should look for Montereys manufactured after July 2011 to ensure they are getting the newer version.

Meanwhile, the Evenflo Symphony 65, which has been a Good Bet since 2009, now has a sister seat, the Symphony 65 e3. It has a slightly different shoulder belt guide, and that makes enough of a difference to make it a Best Bet.

“Booster manufacturers often use similar names for different seats or, in the case of the redesigned Monterey, even the same names,” McCartt says. “It’s important for consumers to look at model numbers and manufacture dates when consulting our ratings.”

For more on child safety issues, see the library of articles by Daytona Beach car accident attorney.

And that’s a big risk when you consider an estimated 40 million children between the ages of 5 and 14 could hit the trick-or-treat trails this Halloween, according to numbers form the U.S. Census Bureau. Other common Halloween injuries include eye injuries from sharp objects and burns from flammable costumes.

The nation’s emergency physicians want children and families to enjoy the holiday traditions safely and not experience any Halloween horrors that would include spending time in the emergency department. 

“

Children should be out having fun and spending time with family and friends,” said Dr. Sandra Schneider, with the American College of Emergency Physicians, in a news release. “They should not have to spend Halloween in the ER because of some injury that could have been easily prevented.”

Emergency physicians recommend that children “trick-or-treat” at organized Halloween festivities, such as local churches, shopping malls or schools. This way children are not walking in the dark and it allows constant adult supervision.

The ACEP suggests that adults follow these tips for a safe and fun Halloween:

• Make sure your child stays on the sidewalks as much as possible (off streets) and obeys all traffic signals.
• Discuss the importance of staying together in a group. Require at least one adult to serve as chaperone during trick-or-treat gatherings.
• Make sure your child knows the potential dangers from strangers. Make sure they know never to accept rides from strangers or visit unfamiliar homes or areas.
• Avoid costumes that could cause children to trip, such as baggy pants, long hems, high heels and oversized shoes.
• Avoid costumes that obstruct the child’s sight or vision.
• Avoid masks if possible. If your child must wear one, make sure it is well ventilated.
• Make sure costume fabric, wigs and beards area made of flame-resistant materials, such as nylon or polyester.
• Keep candlelit Jack-O-Lanterns away from children so they can’t get burned or set on fire.
• Make sure costumes are visible at night: avoid dark colors. Add reflective tape to costumes so your child is more visible to motor vehicles.
• Make sure you see all of the candy before your child eats it. Avoid candy that is not wrapped in its original wrapper, as well as all fruit
• Take a flashlight while trick-or-treating as visibility decreases long before it gets really dark.
• Check accessories such as swords, knives, wands and other pointed objects. Make sure they are made from flexible materials and have dulled edges.

For more on child safety issues, see the library of articles by Daytona Beach child injury attorney.

The rise in exposure to prescription products has been so striking that the Centers for Disease Control and Prevention has established the PROTECT Initiative, intended to prevent unintended medication overdoses in children. According to the CDC, more than 70,000 emergency visits each year result from unintentional overdoses among children under the age of 18.

Dr. Randall Bond, an emergency medicine physician at Cincinnati Children’s Hospital Medical Center, presented his study on children and pharmaceutical poisonings at a recent PROTECT Initiative meeting in Atlanta. The study was published in September in the Journal of Pediatrics.

“The problem of pediatric medication poisoning is getting worse, not better,” says Dr. Bond, who also is medical director of the Drug and Poison Information Center at Cincinnati Children’s, in a news release. “More children are exposed, more are seen in emergency departments, more are admitted to hospitals, and more are harmed each year.”

Bond found that exposure to prescription products accounted for most of the emergency visits (55 percent), admissions (76 percent) and significant harm (71 percent). Levels of ingestion of opioids, most often prescribed to treat pain; sedatives-hypnotics, frequently prescribed as sleep aids; and cardiovascular medications were particularly high.

“Prevention efforts at home have been insufficient,” Bond said. “We need to improve storage devices and child-resistant closures and perhaps require mechanical barriers, such as blister packs. Our efforts can’t ignore society’s problem with opioid and sedative abuse or misuse.”

Bond studied patient records from 2001 to 2008 in the National Poison Data system – an electronic database of all calls to members of the American Association of Poison Control Centers. Bond studied children 5 years old and younger exposed to a potentially toxic dose of a single pharmaceutical agent, either prescription or over-the-counter. A total of 453,559 children were included in the study.

The largest part of increasing admissions, injuries and death was due to children finding and ingesting medication on their own. Therapeutic errors at home were uncommon and increased only minimally.

The most likely explanation for these trends is a rise in the number of medications around small children, he says. A 1998-99 survey found that half of adults had taken at least one prescription medication in the preceding week and 7 percent had taken five or more. In 2006, the same surveyors found that 55 percent had taken at least one prescription medication in the preceding week and 11 percent had taken five or more.

There are 57 poison control centers in the United States. Together they provide free, 24-hour poison expertise and treatment advice by phone. All poison centers can be reached by calling the same telephone number 1-800-222-1222. Poison centers are staffed by pharmacists, physicians, nurses and poison information providers who are toxicology specialists.

For more on child medical safety issues, see the library of articles by Daytona Beach child injury attorney.

According to the Archives of Pediatrics & Adolescent Medicine, parents can do several things to help a child with pain from a procedure:

Stay with your child during the pain. This is important for children as young as babies and as old as teenagers. Having a loved one near is very comforting to children.

Hold or touch your child. If you can hold your child in your arms during the procedure or without causing pain, this can greatly lessen your child’s pain.

• Kangaroo care: This is when a mother or father holds the baby against her or his bare chest, like a kangaroo holds their young, with the baby wearing only a diaper.  It has been used all over the world, and research suggests that it can increase babies’ breastfeeding, bonding with parents, and growth and development. A recent study found that babies who had kangaroo care during a painful procedure had less pain, even compared with babies who were given other pain management techniques.

• Holding hands: If you are not able to hold your child during a procedure, even a gentle touch or holding a hand can be helpful to your child.

Be honest. It is not a good idea to lie to your child and say that a painful procedure will not cause pain; this may hurt the trust your child has in you.

Distract your child during the procedure. There are many ways to help your child focus on things he or she enjoys, even during a procedure. If a child has other things to think about, the procedure may not affect him or her as much. Some ways to distract your child include playing music or singing with your child, showing a favorite video, reading a book, or just telling your child a favorite story.

Include time for play. If a visit to the doctor’s office or hospital included a painful procedure, make some time for fun afterward. Consider a trip to a favorite toy store, the zoo, or the library or spending time at a friend’s house.

Ask for help from experts. Many hospitals include staff with special training in ways to help children cope with being in the hospital, including ways to help children cope with procedures. Pediatric psychologists can also be helpful in working with children who are struggling with chronic illnesses or numerous painful procedures. Expressive therapists can help children find ways to express their anger or frustration from having procedures in a beneficial way.

For more on child medical issues, see the library of articles by Daytona Beach child injury attorney.

The new mandatory crib standards, approved unanimously on Dec. 15, 2010, are the most stringent crib safety standards in the world. As of  June 28, 2011, all importers, distributors, manufacturers, and retailers must offer only cribs that meet the CPSC’s new and improved full-size and non-full-size crib standards.

Federal mandatory crib standards had not been updated in nearly 30 years and the new rule will usher in a safer generation of cribs, which will mean a safer sleep for babies across the country. These mandatory standards will:

• Stop the manufacture and sale of dangerous, traditional drop-side cribs
• Make mattress supports stronger
• Improve slat strength
• Make crib hardware more durable
• Make safety testing more rigorous

“A safe crib is the safest place for a baby to sleep. It is for this reason that I am so pleased that parents, grandparents and caregivers now can shop with confidence and purchase cribs that meet the most stringent crib standards in the world,” said CPSC Chairman Inez Tenenbaum in a news releasea. “From the start, our goal has been to prevent deaths and injuries to babies in cribs, and now the day has come where only stronger and safer cribs are available for consumers to purchase.”

CPSC has recalled more than 11 million dangerous cribs since 2007. Drop-side cribs with detaching side rails were associated with at least 32 infant suffocation and strangulation deaths since 2000. Additional deaths have occurred due to faulty or defective crib hardware. The new standards aim to prevent these tragedies and keep children safer in their cribs.

Starting on December 28, 2012, child care facilities, including family child care homes and infant Head Start centers, as well as places of public accommodation, such as hotels and motels, and rental companies must use only cribs that comply with the new crib standards.

To learn more about crib safety, visit CPSC’s crib information center at: www.cpsc.gov/cribs

For more on child safety issues, see the library of articles by Daytona Beach child injury attorney.

The study, involving 257 students, highlights that a higher degree of pain was experienced with the use of gaming devices compared to mobile phones. Pain reported by children using Xbox and Gameboy was statistically higher than pain reported for the iPhone.

Importantly, the length of time spent on the devices heightened the pain suffered, as the data demonstrated that length of time was independently associated with the pain reported, with the odds of reporting pain increasing by two for every one hour of play.

“Our study has shown the negative impact that playing computer games and using mobile phones can have on the joints of young children, raising concerns about the health impact of modern technology later in life,” said Professor Yusuf Yazici, Rheumatology, NYU Hospital for Joint Diseases, New York. “We hope that further research in this area will shed light on what could be a serious health concern for today’s gaming children, in later life.”

The study also investigated pain attributed to mobile phone usage for the sending of text messages, the number of texts sent, the use of abbreviations, and the type of keyboard used, according to age and gender.

The results indicated that female students reported twice as much pain as male students respectively, measured using the 10cm Visual Analogue Scale (VAS, a pain measurement scale) and gender was the only independent variable associated with pain.

The study involved 257, nine to 15 year old students from two schools in St Louis. They were administered with a questionnaire to aid researchers in determining the possible association device type, age of children and hours played may have on wrist and finger pain.

A multivariable generalised linear model examined whether reported pain was associated with game device usage adjusting for age, gender, school and duration of game play per game device.

The study results were presented last week during the European League Against Rheumatism 2011 Annual Congress.

For more on medical issues, see the library of articles by Daytona Beach child injury attorney.