The XY factor

Do you remember the days when dads didn’t change diapers? Yeah, neither do I. But, as acerbic X Factor judge Simon Cowell prepares for fatherhood at age 53, he has made it clear that changing any diapers at all will not make the cut. I suspect he’s worried that his newborn will be just as critical as he is: “No, stop. Just stop. I mean it. That’s enough. You call that wiping? There was a moment there when I shut my eyes, and I thought you were actually trying to sand my bum. You have absolutely no talent for this. Just call one of those boys to take over -- what are their names? Niall? Liam? Zayne? Is Zayne even a real name? Oh, look, I just peed on your V-neck!”

Ingram Publishing

Urine trouble

I’ve often daydreamed of authoring an evidence-based guideline, just because I think they’re so cool! Then I see an article like the one in this month’s Pediatrics about urine testing in kids treated for urinary tract infections (UTIs), and I realize I may as well skip the whole guideline-development step and go straight to beating my head against a rock. The entire article is worth a read, at least if you’re not given to bouts of depression, but let me sum it up: The more important it is that a child get a urinalysis or urine culture before being treated with antibiotics for a UTI, the less likely that child is to get any urine study at all. Now, where’s my rock?

The authors examined records of 28,678 children who were prescribed antibiotics for more than 5 years, for a total of 40,603 UTIs. Overall, 80% of cases saw at least some sort of testing, which seems pretty good, until you look at who wasn’t tested. Boys, for example, were less likely to be tested than girls, because, you know, anatomically normal boys get bladder infections all the time. Children under age 2 years also had fewer tests, which makes sense since you can usually rely on them to give you a good history and physical exam, and pretty much nothing else causes fever and fussiness in toddlers. Kids recently discharged from the hospital were also less likely to be tested, since, resistance, schmesistance!
 
I know I’m being sort of a downer about these findings, especially as we live in a world where antibiotic-resistant organisms are not causing an epidemic of hospitalizations, and where unnecessary invasive testing, irradiation, and specialty referrals have no health or financial consequences. Oh, wait, that was part of my daydream. Okay, people, what will it be, granite or schist?

Prize fighter

Dr. James Sargent and his team at Dartmouth’s Geisel School of Medicine have made a major leap forward in their efforts to improve fast food marketing in the United States. Publishing in PLoS One (the journal for people who can’t spell “PLUS”), researchers analyzed advertisements designed to promote unhealthy meals to kids and adults, and they noticed a glaring omission. While 70% of advertisements airing on networks such as Nickelodeon and Cartoon Network focused on free toys, campaigns targeted to adults emphasized flavor, portion size, and cost, with only 1% of ads featuring some sort of giveaway. Do I smell fries? Or is that the scent...of opportunity?

You see where this is going, right? I mean, one cheap slab of salt and fat between two buns is pretty much the same as the next, but what if it came in a cardboard box printed with images of underwear models, cool cars/vacation rentals, and sports trivia/celebrity gossip (“Will that be the man’s meal, or the lady’s?”)? Inside would be freebies of interest to adults: nose hair trimmers, deodorant samples, vodka... There could even be movie tie-ins. Would The Lone Ranger have fared so poorly if some fast food chain had given away free neckerchiefs with a large burger?

My guess is that Dr. Sargent and his team are already all over this. I bet they’re days away from opening a new fast food chain to feature the Geisel Green-Eggs-and-Hamburger, the Filet-of-One-Fish-Two-Fish, and the large, medium, or super-sized Hop-On Pop. I’ll have mine with the free pair of Fox-In Socks, please.

Baby talk

Minna Huotilainen and her colleagues published a paper last week in the Proceedings of the National Academy of Sciences demonstrating that fetuses can learn the words their parents say while still in utero. Dammit!

I mean “darnit!” Oh well, it’s way too late now. While previous work had suggested that language learning begins before birth, the new study actually monitored electrical activity in the brain to show that words newborns had heard in utero produced the sorts of responses associated with familiarity. I have no idea what expectant father might benefit from this information... Simon?

David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and  adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.

Do you remember the days when dads didn’t change diapers? Yeah, neither do I. But, as acerbic X Factor judge Simon Cowell prepares for fatherhood at age 53, he has made it clear that changing any diapers at all will not make the cut. I suspect he’s worried that his newborn will be just as critical as he is: “No, stop. Just stop. I mean it. That’s enough. You call that wiping? There was a moment there when I shut my eyes, and I thought you were actually trying to sand my bum. You have absolutely no talent for this. Just call one of those boys to take over -- what are their names? Niall? Liam? Zayne? Is Zayne even a real name? Oh, look, I just peed on your V-neck!”

Ingram Publishing

Urine trouble

I’ve often daydreamed of authoring an evidence-based guideline, just because I think they’re so cool! Then I see an article like the one in this month’s Pediatrics about urine testing in kids treated for urinary tract infections (UTIs), and I realize I may as well skip the whole guideline-development step and go straight to beating my head against a rock. The entire article is worth a read, at least if you’re not given to bouts of depression, but let me sum it up: The more important it is that a child get a urinalysis or urine culture before being treated with antibiotics for a UTI, the less likely that child is to get any urine study at all. Now, where’s my rock?

The authors examined records of 28,678 children who were prescribed antibiotics for more than 5 years, for a total of 40,603 UTIs. Overall, 80% of cases saw at least some sort of testing, which seems pretty good, until you look at who wasn’t tested. Boys, for example, were less likely to be tested than girls, because, you know, anatomically normal boys get bladder infections all the time. Children under age 2 years also had fewer tests, which makes sense since you can usually rely on them to give you a good history and physical exam, and pretty much nothing else causes fever and fussiness in toddlers. Kids recently discharged from the hospital were also less likely to be tested, since, resistance, schmesistance!
 
I know I’m being sort of a downer about these findings, especially as we live in a world where antibiotic-resistant organisms are not causing an epidemic of hospitalizations, and where unnecessary invasive testing, irradiation, and specialty referrals have no health or financial consequences. Oh, wait, that was part of my daydream. Okay, people, what will it be, granite or schist?

Prize fighter

Dr. James Sargent and his team at Dartmouth’s Geisel School of Medicine have made a major leap forward in their efforts to improve fast food marketing in the United States. Publishing in PLoS One (the journal for people who can’t spell “PLUS”), researchers analyzed advertisements designed to promote unhealthy meals to kids and adults, and they noticed a glaring omission. While 70% of advertisements airing on networks such as Nickelodeon and Cartoon Network focused on free toys, campaigns targeted to adults emphasized flavor, portion size, and cost, with only 1% of ads featuring some sort of giveaway. Do I smell fries? Or is that the scent...of opportunity?

You see where this is going, right? I mean, one cheap slab of salt and fat between two buns is pretty much the same as the next, but what if it came in a cardboard box printed with images of underwear models, cool cars/vacation rentals, and sports trivia/celebrity gossip (“Will that be the man’s meal, or the lady’s?”)? Inside would be freebies of interest to adults: nose hair trimmers, deodorant samples, vodka... There could even be movie tie-ins. Would The Lone Ranger have fared so poorly if some fast food chain had given away free neckerchiefs with a large burger?

My guess is that Dr. Sargent and his team are already all over this. I bet they’re days away from opening a new fast food chain to feature the Geisel Green-Eggs-and-Hamburger, the Filet-of-One-Fish-Two-Fish, and the large, medium, or super-sized Hop-On Pop. I’ll have mine with the free pair of Fox-In Socks, please.

Baby talk

Minna Huotilainen and her colleagues published a paper last week in the Proceedings of the National Academy of Sciences demonstrating that fetuses can learn the words their parents say while still in utero. Dammit!

I mean “darnit!” Oh well, it’s way too late now. While previous work had suggested that language learning begins before birth, the new study actually monitored electrical activity in the brain to show that words newborns had heard in utero produced the sorts of responses associated with familiarity. I have no idea what expectant father might benefit from this information... Simon?

David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and  adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.

Do you remember the days when dads didn’t change diapers? Yeah, neither do I. But, as acerbic X Factor judge Simon Cowell prepares for fatherhood at age 53, he has made it clear that changing any diapers at all will not make the cut. I suspect he’s worried that his newborn will be just as critical as he is: “No, stop. Just stop. I mean it. That’s enough. You call that wiping? There was a moment there when I shut my eyes, and I thought you were actually trying to sand my bum. You have absolutely no talent for this. Just call one of those boys to take over -- what are their names? Niall? Liam? Zayne? Is Zayne even a real name? Oh, look, I just peed on your V-neck!”

Ingram Publishing

Urine trouble

I’ve often daydreamed of authoring an evidence-based guideline, just because I think they’re so cool! Then I see an article like the one in this month’s Pediatrics about urine testing in kids treated for urinary tract infections (UTIs), and I realize I may as well skip the whole guideline-development step and go straight to beating my head against a rock. The entire article is worth a read, at least if you’re not given to bouts of depression, but let me sum it up: The more important it is that a child get a urinalysis or urine culture before being treated with antibiotics for a UTI, the less likely that child is to get any urine study at all. Now, where’s my rock?

The authors examined records of 28,678 children who were prescribed antibiotics for more than 5 years, for a total of 40,603 UTIs. Overall, 80% of cases saw at least some sort of testing, which seems pretty good, until you look at who wasn’t tested. Boys, for example, were less likely to be tested than girls, because, you know, anatomically normal boys get bladder infections all the time. Children under age 2 years also had fewer tests, which makes sense since you can usually rely on them to give you a good history and physical exam, and pretty much nothing else causes fever and fussiness in toddlers. Kids recently discharged from the hospital were also less likely to be tested, since, resistance, schmesistance!
 
I know I’m being sort of a downer about these findings, especially as we live in a world where antibiotic-resistant organisms are not causing an epidemic of hospitalizations, and where unnecessary invasive testing, irradiation, and specialty referrals have no health or financial consequences. Oh, wait, that was part of my daydream. Okay, people, what will it be, granite or schist?

Prize fighter

Dr. James Sargent and his team at Dartmouth’s Geisel School of Medicine have made a major leap forward in their efforts to improve fast food marketing in the United States. Publishing in PLoS One (the journal for people who can’t spell “PLUS”), researchers analyzed advertisements designed to promote unhealthy meals to kids and adults, and they noticed a glaring omission. While 70% of advertisements airing on networks such as Nickelodeon and Cartoon Network focused on free toys, campaigns targeted to adults emphasized flavor, portion size, and cost, with only 1% of ads featuring some sort of giveaway. Do I smell fries? Or is that the scent...of opportunity?

You see where this is going, right? I mean, one cheap slab of salt and fat between two buns is pretty much the same as the next, but what if it came in a cardboard box printed with images of underwear models, cool cars/vacation rentals, and sports trivia/celebrity gossip (“Will that be the man’s meal, or the lady’s?”)? Inside would be freebies of interest to adults: nose hair trimmers, deodorant samples, vodka... There could even be movie tie-ins. Would The Lone Ranger have fared so poorly if some fast food chain had given away free neckerchiefs with a large burger?

My guess is that Dr. Sargent and his team are already all over this. I bet they’re days away from opening a new fast food chain to feature the Geisel Green-Eggs-and-Hamburger, the Filet-of-One-Fish-Two-Fish, and the large, medium, or super-sized Hop-On Pop. I’ll have mine with the free pair of Fox-In Socks, please.

Baby talk

Minna Huotilainen and her colleagues published a paper last week in the Proceedings of the National Academy of Sciences demonstrating that fetuses can learn the words their parents say while still in utero. Dammit!

I mean “darnit!” Oh well, it’s way too late now. While previous work had suggested that language learning begins before birth, the new study actually monitored electrical activity in the brain to show that words newborns had heard in utero produced the sorts of responses associated with familiarity. I have no idea what expectant father might benefit from this information... Simon?

David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and  adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.