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Cardiology

CB cardiologist facing sex crimes with 10-year-old appears in court – Port City Daily

CAROLINA BEACH A local doctor charged with first-degree sex offense and indecent liberties with a child appeared virtually in court Monday.

READ MORE: Local cardiologist, nonprofit founder arrested for sex crimes with a minor

Damian Alexander Brezinkski, 61, was arrested Friday, May 3, at his practice, Island Cardiology on Pleasure Island, for an incident that allegedly happened April 17. He is being held at the New Hanover County Detention Center under a $1.5 million bond.

Brezinksi was arrested on two felonies of sex offenses with a juvenile that, according to arrest warrants, is 10 years old.

First degree statutory sex offense, by state statute, is when a perpetrator at least 12 years old and four years older than the victim engages in a sex offense with someone under the age of 13. It carries a144 months to life imprisonment sentence, if found guilty.

Indecent liberties with a child refers to incidents when a person over 16 years of age and at least five years older than the victim takes immoral liberties with someone under 16 for the purpose of arousal and meeting sexual desire. Its a Class F felony, which means anyone found guilty may face a maximum sentence of 59 months imprisonment and potential fines.

Documents show Brezinski must go under electronic house arrest and surrender his passport if he makes bond. It was determined by Judge Noecker on his arrest date.

It also mandates Brezinski have no contact with any minor children, nor with the victim or victims family.

He was required to turn in a DNA sample under state statue 15A266.3A.

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Cardiology

Cardiologists want better data on how legal marijuana will impact heart health in the US – Cardiovascular Business

Rezkalla and Kloner did note that marijuana use has been linked to certain health benefits. However, they added, it has also been associated with a variety of cardiovascular complications, including myocardial infarction, stroke and congestive heart failure. With recreational marijuana use now legal in approximately half of the country, should cardiologists expect the number of patients presenting with these adverse events to increase dramatically?

Many studies have indicated an increase in cardiovascular events, and some indicated an increase in mortality, in people who use marijuana, Rezkalla and Kloner wrote. An important question is, did legalization of marijuana in any states cause an increase in cardiovascular events and/or mortality?

Overall, the duo concluded, there is an urgent need for the National Institutes of Health and other federal agencies to step forward and fund studies that can provide some definitive answers. Learning more about the cardiovascular impact of marijuana legislation will benefit the general public and it may even help influence future policies and industry guidelines.

Click here to read the full manuscript in Cardiology Research.

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Cardiologists want better data on how legal marijuana will impact heart health in the US - Cardiovascular Business

Cardiology

Cardiologist charged with 9 more sex crimes as police search his home and private practice – Cardiovascular Business

A cardiologist in Carolina Beach, North Carolina, is now facing additional charges for allegedly raping a 10-year-old child.

Damian Brezinski, 61, was originally arrested on May 3. At the time, he was charged with indecent liberties with a child and first-degree statutory sexual offense.

According to new reporting from WECT, a local television station based out of Wilmington, North Carolina, Brezinski has now been charged with nine additional counts, including the rape of a child by an adult offender and the solicitation of a child by computer.

Brezinskis judge raised his bond from $1.5 million to $5 million after the new charges were announced. The judge also said Brezinski could face life in prison without parole if convicted.

WECT obtained copies of multiple search warrants related to the case, revealing new details. Those warrants allowed investigators to search Brezinskis home, cars and even his private practice, Island Cardiology, for evidence.

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Cardiologist charged with 9 more sex crimes as police search his home and private practice - Cardiovascular Business

Pediatrics

Modest Changes in Kids’ Developmental Scores Seen From Pandemic – Medpage Today

Young children who lived through the COVID-19 pandemic demonstrated modest changes in developmental screening scores, according to a cohort study of more than 50,000 U.S. children.

Among kids age 5 and under, there were significant mean score decreases from the pre-pandemic to intra-pandemic periods in communication (0.029, 95% CI 0.041 to 0.017), problem-solving (0.018, 95% CI 0.030 to 0.006), and personal-social (0.016, 95% CI 0.028 to 0.004) domains as measured by the Ages and Stages Questionnaire (ASQ), according to Sara Johnson, PhD, MPH, of Johns Hopkins School of Medicine in Baltimore, and colleagues.

At the same time, there were no changes in fine or gross motor scores between the pre-pandemic and intra-pandemic periods, they reported in JAMA Pediatrics.

"Communication scores decreased approximately 3% and personal-social and problem-solving scores decreased approximately 2%," the researchers wrote. "Applied at the population level, a change of this magnitude would translate to 1,541 more recommended referrals per month across the U.S. over baseline."

Johnson said in an email to MedPage Today that there has been "a lot of uncertainty about what being isolated from friends and extended family, closures of schools and childcare, job loss, and other family stresses might mean for children's development. Until now, though, there hasn't been a large study of children across the U.S. to help answer this question."

As to potential mechanisms, she noted that the affected domains were "areas of development that children practice through interacting with others -- so these outcomes might be influenced by caregiver stress during lockdowns, childcare closures, and social distancing. On the other hand, we didn't see any differences in gross or fine motor development, which don't rely so much on interactions."

Overall, the study used an interrupted time series analysis comparing time periods classified as pre-pandemic (March 1, 2018 to Feb. 29, 2020), interruption (March 1, 2020 to May 31, 2020), and intra-pandemic (June 1, 2020 to May 30, 2022).

Ultimately, 50,205 children were included from a randomly sampled population of 502,052 children ages 0 to 5 years whose parents or caregivers completed developmental screening during pediatric visits at primary care practices participating in a web-based clinical process support system. Most respondents were mothers. However, the proportion of non-parent respondents increased over time from 9.1% during the pre-pandemic period to 20% during the intra-pandemic period.

The children had a mean age of 18.6 months, and the mean age for infants was 5.1 months.

Among infants specifically, there were similar effect sizes for communication (0.027, 95% CI 0.044 to 0.011) and problem-solving (0.018, 95% CI 0.035 to 0.001). However, there were no significant changes in personal-social, fine motor, or gross motor scores from the pre-pandemic to intra-pandemic periods.

Additionally, during the study period, 51% of caregivers completed two questions on worries and concerns about their children. "Overall, we saw limited evidence that caregivers' worries and concerns about their children changed over the study period," Johnson and colleagues wrote.

Rates of behavioral concerns were less prevalent (range 5.1% to 6.2%) than worries about the child (range 15.3% to 17.4%). After controlling for ASQ scores and changes, there was a small increase in caregiver worries in the intra-pandemic period compared with the pre-pandemic period (rate ratio 1.088, 95% CI 1.036-1.143).

Limitations of the study included that some covariates like prenatal substance use, prenatal or postnatal SARS-CoV-2 infection, and comorbidities were unavailable, Johnson and colleagues noted. Additionally, the ASQ was caregiver reported, and infants born preterm were excluded from the study.

Furthermore, primary care clinics in communities hard hit by COVID-19 might not have offered health supervision for portions of the follow-up period, they added. And there was no contemporaneous pandemic-unexposed comparison group possible.

"It will be important for future studies to continue to follow these large samples of children from across the U.S. to help us understand the long-term implications of our findings," Johnson said. "It's possible that after the pandemic, these changes in development will disappear for most children as families get back to more normal routines and experiences. It's also possible that new challenges will emerge as children age, for example when they enter kindergarten, or these deficits will get larger over time if changes in routines that were prompted by the pandemic, like greater reliance on screen time or school absenteeism, persist."

"Future studies should also look at variation in the pandemic's developmental impact among subgroups," Johnson added, "for example in preterm infants (who weren't included in our study) or in families living in poverty, who may have had the fewest resources to rely on during this time."

Jennifer Henderson joined MedPage Today as an enterprise and investigative writer in Jan. 2021. She has covered the healthcare industry in NYC, life sciences and the business of law, among other areas.

Disclosures

The study was supported by the Johns Hopkins Population Center and a grant from the National Institute of Child Health and Human Development.

Authors reported relationships with CHADIS, the NIH, the Center for Promotion of Child Development Through Primary Care.

Primary Source

JAMA Pediatrics

Source Reference: Johnson SB, et al "Developmental milestone attainment in US children before and during the COVID-19 pandemic" JAMA Pediatr 2024; DOI: 10.1001/jamapediatrics.2024.0683.

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Modest Changes in Kids' Developmental Scores Seen From Pandemic - Medpage Today

Pediatrics

This pediatrics subspecialty has the best work-life balance – MD Linx

Studies show that 1 in 4 kids or teens has a behavioral, developmental, emotional, or learning problem.[]

MDLinx spoke with Emily Wassmer, MD, IBCLC, a fellow at Childrens Hospital of Philadelphia, for an insider's perspective on the critical need for more developmental and behavioral pediatric (DBP) specialists.

According to Dr. Wassmer, DBP is a highly rewarding specialty with a great work-life balance. Despite this, she feels its often overlooked in medical school. Heres what else she had to say.

Dr. Wassmer says the dearth of DBP specialists primarily stems from a lack of exposure during training. While pediatrics is a required rotation, its subspecialties arent. If you do your core rotations at an institution without DBP, you wont experience the subspecialty clinically, she explains. You may hear about it in passing while seeing primary care patients, but that will also be attending-dependent.

She notes that many students aim for child and adolescent psychiatry or neurodevelopmental disabilities specialties, until they realize DBP is a better fit.

Typical career path

DBPs start with a 3-year residency in pediatrics, followed by 3 years of fellowship training.

Dr. Wassmer described the path to DBP: You get into any pediatric fellowship through the ERAS fellowship match, similar to the process you go through for residency. For pediatric subspecialties, applications are due in the summer, interviews are in the fall, and Match is in late November or early December. This process is done in the academic year before you plan on starting fellowship (summer/fall 2024 cycle if you want to start fellowship in summer 2025).

She also shared that since this pediatric subspecialty match was recently combined with the subspeciality match for Internal Medicine, partners trying to couples-match may want to consider this option.

A disheartening but common reason why people dont go into pediatric subspecialties is the salary, says Dr. Wassmer. Doing subspecialty training in pediatrics almost always guarantees youll lose lifetime earnings by doing extra training. Unlike adult specialists, pediatric specialists do not see a big jump in salary (or jump at all) after completing subspecialty training. Her opinion aligns with salary data for pediatric subspecialists.[]

Dr. Wassmer said that most DBPs make just under $200,000 as attendings. Ive heard of starting salaries as low as $150,000 to $160,000, but have also seen places that will start over $200,000. Pediatric subspecialties, in general, often end up with salaries in the $180,000 to $240,000 range, which is the same as or lower than that for general pediatricians, she explained.

Dr. Wassmer understands that mental health fields can be challenging, and many clinicians experience burnout, particularly when treating young patients. Nonetheless, she finds the field rewarding. We love having long-term continuity with our patients. We also love diving deep into issues and trying to get to the bottom of them, she shared.

Its a common misconception that DBPs only treat autism. On the contrary, Dr. Wassmer says they manage a broad scope of conditions.

You can be more of a general DBP who diagnoses and manages things like autism, ADHD, and developmental delays, she explains. Or, you can pick a more specific niche within the field, such as focusing on genetic disorders like Down syndrome or Fragile X. I personally have a clinical interest in hearing loss, so Im interested in working in a pediatric hearing loss clinic doing autism evaluations, as autism often presents very differently in kids with hearing loss.

Theres a long list of reasons to refer to a DBP, note researchers writing in Pediatrics, such as aggression, adoption and foster care, cerebral palsy, fetal alcohol spectrum disorders, gender identity and sexuality issues, OCD, Tourettes syndrome, and traumatic life events.

Such a varied field means Dr. Wassmer enjoys its multidisciplinary nature that allows her to collaborate with speech therapists, occupational therapists, audiologists, and genetic counselors.

"DBPs generally have a nice work-life balance, working 3 to 5 days per week and rarely working on weekends."

Emily Wassmer, MD, IBCLC

Dr. Wassmer said her schedule changes weekly in fellowship. She sees her own patients one half-day per week, but in her 2nd and 3rd years, itll increase to a full day. She spends another half-day per week participating in a LEND fellowship, a 1-year government-funded multidisciplinary program for trainees working with children with neurodevelopmental disabilities.

The other 3 days vary depending on my rotation, which could be neurology, genetics, rehab, resident teaching, community experiences, child psychiatry, or DBP, she explains. She said fellows occasionally have consults with patients in the hospital (about two or three times a month), but the consults arent urgent. She also covers her own patient messages throughout the day.

In my program, the fellows cover patient calls on weeknights, and the attendings cover patient calls on weekends. After-hours patient calls are infrequent, hardly ever more than one per night, she says.

What this means for you

The DBP subspecialty is a growing field with immeasurable rewards. Specializing in DBP means you can steer your career toward your interests while enjoying a manageable schedule. For residents considering pediatric-related fields, DBP is worth a closer look.

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This pediatrics subspecialty has the best work-life balance - MD Linx

Pediatrics

PM Pediatrics Cobble Hill closing Pediatric urgent care options in Brooklyn and lower Manhattan – Brooklyn Bridge Parents

PM Pediatric Urgent Care in Cobble Hill has announced that they will be closing on Sunday, May 19 after over 10 years at 240 Atlantic Avenue. Check out our overview of alternative urgent care options for kids in our neighborhoods, including dedicated pediatric emergency rooms, inpatient pediatric units, and services for all types of urgent care needs, from X-rays to stitches to treatments for colds and other common illnesses.

If your child needs emergency care, keep in mind that the co-pay at an urgent care clinic will typically be much less than a visit to the emergency room depending on your insurance. Our guide lists urgent care options first, followed by emergency room options.

CityMD has many locations in our neighborhoods, and while no appointment is needed, you can book a visit at your closest clinic. You can also check estimated wait times on their website. CityMDoffers quick, reliable, emergency care service 365 days a year. Board-certified doctors are availability to treat all of urgent care needs, from suturing and X-rays, to coughs, colds, and other common illnesses. All locations offer pediatric care.

+MEDRITE offers pediatric services for newborns up to age 18. No appointments are needed, and children are seen within minutes of arriving. Theyprovide onsite lab and X-ray facilities, as well as pediatric orthopedic care. Physicians treat urgent care needs from broken bones to strep throat to abrasions, cuts & stitches.

The NYU Langone medical center opened last spring on Atlantic Avenue with a 24-hour emergency department. Children and patients of all ages are being taken care of 24/7 with two emergency specialists on site all times and a pediatric ER specialist on site from 2 to 10 pm daily. Their services are more comprehensive than those offered by urgent care centers, which usually do not have advanced imaging services, cast set-up for fractures or emergency-trained nurses. If a person needs to be admitted to the hospital, their in-house team transports patients for free to the assigned hospital within their network. The center also offers valet parking. Emergency care wait times are posted on the website and updated every 5 minutes here.Learn more about the facility and its pediatrics team here!Pediatric patients who require advanced care or hospitalization will be transferred to NYU Langones Hassenfeld Childrens Hospital at 430 E 34th Street, right off the FDR in Manhattan.

506 6th Street

Located within NewYork-Presbyterian Brooklyn Methodist Hospitals main emergency room, the pediatric emergency service is a self-contained area staffed by physicians certified in both emergency medicine and pediatrics, and by registered nurses with specialized training.Everything in the pediatric emergency service is geared toward treating children and their families: all equipment is child-sized, the patient gowns feature cartoon characters, and the staff is sensitive to the needs of parents, as well as children.The separate pediatric waiting room is open 24 hours per day, seven days per week. Learn more here.

170 William Street

NewYork-Presbyterians location in Lower Manhattan also has a dedicated pediatric emergency room, and is located right over the Brooklyn Bridge. Physicians in the pediatric emergency service treat life-threatening illnesses, traumatic injuries, and less serious conditions.Pediatric patients who require advanced care or hospitalization will be transferred to the pediatric inpatient unit at Komansky Childrens Hospital at NewYork-Presbyterian/Weill Cornell Medical Center at 525 East 68th Streeton the Upper East Side.

121 DeKalb Avenue

The Brooklyn Hospital Center finished a major Emergency Department renovation in the summer of 2022. This renovation significantly improves the hospitals response to traumatic injury and illness, and has resulted in a state-of-the-art facility with a separate pediatric emergency room. The pediatric ED provides emergency services to infants, children and adolescents from birth to age 21 and is open 24 hours a day, 365 days a year. Highly trained board certified pediatric emergency physicians, residents, nurses and staff offer the crucial care needed in all types of pediatric emergencies.The facility is focused on all conditions affecting children, from minor to major illness, as well as injuries. In addition, TBHC offers a full range of pediatric services, including an inpatient pediatric unit, a six-bed pediatric intensive care unit and a neonatal intensive care unit, as well as many pediatric specialists on hand to provide their expertise if necessary.

4802 10th Avenue

The Maimonides Childrens Hospital has provided Brooklyns families with dedicated pediatric emergency care for over 30 years, treating infants, children, and adolescents 24 hours a day, 7 days a week. Healthcare providers in the fully-accredited Pediatric Emergency Room treat a range of conditions from allergic reactions to injuries and acute illnesses. Maimonides team is comprised of board-certified pediatric emergency medicine physicians, fellows, and nurses, as well as other specialists who can consult and provide additional services as needed. Translation services are also available at all times. Maimonides is also prepared for emergency conditions that may be uncommon in the United States. Maimonides also has Brooklyns only pediatric trauma center to treat life-threatening injuries that result from serious incidents like falls and car accidents.

For broken bones and other orthopedic emergences, its worthwhile to head to NYU Langones Samuels Orthopedic Immediate Care Center in Manhattan, one of New York Citys only walk-in orthopedic immediate care facilities. They offer medical care specifically for people with orthopedic injuries, unlike emergency rooms that treat people who have a broad range of urgent health problems. The result is that you receive specialized orthopedic care with less waiting time. The vast majority of patients are treated and discharged within two and a half hours. Their teamcomprised of an emergency medicine doctor and an orthopedic surgery resident doctor or physician assistantevaluate and treat children for sprains, dislocations and joint injuries, hand and foot injuries, hip, arm, or leg fractures, and joint and bone infections. They are open seven days a week: Sunday through Thursday, 8am to 9pm, and Fridays & Saturdays, 8am to 10:30pm.

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PM Pediatrics Cobble Hill closing Pediatric urgent care options in Brooklyn and lower Manhattan - Brooklyn Bridge Parents

Pediatrics

Bethesda Pediatrics awarded $18,000 grant by GIVE – Yahoo! Voices

Girls Invested in Volunteer Efforts (GIVE) awarded their $18,000 2024 grant to Bethesda Pediatrics during an event at The Venue at Cantina Laredo in Tyler on Sunday. Visit this article to learn more: https://www.ketk.com/community/bethesda-pediatrics-awarded-18000-grant-by-give/ KETK/FOX51 News covers East Texas, bringing you the latest local stories, weather, sports and lifestyle coverage from the Piney Woods. Keep up with KETK/FOX51 News: https://www.ketk.com/ Download the KETK/FOX51 app: https://www.ketk.com/apps/ Subscribe to KETK/FOX51 News: https://www.youtube.com/@KETK Find us on Facebook: https://www.facebook.com/KETKnbc and https://www.facebook.com/kfxkfox51

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Bethesda Pediatrics awarded $18,000 grant by GIVE - Yahoo! Voices

Pediatrics

Nemours Children’s Health, UCF Partner to Elevate the Quality of Healthcare for Florida’s Children – UCF

Nemours Childrens Health, one of the nations largest multistate pediatric health systems, and UCF today announced a formalized, expanded partnership aimed at improving the health of children in Central Florida and beyond. Together, they will establish the UCF College of Medicine Nemours Childrens Health Department of Pediatrics to train the next generation of pediatric physicians. In addition, Nemours Childrens has signed on as UCFs first Pegasus Partner whose sole focus is pediatric healthcare.

With projections forecasting a shortfall in the number of physicians needed to meet the demand within the state of Florida in the coming years, this expanded partnership aims to help address those potential shortages by drawing from the organizations long-standing history of collaboration and accentuating their mutual commitment to advancing medical training, workforce development, innovation, community partnerships and advocacy to ensure the delivery of high-quality health care for children.

The UCF College of Medicine Nemours Childrens Health Department of Pediatrics is expected to impact all 480 UCF medical students each year and will set a new standard for pediatric academic programs by further leveraging Nemours Childrens preeminence. Expanding upon current joint educational programs, the department will enable new collaborations and support both organizations efforts in clinical excellence, research and the recruitment and retention of the next generation of pediatricians.

Nemours Childrens has been a fabulous partner to the College of Medicine, providing pediatric education to every UCF medical student, says Deborah German founding dean and UCF vice president for health affairs. Nemours shares our three missions. They are fully engaged in research, finding new cures and treatments. They provide care across the spectrum of pediatrics. And they are focused on education of UCF medical students, residents and fellows. We are now expanding a great partnership that has allowed us both to thrive.

Every UCF medical student receives their pediatric training at Nemours Childrens. Over the years, the pediatric health system has trained more than 1,100 M.D. candidates across a number of clinical departments and pediatric disciplines, including general and orthopedic surgery, anesthesiology, pathology and radiology. After graduation, medical school graduates must complete residencies in their specialty of choice and pediatrics has been one of the most popular specialties for UCF students. Nemours Childrens also participates in many of the UCF College of Medicines residency and fellowship programs, which are among the fastest growing in the state.

We have long valued our partnership with UCF, and this newly established department is a natural continuation of our joint efforts, says Martha McGill, president of the Central Florida Region for Nemours Childrens Health. Nemours Childrens is one of the nations largest pediatric health systems, and together we will be able to provide medical students and trainees with the depth, complexity and variety of experience and skill-building we offer.

The partnership further emphasizes Nemours Childrens commitment to directly supporting the growth and training of future clinical leaders. Other partnerships for Nemours Childrens include working with the Mayo Clinic and University of Florida in Jacksonville, Florida, to train pediatric residents and fellows representing more than 15 specialties. In Delaware, Nemours Childrens jointly runs a pediatric residency program in collaboration with Sidney Kimmel Medical College at Thomas Jefferson University.

This new department underscores the value and importance of partnerships between industry and academic institutions, especially those aligned to a common mission, says Kanekal Gautham, pediatrician-in-chief for Nemours Childrens Hospital, Florida who will serve as the inaugural chair of the department. Pediatric health care is more complex than it has ever been, so creating a pipeline of skilled, well-trained clinicians is pivotal to meeting the ongoing and evolving care needs of children.

The UCF Pegasus Partner Program is a comprehensive partnership initiative designed to foster deep, intentional, mutually beneficial relationships between the university and leading industry partners. UCFs objective is to strategically align in key partnerships where the university and an industry partner can collectively drive talent development, discovery and innovation through collaboration and philanthropy.

Through the Pegasus Partner Program, Nemours Childrens and UCF will work collaboratively to identify opportunities and establish initiatives that leverage their collective medical and academic preeminence toward the overall advancement of pediatric healthcare.

By further aligning our nationally recognized pediatric expertise with UCFs prowess in innovation and technology, this expanded partnership builds upon Nemours Childrens commitment to creating the healthiest generations of children, says R. Lawrence Moss, president and CEO of Nemours Childrens Health. As we expand our long history of collaborating to address the unique health needs of children, we improve the care given in the multitude of communities we serve, and positively influence childrens quality of life for years to come.

We are grateful for Nemours Childrens longstanding partnership with UCF and the impact growing our collaboration will have for children and their families and for our College of Medicine students and faculty, says UCF President Alexander N. Cartwright. Together, we are strengthening our communitys health and well-being, investing in the development of new innovative clinical practices and devices, and developing the talent that will serve future generations of Floridians for decades to come.

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Nemours Children's Health, UCF Partner to Elevate the Quality of Healthcare for Florida's Children - UCF

Pediatrics

Pediatricians told to talk to patients and parents about climate. – Grist

The reality of climate change came home for Dr. Samantha Ahdoot one summer day in 2011 when her son was 9 years old.

An assistant professor at the University of Virginia School of Medicine, Ahdoot and her family were living in Alexandria, when there was a heat wave. Morning temperatures hovered in the high 80s, and her son had to walk up a steep hill to get to his day camp.

About an hour after he left for camp, she received a call from a nearby emergency room. Her son had collapsed from the heat and needed IV fluids to recover.

It was after that event that I realized that I had to do something, she said. That, as a pediatrician and a mother, this was something that I had to learn about and get involved in.

Dr. Ahdoot made good on that vow. She is the lead author of the American Academy of Pediatrics newly updated policy statement on climate change,which appeared earlier this year. The statement urges pediatricians to talk about climate change to their patients. But research suggests thats not happening very much yet, and there are practical barriers in the way.

Back in 2007, the AAP was the first national physicians group to make a public statement about climate change. The updated statement covers the growing research on the many ways climate disproportionately affects children in particular. Heat raises the risk of preterm birth; infants are among the most likely to die in heat waves. Because their bodies cool themselves less efficiently than adults, children remain more susceptible to heat-related illness as they grow. Children breathe more air per pound of body weight, making them up to 10 times more affected by toxins in wildfire smoke. Excess heat hurts childrens performance in school, especially low-income children with less access to air conditioning. And research suggests that teens and youth are feeling more climate anxiety than older adults.

The new policy statements number one recommendation is that its members incorporate climate change counseling into clinical practice. This may seem like a tall order, considering the average pediatrician visit is 15 minutes.A 2021 study found that 80 percent of parents agreed that the impact of global warming on their childs health should be discussed during their routine visits. But, only 4 percent said that it had actually happened in the past year.

How do you talk about climate change in a visit where you have to talk about X, Y, Z, do all the vaccines, answer every concern? said Dr. Charles Moon, chief resident at the Childrens Hospital at Montefiore in New York.A member of the AAP Council on Environmental Health and Climate Change, he has been working to build a curriculum at his hospital to start teaching pediatricians and other doctors about this.

I dont think we have all the answers to that yet, he said. I do a lot of work teaching other pediatricians, and it requires a little bit of a mindset shift.

Dr. Moon sees patients in the South Bronx, nicknamed Asthma Alley for its air pollution. Part of his challenge is putting environmental threats in perspective for families who face many different obstacles in their lives, in a way that doesnt lead to despair or disempowerment.

Or, as he put it: If you cant put food on the table, who wants to hear about climate change?

In Oakland, California, Dr. Cierra Gromoff has a lot of experience with families on Medicaid, and she says the pressure on them and their healthcare providers is real.There are these already incredibly marginalized groups of kids facing other insurmountable things, she said. These providers have so little time, they have to focus on the biggest burning fire whatever systemic problem is going on.

A clinical child psychologist, Gromoff has been concerned about the environment since her childhood as an Alaskan Native in the remote Aleutian Islands. She thinks that to overcome these obstacles, state and federal insurance providers should require or reward doctors for taking the time to include environmental health in their assessments.

She is the co-founder of a telehealth startup, Kismet Health, which is building a tool that could show local environmental threats that are indexed to a patients home or school address.

The tool could help doctors recognize climate risks, by showing if a patient lives near a green space, an urban heat island, or a polluting chemical plant.

Gromoff said she would like to see free resources that pediatricians can give families on everything from the signs of heatstroke in a baby to eco-anxiety.

We should have a screening question, she said. Are you worried about whats happening to our earth? And if they say yes, we should be able to provide some type of handout: What youre feeling is real. These are small steps you can take.

The good news, say Moon and Ahdoot, is that interest in the topic is picking up in the medical community. Over half of medical schools are covering climate change in the curriculum, a number thats more than doubled since 2019. And there are state research consortiums on climate and health in 24 states, Ahdoot said. The American Academy of Pediatrics has been creating continuing education materials on the topic as well.

Incorporating climate change into clinical practice is not about adding another item to an already long checklist, Ahdoot said. Its also not about transforming pediatricians into activists, or talking about factors that families cant do anything about.

Pediatricians never want to be proselytizing, she added. It always has to be valuable to the individual patient.

The goal of the new climate policy for pediatricians is to help doctors translate their climate knowledge into solutions and helpful advice for their patients. A few examples from Ahdoot include: running a test for Lyme disease for patients in Maine, which used to be too cold for ticks; beginning allergy medication in February because pollen arrives earlier in the year; or teaching athletes the warning signs for heat exhaustion.

For Ahdoot, its also important to be aware of how climate affects a childs mental health. Part of the answer, she said, is talking about actions that families can take that benefit both peoples health and the planet, like eating more plant-based diets, and walking or biking instead of driving.

Whats good for climate, she said, is generally good for kids.

This story has been updated.

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Pediatricians told to talk to patients and parents about climate. - Grist

Pediatrics

Getting a good night’s rest is vital for neurodiverse children pediatric sleep experts explain why – The Conversation

Most of us are all too familiar with the consequences of a poor nights sleep be it interrupted sleep or simply too little of it. If youre a parent with kids at home, it often leaves you and your children on edge.

Children with neurodiverse conditions, such as autism and attention-deficit/hyperactivity disorder, or ADHD, are even more susceptible to the effects of poor sleep, given their emotional reactivity and impulsivity.. Struggles with sleep have been linked to increased aggression, irritability, inattention and hyperactivity in children with autism spectrum disorder.

We are three sleep experts a neurology physician with expertise in pediatrics, a psychologist and a pediatric nurse practitioner who are working together to help neurodiverse kids, including those on the autism spectrum, get better sleep. Two of us wrote a 2014 book for parents on the topic.

We are passionate about improving sleep because its an opportunity to help neurodiverse kids and their families both at night and throughout the day to improve how they function in the world.

There are multiple reasons why neurodiverse children dont sleep well, including medical conditions, biological causes and behavioral and environmental factors.

Medical conditions, such as obstructive sleep apnea or epilepsy, can affect a childs sleep. Medications that are used to treat medical conditions, such as antidepressants for mood disorders or stimulants for ADHD, can further disrupt sleep.

Biological causes include genes that affect sleep and issues with processing brain chemicals, such as melatonin.

Behavioral and environmental factors, including the common culprits of increased caffeine, too much screen time and too little physical activity, or any combination of these, can also affect sleep.

Neurodiverse children often struggle with understanding whats expected of them at bedtime and have difficulty transitioning from after-dinner activities to bedtime routines. They also describe having trouble turning off their brains when its time to go to sleep.

All of these factors can be addressed and treated. A thorough evaluation by the childs health care provider may reveal a medical cause, or medication, that is interfering with sleep.

Behavioral approaches can make a big difference in improving sleep. These might include:

Changes to daytime habits, including getting lots of morning light and physical activity.

Shifts in evening habits, such as removing all screens (TV, computers, phones, etc.) and establishing calming bedtime routines.

Modifications to how a parent interacts with their child for those families who would like a child to fall asleep and stay asleep independently.

While behavioral approaches can be successful in helping a neurodiverse child sleep, they need to be tailored to the needs of the individual child and their family. Its important to note that not all families want their children to sleep on their own. For instance, some cultures value a family bed, and in many families, children share a room with one or more siblings or other relatives.

Because there are so many factors that can cause disrupted sleep, addressing sleep problems cannot be a one-size-fits-all approach and should be done in partnership with parents.

Our team has developed a family-centered approach to address sleep problems in neurodiverse children. This involves brief behavioral sleep education, usually in an initial session lasting up to 90 minutes, and two 30-minute follow-up sessions. In this unique care model designed to increase access to sleep care for families, we train clinicians, including behavioral, speech and occupational therapists, to work with parents to put together a personalized plan.

After only four weeks using this approach, we found that childrens sleep patterns improved, as did their behaviors, and that parents reported feeling more competent in their parenting.

Melatonin is a natural substance that is produced in your brain when it becomes dark in the evening. It makes us drowsy and helps set your brains internal clock to promote sleep. Melatonin reduces anxiety and calms down an overaroused brain.

Melatonin is one of the most studied supplements for sleep, and carefully designed studies have shown that it is safe and effective, including large retrospective reviews, systematic reviews, and randomized clinical trials.

While behavioral approaches are recommended as a first-line treatment, melatonin can be helpful in jump-starting a behavioral routine.

There are potential downsides to melatonin, though. It is considered a dietary supplement and is not regulated by the U.S. Food and Drug Administration. This makes it hard for parents to tell how much melatonin a pill or gummy contains, let alone what other substances the supplement may include.

In the past several years, there has been an uptick in overdoses of melatonin. In 2021, compared to 2012, the yearly number of overdoses increased 530%, with more than 260,000 overdoses reported.

That report found that, in cases of overdoses, children experienced drowsiness, dizziness, headache, vomiting and more serious side effects, such as low blood pressure and increased heart rate. Although only a small number of overdoses 1.6% resulted in serious outcomes, five children required breathing assistance through mechanical ventilation, and two children died. Overdoses can result from children eating a bunch of gummies, or parents not understanding how much melatonin is safe to give.

To help parents sift through all the resources and articles on melatonin on the internet and social media, one of us created a video and wrote several blogs on melatonin safety. These include topics like whether children can become dependent on melatonin supplements over time, whether taking melatonin will delay puberty, whether children might experience side effects from taking melatonin and more.

Here are some general tips for helping your child sleep better, regardless of whether they are neurodiverse:

Choose a consistent bedtime and wake time. This consistency will help childrens own natural melatonin kick in.

Make sure bedtime isnt too early. For example, an 8 p.m. bedtime is too early for most 10-year-olds. Neurodiverse children may struggle to sleep and will become more anxious, which makes going to sleep even harder.

Help your child get natural sunlight in the morning. Morning sunlight sets our brains internal clock so that we can fall asleep more easily at bedtime.

Ensure your child is getting physical activity during the day.

Minimize naps longer than one hour, or after 4 p.m. for school-age children. Naps can interfere with going to sleep at night.

Avoid caffeine, including many types of soda, tea and chocolate.

Turn off all screens and smartphones at least 30 minutes before bedtime.

In the evening leading up to bedtime, turn down all lights in the house. Consider using red night lights, if possible. Set any devices to night mode in the evening to limit exposure to blue light.

Create wind-down time in place of screens. Have your child identify an activity they enjoy that is calming and soothing, such as reading a book, coloring or listening to music. If a bath is stimulating, move it to earlier in the evening, such as after dinner.

Help your child learn to fall asleep without needing you or their devices to be there with them. That way, they will settle down on their own at bedtime. And when they wake up throughout the night, since we all wake up in the night, they will be able to go right back to sleep without becoming fully awake.

For more tips, see Autism Speaks for free downloads of brochures and visual aids.

Read more here:

Getting a good night's rest is vital for neurodiverse children pediatric sleep experts explain why - The Conversation