Top hot reads November 2008

Ten top hot reads provided monthly by australian colleague Dr Mavis Duncanson

• 1. Closing the gap in a generation: health equity through action on the social determinants of health The Lancet. 2008; 372, 1661 – 1669. A summary of the key findings and recommendations of the report in August from the Commission on Social Determinants of Health. You can register with the Lancet and read this full article free of charge. This whole issue of the Lancet has a focus on health equity. The article below particularly relevant for child population health.
• 2. Effects of fully-established Sure Start Local Programmes on 3-year-old children and their families living in England: a quasi-experimental observational study. The Lancet. 2008; 372, 1641 – 1647. A quasi-experimental observational study, comparing 5883 3-year-old children and their families from 93 disadvantaged Sure Start Local Programmes (SSLP) areas with 1879 3-year-old children and their families from 72 similarly deprived areas in England without SSLPs. SSLPs are area-based interventions to improve services for young children and their families in deprived communities, promote health and development, and reduce inequalities. After controlling for background factors, children in the SSLP areas showed better social development than those in the non-SSLP areas, with more positive social behaviour and greater independence. Families in SSLP areas showed less negative parenting, provided a better home-learning environment, and used more services for supporting child and family development than those not living in SSLP areas. This paper shows that once the SSLPs became established they provided an effective early intervention that can improve the life chances of young children living in deprived areas. (A criticism of earlier evaluations was that they often took place within six months of SSLP implementation at a local level). 
• 3. Effect of Parents’ Wartime Deployment on the Behavior of Young Children in Military Families Arch Pediatr Adolesc Med.2008;162:1009-1014. A bit out of left field for this collection, but from a US Marine base comes the first study to show that having a parent deployed overseas is associated with increased behavioural symptoms compared with peers without a deployed parent, among children aged over 3 years. Spouses of deployed personnel showed higher depression scores: this was controlled for along with caregiver’s stress and other factors. Perhaps further evidence that war is not good for health!
• 4. Growth Monitoring Following Traumatic Brain Injury Arch Dis Child. 2008. doi:10.1136/adc.2008.145235. A retrospective audit of case notes of 123 children who required intensive care unit admission with TBI found that growth monitoring was poorly performed. Height and weight were documented in only one third of visits and serial growth measurements were available for only 22 patients (17%), over a mean follow-up period of 25.2±21.6 months. The clinical issue is to do with hypopituitarism. The population health issue is a timely reminder in terms of service quality and audit.
• 5. Preparticipation screening for cardiovascular abnormalities in young competitive athletes BMJ 2008;337:a1596. An opinion piece that promises to provide a factual overview of preparticipation screening of athletes aged under 35 years to identify that small group with cardiac anomalies that could put them at risk of exercise related sudden cardiac death. Authors note that the efficacy, cost effectiveness, and impact of false positive tests of preparticipation screening strategies remain controversial.
• 6. Extending the benefits of One Laptop per Child to health BMJ 2008;337:a2459. Could the laptop computer be the means of achieving Health for All? If you have access to full text BMJ this article from the National Library of Medicine could provide an interesting read!
• 7. Dissection of the retrieval times of a centralised transport service, New South Wales, Australia Arch Dis Child. 2008. doi:10.1136/adc.2007.125211. An observational study to establish baseline data for database review of the records of 17,011 requests for retrieval to a centralised transport service in New South Wales and the Australian Capital Territory, Australia from 2000 to 2006. The median stabilisation time was 97 min for neonatal compared to 50 min for paediatric retrievals. This will be important information to monitor service delivery and evaluate the effect of new interventions on retrieval times.
• 8. Efficacy of percutaneous versus intradermal BCG in the prevention of tuberculosis in South African infants: randomised trial BMJ 2008;337:a2052. Randomised trial from South Africa involving 11 680 newborn infants found equivalence between intradermal BCG vaccine and percutaneous BCG in the incidence of tuberculosis in South African infants vaccinated at birth and followed up for two years. Authors suggest that WHO guidelines should allow for national immunisation programmes to choose percutaneous vaccination if that is more practical.
• 9. Pre- and postnatal influences on preschool mental health: a large-scale cohort study Journal of Child Psychology and Psychiatry, 49(10), 1118-1128, 2008. From Western Australia, this prospective cohort study of 2,868 live born children involved 2,979 pregnant women recruited at 18weeks gestation and followed up at age two and five years using the Child Behaviour Checklist (CBCL). Early childhood mental health at age 2 and age 5 was significantly affected by prenatal events, particularly maternal experience of multiple stress events in pregnancy, and smoking. Mother’s ethnicity was important at age 2, and at age 5 gender of the child, shorter period breastfeeding, and multiple baby blues symptoms were significant predictors of mental health problems. Interventions targeting adverse prenatal, perinatal and postnatal influences can be expected to improve mental health outcomes for children in the early years. This full issue of the Journal of Child Psychology and Psychiatry is available free on-line and contains other interesting articles on pre- and peri-natal origins of child and adolescent mental health (including maternal oily fish intake and effects of caesarean section).
• 10. Regular consumption of dark chocolate is associated with low serum concentrations of C-reactive protein in a healthy Italian population. J Nutr 2008; 138: 1939-1945. Finally a little item from Medscape News for adults approaching the holiday season. A new Italian study has shown that consuming moderate amounts of dark chocolate is associated with a significant reduction in the risk of cardiovascular disease. But don’t eat too much! Beyond a small square of chocolate two or three times a week the beneficial effect tends to disappear. “It could be that if you increase the amount of chocolate by too much, the increase in lipids and calories overcomes the effects of the antioxidants.” Celebrate well colleagues! Top Hot Reads will return in January 2009.