December 11, 2017Quiz
Pediatrics is the branch of medicine that involves the medical care of infants, children, and adolescents. The American Academy of Pediatrics recommends people be under pediatric care up to the age of 21. A medical doctor who specializes in this area is known as a 1) ___. The word pediatrics and its cognates mean "healer of children"; they derive from two Greek words: pais ("child") and iatros ("doctor, healer"). Pediatricians work both in hospitals, particularly those working in its subspecialties such as neonatology, and as primary care physicians.
The body size differences are paralleled by maturation changes. The smaller body of an infant or neonate is substantially different physiologically from that of an 2) ___. Congenital defects, genetic variance, and developmental issues are of greater concern to pediatricians than they often are to adult physicians. A common adage is that children are not simply "little adults". The clinician must take into account the immature physiology of the infant or child when considering symptoms, prescribing medications, and diagnosing illnesses. A major difference between the practice of pediatric and adult medicine is that children, in most jurisdictions and with certain exceptions, cannot make decisions for themselves. The issues of guardianship, privacy, legal responsibility and informed 3) ___ must always be considered in every pediatric procedure. Pediatricians often have to treat the parents and sometimes, the family, rather than just the child. Adolescents are in their own legal class, having rights to their own health care decisions in certain circumstances. The concept of 4) ___ consent combined with the non-legal consent (assent) of the child when considering treatment options, especially in the face of conditions with poor prognosis or complicated and painful procedures/surgeries, means the pediatrician must take in to account the desires of many people, in addition to those of the patient.
New research shows that the amount of physical contact between infants and their caregivers can affect children at the molecular level. The study of DNA methylation patterns showed that children who had been more distressed as 5) ___ and had received less physical contact had a molecular profile that was underdeveloped for their age. This is the first study to show in humans that the simple act of touching, early in life, has deeply-rooted and potentially lifelong consequences on genetic expression. The amount of close and comforting contact between infants and their 6) ___ can affect children at the molecular level, an effect detectable four years later, according to new research from the University of British Columbia and BC Children's Hospital Research Institute. The study showed that children who had been more distressed as infants and had received less 7) ___ contact had a molecular profile in their cells that was underdeveloped for their age -- pointing to the possibility that they were lagging biologically. "In children, we think slower epigenetic aging might indicate an inability to thrive," said Michael Kobor, a Professor in the UBC Department of Medical Genetics who leads the "Healthy Starts" theme at BC Children's Hospital Research Institute.
Although the implications for childhood development and adult health have yet to be understood, this finding builds on similar work in rodents. This is the first study to show in humans that the simple act of touching, early in life, has deeply-rooted and potentially lifelong consequences on genetic expression. The study, published last month (November 2017) in Development and Psychopathology, involved 94 healthy children in British Columbia. Researchers from UBC and BC Children's Hospital asked parents of 5-week-old babies to keep a diary of their infants' behavior (such as sleeping, fussing, crying or feeding) as well as the duration of caregiving that involved bodily contact. When the children were about 4 1/2 years old, their DNA was sampled by swabbing the inside of their 8) ___. The team examined a biochemical modification called DNA methylation, in which some parts of the chromosome are tagged with small molecules made of carbon and hydrogen. These molecules act as "dimmer switches" that help to control how active each gene is, and thus affect how cells function. The extent of methylation, and where on the DNA it specifically happens, can be influenced by external conditions, especially in childhood. These epigenetic patterns also change in predictable ways as we age. The authors found consistent methylation differences between high-contact and low-contact children at five specific DNA sites. Two of these sites fall within genes: one plays a role in the immune system, and the other is involved in metabolism. However, the downstream effects of these epigenetic changes on child development and health aren't known yet. The children who experienced higher distress and received relatively little contact had an "epigenetic age" that was lower than would be expected, given their actual age. Such a discrepancy has been linked to poor 9) ___ in several recent studies. The authors plan on following up to see whether the ?biological immaturity' they saw in these children carries broad implications for their health, especially their psychological development. The authors added that if further research confirms this initial finding, it will underscore the importance of providing physical 10) ___, especially for distressed infants.
Sources: University of British Columbia: Sarah R. Moore, Lisa M. McEwen, Jill Quirt, Alex Morin, Sarah M. Mah, Ronald G. Barr, W. Thomas Boyce, Michael S. Kobor. Epigenetic correlates of neonatal contact in humans. Development and Psychopathology, 2017; 29 (05): 1517 DOI: 10.1017/S0954579417001213; ScienceDaily; Wikipedia
ANSWERS: 1) pediatrician; 2) adult; 3) consent; 4) legal; 5) infants; 6) caregivers; 7) physical; 8) cheeks; 9) health; 10) contact