Safety and immunogenicity of a toddler dose following an infant series of a hexavalent diphtheria, tetanus, acellular pertussis, inactivated poliovirus, Haemophilus influenzae type b, hepatitis B vaccine administered concurrently or at separate visits with a heptavalent pneumococcal conjugate vaccine.

Background: Combination diphtheria-tetanus-5 component acellular pertussis-inactivated poliovirus-Haemophilus influenzae b conjugate-hepatitis B vaccine (DTaP5-IPV-Hib-HepB) administered either concurrently with 7-valent pneumococcal conjugate vaccine (PCV7) or 1 month apart was generally safe and immunogenic at 2, 4 and 6 months of age. This study examined the effects of a booster dose at age 15 months.

Methods: Participants were randomized to DTaP5-IPV-Hib-HepB plus PCV7, DTaP5-IPV-Hib-HepB with PCV7 administered 1 month later or a pentavalent DTaP5-IPV/Hib plus HepB plus PCV7 at 15 months of age in a randomized, open-label, phase IIb clinical trial.

Co-bedding between preterm twins attenuates stress response after heel lance: results of a randomized trial.

Objective: To examine the effect of co-bedding between preterm twins on stress response after heel lance.

Methods: Using a multisite randomized controlled trial design, stable preterm twins (67 sets, N=134 infants) between 28 and 36 completed weeks' gestational age, stratified by gestational age (≤ and >32 weeks) and site, were randomly assigned to a co-bedding group, cared for continuously in the same incubator or crib or a standard care group, cared for in a separate incubator or crib, and underwent a medically indicated heel lance after at least 24 hours and no greater than 10 days of group allocation. The reported outcome was cortisol from saliva samples from 89 twins (n=49 co-bedding, n=40 standard care) collected immediately before the heel lance (baseline levels) and 113 twins (n=58 co-bedding, n=55 standard care) collected 20 minutes after heel lance (stress levels) as an index of stress response.

Program evaluation of a child and youth mental health training program for family physicians in british columbia.

Introduction: This brief report presents findings from the program evaluation of a portion of an educational program developed to support family physicians in improving their mental health care competencies in children and youth in British Columbia.

Method: The Child and Youth Mental Health (CYMH) learning module is part of a broader initiative from the Practice Support Program (PSP) of the British Columbia Medical Association and was created specifically to assist family physicians in improving their competencies in the identification, diagnosis and delivery of best evidence-based treatments for children and youth exhibiting the most common mental disorders that can be effectively treated in most primary care practices.

Results: The initial results from the program evaluation demonstrate a substantial improvement in family physicians' knowledge of child and youth mental disorders and their self-rated clinical confidence in identifying and treating (both pharmacologically and psychotherapeutically) the most common child and youth mental disorders.

Early illness features associated with mortality in the juvenile idiopathic inflammatory myopathies.

Objective: Because juvenile idiopathic inflammatory myopathies (IIMs) are potentially life-threatening systemic autoimmune diseases, we examined risk factors for juvenile IIM mortality.

Methods: Mortality status was available for 405 patients (329 with juvenile dermatomyositis [DM], 30 with juvenile polymyositis [PM], and 46 with juvenile connective tissue disease-associated myositis [CTM]) enrolled in nationwide protocols. Standardized mortality ratios (SMRs) were calculated using US population statistics.

Are YouTube seizure videos misleading? Neurologists do not always agree.

The internet has become the first stop for the public and patients to seek health-related information. Video-sharing websites are particularly important sources of information for those seeking answers about seizures and epilepsy. Because of the widespread popularity of YouTube, we sought to explore whether a seizure diagnosis and classification could reliably be applied.

An update on inflammatory myositis in children.

Purpose Of Review: Childhood myositis (juvenile idiopathic inflammatory myopathies - JIIMs) is a rare, but important, group of rheumatic diseases. There has been continuing worldwide progress in the understanding of these diseases, and continuing pursuit of better therapies. We review some important contributions from the recent published literature.

Diversity of Canadian meningococcal serogroup B isolates and estimated coverage by an investigational meningococcal serogroup B vaccine (4CMenB).

Background: In collaboration with the Canadian Immunization Monitoring Program Active (IMPACT), the National Microbiology Laboratory, the UK Health Protection Agency and Novartis Vaccines, we tested the potential of an investigational 4-component meningococcal B vaccine (4CMenB) to cover Canadian strains circulating from 2006 to 2009.

Methods: IMPACT meningococcal surveillance is population based and includes over 50% of Canadian adults and children. All isolates were characterized by Meningococcal Antigen Typing System (MATS) and sequencing for factor H-binding protein (fHbp), Neisseria Heparin Binding Antigen (NHBA) and Neisserial adhesin A (NadA).

Attitudes of Canadian researchers toward the return to participants of incidental and targeted genomic findings obtained in a pediatric research setting.

Purpose: The purpose of this study was to explore the attitudes of genomics researchers in a pediatric setting in the context of regulatory guidance recommending the disclosure of clinically significant research findings.

Methods: A validated 32-item questionnaire was sent to 107 researchers with two large-scale projects (the Canadian Pediatric Cancer Genome Consortium and the Finding of Rare Genes Canada Consortium). We examined researchers' attitudes toward obligations to offer genomic research results (including if the participant was deceased, a relative, or a child), influence of the certainty/severity of the condition on this obligation, and personal experiences.

The effectiveness of school mental health literacy programs to address knowledge, attitudes and help seeking among youth.

Aim: Conduct a systematic review for the effectiveness of school mental health literacy programs to enhance knowledge, reduce stigmatizing attitudes and improve help-seeking behaviours among youth (12-25 years of age).

Methods: Reviewers independently searched PubMed, PsycINFO, Cochrane Library, CINAHL, ERIC, grey literature and reference lists of included studies. They reached a consensus on the included studies, and rated the risk of bias of each study.

Unprovoked status epilepticus: the prognosis for otherwise normal children with focal epilepsy.

Objective: To document the effect of unprovoked status epilepticus (SE) on the prognosis for otherwise normal children with focal epilepsy.

Methods: From the Nova Scotia Childhood Epilepsy Study (population-based), we identified patients with focal epilepsy, normal intelligence, and neurologic examination and follow-up ≥ 10 years. We compared those with and without unprovoked SE.

Mental health and the school environment: secondary schools, promotion and pathways to care.

Purpose Of Review: Addressing youth mental health in secondary schools has received greater attention globally in the past decade. It is essential that educators, mental health experts, researchers, and other related service providers understand the most current research findings to inform policy making, and identify priority areas for the development of future interventions and research strategies. This review describes literature during the past year on school-based mental health programs addressing mental health promotion, prevention, early identification and intervention/treatment.

Consensus treatments for moderate juvenile dermatomyositis: beyond the first two months. Results of the second Childhood Arthritis and Rheumatology Research Alliance consensus conference.

Objective: To use consensus methods and the considerable expertise contained within the Childhood Arthritis and Rheumatology Research Alliance (CARRA) organization to extend the 3 previously developed treatment plans for moderate juvenile dermatomyositis (DM) to span the full course of treatment.

Methods: A consensus meeting was held in Chicago on April 23-24, 2010, involving 30 pediatric rheumatologists and 4 lay participants. Nominal group technique was used to achieve consensus on treatment plans that represented typical management of moderate juvenile DM.

Telephone-based mental health interventions for child disruptive behavior or anxiety disorders: randomized trials and overall analysis.

Objective: Most children with mental health disorders do not receive timely care because of access barriers. These initial trials aimed to determine whether distance interventions provided by nonprofessionals could significantly decrease the proportion of children diagnosed with disruptive behavior or anxiety disorders compared with usual care.

Method: In three practical randomized controlled trials, 243 children (80 with oppositional-defiant, 72 with attention-deficit/hyperactivity, and 91 with anxiety disorders) were stratified by DSM-IV diagnoses and randomized to receive the Strongest Families intervention (treatment) or usual care (control).

Anxiety and separation disorders.

• Based on strong research evidence, anxiety disorders are the most common psychiatric illness in children and adolescents. • Based on some research evidence, the neurobiology of anxiety disorders is linked to dysregulation in the fear and stress response system in the brain. • Based on strong research evidence, separation anxiety disorder is one of the most common causes of school refusal, and addressing both the function of the behavior and returning to school as soon as possible is recommended.

Dose-sparing H5N1 A/Indonesia/05/2005 pre-pandemic influenza vaccine in adults and elderly adults: a phase III, placebo-controlled, randomized study.

Background: Highly pathogenic avian influenza H5N1 viruses remain a threat to human health, with potential to become pandemic agents.

Methods: This phase III, placebo-controlled, observer-blinded study evaluated the immunogenicity, cross-reactivity, safety, and lot consistency of 2 doses of oil-in-water (AS03(A)) adjuvanted H5N1 A/Indonesia/05/2005 (3.75 μg hemagglutinin antigen) prepandemic candidate vaccine in 4561 adults aged 18-91 years.

Development and preliminary testing of a scale to assess pain-related fear in children and adolescents.

Unlabelled: It is assumed that pain-related fear, a present response to an immediate danger or threat such as pain, plays a significant role in the experience of pediatric pain. However, there are no measures to adequately measure this construct in children and adolescents. The purpose of this study was to develop and test the psychometric properties of a scale to assess pain-related fear to be used with Catalan-speaking children and adolescents between 7- and 16-years-old.

Benefits of an international working exchange in pediatric cardiology.

This report describes a 1-year exchange between members of two pediatric cardiology centers: one in Canada and one in Australia. Five cardiologists participated in sequence, fully engaging in the activities of the host department. The motivation of the exchange was broadly educational including clinical experience, shared expertise, teaching, and research collaboration.

Meningococcal serogroup C conjugate vaccination in Canada: how far have we progressed? How far do we have to go?

Since routine meningococcal C conjugate vaccination was introduced into Canada in 2002, there have been a large regional variation in the routine programs, changes to the timing of the infant series in some provinces, and wide differences in catch-up programs. As immunization is viewed as a provincial responsibility, less attention has been paid to determining national coverage rates and the direct and indirect effects of the widely varying provincial/territorial vaccination programs on the nation as a whole. Canada's disjointed regional immunization campaigns leave the population at risk of disease for an extended length of time.

Measurement of self-reported pain intensity in children and adolescents.

Acute and chronic pain is a common experience in children and youth. A thorough assessment is fundamental to understand this experience and to assess and monitor treatment responses. The intensity of pain is the parameter most commonly assessed.

Research design considerations for confirmatory chronic pain clinical trials: IMMPACT recommendations.

There has been an increase in the number of chronic pain clinical trials in which the treatments being evaluated did not differ significantly from placebo in the primary efficacy analyses despite previous research suggesting that efficacy could be expected. These findings could reflect a true lack of efficacy or methodological and other aspects of these trials that compromise the demonstration of efficacy. There is substantial variability among chronic pain clinical trials with respect to important research design considerations, and identifying and addressing any methodological weaknesses would enhance the likelihood of demonstrating the analgesic effects of new interventions.

Protocols for the initial treatment of moderately severe juvenile dermatomyositis: results of a Children's Arthritis and Rheumatology Research Alliance Consensus Conference.

Objective: To use juvenile dermatomyositis (DM) survey data and expert opinion to develop a small number of consensus treatment protocols, which reflect current initial treatment of moderately severe juvenile DM.

Methods: A consensus meeting was held in Toronto, Ontario, Canada on December 1-2, 2007. Nominal group technique was used to achieve consensus on treatment protocols, which represented typical management of moderately severe juvenile DM.

Child and adolescent mental health policy and plans in Canada: an analytical review.

Objective: Child and adolescent mental disorders are common, with a substantial disease burden, yet services for young people are nationally inadequate. As services should be based on policies and (or) plans, we analyzed the availability and content of child and adolescent mental health policies and plans in all provinces and territories.

Method: The World Health Organization (WHO) framework for Child and Adolescent Mental Health Policy and Plans was applied.