Annotated Source List

Abeles, Vicki. “Is the Drive for Success Making Our Children Sick?” The New York Times, 2
Jan. 2016.

In an effort to decrease the rates of anxiety and depression in his medical students, Dr.
Slavin of Saint Louis University School of Medicine reinvented his program. He implemented
pass or fail grading in introductory classes, instituted a half-day off every other week, and
created small groups of students to strengthen connections among students. This caused the
students’ rates of anxiety and depression to drop. Dr. Slavin did another test on Irvington High
School in Fremont, California. Here, he surveyed 2,100 anonymous students using the Center for
Epidemiologic Studies Depression Scale and the State-Trait Anxiety Inventory. The results were
shocking; 54 percent of students showed moderate to severe symptoms of depression. Even more
shocking was the fact that 80 percent suffered from moderate to severe symptoms of anxiety.
The results show just how out of control expectations of education are. Kids are in school for 7
hours, have hours of homework, have band rehearsals and sports practices, and a bunch of
activities on the weekend as well. College admissions are very competitive, as is the competition
for scholarships. This stress is degrading children’s health and lowering their potential.
According to the American Psychological Association, nearly one in three teens said that stress
drove them to be sad or depressed and that their greatest cause of stress was school. The Centers
for Disease Control and Prevention has said that teenagers in America get at least 2 hours less
sleep than what is recommended. This lack of sleep is caused by the increase in homework they
are expected to complete. Doctors have seen increasing rates of children in elementary school
suffering from migraines and ulcers, which used to be extremely rare. A change is needed.
Teachers are re-evaluating their homework demands to 20 minutes or less daily and assigning
none on the weekends. This is supported by research because it has led to students promoting
healthier habits and more balanced schedules. Long Term childhood stress can also lead to heart
disease, lung disease, cancer, and short life span.
This article was helpful because it detailed the effects childhood stress causes. It also
explains what are the factors that impact the stress being created. This article would be used if I
chose to write about stress in children and teenagers.

American Academy of Pediatrics. https://www.aap.org/en-us/Pages/Default.aspx. Accessed 08

Oct. 2017.

The American Academy of Pediatrics website includes relevant and recent articles from
the association itself and from the pediatric field in general. They have a page for journals and
publications that provide not only the articles, but also links to other articles and websites.
Information about professional education and how they advocate is also included on the website.
Another thing they provide is information about the organization itself. They detail their
leadership, how they are funded, different awards professionals in the field have received, and
the plans they have for the organization. They are a non-profit association that has fifty seven
chapters in the United States and seven chapters in Canada.
 This source was very helpful. They provide articles on topics relevant to the field that can
help me with figuring out what I want to research and provide information on my research topic.
The fact that they are involved across North America is also very informative. It gives more
insight on the pediatric field outside of the United States. The links they provide to other
websites is also very beneficial because it provides other sources I may use for my research.

American Academy of Pediatrics Gateway. American Academy of Pediatrics,

www.aappublications.org/. Accessed 09 Oct. 2017.

The website of the American Academy of Pediatrics Gateway is dedicated to articles,

journals, case reports, and research in the field of pediatrics. There is a page on trending article
that includes topics like breastfeeding and the affect social media has on adolescents. They also
have several different journals and periodicals attached to website like Hospital Pediatrics and
NeoReviews.
This is incredibly useful because it not only provides articles I can use for my research,
but it also has case studies that may be insightful on the topic I decide to research. It also has
several different journals and periodicals that I can use to narrow my topic and use to research
my topic. All of the topics the articles and case studies are on are relevant and recent which will
help me build my research.

"Brief Training Increases Pediatricians' use of Substance Abuse.."National Institutes of Health,

02 Nov, 2015, https://www.nih.gov/news-events/news-releases/brief-training-increases-
pediatricians-use-substance-abuse-mental-health-interventions. Accessed 24 Oct. 2017.

This article is about how training pediatricians can increase their ability to identify and
treat young people with potential alcohol addiction, substance use, and mental health problems.
Techniques like screening, brief intervention, and referral to treatment (SBIRT) are important
tools used to prevent and treat these issues found commonly in teens. The addition of behavioral
health clinicians to their teams can improve support for patients who need it. Underage drinking
and drug use has been known to coexist with mental health issues. It is a common and dangerous
habit that can cause injuries and school troubles. Research has shown that physicians that have
used SBIRT training on adults can reduce heavy drinking, its harmful effects, and related health
problems. It can also be used to prevent substance abuse from starting or escalating in teens.
However, not many physicians have the training or time to do so. There have been studies
comparing groups of doctors that have SBIRT training and those who do not. The doctors that
had been trained were 10 times more likely to conduct brief interventions with patients that they
deemed were at risk. Doctors that were trained and worked with clinical psychologists were
found to have brief interventions 24.5 percent of the time compared to the 16 percent of doctors
alone.
This article was very interesting as it was something I had never thought about or heard
of. I do not think I will pursue this as my topic or research, though it was very eye opening and
insightful.

Brody, Jane E.. “Hard Lesson in Sleep for Teenagers.” The New York Times, 20 Oct. 2014.
 Few people get enough sleep on a daily basis, especially teens. An average adolescent
needs about 8-9.5 hours a night. A poll showed that less than 20 percent of the students got
enough sleep. A study done in Fairfax, VA., concluded that 6 percent of children in 10th grade
and only 3 percent in the 12 grade get the recommended number of hours of sleep. It was found
that 2 in 3 teens were found to be sleep deprived. The causes of this could be biological,
behavioral, or environmental. Sleep is important to your health, and sleep deprivation is a huge
issue in teens. The lack of sleep can lead to increased risks of high blood pressure, heart disease,
type 2 diabetes, and obesity. It is also linked to risk-taking behavior, depression, and suicidal
ideation, and car accidents. Sleep deprived drivers are as dangerous as a drunk driver.
Insufficient sleep impairs judgement, decision-making skills, and the ability to make less
impulsive decisions. When students are more alert, their academic performance gets better. Not
sleeping can also negatively affect a person’s mood. It is a serious issue that doctors, parents, and
schools need to pay attention to. A teenager’s sleep schedule can change by at least 2 hours and
with high school starting so early, it is impossible to get enough sleep. Having an over scheduled
life can lead to less sleep as well. Parental pressure on academic success can also be a factor that
contributes to the lack of sleep. And trying to catch up on sleep on the weekends does not work.
All it does is make you feel jet lagged all the time.
The article was very informative about sleep and the dangers of not getting enough. It
describes the health issues that come with sleep deprivation. This was a very useful source and is
a very interesting topic that I may be interested in further examining.

Buia, Carolina. “The Big Problem with Children’s Vitamins and Supplements.” Newsweek, 14
Jun. 2015, http://www.newsweek.com/2015/06/26/problem-childrens-multivitamins-sup
plements-324545.html. Accessed 25 Oct. 2017.

Children are given gummy vitamins and supplements because they are told that they are
good for them. Recently, it has been made known that what is on the label is probably not what
is in the supplement or vitamin. In 2013, for example, Kaiser Permanente studied 55 bottle of
OTC vitamin D supplements. It was discovered that the actual amount of vitamin D varied from
9 to 146 percent of what was actually listed on the label. This is very impactful, especially in
children. 7 children under the age of 4 overdosed on vitamin D because of a manufacturing issue.
Another group of kids experienced nausea, vomiting, loss of appetite, and fever after taking fish
oil pills. This shows how dangerous manufacturing errors are. Health advocates want
supplements regulated as if they were prescription drugs. As of now, dietary supplement
manufacturers and distributors are not required to get FDA approval on their products, though
they must register with them, ensure that their products are harmless, do not have misleading
claims, and follow good manufacturing practices. It is up to the manufacturer to vouch for the
quality of the raw materials, which concerns people. One of the biggest vitamin C manufacturing
countries in the world is China, and, recently, they have been making headlines due to the
manufacturing of fake drugs, lead-laced ginger candies, and contaminated pet treats that killed a
thousand dogs in the United States. Because they are self regulated, they are essentially
unregulated. Some companies forgo USP verification because they think that they are above it,
though some companies do not. Children do not get enough of the necessary vitamins in their
diet alone and use supplements to even out the imbalance. That is why supplements and vitamins
are so popular among children. Though it is not known for sure if the ingredients in supplements
and vitamins are good for them. Gummies contain a load of sugar to make them appealing to
young children.
The article was helpful because it provided a lot of information on what supplements and
vitamins are and why they are controversial. It was not very useful because I am not going to
choose this for my topic.

“Child & Baby CPR.” American Red Cross, http://www.redcross.org/take-a-class/cpr/perfoming

-cpr/child-baby-cpr. Accessed 24 Oct. 2017.

The page describes the steps of preparing for and giving CPR to a child or infant. The
first step is to check if the child or baby is alright and then call 911. Then you should position the
child so that their airway is unblocked. You should position the child on their back with their
head back and chin tilted. After that, you should listen for any signs that they are breathing. If
after 10 seconds you do not hear anything, deliver 2 rescue breaths. You do this by tilting their
chin, holding their nose shut, and breathing into their mouth twice. If the child is still not
responding, then you should start administering CPR. In order to perform CPR, you must kneel
beside the child. Then, placing your hands on top of each other with your fingers laced together,
you should place your hand on the center of their chest. After doing so, deliver 30 fast
compressions that go about 2 inches into the chest. Continue to do this until you see signs of life
or professional help arrives.
This website was helpful because it details how to give CPR to children. This is very
important because it could potentially save a child’s life. It is also important to understand that
giving a child CPR and a grown adult are different. It is an important skill to know how to do. If
I decide to use first aid as my topic, this will be a very helpful source.

Digitale, Erin. “Sleep disturbances predict increased risk for suicidal symptoms, study finds.”
Stanford Medicine, 28 Jun 2017, https://med.stanford.edu/news/all-news/2017/06/sleep-
disturbances-predict-increased-risk-for-suicidal-symptoms.html. Accessed 24 Oct. 2017.

The article illustrates the risk of suicide due to highly variable sleep patterns. It is said
that sleep disturbances can worsen suicidal thoughts in teens. This is a valid concern especially
because of the common sleep deprivation found in teens. The U.S. Centers for Disease Control
and Prevention confirmed that suicide is the second leading cause of death for teens. Lack of
regulated sleep is one of the risk factors that are visible and treatable; this is why it is highly
targeted for suicide prevention. A study was conducted on young adults on their sleep patterns. It
was concluded that those who had a varying sleep schedule throughout the week were more
likely to experience suicidal symptoms. Also, some people who experience more sleep
disturbances also deal with insomnia and nightmares. Poor sleep can change the way mood is
regulated, therefore, making way for more more suicidal behaviors. Researchers are testing the
efficacy of treated insomnia on suicidal thoughts and behavior.
This article was useful. I did not know that sleep patterns could affect suicidal thoughts in
teens. It emphasizes the fact that sleep is imperative to not only your physical health but your
mental health as well. The article will be helpful if I decide to choose something sleep related for
my research topic.

Goodnough, Abby, and Katie Zezima. “Newly Born, and Withdrawing From Painkillers.” The
New York Times, 9 April 2011.

Drug abuse during pregnancy is very dangerous and could lead to miscarriages. Babies,
whose mother did drugs while pregnant, are born dependent on drugs. These infants cry
excessively, have stiff limbs, tremors, diarrhea, and other issues their first couple days of life.
Because they need to be weaned off the drugs, the babies tend to stay for a while after being
born, which is extremely expensive. In the last decade, there has been a large increase in the
number of newborns being treated or observed for opiate withdrawal, which is also known as
neonatal abstinence syndrome. The studies on treating infants with withdrawal symptoms are
few due to little advances on the subject. Because of this, each hospital treats the situation
differently. Some places used methadone, while others use morphine and phenobarbital, which
prevents seizures. The debate over the treatment of pregnant women who are addicted to
prescription drugs has been growing due to the concerns for their babies. Methadone is used to
keep a steady amount of opiate in the body, preventing withdrawal and drug cravings. This can
also be addictive and causes side effects like drowsiness. Some addicts take buprenorphine,
which is a drug that is used to treat addiction by preventing drug cravings. This drug is seen as
more promising due to the fact that it can be prescribed by a primary doctor and taken home. It
has also been seen that it requires less medication after birth and less time in the hospital. But, at
the same time buprenorphine is not effective on every single addict. The long term effects on
babies is not truly known, but it is known that babies exposed to opiates in utero had higher rates
of birth defects, heart defects, glaucoma, and spina bifida. Also, not all infants require medicine
for the withdrawal symptoms. If a baby’s mother was on a high dose of either drug, she might
not need anything, while the mother who took a low dose might experience acute withdrawal.
Babies going through withdrawal usually are kept in the hospital for at least five days. They are
checked on every couple hours by a nurse. Not many doctors or hospitals treat addicted pregnant
women, so it is important that there are more doctors who are willing to treat these women and
deliver their babies.
This article was very interesting. It discussed the symptoms addicted babies experience as
well as how to treat these babies and wean them off the drug. The topic is something that
interests me, but I do not think it is a good topic to use for my research.
Hewings-Martin, Yella. “How do your allergies develop?” Medical News Today, 10 Oct. 2017,
https://www.medicalnewstoday.com/articles/319708.php. Accessed 24 Oct. 2017.

This article discusses how allergies develop and how it progressing world-wide. Allergies
can be discovered at any time during your life. Allergies also affect millions of people. Asthma
affects 300 million people in the world, while drug allergies affect at least 20 percent of the
population. The most common allergy found, though, is hay fever which affects 400 million
people. The World Allergy Organization has noticed a rise in allergic diseases in both developed
and developing countries. Things that have to potential to cause allergies can be found
everywhere in our environment; they can be found in pollen, food, dust, animals, and mold. The
body mistakes these things as a threat to the body and reacts, causing allergic reactions. Allergic
reactions are not something you are born with, but something that you develop once you come in
contact with the allergen. There are 2 main classifications of allergies: Type 1 immune response
and Type 2 immune response. Within the Type 2 immune response category is T helper type 2
cells, which stimulate the production of Immunoglobulin E molecules. When a Type 2 immune
response is triggered, you experience allergic sensitization. This reaction creates a lasting
memory of the substance that caused the reaction. Then if you come into contact with the
substance again, you body will release Immunoglobulin E molecules which creates the
symptoms of your allergies. The body can react in different ways including eczema, hay fever,
asthma, food allergies, or anaphylaxis, which can be deadly.
This article was helpful. Allergies are very relevant and well known in the world and
learning about why we have allergies and what causes allergic reactions is interesting. Being that
the topic is relatable and commonly found in children, I can consider it for the topic of my
research.

“How Does Type 2 Diabetes Affect Children?” WebMD,

https://www.webmd.com/diabetes /type-2- diabetes-guide/type-2-diabetes-in-children#1,
Accessed 24 Oct. 2017.

The page is about the effects of type 2 diabetes. Type 2 diabetes is when your cells do not
respond to insulin and glucose builds up in the bloodstream, which is called insulin resistance.
Insulin is a hormone that is used to move glucose from your blood into cells, where it is then
used as fuel. If it goes untreated, type 2 diabetes can cause heart disease, blindness, and kidney
failure. Type 2 diabetes is most likely to affect girls, overweight children, families with a history
of the disease, certain nationalities, and people who have insulin resistance. The most common
cause is being overweight. This can be attributed to unhealthy eating, lack of physical activity,
family members who are overweight, and other medical conditions. Some symptoms include
unexplained weight loss, peeing frequently, fatigue, itchy skin, dry mouth, etc. You can treat this
disease in several ways. There are medications like metformin and insulin. Another possibility is
changing your lifestyle and becoming more healthy and active. Frequent blood sugar checks are
necessary to monitor the level of insulin in your bloodstream. It is possible to prevent type 2
diabetes. To do so, it is necessary to get daily physical activity and eat healthier.
The information of the pages were very useful. I learned a lot about what type 2 diabetes
is, how to treat it, what the symptoms are, and how to prevent it. Type 2 diabetes is becoming
more and more common due to the rising obesity levels, so it is important to know about the
disease. I am doubtful that I will choose this as my research topic, but it was very insightful.

“If You Choose Not to Vaccinate Your Child, Understand the Risk and Responsibilities.”
Centers for Disease Control and Prevention,
https://www.cdc.gov/vaccines/parents/vaccine-decis ion/no-vaccination.html. Accessed
25 Oct. 2017.

The decision to give a child vaccines is the parent’s responsibility. It is important to tell
healthcare professionals the child’s vaccination records. The doctor will need to consider the
possibility that the child has a vaccine-preventable disease, though they are uncommon. The staff
can then isolate the child to prevent the disease from spreading to others, especially those that are
infants or have weak immune systems. It is important to keep children’s medical histories up to
date. Sometimes if you do not have all of your vaccinations, you will not be able to participate in
certain activities or be around others until it is safe for an unvaccinated child to return. Travelling
with children that are not vaccinated can be dangerous because your body is being invaded with
foreign germs and substances that you body has yet to be acclimated to. Vaccines do not
guarantee that you will not get sick, but they give you a lower chance of being infected.
The page was very informative, though slightly short. Vaccines are very important, and
the debate on the necessity of vaccines is very relevant. The source was mostly useful.

KinderMender. https://www.kindermender.com/. Accessed 08 Oct. 2017.

The KinderMender website provides all kinds of information about the business from
their hours to what they treat. It also details their different locations, their staff members, the
current wait times at each of their locations, and what services they provide. They provide urgent
care, primary care, sports and school physicals, and immunizations. In addition, the website also
has a news and blog section. The news section comprises of relevant information about the
business like their new location in Timonium, Maryland, while the blog section includes more
medical related articles including topics like strep throat and high fevers in children. Parents
feedbacks, recent diagnoses, and frequently asked questions are also provided on the website.
This website was a very helpful source. Being that it is the place of my internship, the
information on the website gave me a better insight on what services KinderMender provides and
a better insight on the environment of the business. On the website, they detail how they are
different from other pediatric offices in how they also provide urgent care. They also have about
me pages for their staff members which provides information about the staff’s backgrounds. This
is helpful in that I can learn a lot about the staff members. In addition, there are a lot of relevant
blog articles on the website that could be useful for my research and in choosing the topic of my
research.
Kounang, Nadia. "Are kids getting more concussions than we realize?" CNN, 07 Jun, 2016,
http://www.cnn.com/2016/06/21/health/kids-concussions-underreported/index.html.
Accessed 25 Oct. 2017.

The article is about how the children that come into emergency rooms with concussions
does not include the children that are not diagnosed. Annually, half a million children in the
United States are sent to emergency rooms for concussions. Pediatrics journal did a study in their
June 20 edition on the estimated number of concussions in those who are 18 years old or
younger. It is estimated that it ranges between 1.1 and 1.9 million children every year. The
Centers for Disease Control and Prevention base their concussion rates on those that are found in
emergency room visits. However, it was found that more than half a million of children with a
concussion are not seen in the ER or by any doctor. Majority of children’s concussions are seen
by athletic trainers, instead. The Children’s Hospital of Philadelphia did a study that evaluated
more than 8,000 concussions in youth and found that 82 percent of the diagnoses were made in a
doctor’s office, while only 12 percent of them were made in the emergency room. Conclusively,
the majority of children with concussions are being diagnosed in places other than the emergency
room, and the rates of concussions in youths is much larger than what is presented to the public.
This issue shows how large the gap is for the amount of recorded pediatric concussions. It is said
that to fix this issue, doctors should increase the surveillance of the injury. In an effort to do this,
President Obama had included a request for 5 million dollars to establish and maintain a National
Concussion Surveillance System that would track concussions through a national household
phone survey. The most concerned age group is that of high school athletes and older children,
though children who are younger than 12 make up one third of youth concussions. Younger
children who are under the age of 4 are more likely to be diagnosed in the emergency room,
while older children tend to go to their pediatrician’s office instead. This is not necessarily a bad
thing, however, because sometimes emergency rooms are not the best locations equipped to
diagnose concussions and they are very expensive. Families should go to their primary
pediatrician for these injuries, mostly because most concussions only need to be medically
evaluated, given rest, and followed up to see whether or not the injury has healed. The only times
ER visits are necessary are when the child’s mental status is deteriorating, if the child is having
problems conversing, if the child’s eyes can’t focus, and if the child is continually vomiting.
This source was very helpful because concussions are a very common injury in high
schoolers and affect a lot of children. It is also useful because interning at a walk-in pediatric
center, I am bound to see patients that have concussions. I think this is a highly possible research
topic.

Lam, Janet C. et al. “The Effects of Napping on Cognitive Function in Preschoolers.” Journal of
developmental and behavioral pediatrics : JDBP 32.2 (2011): 90–97. PMC.

The article details the effects napping has on the cognitive function in preschoolers. It
was found that children who nap during the weekdays are also likely to nap during the weekend.
People that nap longer during the day tend to sleep less during the night. Weekday napping also
tends to negatively affect vocabulary skills and auditory attention span. It was also found that
people that sleep less at night tend to make more impulsive errors on computerized tests. They
concluded that daytime napping is negatively correlated with neurocognitive function in
preschoolers. They also concluded that nighttime sleep is more crucial for the development of
cognitive performance. The absence of napping may help mature the brain and does not cause
sleep deprivation. In fact, it is possible that children that sleep less at night are sleep deprived
and therefore, need naps the following day. This was concluded from research conducted on
preschool children, ages 3 to 5. The child’s sleep patterns, activities, time in bed, and nap habits
were recorded.Then the child was asked to complete a 20 minute screening battery of
neuropsychological tests that tested their behaviors, auditory performance, vocabulary, number
recall, and inhibition and motor persistence.
This article was helpful. The topic is interesting and comparable to similar research done
on different age groups. Knowing how common napping is during young childhood in school
and home provided more emphasis on the importance of the research. The article also provided
more information on the effect napping has on cognitive development in young children. I think
this is a very interesting possible research topic.

LaMendola, Bob. “Obesity Bringing Adult Diseases and Death Risks into Childhood.” Sun-
Sentinel, 9 Mar. 2008.

Overweight teens and preteens are developing serious adult diseases as kids. There are
more and more children being treated for heart issues, abnormal breathing, and difficulty
walking. There are also cases on obesity related diabetes, high blood pressure, and high
cholesterol. There have even been some cases of death due to obesity. About 1 in 5 children who
are between the ages of 6 and 18 and 1 in 7 children younger than 6 are considered obese. This
means that they weigh more than 95 percent of children their age. The amount of overweight
children has also risen. A total of one million teens have metabolic syndrome which is a
combination of obesity, pre-diabetes, high cholesterol, and high blood pressure. These can lead
to early death and other diseases. Diets high in fast food, snacks, and giant portions are all factors
that lead to obesity. A quarter of children that are 5-10 years old have early signs of heart
disease, while a tenth of teens have fat deposits in their arteries that can later cause heart attacks.
A study conducted in 2006 showed that obese children’s hearts were enlarged and weakened, a
sign of heart failure.The biggest threat to overweight children is apnea, irregular breathing during
sleep. This occurs when fat in the chest collapses airways, causing brief pauses in breathing
which then causes strain on the heart. An estimated 7 percent of overweight children have this
condition. It is a hard problem to change as parents usually do not have enough time to watch
their children's habit all the time. It has been found that children have an easier time keeping off
the weight they lose than adults do, though, that does not mean to go easy on them because that
will not do anything.
This article was helpful in that it further explained the risks of child obesity and the
consequences that come with it. I think that this is a very common issue in the U.S. currently and
this would be something to further look into.

O’Neill, Maggie. “Keeping an Eye on the Onset of Puberty.” USA Today, 24 May 2016,
https://w ww.usatoday.com/story/life/wellness/2016/05/24/puberty-in-boys-and-
girls/84860970/. Accessed 25 Oct. 2017.
 Children are beginning puberty at a younger age. This could be due to many causes
including weight and environmental exposures to toxins or hormones. The current average age of
puberty in girls is 12. Some girls start as young as 8 years old and be considered normal. The
average age of puberty in boys is 12, but they can start as early as 9. The signs of a girl starting
puberty include the development of breast buds and public hair. In boys, the signs are the
enlargement of testicles and penis. During puberty, hormones levels are changing which can
cause crying, depression, moodiness, and anxiety. It is found that girls are more likely to
experience early puberty, especially girls that are overweight. African American children have
been found to be more likely to undergo premature puberty. Also, coming into contact with
hormone-containing substances could be risky. The Mayo Clinic recommends keeping children
away from external sources of hormones and encouraging children to keep a healthy weight in
order to help prevent the early onset of puberty.
This article was interesting. I think that the topic is very insightful, but I think that the
source could have contained more information than it did.

Pennington, Bill. “A New Way to Care for Young Brains.” The New York Times, 5 May 2013.

Concussions are one of the most common athletic injuries and one of the most dangerous.
Specialized youth sports concussion clinics have become a new phenomenon. Dozens of these
clinics have opened in almost 35 states. These clinics are outpatient centers that are often
connected to larger hospitals. They are packed with student athletes that have headaches,
amnesia, dizziness, or problems concentrating. Parents are very concerned about how
concussions are affecting their children as there have been cases where they can lead to brain
disease. In the last 5 years, the number of patients visiting the sports concussion clinic attached
to Boston’s Children Hospital has increased from 25 to 400. Due to recent media reports on the
cognitive problems and illnesses concussions cause, parents have been more active in seeking
care and taking concussions seriously. Several ex-NFL players have committed suicide due to
degenerative brain disease caused by repeated head trauma. There are also new laws in place that
require student athletes who have concussions to get written consent from a medical professional
that they are able to participate in sports again. 90 percent of concussions are healed within in a
month, so the injury, while serious if untreated, is not long term. There is no set treatment for
brain injuries. A lot of modern concussion treatments are a mix of past experiences, science, and
common sense. There is also no test that will tell someone if they have a concussion; only a
doctor’s examination can determine whether or not they have one. And though brain scans can
be used, they cannot identify a concussion and they are risky due to the radiation it produces.
One of the things known about the injury is that it is more dangerous the younger you are
because your body heals slower when you are younger, though each case differs. Another danger
of concussions is repeated concussions; worse case scenario, it can cause second-impact
syndrome which can be fatal. In order to ensure the brain has time to heal, doctors order that
patients avoid mental stimulation including video games, television, or anything with bright
lights or loud noises. The duration of this restriction also depends on the case. Schools require
athletes to take a test that measures their reaction time, learning and memory skills, and how
quickly they can think or solve a problem. This baseline is used to determine if the athlete’s
cognitive function has changed and if sometime after the injury, the athlete is still cognitive
deficit. This, however, is not a concussion test, but just used to compare a person’s cognitive
abilities before and after a concussion.
The information this article provided on concussions was very in depth. It explained what
a concussion is and how it is treated. This article was very helpful and expanded my previous
knowledge on concussions.

Preidt, Robert. “Kids, Don’t Touch the Toys at the Doctor’s Office.” U.S. News, 23 Oct. 2017,
https://health.usnews.com/health-care/articles/2017-10-23/kids-dont-touch-the-toys-at-
the-doctors-office. Accessed 24 Oct. 2017.

The Article discusses the germs found in a doctor’s office. The AAP (American
Academy of Pediatrics) wrote in their guidelines that it is better to bring toys from home to your
appointments. It also says that waiting rooms should not contain plush toys because they can
harbor germs and are hard to clean. The Academy suggests that doctor’s offices should be kept
within the same standards as hospitals. They also suggest that sneezing and coughing etiquette
should be maintained within the offices in order to prevent the spread of germs. Sanitizers and
masks should also be provided to stop the spreading of germs. The guidelines also say that
people that work in these environments should get annual flu vaccinations and should have
documentation of immunization records for whooping cough, measles, mumps, rubella,
chickenpox, and Hepatitis B. Cystic fibrosis patients should be especially careful because their
lungs are vulnerable to bacterial infections and should be taken immediately into an exam room.
This article was helpful because it is relevant at my internship site. During cold and flu
season a lot of germs are spread around in the office. And, while we strive to sanitize as much as
possible, there are still going to be germs. The article was very helpful in informing me how to
stop the spread the germs and further my information on etiquette in my working environment.

Rafei, Dr. Keyvan. Personal interview. 08 Oct. 2017.

Dr. Keyvan Rafei is one of the doctors that work at KinderMender. He is also the
Managing Director and Founder of the business. He has eleven years of experience in the
pediatric field. He graduated with his M.D. Degree at The Medical College of Pennsylvania and
completed his residency at Baylor College of Medicine Affiliated Hospitals in Texas. He later
went back to school at the University of Maryland School of Business for his Masters of
Business Administration. His career consists of several publishes in pediatric textbooks and
journals. He has also presented his work at several national and international conferences.

"Rates of New Diagnosed Cases of Type 1 and Type 2 Diabetes." National Institutes of Health,
13 Apr. 2017, https://www.nih.gov/news-events/news-releases/rates-new-diagnosed-cau
ses-type-1-type-2-diabetes-rise-among-children-teens. Accessed 25 Oct. 2017.

Rates of newly diagnosed type 1 and type 2 diabetes are rising in youths in the United
States. In the United States alone, 29.1 million are living with diabetes whether they know it or
not; 208,000 younger than 20 years old live with diagnosed diabetes. This study is the first to
estimate the trends in newly diagnosed cases of type 1 and type 2 diabetes in people under the
age of 20 from five ethnic backgrounds, including whites, blacks, hispanics, asians, and Native
Americans. The Control for Disease Control and Prevention (CDC) and the National Institutions
of Health (NIH) created the SEARCH for Diabetes in Youth study. From this they found that
from 2002-2012, the rate of diagnosed cases of type 1 diabetes increased by 1.8 percent annually.
They also found that the rate of diagnosed cases of type 2 diabetes increased by 4.8 percent
during that same time span. Youth are at risk for developing diabetes related complications
because of early onset and longer diabetes duration. This lessens their quality of life, their life
expectancy, and creates an increase in health care costs. From the study they learned many
things. Males had the highest increase in diagnosed type 1 cases in all ethnic groups. They also
found that the newly diagnosed cases for type 1 was most increased in hispanics. For type 2
diabetes, however, the most increased was Native American, though the results can not be
generalized for all Native Americans, asians, and blacks. They also discovered that type 2
diabetes was most commonly found in females rather than males: their rates almost double the
males’. Not only is the cause of type 1 unknown, but the cause for the increase in both types is
also unclear. It is suspected, though, that disease development is caused by exposure of
genetically predisposed people to an “environmental trigger” which stimulates an immune attack
against the insulin-producing beta cells found in the pancreas. Type 1 diabetes is when the body
in unable to create insulin while type 2 is when the body does not make or use insulin as it
should be used. While type 2 had been rare in children, in recent years, it has become more
common.
This article was useful because it expands my knowledge on diabetes. It also taught me
about the different rates in different ethnicities and how the rates of the different types are
different depending on gender and ethnicity.

Richter, Ruthann. “Among teens, sleep deprivation an epidemic.” Stanford Medicine, 8 Oct.
2015, https://med.stanford.edu/news/all-news/2015/10/among-teens-sleep-deprivation-an
-epidemic.html. Accessed 24 Oct. 2017.

The article is about how sleep deprivation affects teens. It is said that sleep deprivation
can lead to the inability to concentrate, poor grades, drowsy-driving incidents, anxiety,
depression, and thoughts of suicide. According to a poll the National Sleep Foundation
conducted in 2006, more than 87 percent of high school students are not getting enough sleep.
Another factor that causes teens to get less sleep is a biological one; it has been found that teens
tend to sleep two hours later than people younger than them. And, because they have to wake up
earlier, teens are getting less and less sleep. Teens that are sleep deprived get more tired as the
week progresses.This is known as sleep debt. The integration of technology is another factor that
influences the amount of sleep teens get. Most teens use their phones or play video games before
they go to bed, causing a less restful night of sleep. Also the lack of discipline parents are
demonstrating on their teen’s sleep cycle can prevent them from getting the necessary hours of
sleep every night. Trying to catch up on sleep during the weekend does not help either because it
is not enough to make up for all the sleep that was lost during the past week. Lack of sleep can
cause lot of consequences as well. For example, it can cause a decrease in academic
performance, can affect memory and learning, and can affect appetite and weight gain. In an
effort to fix this issue, schools are debating if changing the start time of school will help. The
American Academy of Pediatrics suggest that middle and high school should start no earlier than
8:30 in the morning. And though this might help, it is only part of the issue that teens are facing.
This article was very useful. It gave me detailed insight on the effects of sleep
deprivation, which is very relevant to me because I am guilty of this issue as well. The article
was very interesting and made me see sleep differently. It is a very possible research topic that I
am willing to explore.

Rotrosen, Elizabeth T., and Kathleen M. Neuzil. "Influenza: A Global Perspective." Pediatric
Clinics of North America, vol. 64, no. 4.

This article is about influenza. It discusses what the disease is, how it affects children,
and how to treat it. Children younger than five years old have the highest risk of being
hospitalized for influenza-associated diseases including acute otitis media (AOM) and
pneumonia. The article also explains, using case studies and research, how vaccines are the most
effective way of preventing influenza. Another method used to treat influenza is antiviral
medication. The mortality rate of influenza can vary yearly, ranging from 37 to 288.
The article was useful because it interested me in the topic of influenza. The extent of
knowledge I have on influenza has been limited to the fact that it is a disease and that people get
vaccines for it annually. The article provided more information on the disease and why the
vaccines are actually effective. I think this topic is interesting and may be a possible topic for my
research.

Saint Louis, Catherine. "Pediatricians Say No Fruit Juice in the Child’s First Year.." New York
Times, 23 May, 2017.

This source discusses the recently released information about giving fruit juice to
children. Pediatricians are recommending that children younger than a year old should not be
given fruit juice because it is not good for them. Previously, the American Academy of
Pediatrics had told parents not to give their children 100 percent fruit juice if they were babies
younger than 6 months. The restriction has changed to one year. This restriction is due to the
concern that juice offers no nutritional benefits when you are young, and can take place of things
that do contain the necessary nutrition including breast milk, formula, and all the fats and
minerals contained in them. It is a common misconception that children should drink fruit juice.
Fruit juice itself contains a lot of sugar while whole fruit contains less. It is recommended that
fruit juice should not replace the necessary daily fruit portions children need. Store bought fruit
juice is very similar to soda in their sugar levels and amount of calories it contains. Pediatrics
journal advised limiting the amount of fruit juice 1-3 year old intake to 4 ounces and restricting it
to 5 ounces for children that are 4-6 years old. The amount older children were advised to limit
themselves to decreased from 12 ounces to 8 ounces. Fruit juice is not a substitute but a
nutritious complement to fruit in a balanced diet. Another thing that was found in a study is that
infants that drink more juice are more likely to drink soda and sugary beverages when they are
older.
This article was interesting and relatable, but not so helpful. I do not think that this will
help me with my research nor will it likely be the topic of my research.
Scutti, Susan. “Cell phones and screens are keeping your kid awake.” CNN, 1 Nov. 2016, http://
www.cnn.com/2016/10/31/health/kids-sleep-screens-tech/index.html. Accessed 25 Oct.
2017.

More and more students are coming into school tired because they are staying up later on
their technologic devices. Using tablets and computers before bed is associated with losing sleep
time and quality. Even children that do not use technology before bed are losing sleep and are
more tired during the day. After conducting several experiments, it has been concluded that there
is a strong correlation between bedtime media device use and lower sleep quantity, poor sleep
quality, and excessive daytime sleepiness. But, even children that did not use their media devices
before bed were found to suffer from the same problems as the children who did use their
devices before bed. 72 percent of all children and 89 percent of teens have at least one electronic
device in their room before bed. This negatively affects children’s sleep by delaying their time of
sleep. The light that is displayed from these devices can also affect circadian rhythm, which is
the internal clock that times biological processes including body temperature and hormone
release. Electronic lights can delay the release of melatonin, a hormone that induces tiredness
and contributes to our sleep cycles; this disrupts the sleep cycle and makes it harder to fall
asleep. Sleep is vital for children as it helps with brain development, memory, self-regulation,
attention, immune functions, cardiovascular health, and more. The time of greatest brain
development is during the first 3 years of life which is when we need the most sleep. Technology
can also affect sleep hygiene which help facilitate good, continuous, and adequate sleep. This
includes a silent room without any interference from technology or even pets. The National
Sleep Foundation suggests at least 30 minutes of transition before falling asleep. This includes
no exercising, having a regular sleep schedule, limiting exposure to light, avoiding alcohol,
caffeine, and nicotine, and creating a dark and quiet room.
This article was very informative on the importance of sleep and how to get the optimal
sleep. It also describes how technology negatively affects sleep patterns and quality. Lack of
sleep is very important. This article could possibly be used, depending on the topic I choose.

Semeria, Joan. “Sofia Montoya: Living proof of the power of CPR.” Stanford Medicine, 16 Jun.
2016, https://med.stanford.edu/news/all-news/2016/06/living-proof-the-power-
ofcpr.html. Accessed 24 Oct. 2017.

The article is about a young girl who was saved due to CPR. After becoming
unresponsive at school, Sofia was rushed to the hospital. At the hospital, she was diagnosed with
Long QT Syndrome which is a disorder of the heart’s electrical system that causes fast, chaotic
heartbeats. This can lead to fainting, seizures, and sometimes even death. The doctor inserted an
implantable cardioverter defibrillator (ICD) after Sofia was stable in order to regulate her
heartbeat. Though the ICD helps, CPR and defibrillation are what saved her life. This exact
situation is what bystander CPR for. Every minute that someone who is in cardiac arrest does not
receive chest compressions, their survival rate decreases by 10 percent. Parents whose children
had high-risk diagnoses were sent home with a device called CPR anytime, which is an
instructional kit that shows you how to give CPR. This device has saved at least 10 children
because their parents had the tools to help. Children born or admitted to Packard’s Children are
sent home with a kit. That is a total of 6,500 families who now have the kit, along with 13,000
members of the community who are CPR trained. It is also important to understand the
difference in administering CPR to an adult and to a child.
The article was very important in that it emphasized the importance of knowing how to
administer CPR. It could save a person’s life. In the medical or even just in everyday life, it is a
very important skill to know. The topic is very relevant and imperative to the field I am studying.
It is also a very possible contender for my research.

Scudellari, Megan. “Almost 4 in 10 concussed student athletes stay on the field, study finds.”
Boston Globe, 31 Oct. 2016.

Medical guidelines and certain states have laws that insist that if a young athlete displays
any symptoms of a concussion following an injury, they should be taken off the field
immediately until they are better. Still, 28 percent of student athletes return to the field despite
their injury. These athletes suffered from more severe symptoms than those who had sat out of
the game. The continuance of playing places more strain on the brain, risking an even more
severe injury and a longer recovery time. A study was conducted to determine just how many
student athletes were going back out to play after getting concussed. 38 percent of the patients
that reported said they returned to play the same day they were injured. Football and soccer
having the highest responses. Those that returned to the field early experienced worse symptoms
including nausea, dizziness, imbalance, and confusion. The athletes that go back out usually
either have a mentality that makes them want to keep playing even they were injured or think
their injury is minor.
The article was very eye opening on just how many students continue to play with
concussions. It could have been more detailed, but overall was very helpful. It could be used as a
source.

Storrs, Carina. “All teens should be screened for depression, task force recommends.” CNN, 8
Feb. 2016, http://www.cnn.com/2016/02/08/health/teen-depression-screening/index.html.
Accessed 25 Oct. 2017.

Physicians should begin to screen teens for depression and provide help if needed. The
U.S. Preventive Services Task Force decided that there was enough evidence to support the need
for screening people from the ages 12 to 18. Though the Task Force did not specify the type of
system primary care doctors could create, there is a wide variety to choose from. For example,
having mental health providers in the primary care practice or referring at-risk patients to
therapists at other clinics in the community. It is important to have mental health providers on
hand so that patients can go directly to them for a diagnosis and to discuss their options for
treatment. Without screening, a lot of teens fall through the cracks and are not diagnosed until
their symptoms progress. There are 2 types of questionnaires doctors use to screen adolescents.
This includes PHQ-A which is a version of the nine question test for adults and the other one is
based off of the 21 question survey. Another thing that can be done to treat teens with depression
is to administer antidepressants. Cognitive behavioral therapy, a type that focuses on modifying
thoughts and behaviors is another way to treat depression and reduce suicide attempts. Lexapro
has been shown to give good recovery results from depressive symptoms among teenagers than a
placebo control. The drug also has no greater adverse effects. Antidepressants that are approved
for use in adolescents are fluoxetine, Prozac, which can be administered to children 8 years old
or older and Lexapro, which can be administered to children who are 12 years and older.
Depression can also be found in children. When it happens, they are to speak with their physician
in order to further evaluate their illness and get treated. 8 percent of adolescents suffered from
depression in 2015.
The article was useful because it provided more information on depression in adolescents
and children. It also detailed treatment options that teens and preteen have. It can be used
depending on the subject of my topic.

Tanner, Lindsey. “Stress Can Affect a Child in a Major Way.” U.S. News, 12 Jul. 2017, https://w
ww.usnews.com/news/news/articles/2017-07-12/how-severe-ongoing-stress-can-affect-a-
childs-brain. Accessed 25 Oct. 2017.

Stress can lead to behavior and learning issue in kids. It has been found that ongoing
toxic stress throughout a child’s early childhood from poverty, neglect, parents’ drug issues, and
other issue can be bottled up inside children, harming their brains and body systems. In some
cases, it can cause death and disease once they reach adulthood from heart attacks and diabetes.
Stress can be as harmful as meningitis or polio. Extreme stress or trauma can cause brain
changes that may affect learning, cause troubling behavior, and negatively affect health. The goal
is to identify stressed children and families and give them options for services that will treat or
prevent any more stress. Children that come from foster homes that have drug or alcohol
problems, depression, or domestic violence are found to be more unfocused, withdrawn, and
aggressive because they do not feel safe in school. These children’s home lives are
unpredictable. Children who are neglected during their childhood are also at risk. The brain and
disease-fighting immune system has not been fully formed by birth, which leaves them
vulnerable to damage. Severe and toxic stress can also cause constant elevated hormones that
produced elongated responses like increased heart rate and increased level of cortisol produced.
This elongated response creates the “flight or fight” response. Studies have found that stress can
change the body’s metabolism and create internal inflammation, which can increase the risk for
developing diabetes and heart disease. There have also been experiments done on both animals
and humans that suggest that stress may alter brain structures in the parts that control emotions
and behavior. Neglected children that were moved to loving homes displayed great progress.
This article was very insightful on the topic of toxic stress: something that I just learned
about. The subject is very interesting, though I am doubtful that I am going to use this to get a
job.

Thornton, Clifton. Personal interview. 25 Oct. 2017.

 Clifton Thornton is a CRNP, which stands for certified registered nurse practitioner. He
works at several of the KinderMender sites and treats the patients that come in. He has
previously worked in the field of oncology and currently works two jobs.

Wendholt Silva, Jill. “Teens need help making healthy lifestyle choices in a super-carbonated,
fast food world.” Knight-Ridder, 13 Jun. 2003.

Drinking milk in teens has decreased 40 percent as soda has become more popular. The
average teen drinks 500 cans of soda a year and each 12 ounce can has 10 teaspoons of sugar. 11
percent of adolescents are overweight which is triple the amount from 20 years ago. 14 percent
of adolescents are at risk of being overweight. Fast food culture, TV, video games, lack of
physical activity in schools are all causes of weight gain. A lot of a teen’s diet consists of junk
food, including pizza, fast food, chips, etc. This causes teens to have a lack of nutrients like
calcium, iron, magnesium, and vitamin E which can all be found in healthier foods. These poor
eating habits are having a negative impact on their health. They are beginning to show increased
signs of high cholesterol, type 2 diabetes, and possible osteoporosis. Many teens are also
physically unfit due to lack of exercise. Poor body image can lead to eating disorders and
depression. School cafeterias serve healthier options for students, while students that bring lunch
from home have more opportunities to bring junk food. School also have vending machines that
contain unhealthy food, negating all the healthy options in the cafeteria. There are programs that
are designed to encourage kids to make healthier life choices, but change is hard for teens.
Another unhealthy habit teens have is skipping breakfast. This makes them more likely to miss
important groups of nutrients: iron, zinc, vitamins A and B, and calcium. Calcium deficiencies
are partially due to the lack of milk teens drink. Teenagers need 1,300 milliliters of calcium a
day which is equivalent to 4 glasses of milk. Lack of calcium can lead to stunted growth and
possible osteoporosis as an adult. Parents are very much responsible for their children’s dietary
habits as they spend most of their time at home. At home, children have access to the TV and
other electronic devices that prevent them from physical activity. College students also suffer
from these issues as there are many unhealthy options provided to them which causes weight
gain.
The article provided a lot of information about health choices and consequences of these
health choices teens make. It is very relevant information and is very explorable. It is a possible
contender.