Podcasts about canadian pediatric society

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This episode covers ADHD in youth with Dr. Daniel Gorman, an Associate Professor in the Department of Psychiatry at the University of Toronto and a Staff Psychiatrist at The Hospital for Sick Children. Dr Gorman's clinical and academic interests include ADHD, Tourette syndrome, obsessive-compulsive disorder, child psychopharmacology, psychiatric education, and narrative medicine. He is highly involved in resident teaching and clinical supervision, and from 2014 to 2022 he was the Program Director for the Child and Adolescent Psychiatry subspecialty program at the University of Toronto. Dr. Gorman has given over 85 invited presentations and authored or co-authored over 35 peer-reviewed articles and book chapters, mainly related to childhood neuropsychiatric disorders and their pharmacological management. He also contributed to several Canadian guidelines, including guidelines on cardiac risk assessment before the use of stimulants, management of tic disorders, pharmacotherapy for childhood disruptive and aggressive behaviour, and pharmacogenetic testing for children treated with psychiatric medications. The learning objectives for this episode are as follows: By the end of this episode, the listener will be able to… Review diagnostic criteria for ADHD Describe important considerations in making the diagnosis of ADHD Describe psychosocial aspects of management of ADHD Outline the pharmacological management of ADHD Guest: Dr. Daniel Gorman Hosts: Dr. Kate Braithwaite, Dr. Shaoyuan Wang (PGY-4), Matthew Cho (MS-4) Audio editing by: Dr. Angad Singh (PGY-1) Resources: CADDRA - Canadian ADHD Resource Alliance: Canadian ADHD Practice Guidelines, 4.1 Edition, Toronto ON; CADDRA, 2020. References: American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596 Biederman, J., DiSalvo, M., Fried, R., Woodworth, K. Y., Biederman, I., & Faraone, S. V. (2019). Quantifying the protective effects of stimulants on functional outcomes in attention-deficit/hyperactivity disorder: A focus on number needed to treat statistic and sex effects. Journal of Adolescent Health, 65(6), 784–789. https://doi.org/10.1016/j.jadohealth.2019.06.016 Peterson, B. S., Trampush, J., Brown, M., Maglione, M., Bolshakova, M., Rozelle, M., Miles, J., Pakdaman, S., Yagyu, S., Motala, A., & Hempel, S. (2024). Tools for the diagnosis of ADHD in children and adolescents: A systematic review. Pediatrics, 153(4), e2024065854. https://doi.org/10.1542/peds.2024-065854 Fedder, D., Patel, H., & Saadabadi, A. (2018). Atomoxetine. StatPearls. Retrieved January 31, 2025, from https://www.ncbi.nlm.nih.gov/books/NBK493234/ Canadian Pediatric Society. (2022). Mental health: Screening tools and rating scales. Canadian Pediatric Society. Retrieved January 31, 2025, from https://cps.ca/mental-health-screening-tools For more PsychEd, follow us on Instagram (@psyched.podcast), X (@psychedpodcast), and Facebook (PsychEd Podcast). You can provide feedback by email at psychedpodcast@gmail.com. For more information, visit our website at psychedpodcast.org.

Send us a textOn this episode of the CMAJ Podcast, Dr. Blair Bigham and Dr. Mojola Omole explore effective ways to manage pain during intrauterine device (IUD) insertions. They also address a broader issue: how women's pain is often neglected during gynecologic procedures, and the failure of physicians to adequately seek consent. They are joined by Dr. Kristina Arion, an obstetrician and gynecologist at the Children's Hospital of Eastern Ontario, and Dr. Nadia Von Benzon, a lecturer and social geographer at Lancaster University.The episode begins with Dr. Arion discussing the CMAJ article she co-authored, which outlines strategies for better management of pain during IUD insertions. She explains that the IUD is recommended as the first-line therapy for birth control and period management by the Canadian Pediatric Society and the Society of Obstetricians and Gynaecologists of Canada. Dr. Arion highlights how patient anxiety, lack of sedation options, and inconsistent practices contribute to unnecessary pain.Her key advice to doctors: listen to patients, explain each step of the procedure, and provide adequate pain management options.Dr. Von Benzon broadens the discussion beyond IUD pain management to the neglect of women's pain and autonomy during other gynecologic and obstetrical procedures. Her research article "My doctor just called me a good girl, and I died a bit inside: From everyday misogyny to obstetric violence in UK fertility and maternity services," illustrates how women's pain is frequently dismissed and their consent overlooked. She discusses the long-term impact of these practices, with some women opting out of future pregnancies due to trauma. She advises healthcare professionals to clearly explain procedures, seek consent, and prioritize patient comfort and autonomy.Dr. Omole and Dr. Bigham reflect on how patriarchal structures and time constraints within healthcare systems often lead to the failure to prioritize women's pain and autonomy. The episode closes with a powerful call for healthcare providers to take the time to listen to their patients, ask questions, and ensure that consent and comfort are prioritized at every stage of care.For more information from our sponsor, go to Rainbow Health Ontario.Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.You can find Blair and Mojola on X @BlairBigham and @DrmojolaomoleX (in English): @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

The Canadian Pediatric Society says "risky play" is good for kids' mental, physical and social health — even if it might result in injury. In an interview from January, we hear what's behind this new advice, why ”incredibly boring playgrounds” are part of the problem, and why parents might need to just take a deep breath.

In this episode of the Peaceful Parenting Podcast, we discuss the recent findings by the Canadian Pediatric Society about the health benefits of risky play. We cover not only why risky play is beneficial but also how to manage our own anxiety as parents. We talk about: 2:00 Seven categories of risky play 4:00 Risky play vs. actual dangerous play 5:10 Benefits of risky play 5:56 Play is the work of children 7:20 Risk assessment 11:40 Why is letting our kids do risky play hard? 12:26 Managing our own anxiety around our kids getting hurt 13:38 17 second rule 14:50 What do say instead of safety chatter Download the episode transcript HERE Resources mentioned in this episode: Canadian Pediatric Society “Healthy Childhood Development Through Risky Play: Navigating the Balance with Injury Prevention” https://cps.ca/en/documents/position/outdoor-risky-play  Episode 99 How Anxiety Shows Up in Our Parenting and What to Do About it with Lynn Lyons https://www.sarahrosensweet.com/episode99/  Heather Shumaker's book https://amzn.to/3PbukHi Connect with Sarah Rosensweet   Instagram: https://www.instagram.com/sarahrosensweet/  Facebook Group: https://www.facebook.com/groups/peacefulparentingfreegroup Website: https://www.sarahrosensweet.com  Join us on Patreon: www.patreon.com/peacefulparenting  Newsletter: www.sarahrosensweet.com/newsletter Book a short consult or coaching session call: https://book-with-sarah-rosensweet.as.me/schedule.php     

The Canadian Pediatric Society says "risky play" is good for kids' mental, physical and social health — even if it might result in injury. We hear what's behind this new advice, why ”incredibly boring playgrounds” are part of the problem, and why parents might need to just take a deep breath.

The Centers for Disease Control and Prevention, American Academy of Pediatrics, American College of Obstetricians and Gynecologists, and the World Health Organization all recommend universal topical ocular prophylaxis to prevent gonococcal ophthalmia neonatorum. In the United States, ophthalmia neonatorum caused by N. gonorrhoeae has an incidence of 0.3 per 1000 live births, while Chlamydia trachomatis represents 8.2 of 1000 cases. However, this prophylaxis is not a uniform GLOBAL stance. The Canadian Pediatric Society recommends against universal prophylaxis. Several European countries, including Denmark, Norway, Sweden, and the United Kingdom, no longer require universal prophylaxis, instead opting for a prevention strategy of increased screening and treatment of pregnant women and/or selective use in those delivered without pregnancy screening. But WAIT… it gets even slightly more confusing. According to a 2022 publication from the FROM THE AMERICAN ACADEMY OF PEDIATRICS, the AAP has taken the position that the need for legal mandates for ocular prophylaxis should be reexamined and instead advocates for states to adopt strategies to prevent ophthalmia neonatorum by focusing on maternal treatment, such as compliance with CDC recommendations for prenatal screening and treatment of N gonorrheae and Chlamydia trachomatis. This was also the subject of a recent review published May 2023 in an article titled, “Neonatal ocular prophylaxis in the United States: is it still necessary?”. Confused...don't be. We'll cover all this information in this episode. So, can erythromycin ophthalmic application be avoided in some cases? Is that safe? And if so, doesn't that conflict with current US neonatal care expectations? Listen in and find out.

There's a clear theme in the life and work of Dr. Khorshid Mohammad: no challenge is too large to face. Known for his innovation as both a scientist and as an educator, Dr. Mohammad is quick to share how others impacted his approach to life and learning and what he hopes others will take from those experiences. Dr. Khorshid Mohammad (MD, MSc, FABP, FRCP (Edin)) is a Staff Neonatologist at Alberta Health Services, Professor of Pediatrics at the University of Calgary's Cumming School of Medicine, Medical Site lead of Neonatology at Alberta Children's Hospital, and Medical Director of Southern Alberta Transport Service. He's a founding member of the Sonographic Clinical Assessment of the Newborn (SCAN) program and the Newborn Brain Society. A graduate of the University of Damascus and Arab League with Master and Specialty degrees in Pediatrics, Dr. Mohammad trained in Neonatal Neurology and Targeted Neonatal Echocardiography at the Universities of British Columbia and Calgary, and completed his neonatal fellowship training at the University of Calgary, where he established the Neonatal Neuro-Critical Care program. Dr. Mohammad was recognized with an Emerging Leader Award in Neonatology by the Canadian Pediatric Society for his quality improvement work that led to significant reduction in mortality and brain injury in infants who suffered from asphyxia and seizure.For more on Dr. Mohammad:https://newbornbrainsociety.org/team-member/khorshid-mohammad-md-msc-fabp-frcp-edin/Small Brains, Big Dreams is a podcast created by the Newborn Brain Society, in partnership with the Canadian Premature Babies Foundation, and hosted by preemie parent & journalist, Jenna Morton.The Newborn Brain Society is a non-profit organization supporting a world in which all newborns have access to and receive the optimal brain care. We promote international, multi-disciplinary collaboration, education, and innovation among clinicians, scientists, and parents.Connect with us at newbornbrainsociety.org, on Facebook @NewbornBrainSociety, and on Twitter @NewbornBrains.If you've enjoyed this episode, please rate, share & subscribe.

With Dr. Stacey Bélanger, pediatrician at CHU Sainte-Justine Hospital in Montréal and Mental Health Task Force member at the Canadian Pediatric Society. Young people in Canada aged 12 to 17 say their mental health has declined since 2015, and the decline is more pronounced amongst young women. On top of that, children and youth who are recent immigrants or refugees, racialized, or in rural and remote communities are less likely to get appropriate mental health care.  Think social media pressures, hyper-sexualization, stereotyping, toxic masculinity, bullying, fear of rising abuse and harassment, climate anxiety, and generally feeling left behind. The list of what girls and gender-diverse young people face today is intense. Their mental health and well-being, as well as their sense of connection, belonging, and confidence have been shaken. Their healthy relationship skill development opportunities have taken a hit, too.  How can caring adults in the lives of girls and young people smooth the transition back to school? How can we support improved youth mental health, confidence, and healthy relationships?  Dr. Stacey Bélanger, pediatrician with specialized training in pediatric neurology and a doctorate degree in neurological sciences, joins us. At CHU Sainte-Justine Hospital in Montréal, her focus is on patients with neurodevelopmental and mental health conditions. Dr. Bélanger is also Associate Professor of Medicine at Université de Montréal where she teaches about mental health and mental illness. She authored a book on mental health and has written in peer-reviewed journals on mental health disorders in children and youth. Amongst other roles, she sits on the Mental Health Task Force and Digital Health Task Force at the Canadian Pediatric Society.  Relevant links: find mental health and other services and resources at canadianwomen.org⁠.  Episode ⁠Transcripts⁠  Please listen, subscribe, rate, and review this podcast and share it with others. If you appreciate this content, if you want to get in on the efforts to build a gender equal Canada, please donate at ⁠canadianwomen.org⁠ and consider becoming a monthly donor.  Facebook: Canadian Women's Foundation  Twitter: @cdnwomenfdn  LinkedIn: The Canadian Women's Foundation  Instagram: @canadianwomensfoundation 

The reputation that fairytales have received over the past years precedes itself, which is precisely what made Michelle fall in love with it. She loved the rich imaginary of it all and as she started to also tell more and more of these fairytales, she found her voice changing and herself moving into this interior landscape that was rich in imagery and in human experience. So many of these stories start with wounds, descents, and struggles, like reflective mirrors where she could see her experience in these stories. As she delved deeper into fairytale, the morse she realized that all around the world, people have told these kinds of stories and that there are similar patterns across countries and continents. These stories are all coming out of a human experience; we are all part of one human experience and these stories precisely reflect our shared human experiences. Michelle Tocher has been writing and telling warm, poignant, and humane stories often from a woman's perspective. She is the author of the celebrated book “How to Ride a Dragon: Women With Breast Cancer Tell Their Stories”. She has recently published the lauded “The Tower Princess” as well as her new play “The Departure Train”. She has had a long career in communications and storytelling as President of Creative Premise LTD., a 10-year Toronto-based health communications company. She produced books and films for many organizations and community leaders, including The Canadian Pediatric Society, the Canadian Career Development Foundation, and the Women Scientists of Waterloo. What we discuss: 01:09 – Introducing Michelle 03:15 – Young Michelle and Myths and Stories 05:22 – The Bardic Tradition 06:58 – Printing of Stories 08:54 – Humans Connecting to Stories 12:28 – “The Wheel of Time” 17:25 – Divine Intelligence and Our Relationship to the World 25:12 – Changing the Inside and Outside World Through Storytelling 30:29 – Gnomes in Fantasy  34:56 – What is the Story We Are Living? 37:47 – Healing Trauma and Imprints of Belief Systems 44:31 – The Clue Within the Suffering 50:14 – Innocence and Imaginative Exploration 52:04 – Michelle Relating to Being Human, Leaving the Body, and what Happens Next? 55:20 – Michelle in Behalf of the Divine Mother 56:26 – Where to Find Michelle   You can find Michelle and her wonderful stories at michelletocher.com, wonderlit.com, and her play thedeparturetrain.com.   To amplify your health with GoddessWell products, go to Goddesswell.co to and use the code SISTERHOOD at checkout to buy one and get one free!   To join a virtual circle with us, go to http://www.globalsisterhood.org/virtual-circles To follow us on Instagram, @theglobalsisterhood @Laurenelizabethwalsh @shainaconners  

The holidays have brought us tremendous screen time riches, so we're sharing quick reviews of four new holiday releases: A Christmas Story Christmas; The Guardians of the Galaxy Holiday Special; The Santa Clauses; and Spirited. As a bonus, Katie gives a mini-review of the latest Disney animated release: Strange World. In Screen Time in the News, we chat about the Canadian Pediatric Society's decision to ditch strict time-based recommendations for toddler screen time.

Global News: Canadian Pediatric Society outlines steps to conserve 'vital supply' amid shortages. Critical drug shortages continue across Canada. CPS provides guidelines to help healthcare providers to ensure that children have access to safe and secure supply of necessary medications. Guest: Dr. Charlotte Moore Hepburn. Special advisor for Pediatric Drugs and Therapeutics for the Canadian Pediatric Society and one of the authors of the new guidance document on managing critical drug shortages. Learn more about your ad choices. Visit megaphone.fm/adchoices

Marc Aflalo tells us about the Canadian Paediatric Society's new screentime guidelines for toddlers.

Jim Krysko tells you all about the newly proposed accessibility legislation in Saskatchewan. Community reporter Elizabeth Mohler shares details about the ‘State of Schools' tour by the National Educational Association of Disabled Students. Marc Aflalo tells us about the Canadian Paediatric Society's new screentime guidelines for toddlers. And Amy Amantea shares her commentary on the Netflix limited series “The Inside Man starring Stanley Tucci. This is the November 28, 2022 episode.

In this main episode podcast on ED risk stratification and workup of the febrile infant, recorded at the CAEP 2022 Conference in Quebec City with Dr. Brett Burstein and Dr. Gary Joubert, we answer such questions as: Which febrile infants require lumbar puncture? How accurate is procalcitonin in identifying low risk febrile infants? What is the difference between serious bacterial infection (SBI) and invasive bacterial infection (IBI) and why is this important in the work up of the febrile infant? How do the PECARN, Step-by-Step and Aronson decision tools for identifying febrile infants at low risk for IBI and SBI? Can EM Cases incorporate all these decision tools and the upcoming Canadian Pediatric Society position statement on febrile infants recommendations into one concise algorithm? and many more... The post Ep 173 Febrile Infant – Risk Stratification and Workup appeared first on Emergency Medicine Cases.

Over the past few years, interest in plant-based diets and plant-based foods has been on an upward trend. Yet during the pandemic, meat shortages, supply chain issues, and financial concerns led Americans to purchase plant-based foods at a rapid pace and interest soared further. According to the Plant-Based Association, in 2020, sales of plant-based foods in the U.S. increased 27%, bringing the total market value to $7 billion. Following a vegan, vegetarian, or plant-based plan can be a healthy way to feed kids, but there are some considerations to think about.  In this episode, I sat down with Alexandra Caspero MA, RD, RYT, a registered dietitian nutritionist, creator of the award-winning website, Delish Knowledge, and co-founder of Plant-Based Juniors, an evidence-based platform that helps parents navigate the world of plant-based prenatal and pediatric nutrition. Alexandra is also the author of Fresh Italian Cooking for the New Generation and co-author of the bestselling book, The Plant-Based Baby and Toddler.  We talked about what research shows about plant-based eating, how to get your kids to eat more vegetables, and which supplements you may need. Plus, Alexandra talks about her favorite quick and easy meal ideas, how to eat plant-based on a budget, and how to navigate Thanksgiving.  Welcome 4:49 Let's talk about your story! 9:29 What can listeners find at Plant-Based Juniors? 11:17 What does research show about the benefits of plant-based diets?  16:37 What are the most common myths about plant-based eating? 20:50 Is it safe to raise a vegan child?  24:46 Can you debunk myths about plant-based milk? What are the best options for kids? 28:50 What is the PB3 plate model? 30:16 What are the best steps for starting solids, for both puree and baby-led weaning approaches? 34:06 What are evidence-based ways to get kids to eat their veggies? 42:25 Pediatricians only get about 24 hours of nutrition education. If a parent is getting resistance from their doctor about following a vegetarian or vegan diet, how should they approach it? 45:39 What are your favorite tips for planning plant-based meals and snacks? 49:00 We often don't think about serving veggies for breakfast: what are your favorite ideas? 51:10 What are your tips for eating plant-based on a budget? 54:55 Thanksgiving is around the corner: what are your best ideas? 58:18 What are your favorite recipes from your book? LINKS MENTIONED IN THE SHOW Alex mentions the book, “Skinny Bitch,” by Rory Freedman and Kim Barnouin.  Alex talks about the CDC study which found that only 1 in 10 Americans get enough fruits or vegetables and a study in BMJ Open which found 60% of American's calories come from ultra-processed foods.  The American Academy of Pediatrics, Academy of Nutrition and Dietetics, and the Canadian Pediatric Society all say vegetarian/vegan diets are safe for kids.  Learn more about Alexandra Caspero and Plant-Based Juniors at PlantBasedJuniors.com and follow them on Instagram.  FROM OUR PARTNERS Kids Cook Real Food eCourse The Kids Cook Real Food eCourse, created by a mom of 4 and a former elementary school teacher, is designed to build connection, confidence, and creativity in the kitchen. The course includes 30 basic cooking skills, 45 videos including several bonuses, printable supply and grocery shopping lists, and kid-friendly recipes. The course is designed for all kids ages 2 to teen and has three different skill levels. More than 18,000 families have taken the course and The Wall Street Journal named it the #1 cooking class for kids. Sign up now for the Kids Cook Real Food ecourse and get a free lesson for being a “Food Issues” listener.    Thrive Market  Thrive Market is an online membership-based market that has the highest quality, organic, non-GMO, healthy, and sustainable products. From groceries, clean beauty, safe supplements, and non-toxic home products to ethical meat, sustainable seafood, clean wine,

We hear about global data on what impact the pandemic has had on the number of suicides. Psychiatrist and suicide prevention researcher Dr. Mark Sinyor tells us what's been learned; This week the Canadian Pediatric Society and the Mental Health Commission of Canada released new recommendations to help policy makers support families coping with many of the stresses brought on by the pandemic. We find out more from child psychiatrist Dr. Jean Clinton; A new study from the University of Waterloo shows the opioid epidemic was underway long before it made headlines. We hear from the lead author of the study, Wasem Alsabbagh, a professor of pharmacy at the University of Waterloo; In the afterniath of the hundreds of graves discovered at residential school sites, some Catholics are questioning their church nd their faith. Retired Catholic priest, Monsignor Sam Bianco offers his opinions on accountability and healing, and how he's addressing the issues; Family doctor Peter Lin outlines how the U.K. will be removing restrictions with respect to the coronavirus and leaving citizens to behave safely; Rob Benzie, the Queen's Park bureau chief for the Toronto Star discusses how the province is reluctant to move to Step 3 in the reopening plan despite vaccination rates that are already higher than required.

This podcast is a review of the Canadian Pediatric Society's position statement on bruising in infants and children. In this episode, learners will learn the differential diagnosis and key investigations for bruising, as well as recognize a health professional's obligation to report injuries concerning for child abuse to the appropriate child welfare authority. This podcast was developed by Josie Cipolla, a third year medical student at McGill University, in collaboration with the lead author of this CPS statement, Dr. Michelle Ward, pediatrician and head of the Division of Child and Youth Protection at the Children's hospital of eastern Ontario.

This podcast is a review of the Canadian Pediatric Society's position statement on postnatal corticosteroids to prevent or treat bronchopulmonary dysplasia in preterm infants.  It was developed by Dr. Amélie Cyr, a pediatric resident at the University of Saskatchewan with Drs. Brigitte Lemyre, Michael Dunn, Bernard Thébaud, the principle authors of the statement. Dr. Brigitte Lemyre is a clinical investigator and an academic neonatologist at the Children's Hospital of Eastern Ontario (CHEO) and at the Ottawa Hospital.  Dr. Michael Dunn is a neonatologist at Sunnybrook Health Science in Toronto and Dr. Bernard Thébaud is a senior scientist with the Ottawa Hospital Research Institute and a neonatologist at CHEO and the Ottawa Hospital.  

This podcast is a review of the Canadian Pediatric Society's position statement on housing need in Canada. In it, the listener will learn to define types of housing need in Canada, to understand the health impacts of housing need, to assess housing status in the clinical setting, and to discuss how pediatricians, residents, and medical students can advocate for the housing needs of their patients.

In 2008, Sandra Hart wanted to get her son Christopher some extra help. He lives with autism and has limited verbal skills, and his mother was frustrated by mainstream medical treatments. Christopher saw a chiropractor for cranial adjustments, and later went for electro-dermal testing. Sandra Hart is not alone: alternative therapies are getting so popular, the Canadian Pediatric Society has created guidelines to help doctors deal with questions from patients. Today on Front Burner, CBC health reporter Vik Adhopia on the boom in “pseudo-scientific” treatments advertised to treat autism.

History of the Mormon Colonies in Mexico Hit by Brutal Violence This Week (0:31)Guest: Cristina Rosetti, PhD, Department of Religious Studies, University of California, RiversideFunerals are being held now for the nine American women and children murdered in northern Mexico by cartel gunmen. They are part of a fundamentalist Mormon community with a long history in the region. More than a century ago, former members of the Church of Jesus Christ of Latter-day Saints fled to Mexico when the church and US laws banned polygamy. Many of their descendants ranch and farm the region today with dual citizenship in the US and Mexico. Harriet Tubman, Abolition Super Hero (17:00)Guest: Kellie Carter Jackson, Assistant Professor of Humanities and Africana Studies at Wellesley College, Author of “Force and Freedom: Black Abolitionists and the Politics of Violence”Someday Harriet Tubman might be on the $20 bill –the plan for that switch is stalled. But for now, people are handing over their $20s to see Harriet on screen. The new film depicts Harriet Tubman as a gun toting action hero. Which Kellie Carter Jackson says is true-to-life.  After 51 Years Are Movie Ratings Still Relevant? (34:58)Guest: Kelly McMahon is the Senior Vice President and Chair of the Classification and Rating Administration for the Motion Picture AssociationHave you ever gone to a movie with your kids and have been surprised at the amount of violence or profanity you saw? Or an unexpected sexual moment? But are parents actually using the ratings? And do they understand what they mean? The CIA's Failed Quest to Develop Mind Control (51:08)Guest: Stephen Kinzer, Author of “Poisoner in Chief: Sidney Gottlieb and the CIA Search for Mind Control”The CIA has developed the ability to reprogram minds and wipe away inconvenient memories. At least in the movies, it can. That's what the CIA did to assassin Jason Bourne once they were finished with him. And that's where the Men in Black got their flashing pen-like “neutralizer” to erase knowledge of aliens from ordinary folks. So that's all fun and fiction, but for 10 years during the Cold War, the CIA really did have a secret mind control project. Instead of flashing pens, they were experimenting with LSD. And instead of a little harmless amnesia about aliens, the CIA was wreaking havoc on the minds of prisoners, children, sex workers and even some of their own government employees. 13-Year-Old's Study Shows Hand Dryers Hurt Kids' Ears (1:28:15)Guest: Nora Keegan, Thirteen-Year-Old ScientistWhen kids cry about things like their ice cream melting or their water being too wet, it can be hard for parents to gauge how serious their children's concerns really are. But a new study shows that when kids complain about hand dryers in bathrooms are hurting their ears, it's real. Nora Keegan has spent the last four years researching the negative impacts hand dryers on kids' hearing, and her study was recently published in the official journal of the Canadian Pediatric Society. And get this, she's only 13-years-old.

Joining Audrey for this week's REELTalk - MA is about to consider legislation that would make it illegal for licensed therapists to engage in conversion therapy for minors…And the Canadian Pediatric Society’s new guidelines now state that it’s normal for children to change their gender every day…Have we lost our minds as a society…and does this border on child abuse? Dr. MICHELLE CRETELLA, President of the American College of Pediatrics, will be here to answer this and more! PLUS, It’s always awesome to have fellow actors on the show…but how much better when they’re heroes who have served nobly in our Armed Forces. MIKAL VEGA is a former Navy Seal, having served our nation for over 22 years. He’s now an actor, writer, producer and director. And the founder of Vital Warrior...and he'll be with us to share about all his work! AND, The NFL continues to plummet in popularity…have they destroyed their brand beyond repair? And the black family has been devastated…is it the fault of white racists or the Liberal policies of the Democrat party? Super Bowl Champion BURGESS OWENS will be back with us to share about this and more! PLUS, I have a special guest joining me in a few minutes to discuss NoKo…author of Echo in Ramadi, MAJ Scott Huesing will be here to share his knowledge! In the words of Benjamin Franklin, "If we do not hang together, we shall surely hang separately." Come hang with us...

MK - Alicia, we both get to field alot of questions about babies.  Let's do a listener question: AP - Dr. Kang and Dr. Power, my baby just turned 4 months old and my mom is telling me to start rice cereal already.  This seems really young to me.  When should I start trying out solids, and what should I start with.  I am really worried my baby will choke.  MK - that's a common one. AP -  The WHO and CPS suggest starting solids between 4-6 months of age.  General readiness signs include: 1) able to sit in chair that the infant will eat with good head control  2) interest in what family is eating and ability to take food from the front of the mouth and pull it to the back with their tongue.   MK - What do you think about holding babies in your lap and feeding solids? AP - If they're able to hold their head up themselves that seems reasonable, but it can also get awkward to hold your baby in your lap and feed at the same time. AP - what should parents start with? MK - Because breast fed babies tend to run out of their iron stores by about 6 months of age, we generally recommend starting with an iron fortified cereal while your baby is learning how to process the food in their mouth.  You can play around with how liquid you make the cereal as well.  I like to remind parents that starting solids is practice.  It's not about calorie intake.  Most of that will come from breastmilk or formula, in the beginning.  You can then add in vegetables, meats and fruits slowly over time as your child get used to different substances.   MK - I get a lot of questions about food allergies and family history of allergies.  What do you think parents should do in that case? AP - If starting prior to 6 months of age we generally recommend adding one new food every three days, while continuing on with all the others they have already eaten.  If starting after 6 months of age you can just add on as you like.  If you have a high risk of allergies in your family, you may want to get the advice of your health care professional before you start solid foods.    We know earlier exposure to foods decreases allergies, so the only food you should avoid prior to one year of age is unpasteurized foods, such as honey and cheese.    We generally get you to start Cow's milk products such as cheese and yougurt after 9 months of age, and milk after one year of age, but other than that you can add on as you like.  Please do not feed your child sugar or fruit juices, as these have no benefit and increase the risk of childhood obesity.   MK - That's a really important tip.  Toddler obesity is associated with adult obesity and all the complications that are related.  If you and your family don't have the best dietary habits, what a great time to start fresh.  Remove those fruit juices and excessive treats from your home.   And what about water? AP - water is great for your child, and we highly encourage starting to introduce it to your child at meals around 6-9 months of age.  Using a sippy cup is great as it will also help enable your child to learn the skill of drinking from a cup.   MK - Just a word of caution here.  Baby kidneys are still maturing, so too much free water (as we say) can actually be harmful.  So I usually tell parents to limit their baby's daily intake of free water to 1 cup.  But after 18 months or so, when your baby is more active and eating much more, you can consider increasing that. I'm gonna bring us back to our listener questions.  It sounds like they were worried about choking specifically.  I know you've had experience with choking episodes.  It can be a really scary thing. AP - choking is always a concern with starting solids.  Infant's choking reflex is much farther forward than adults, and so your child will at some point seem like they are choking.  It is a protective mechanism while they are learning to manage solid foods.  For this reason we recommend all parents take an infant first CPR course...but the chances are you will not need to use it!  Because their choking reflex is so much more forward they will probably just sputter and spit out the offending food...but always stay close by to your infant and child while they are eating, and  do not let them walk around with food, or eat in the car!  You need to be able to react in a moment's notice on the rare occasion that they might need help! MK - I've done back blows to my kids.  It's so important to do an infant CPR course.  You can access infant cpr courses at a variety places locally, like Mothering Touch. So after being equipped with good knowledge on choking, you can move through the different tastes and textures as our baby tolerates them.  You can experiment with more soft chunks, first larger chunks, then smaller ones, then more firm chunks as well. AP - Family dinners are so important, to show your children how to eat, what to eat, how to act and most importantly to connect with each other at the end of the day!  This is a great time to teach your children the art of communication.  A great way of learning about your childs day is by the rose, the thorn and the bud!   MK - What a great reminder for parents.  It's amazing to watch babies watch you!     Stay tuned, folks as we keep on....Growing Healthy. Canadian Pediatric Society - starting solids: http://www.caringforkids.cps.ca/handouts/feeding_your_baby_in_the_first_year World Health Organization:  http://www.who.int/mediacentre/factsheets/fs342/en/ Starting solids in allergic families:  http://www.cps.ca/en/documents/position/dietary-exposures-and-allergy-prevention-in-high-risk-infants

The Canadian Pediatric Society says has released recommendations on how much time children should spend looking at various screens. Introduction to screens too early, they say, can be tied to higher risk of obesity, as well as focus and attention issues.

"By the pricking of my thumbs, Something wheezing this way comes." -- Witches in Macbeth, with apologies to William Shakespeare   "Bronchiolitis is like a pneumonia you can’t treat. We support, while the patient heals." -- Coach, still apologetic to the Bard     The Who The U.S. definition is for children less than two years of age, while the European committee includes infants less than one year of age. This is important: toddlerhood brings with it other conditions that mimic bronchiolitis – the first-time wheeze in a toddler may be his reactive airway response to a viral illness and not necessarily bronchiolitis. The What The classic clinical presentation of bronchiolitis starts just like any other upper respiratory tract infection: with nasal discharge and cough, for the first 1-2 days. Only about 1/3 of infants will have a low-grade fever, usually less than 39°C. We may see the child in the ED at this point and not appreciate any respiratory distress – this is why precautionary advice is so important in general. Then, lower respiratory symptoms come: increased work of breathing, persistent cough, tachypnea, retractions, belly breathing, grunting, and nasal flaring. Once lower respiratory symptoms are present, like increased work of breathing, they typically peak at day 3. This may help to make decisions or counsel parents depending on when the child presents and how symptomatic he is. You’ll hear fine crackles and wheeze. A typical finding in bronchiolitis is a minute-to-minute variation in clinical findings – one moment the child could look like he’s drowning in his secretions, and the next minute almost recovered. This has to do with the dynamic nature of the secretion, plugging, obstruction, coughing, dislodgement, and re-plugging. The Why Respiratory syncytial virus is the culprit in up to 90% of cases of bronchiolitis. The reason RSV is so nasty is the immune response to the virus: it binds to epithelial cells, replicates, and the submucosa becomes edematous and hypersecretes mucus. RSV causes the host epithelia and lymphocytes to go into a frenzy – viral fusion proteins turn the membranes into a sticky goop – cells fuse into other cells, and you have a pile-on of multinucleated dysfunction. This mucosal chaos causes epithelial necrosis, destruction of cilia, mucus plugs, bronchiolar obstruction, air trapping, and lobar collapse. High-Risk Groups Watch out especially for young infants, so those less than 3 months of age. Apnea may be the presenting symptom of RSV. Premature infants, especially those less than 32 weeks’ gestation are at high risk for deterioration.  The critical time is 48 weeks post-conceptional age. Other populations at high-risk for deterioration: congenital heart disease, pulmonary disease, neuromuscular disorders, metabolic disorders. Guiding Principles In the full term child, greater than one month, and otherwise healthy (no cardiac, pulmonary, neuromuscular, or metabolic disease), we can look to three simple criteria for home discharge. If the otherwise healthy child one month and older is: Euvolemic Not hypoxic Well appearing He can likely go home. The How Below is a list of modalities, treatments, and the evidence and/or recommendations for or against: Chest Radiograph Usually not necessary, unless the diagnosis is uncertain, or if the child is critically ill. Factors that are predictive of a definite infiltrate are: significant hypoxia (< 92%), grunting, focal crackles, or high fever (> 39°C). Ultrasound Not ready for prime time.  Two small studies, one by Caiulo et al in the European J or Pediatrics and one by Basile et al. in the BMC Pediatrics that show some preliminary data, but not enough to change practice yet. Viral Testing Qualitative PCR gives you a yes or no question – one that you’ve already answered. It is not recommended for routine use. PCR may be positive post-infection for several weeks later (details in audio). Quantitative PCR measures viral load; an increased quantitative viral load is associated with increased length of stay, use of respiratory support, need for intensive care, and recurrent wheezing. However, also not recommended for routine use. There is one instance in which viral testing in bronchiolitis can be helpful – in babies less than a month of life, the presence of RSV virus is associated with apnea. Blood or Urine Testing Routine testing of blood or urine is not recommended for children with bronchiolitis.  Levine et al in Pediatrics found an extremely low risk of serious bacterial illness in young febrile infants with RSV. The main thing is not to give in to anchoring bias here. If an infant of 3 months of age or older has a clear source for his low-grade fever – and that is his bronchiolitis – then you have a source, and very rarely do you need to go looking any further. He’s showing you the viral waterfall from his nose, and his increased work of breathing. It’s not going to be in his urine. Bronchodilators! Should we use bronchodilators in bronchiolitis?  It seems lately that this is a loaded question – with strong feelings on either side amongst colleagues. The short answer is that the American Academy of Pediatrics, the UK’s National Institute for Health and Care Excellence, as well as the Canadian Pediatric Society currently recommend against them. However, in continental Europe and Australia, the language is softened to “not routinely recommended”. Pros and Cons in Audio; the 2006 AAP Guidelines and the 2014 AAP Guidelines use same data to come to divergent recommendations. Steroids There is no role for steroids in the treatment of bronchiolitis, even in those with a family or personal history of atopy. Nebulized Hypertonic Saline May show some benefit in admitted patients, after repeated treatments; no data to support its use in ED patients (no immediate effect). Nebulized Epinephrine One randomized controlled double blinded study in eight centers in Norway published in the NEJM showed no benefit to nebulized epinephrine over nebulized saline. Again, probably asking too much of one single intervention. The Cochrane review found 19 studies that included a total of 2256 children with acute bronchiolitis treated with nebulized epinephrine. There were no differences in length of hospital stay between the placebo and treatment groups, and so they concluded that for inpatients, nebulized epinephrine is not worth the hassle. However – and this may just be an artifact of meta-analysis – there may be some benefit to outpatients. One study of combined high-dose steroid and epinephrine therapy was not statistically significant when other factors were controlled, but Cochrane concluded that nebulized epinephrine itself may be helpful for outpatients. It won’t affect the overall disease time course, but it may make them feel better enough to go home from the ED and continue observation there. High-Flow Nasal Cannula Oxygen High-flow oxygen via nasal cannula requires specialized equipment and delivers humidified oxygen at 1-2 L/g/min.  In addition to oxygenation, high flow nasal cannula also likely offers some low-grade positive end-expiratory pressure, which may help with alveolar recruitment. The evidence for its use is based on observational studies, which have found improved respiratory parameters and reduced rates of intubation.  Nasal CPAP also has some promising properties in the right clinical setting. Antibiotics Not recommended. When bronchiolitis is from a clear viral source, the risk of accompanying bacteremia is less than 1%. A meta-analysis of randomized clinical trials found that antibiotics in bronchiolitis did not improve duration of symptoms, length of hospital stay, need for oxygen therapy, or hospital admission. Summary: The Good, the Bad, and the Ugly The Good Nasal suction and hydration are your best allies. You may elect to give a bronchodilator as a trial once and reexamine, if you’re a bronchodilating believer. The Bad Steroids, antibiotics, and a blind obeying of the guidelines. Weigh the risks and benefits of every intervention, including hospitalization – it’s not always a benign thing. The Ugly Take a moment to assess the child and make a clinical diagnosis of bronchiolitis, after you’ve excluded cardiac disease, anatomic anomalies, and foreign body aspiration. Wheezing without upper respiratory symptoms is not viral, and it is not bronchiolitis. When all else fails, remember: in the otherwise healthy, term infant greater than a month of age, if he is well appearing, euvolemic, and not hypoxic, he will often do well with good precautionary advice and supportive care at home. Every thing else: be skeptical, be thorough, and above all, be careful. References Alansari K, Toaimah FH, Khalafalla H, El Tatawy LA, Davidson BL, Ahmed W. Caffeine for the Treatment of Apnea in Bronchiolitis: A Randomized Trial. J Pediatr. 2016 May 14. pii: S0022-3476(16)30170-6. [Epub ahead of print] American Academy of Pediatrics Subcommittee on Diagnosis and Management of Bronchiolitis. Diagnosis and management of bronchiolitis. Pediatrics. 2006 Oct;118(4):1774-93. Beggs S, Wong ZH, Kaul S, Ogden KJ, Walters JA. High-flow nasal cannula therapy for infants with bronchiolitis. Cochrane Database Syst Rev. 2014 Jan 20;(1):CD009609. Bergroth E, Aakula M, Korppi M, Remes S, Kivistö JE, Piedra PA, Camargo CA Jr, Jartti T. Post-bronchiolitis Use of Asthma Medication: A Prospective 1-year Follow-up Study. Pediatr Infect Dis J. 2016 Apr;35(4):363-8. Cunningham S, Rodriguez A, Adams T, Boyd KA, Butcher I, Enderby B, MacLean M, McCormick J, Paton JY, Wee F, Thomas H, Riding K, Turner SW, Williams C, McIntosh E, Lewis SC; Bronchiolitis of Infancy Discharge Study (BIDS) group. Oxygen saturation targets in infants with bronchiolitis (BIDS): a double-blind, randomised, equivalence trial. Lancet. 2015 Sep 12;386(9998):1041-8. Flett KB, Breslin K, Braun PA, Hambidge SJ. Outpatient course and complications associated with home oxygen therapy for mild bronchiolitis. Pediatrics. 2014 May;133(5):769-75. Florin TA, Plint AC, Zorc JJ. Viral bronchiolitis. Lancet. 2016 Aug 20. [Epub ahead of print] Halstead S, Roosevelt G, Deakyne S, Bajaj L. Discharged on supplemental oxygen from an emergency department in patients with bronchiolitis. Pediatrics. 2012 Mar;129(3):e605-10. Johnson LW, Robles J, Hudgins A, Osburn S, Martin D, Thompson A. Management of bronchiolitis in the emergency department: impact of evidence-based guidelines? Pediatrics. 2013 Mar;131 Suppl 1:S103-9. Lashkeri T, Howell JM, Place R. Capnometry as a predictor of admission in bronchiolitis. Pediatr Emerg Care. 2012 Sep;28(9):895-7. Lehners N, Tabatabai J, Prifert C, Wedde M, Puthenparambil J, Weissbrich B, Biere B, Schweiger B, Egerer G, Schnitzler P. Long-Term Shedding of Influenza Virus, Parainfluenza Virus, Respiratory Syncytial Virus and Nosocomial Epidemiology in Patients with Hematological Disorders. PLoS One. 2016 Feb 11;11(2):e0148258. Liet JM, Ducruet T, Gupta V, Cambonie G. Heliox inhalation therapy for bronchiolitis in infants. Cochrane Database Syst Rev. 2015 Sep 18;(9):CD006915. Mammas IN, Spandidos DA. Paediatric Virology in the Hippocratic Corpus. Exp Ther Med. 2016 Aug;12(2):541-549. Mansbach JM, Clark S, Teach SJ, Gern JE, Piedra PA, Sullivan AF, Espinola JA, Camargo CA Jr. Children Hospitalized with Rhinovirus Bronchiolitis Have Asthma-Like Characteristics. J Pediatr. 2016 May;172:202-204.e1. Meissner HC. Viral Bronchiolitis in Children. N Engl J Med. 2016 Jan 7;374(1):62-72. Munywoki PK, Koech DC, Agoti CN, Kibirige N, Kipkoech J, Cane PA, Medley GF, Nokes DJ. Influence of age, severity of infection, and co-infection on the duration of respiratory syncytial virus (RSV) shedding. Epidemiol Infect. 2015 Mar;143(4):804-12. Oakley E, Borland M, Neutze J, Acworth J, Krieser D, Dalziel S, Davidson A, Donath S, Jachno K, South M, Theophilos T, Babl FE; Paediatric Research in Emergency Departments International Collaborative (PREDICT). Nasogastric hydration versus intravenous hydration for infants with bronchiolitis: a randomised trial. Lancet Respir Med. 2013 Apr;1(2):113-20. Epub 2012 Dec 21. Oakley E et al. Nasogastric Hydration in Infants with Bronchiolitis Less Than 2 Months of Age. J Pediatr. 2016. [Article in Press] Principi T, Coates AL, Parkin PC, Stephens D, DaSilva Z, Schuh S. Effect of Oxygen Desaturations on Subsequent Medical Visits in Infants Discharged From the Emergency Department With Bronchiolitis. JAMA Pediatr. 2016 Jun 1;170(6):602-8. Ralston SL, Lieberthal AS, Meissner HC, Alverson BK, Baley JE, Gadomski AM, Johnson DW, Light MJ, Maraqa NF, Mendonca EA, Phelan KJ, Zorc JJ, Stanko-Lopp D, Brown MA, Nathanson I, Rosenblum E, Sayles S 3rd, Hernandez-Cancio S; American Academy of Pediatrics. Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis. Pediatrics. 2014 Nov;134(5):e1474-502. Roqué i Figuls M, Giné-Garriga M, Granados Rugeles C, Perrotta C, Vilaró J. Chest physiotherapy for acute bronchiolitis in paediatric patients between 0 and 24 months old. Cochrane Database Syst Rev. 2016 Feb 1;2:CD004873. Skjerven HO et al. Racemic adrenaline and inhalation strategies in acute bronchiolitis. N Engl J Med. 2013 Jun 13;368(24):2286-93. This post and podcast are dedicated to Linda Girgis MD, FAAFP, for her authenticity, innovation, and clear and honest voice on the the frontlines.  Thank you, Dr Linda. Bronchiolitis Powered by #FOAMed -- Tim Horeczko, MD, MSCR, FACEP, FAAP

This podcast was produced by PedsCases and the Canadian Pediatric Society, and aims to summarize the recently published 2015 Canadian Pediatric Society (CPS) statement on the management of uncomplicated pneumonia in healthy Canadian children and youth. The script for this podcast can be downloaded here. A written summary of these guidelines can be found here. This podcast was developed by Dr. Mara Tietzen, Dr. Peter Gill and Dr. Nicole Le Saux. Dr. Tietzen is a first year paediatrics resident at BC Children's Hospital at the University of British Columbia in Vancouver, Dr. Peter Gill is a pediatric resident at the University of Toronto and Dr. Nicole Le Saux is a pediatric infectious diseases physician and Associate Professor at the University of Ottawa.  Dr. Le Saux is also the lead author on this guideline. These podcasts are designed to give medical students an overview of key topics in pediatrics.  The audio versions are accessible on iTunes.  You can find more great pediatrics content at www.pedscases.com.   Related Content: Podcast: Approach to a Child in Respiratory Distress Podcast: Acute Cough Case: Fever and cough in a 22 month old Case: Fever, cough, and shortness of breath in a 13 year old

Are We There Yet? - Women, Power & Position - An Interview with Janet AustinJanet Austin was recommended as someone to interview for this series by a number of former participants. In addition to being the CEO of the YMCA Metro Vancouver, “one of the largest and most diversified non-profits in Metro Vancouver, if not the whole country” Ms. Austin is the incoming Chair of the Vancouver Board of Trade and serves on the Board of the Canadian Pediatric Society, Big Sisters BC and the Telus Community Board, among others. See acast.com/privacy for privacy and opt-out information.

Are We There Yet? - Women, Power & Position - An Interview with Janet AustinJanet Austin was recommended as someone to interview for this series by a number of former participants. In addition to being the CEO of the YMCA Metro Vancouver, “one of the largest and most diversified non-profits in Metro Vancouver, if not the whole country” Ms. Austin is the incoming Chair of the Vancouver Board of Trade and serves on the Board of the Canadian Pediatric Society, Big Sisters BC and the Telus Community Board, among others. See acast.com/privacy for privacy and opt-out information.