As the nation begins to focus its attention on the prospects of major health care reforms, one important aspect of health must not be overlooked -- access to affordable dental care for children. If left untreated, tooth decay in childhood can lead to lifelong tooth and gum problems, hospitalizations and emergency room visits, delayed physical development and loss of school days.

A new report released reveals that nearly 12 million children in the United States experience serious barriers to getting much needed dental care due to lack of insurance coverage, cost of care and difficulty finding providers who accept their insurance.

"In this poll, we wanted to understand the patterns of dental care for children," says Matthew Davis, M.D., M.A.P.P., director of the C.S. Mott Children's Hospital National Poll on Children's Health. "We asked parents how they access dental health services: whether they had problems accessing services, how often they took their children to the dentist, and whether they experienced barriers to receiving that care."

The poll found that 57 percent of parents say their children began going to the dentist by age 3, and that 82 percent receive regular dental care, defined by going to the dentist at least once per year.

"When we looked at factors associated with not getting regular dental care," Davis says, "one factor that leapt out at us was being uninsured for dental care. We found that while overall, 18 percent of all kids did not get regular dental care, for children without coverage, over 40 percent did not get regular dental care."

The report also shows that cost was a major concern for parents seeking dental health care for their children. For uninsured children, when out-of-pocket costs were more than $25, only 78 percent received regular dental care as compared to 92 percent of children receiving care when visits cost $25 or less.

In addition, for 14 percent of parents whose children have public health insurance, parents reported difficulty finding a dentist who accepts their insurance, compared to only 8 percent for privately insured children.

The National Poll on Children's Health also finds:

-- 16 percent of children have no dental insurance coverage.

-- Only 58 percent of children with no dental insurance receive dental care.

-- Children with no dental health coverage are 3 to 4 times more likely to have no regular dental care when compared with children on private or public dental health insurance.

-- 12 percent of parents have not obtained the dental care they thought their children needed. Of those children, 9 percent have private insurance, 13 percent have public insurance, and 22 percent are children without insurance.

-- Nearly one quarter of parents report "costs too much" as a big problem in getting dental care for their children.

-- 13 percent of parents report their "child doesn't like going to the dentist" is a big problem in getting dental care for their children.

"The good news is that over 80 percent of children are getting regular dental care and that only 16 percent of children have no dental coverage. These numbers are better than expected based on other national numbers from past years. The bad news in terms of children's oral health is that we still have big gaps when it comes to kids without dental insurance getting the care they need," Davis says.

Methodology:

For its report, the C.S. Mott Children's Hospital National Poll on Children's Health used data from a national online survey conducted in August 2008 in collaboration with Knowledge Networks, Inc. The survey was administered to a random sample of 2,245 adults, ages 18 and older, who are a part of Knowledge Network's online KnowledgePanel(R). For this analysis, a subset of parents with children age 3-17 years was used (n=1,608). The sample was subsequently weighted to reflect U.S. population figures from the U.S. Census Bureau. The margin of sampling error is plus or minus 2 to 7 percentage points, depending on the question.

It's a classic academic mismatch: Researchers aren't able to make use of seminal improvements in technology - often from colleagues just across the street - either because they don't know about them or because gaining familiarity makes unrealistic demands on their time.

For those very reasons, Johns Hopkins' Brain Science Institute is underwriting the Center for Translational Imaging (CTI). The new enterprise aims to channel expertise from Hopkins' various imaging-dedicated centers into creating a surge, university-wide, in the understanding and use of imaging techniques for neuroscience research.

The translational goals are both immediate and long-term, says magnetic resonance physicist and CTI Co-Director Susumu Mori. Immediately, the idea is to make accessible very high-quality anatomical MRI, MR spectroscopy, functional MRI, PET and newer offshoots such as diffusion tensor imaging. The prime targets of such "upgrades" are researchers with basic and clinical neuroscience studies in fields such as neurology, psychiatry, developmental biology, psychology, genetics, pathology and biomedical engineering.

But the center's ultimate purpose - and basis for Brain Science Institute support - upholds the traditional meaning of translational. Ideally, improved imaging in Hopkins' brain-oriented projects will hasten therapies for brain diseases.

The timing is right. "It's no coincidence that we're starting our center now," Mori says. "There's currently a bottleneck in the imaging field that interferes with the progress of biomedical research." But the problem, he says, isn't in the ability to acquire good data from imaging.

"That was the bottleneck 15 years ago," says Mori. "Now, however, high-quality MRI and PET scanners are available. Their new technology lets users access state-of-the-art capabilities just by pushing buttons. Yet we're victims of our own success; quality images are so easily generated that the volume overwhelms researchers and clinicians."

The new bottleneck, Mori says, lies in not being able to quantify information from a glut of images or interpret it rapidly enough. It's the access to good image analysis that must increase.

The CTI aims to improve things, University-wide, with several approaches. First, they'll set up a "protocol core" staffed by expert advisors who'll review proposed studies and offer guidance in collecting images. They'll also refer researchers to an appropriate Hopkins imaging data acquisition site. Sites include the F.M. Kirby Research Center for Functional Brain Imaging at the Kennedy Krieger Institute, the Molecular Imaging Center in the Broadway Research Building, the Department of Radiology's PET Center, Radiology's MRI Service Center and its Animal NMR Service Center.

Once high-quality images are generated, the core serves as a bridge to analysis in several ways. For one, it offers training - both individual and group - in the most widely used image analysis techniques. This educational arm of CTI will make computers and training available on a daily basis. "We anticipate high demand for this service," says Marilyn Albert, another of CTI's co-directors. "The interest is already there."

In addition, the CTI aims to centralize services for image analysis, particularly for projects with high-quality anatomical images. Though still in the planning stages, two image analysis stations will open, one, under Mori, in the Traylor Building on the medical campus and another, headed by CTI Co-Director Michael Miller, at Homewood's Center for Imaging Science.

At first, CTI will charge for its comprehensive analysis, but the ultimate hope is to automate the process so fully that investigators can perform it, gratis, in their own laboratories. "That ability is critical because it will free the center to create even more advanced image analysis and share it," Mori adds.

Especially helpful, the planners say, is CTI's "grant support core" opening this year. The intent is to provide the pilot funding that lets studies incorporate useful, quality human or animal imaging, making investigators more likely to get outside grant awards.

These improvements will come in phases. While imaging analysis occurs now at Hopkins, CTI's efforts will ultimately add workstations, improve the ease of analysis and foster wider use of high-quality imaging.

The interests of the CTI's three architects bring considerable breadth to the new center. Susumu Mori, with the School of Medicine's Department of Radiology, was key in developing the MRI capability to study brain anatomy.

Biomedical Engineering's Michael Miller, who directs the Center for Imaging Science in the Whiting School of Engineering, pioneered the field of computational anatomy. Getting computers to generate anatomically correct brain regions, he says, should enable scientists to relate changes in brain structure to patient symptoms in schizophrenia, depression, Alzheimer's disease and others.

Neurology's Marilyn Albert, who directs that department's Division of Cognitive Neuroscience, is well known for work to understand the clinical biomarkers - including those derived from brain imaging - associated with aging and Alzheimer's disease.

Researchers surveying pet owners living in Michigan, USA, found that one in three of the smokers said knowing smoking was bad for their pet's health would make them quit and about one in ten said this would make them ask other smokers they lived with to quit.

The study was carried out by researchers from the Center for Health Promotion and Disease Prevention, Henry Ford Health System in Detroit, Michigan, and is published online on 10 February in the BMJ journal Tobacco Control.

Although studies show that second hand smoke harms humans and animals, there is not a lot of information on the proportion of pet owners who either smoke themselves or allow others to smoke in their homes.

Second hand smoke has been linked with lymph gland, nasal, and lung cancers, plus a range of allergies, diseases of eye and skin, and respiratory problems in cats and dogs.

For this study, the researchers carried out a web-based survery of 3,293 adult pet owners living in the state of Michigan, USA. They asked them about their smoking status, whether any people living with them smoked, whether they allowed smoking in the home or not, and how knowing about the effects of second hand smoke on animal health would change their intentions about smoking and their smoking policies.

The results showed that:

* 21 per cent of the respondents were current smokers.

* 27 per cent of the respondents lived with at least one other person who smoked.

* 28.4 per cent of respondents who smoked said that knowing about the risks of second hand smoke to animal health would make them try to quit.

* 8.7 per cent of respondents said knowing about the risks of second hand smoke to animal health would make them ask co-habitant smokers to quit.

* 14.2 per cent said that knowing about the risks of second hand smoke to animal health would make them change their smoking policy to ban smoking indoors.

* 16.4 per cent of respondents who were non-smokers but lived with smokers said they would ask their co-habitants to quit.

* 24 per cent of non-smokers who lived with smokers said they would be interested in receiving information about smoking, quitting and the effects of second hand smoke.

The authors concluded that:

"Educational campaigns informing pet owners of the risks of SHS [second hand smoke] exposure for pets could motivate some owners to quit smoking. It could also motivate these owners and non-smoking owners who cohabit with smokers make their homes smoke-free."

They said that pet owners are a devoted bunch and would make good targets for anti-smoking public health campaigns that focus on the effects of second hand smoke on animals.

Nearly two thirds of US homes has at least one pet, and Americans spend about 10 billion dollars a year on pet supplies.

But the depth of devotion that Americans have for their pets is perhaps reflected in the results of a recent survey referred to by the authors as carried out by the American Animal Hospital Association where half the respondents are reported to have said if they were stranded on a desert island they would prefer to have their pet with them rather than another person.

Losing weight could be the most effective way of reducing obstructive sleep apnea or OSA symptoms and associated disorders, says a new study.
Weight loss may not be a new miracle pill or a fancy high-tech treatment, but it is an exciting therapy for sufferers of OSA both because of its short- and long-term effectiveness and for its relatively modest price tag.

The prospective, randomised trial found that, in 81 patients with mild OSA, the 40 patients who were in the intervention arm underwent a diet that strictly limited caloric intake combined with lifestyle counseling lost more than 20 pounds on average in a year - and kept it off, resulting in markedly lower symptoms of OSA.

"Very low calorie diet (VLCD) combined with active lifestyle counseling resulting in marked weight reduction is a feasible and effective treatment for the majority of patients with mild OSA, and the achieved beneficial outcomes are maintained at one-year follow-up," wrote Henri P.I. Tuomilehto, department of otorhinolaryngology at the Kuopio University Hospital in Finland.

The 41 patients in the control arm, who only received lifestyle counseling and lost on average less than 6 pounds, and were much less likely to see improvements in their OSA. And not only does sustained weight loss improve OSA, it also improves the many other independently linked co-morbidities such as hypertension, high cholesterol, and diabetes, said a Kupio release.

"The greater the change in body weight or waist circumference, the greater was the improvement in OSA." In fact, mild OSA was objectively cured in 88 percent of the patients who lost more than 33 pounds, a statistic that declined with the amount of weight lost, said Tuomilehto.

Are you clueless as to why your teenage kid ignores home rules? Well, British scientists have got the answer: their brain's ability to adopt the viewpoint of others is still budding.

Dubbed as the theory of mind, the ability to infer another's perspective - emotional, intellectual, or visual -boosts with age.

To reach the conclusion, the researchers made kids watch two puppets - Sally and Anne - play with a marble, then put the marble back in a box. Anne "left" and Sally grabbed the marble, played with it, and then returned the marble instead to a bag.

Where will Anne first search for the marble, the researchers asked the children as part of the study.

"Before four, kids say she's going to look in the bag, but after four they know she has a false belief," New Scientist quoted Iroise Dumontheil, a cognitive neuroscientist at University College London, UK, who led the new study.

However, Dumontheil said, brain scans suggest that a teenage mind toils harder when inferring the outlook of others, compared with adults. And a brain region implicated in theory of mind, the medial prefrontal cortex, continues to develop through adolescence, the scientist added.

To see if there is a behavioural consequence of these biological changes, she and colleagues tested children, adolescents, and adults on their ability to infer the spatial perspective of another person in a simple computer game.

Volunteers- 179 females ranging in age from 7 to 27 - saw a bookshelf with a variety of different sized balls and other objects on four different rows. Few of the objects sit in front of opaque backgrounds, obscured to someone standing on the other side of the shelf, while some sit in front of a see-through background.

Participants were asked to adopt the perspective of a man standing on the other side of the shelf and move the small ball to the left, using a mouse. In a typical test, a golf ball and tennis ball are both visible to the participant, but the golf ball is obscured from the point of view of the observer.
The correct response, then, is to move the tennis ball.

Kids under the age of 10 moved the wrong ball in about three-quarters of trials. Children aged 10 through 13 scored marginally better, and teens answered wrong on two-thirds of trials. Adults, however, did better than 50-50, on average.