Kapi`olani Kids | Fall 2004

` Kapi`olani VOLUME VOL 1. ISSUE 2. ISSUE 1 2. NOVEMBER 2004

kids

` T H E L AT E S T I N C H I L D R E N ’ S H E A LT H F R O M K A P I ` O L A N I C H I L D R E N ’ S H O S P I TA L

Doctor or ER?

Food for Thought

Making the right decision

Help your children develop healthy eating habits

“You know your child best, so you’re the best judge of determining when something is wrong,” says Loren Yamamoto, M.D., M.P.H., M.B.A., U.H. professor of pediatrics and Pediatric Emergency Medicine Director at Kapi‘olani Medical Center.

Often, children will become ill or injured when your doctor’s office is closed. Knowing more about childhood emergencies can assist you in making a decision.

“We are a nation of couch potatoes raising tater tots,” says Nicole Angelique Kerr, M.P.H., R.D., a registered dietitian and a member of Kapi‘olani Medical Center’s Childhood Obesity Task Force. “As a whole, Americans are moving less and eating more — it’s a recipe for disaster.”

To help children embrace sensible nutritional habits, Kerr encourages parents to gradually implement these simple yet effective changes for their household: ■ Strive for five — Make fresh, whole fruits and vegetables a staple of your family’s daily menu. Encourage children to eat five servings of fruits or vegetables each day. Limit fruit juices to a half cup (4 oz.) per day. A 12-ounce can of soda or juice contains 10 teaspoons of sugar.

■ H2O alert — Drink more water. Provide children with water when they wake up and between meals. Stock bottled or filtered water in your house, jazz up a glass of water with a slice of lemon, lime or orange, and stash a six-pack of bottled water in your vehicle.

■ Put a lid on soda — Don’t keep soda or sweetened drinks in your house — if you buy it, they will consume it! Instead, offer children water and save soda for special occasions.

■ Special agenda — Limit snacks and desserts. Kids who Nicole Kerr, eat high-fat, sugary M.P.H., R.D. snacks and desserts every day will likely carry the habit into adulthood. Replace potato chips, sweets or other unhealthy snacks with fruit or low-fat alternatives.

Call your physician to discuss your child’s condition If your physician is unavailable, or you believe that you cannot wait, then seek emergency care. Having an emergency plan developed with your physician ahead of time can be very helpful. Below are some general guidelines to follow when deciding to seek emergency care: Fever is more serious when it occurs with fussiness, irritability or lethargy.

Seizures are more serious when they last more than 2–3 minutes, recur, involve only part of the body, occur for the first time, or occur without a fever. Seizures are less serious when they occur with high fever from 6 months to 6 years, and the child is otherwise active, alert and playful.

Seizures are usually followed by drowsiness, which gradually resolves. continued on page 7

continued on page 6

HAWAII’S EPIDEMIC Unhealthy eating habits have trickled down to our offspring: A recent study at the University of Hawaii of 6- to 11-year-olds showed that 26 percent of children of Hawaiian ancestry and 21 percent of non-Hawaiian children in Hawaii are obese. These numbers are especially shocking when you compare with the national average of 11 percent, according to the study.

To help address the current pediatric obesity epidemic, Kapi‘olani formed a Childhood Obesity Task Force consisting of pediatric medical experts, university professors, community agencies and individuals, and members of the Department of Health. continued on page 6

What Every Parent Should Know About

Vaccinations Watching your child get a shot isn’t easy.

It’s even harder if the fearful one is you.

Millions of parents immunize their kids each year without concern. Yet some parents have heard rumors that vaccinations can cause serious health problems. “It can be confusing for parents,” says pediatrician Keith T. Matsumoto, M.D., president of the Hawaii Chapter of the American Academy of Pediatrics (AAP). “For example, there are Internet sites that present convincing, yet unproven, theories about the risks of vaccines. Deciding who is credible and who is not can be difficult.”

Dr. Matsumoto further adds, “Recent media attention regarding claims that the MMR (measles-mumps-rubella) vaccine causes autism generated significant anxiety among parents. However, large studies have not supported this claim and

experts from the AAP and the Institute of Medicine have concluded that no relationship exists between MMR vaccine and autism.”

So, who can parents turn to for the facts about vaccine safety? “The first place to go is to your child’s doctor,” advises Dr. Matsumoto. He or she knows your child’s health and medical needs better than anybody. By law, physicians must give you information explaining the benefits and risks of each immunization. Reading this material and then discussing with your doctor, can help you make a well-informed decision.

Another resource for in-depth information on vaccine safety is the Centers for Disease Control and Prevention (CDC).

You can check the CDC’s Web site at www.cdc.gov/nip.

Below are answers to some questions you may have about vaccines.

Are vaccinations safe?

Yes. All vaccines are fully tested before being approved for use by the U.S. Food and Drug Administration.

Vaccines contain a dead or weakened form of the disease-causing virus or bacteria, which causes the body to produce antibodies that protect the child from that disease. But it is not enough to spread the disease.

Diseases such as polio and mumps are rare, so why are vaccines necessary?

Many of these diseases still thrive in other parts of the world. Travelers can and do bring these viruses back to the United States. Without the 2

Kapi‘olani Children’s Hospital 808-983-6000

protection of vaccines, these diseases could easily spread here again.

Do vaccines cause harmful side effects, illness and even death?

Some children have minor side effects from being vaccinated, such as a slight fever or swelling at the injection site. The risk of death or serious side effects is so small that it is difficult to document.

Claims that vaccines cause sudden infant death syndrome (SIDS), autism or other diseases have been carefully researched and never proved.

Recent media attention regarding claims that the MMR vaccine causes autism generated anxiety among parents; however, experts say that no relationship exists between the two.

Won’t giving babies multiple vaccines at one time overload their immune systems?

Many studies have been done to assess the safety of multiple vaccinations. None have shown that multiple vaccinations cause a problem. Children are exposed to many foreign substances every day with no harmful effects.

Scientists say that the Keith T. tiny amount of virus Matsumoto, M.D. or bacteria in vaccines is not enough to harm a child. When deciding to vaccinate your child, work closely with your child’s doctor. Your child’s health may depend on it.

Could Your Child Have a Drug Problem?

TEEN CORNER

Project S.P.E.A.K. Helps to Protect Teens A new curriculum for intermediate and high school students on Oahu is being piloted by the Sex Abuse Treatment Center to help teens recognize and prevent sexual violence in their lives.

Project S.P.E.A.K. (Sexual Assault Prevention, Education, Awareness and Knowledge) uses role-playing, interactive exercises and analytical skillbuilding activities to help students understand the connections between media/peer influences, issues of power and control, stereotyping, sexual harassment and sexual assault.

The program includes six 45-minute sessions, each covering a different aspect of sexual assault. The curriculum is offered to all seventh-, eighth- and 10th-grade health classes on Oahu.

For more information, please call the Sex Abuse Treatment Center at 808-535-7600.

“I’m glad I learned how to prevent sexual harassment because now I feel more safe.”

Dole Intermediate School student

“I learned that sexual assault is really about someone taking power and control over someone else.”

Iolani High School student

Many parents blame themselves when faced with the possibility that their child may be using drugs. But most experts recommend that parents worry more about helping the child, rather than trying to deduce the reason for the behavior.

Kapi‘olani adolescent specialist Robert Bidwell, M.D., advises parents that children who use drugs often exhibit the following behaviors: ■ Isolation. They want to hide the effects, the smell and the incriminating paraphernalia. They also want to avoid direct questions about where they’ve been and what they’ve done. The easiest way to do this is to stay out of sight.

■ Personality or attitude changes. Changes in personality or attitude may be gradual, such as a decreasing interest in school.

You may also witness sudden mood swings, irritability, anger and euphoria.

■ Physical changes. Difficulty with concentration, loss of coordination, weight loss and an unhealthy appearance are signs of drug use.

■ New friends. A sudden exchange of one set of friends for another indicates something drastic has changed in the child’s life, and it may be drug use.

“Before assuming your child is taking drugs, find out if something else may be causing him or her to behave unusually,” adds Dr. Bidwell. Are classes getting harder?

Did a friendship fall apart?

If you suspect your child is using drugs, take action.

Some steps to take include: ■ Voice your suspicions.

Talk to your child when he is sober and you’re calm.

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Ask questions. Ask what has been going on in the child’s life. Start by asking how things are in general. Then make it clear what’s bothering you.

Maybe you’ve smelled something, or you’ve seen grades drop, or behavior has changed.

Look up the teacher. If you encounter reluctance to talk, it may be time to talk to your child’s teacher. If your child won’t talk, and you’re concerned about falling grades or other negative signs, say so. Mention the behavior you’ve witnessed and that you’ll be talking to other people, such as teachers and the school’s guidance counselor.

Robert Bidwell, M.D. > > H E A R F R O M T H E E X P E RT:

Is Your Teen Rebelling?

Wednesday, Nov. 17, 6:30–7:30 p.m.

See page 5 for more information.

These conversations don’t have to focus on your drug suspicions. Just ask these people if they’ve noticed anything unusual about your child’s behavior. If you hear anything that deepens your suspicions, bring that information back to the child.

Seek help if you don’t get a response from your child. Ask your family doctor for referrals to professionals and organizations in your area.

www.kapiolani.org

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Research Key to improving pediatric care JESSICA SHIMADA WAS ONLY 12 YEARS old when a routine exam uncovered that she had high blood pressure.

“Our family has a history of heart disease and stroke, and my wife and I take medication for high blood pressure, so we weren’t completely shocked,” Jessica’s father Andrew Shimada explains.

Jessica’s pediatrician recommended that she be enrolled in a research project that studies hypertension in children at Kapi‘olani.

Jessica’s case is an example of the problems facing pediatricians nationwide. Since most children don’t have high blood pressure, clinical studies about best medications have historically been directed toward adults. Therefore the exact dosage appropriate for Jessica is unknown. Pediatricians treating children are forced to make an educated guess based on adult dosages.

This is called prescribing “off-label.” This traditional approach to prescriptions is not ideal because adults and children sometimes react to medications differently.

However, this off-label practice is changing. The United States Food and Drug Administration agrees that medications used to treat children with high blood pressure should be clinically tested in children, to determine the best dosages and effectiveness.

James E. Kapi‘olani is one of Musgrave, M.D. several sites participating in research in medications for children.

Physician researcher James Musgrave, M.D., is the principal investigator.

Kapi‘olani is participating in the study through its affiliate research arm, Hawaii Pacific Health Research Institute. “We hope to gain an understanding from these studies that pinpoints the differences — and there certainly are differences — in how hypertension medications affect kids as compared to adults,” says Dr. Musgrave.

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Kapi‘olani Children’s4 Hospital 808-983-6000

Pediatric medicine: A promising future The hypertension medication trial at Kapi‘olani not only offers excellent care for young patients with high blood pressure, but also may affect the future of pediatric medicine.

“This study and others like it may well change the way in which medications are used in children,” says Dr. Musgrave.

As Hawaii’s only children’s hospital, Kapi‘olani is dedicated to provide the best available medical care for kids.

“The important improvements that have been achieved in children’s medical care are based primarily on new discoveries and knowledge,” says Dexter Seto, M.D., medical and scientific director, Hawaii

Pacific Health Research Institute.

Kapi‘olani’s emphasis on research brings state-of-the-art protocols to Hawaii’s young patients, including treatment options that would not be otherwise available.

“Medical research is essential for today’s children and future generations of children,” says Dr. Seto.

In addition to the hypertension study, Kapi‘olani and the Research Institute collaborate with pediatric centers across the country that focus on children’s health concerns. For example, because Hawaii has the highest rate of pediatric asthma in the nation, Kapi‘olani is participating in a study to prevent and manage asthma attacks in children. Also, to address the epidemic of “ice” or crystal methamphetamine use in

Jessica Shimada is one of the many participants who benefits from research that tests the effectiveness of hypertension drugs in children.

Kapi‘olani Kids is printed by Kapi‘olani Medical Center for Women & Children. This is the November 2004 issue. Kapi‘olani Kids is published twice a year as a service to parents in the community served by Kapi‘olani Medical Center for Women & Children, 1319 Punahou, Honolulu, HI 96826. The information is provided as education about physical, mental and psychosocial health. It is not intended as a substitute for consultation with a physician. If you have questions or concerns about specific items that appear in Kapi‘olani Kids, please contact your child’s doctor. To advise us of changes to your mailing address, please contact us at 808-535-7554.

F R E E L E C T U R E S F O R PA R E N T S the state, the hospital is involved with a study researching the long-term effects of the drug on children who were exposed to it in utero (before birth).

Parents and teachers are invited to join our speakers as they address today’s issues concerning the health and safety of our children and teens. All lectures are FREE and held at Kapi‘olani, 1319 Punahou. Space is limited, and registration is required. Call 808-535-7000, or register online at www.kapiolani.org.

A family affair

IS YOUR TEEN REBELLING?

One of the many children who benefits from Kapi‘olani research is Jessica Shimada.

After a year in the hypertension study, Jessica’s family is pleased with her progress.

“The study has been good for Jessica, and we want to do whatever we can to keep her healthy,” says her father. “Our ultimate goal for her is not to need medications to keep her blood pressure under control.”

Participating in the study has raised the family’s awareness of the importance of physical activity to help manage her blood pressure. Jessica has started a regimen of walking and is learning Dexter Seto, M.D. some new exercises from fitness videos.

“I remind Jessica that it’s best to nip high blood pressure in the bud while she is young, and not to wait until she is old like me,” says Andrew Shimada.

For Parents of Teens and Pre-teens

Children’s Research in Hawaii Medical research is essential for the health of today’s children and future generations of children.

To provide the newest, most promising treatments for children, Kapi‘olani’s clinical research includes: ■ More than 100 pediatric studies, covering areas such as oncology, cardiology, emergency medicine, neonatology, infectious diseases, allergy, immunology, rheumatology ■ $3.5 million targeted for current pediatric research ■ A dedicated staff that includes more than 25 clinical research coordinators, and up to 75 physicians conducting studies ■ A specialized Institutional Review Board assures patient safety in all aspects of research ■ Extensive experience with clinical trials

Wednesday, Nov. 17, 2004, 6:30–7:30 p.m.

If your child is in his teens or approaching adolescence, you’ve probably concluded that this phase of exploration and independence is your biggest parenting challenge yet.

Kapi‘olani Adolescent Specialist Robert Bidwell, M.D., discusses issues today’s parents of teens face. Questions and topics include: ■ What happened to my child?

■ How do I talk to my teen and keep the communication lines open?

■ Respecting your child and knowing when to let go, and when to seek assistance.

Dr. Bidwell has been specializing in adolescent medicine for more than 17 years. He is also an associate professor with the Department of Pediatrics at the University of Hawaii School of Medicine.

H E A LT H Y C H O I C E S , H E A LT H Y C H I L D R E N Parenting Strategies to Prevent and Manage Weight Problems Saturday, Nov. 20, 2004, 10–11 a.m.

Thursday, Dec. 2, 2004, 6:30–7:30 p.m.

This free lecture is recommended for all parents. It’s never too late or too early to develop healthy eating habits.

Children who are overweight suffer from weight-related health problems — diabetes, cardiac disease, and sleep apnea — just like adults. These conditions pose serious threats to our children’s health.

Guest speaker Nicole Angelique Kerr, M.P.H., R.D., is a member of Kapi‘olani’s Childhood Obesity Task Force. She will share weight-management strategies that are showing promising outcomes in a national pilot study. You’ll see that simple changes can make a world of difference for your child’s health and happiness.

Kerr holds a masters in public health in nutrition and is a registered dietitian.

She has worked at the Centers for Disease Control and Prevention in the Division of Nutrition and Physical Activity. Kerr has appeared on shows on CNN, PBS, the Food Channel and other stations for her expertise in this area.

B R E AT H E E A S Y Asthma Management Strategies for Parents and Caregivers Every Tuesday, 6–7:30 p.m.

While Hawaii has the highest rate of pediatric asthma in the United States, studies show that with appropriate management children with asthma can lead active lives.

We will share the information and tools to keep your child on the playground and out of the emergency room (ER). If you would like to see your child living a more active life or are feeling frustrated by repeated visits to the ER, join us for this free workshop. Kapi‘olani respiratory therapists conduct small group sessions for parents and caregivers. This lecture covers signs and symptoms, anatomy, causes, treatment goals, proper use of nebulizers and meter dose inhalers, medication, common concerns and beliefs.

www.kapiolani.org

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[ health bits ]

Food for Thought continued from page 1 ■

Put Milk Back in the Game A good diet is no game — or is it? The National Institute of Child Health and Human Development has added games to its “Milk Matters” Web site (www.nichd.nih.gov/milk/kidsandteens) to mix fun with learning. The site features games, puzzles and mazes. “Most girls and boys between the ages of 12 and 19 don’t get the daily calcium they need,” says the institute’s director, Duane Alexander, M.D. That could raise their risk for broken bones in childhood and osteoporosis later in life. “Milk Matters” seeks to spread the word about the role of calcium in kids’ diets.

What kind of milk is best?

One percent milk or less is recommended to realize the nutritional benefit without the saturated fat.

One percent or skim milk has little or no fat. In comparison, whole and 2 percent milk are among the biggest contributors of saturated fat to Americans’ diets: ■ 8 oz. whole milk = five strips of bacon ■ 8 oz. 2% milk = three strips of bacon

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Mom and pop operation — Dine at home as often as possible. Your home cooking provides comfort, love and better nutrition than fast food. By preparing your family’s meals, you can control the amount of fat and sodium, sugar and portion size.

Keep it kid-sized — Instead of adult-sized helpings, provide youngsters with child-sized portions.

If they are still hungry, let them ask for more.

Remove the remote — The American Academy of Pediatrics recommends that families limit children to two hours of television viewing a day. Watching TV often leads to snacking and prevents children from participating in calorie-burning activities.

Remember: Parents determine what and when to eat, children decide if and how much to eat.

HAWAII’S EPIDEMIC A Spray May Keep the Flu at Bay

continued from page 1

There’s hope for parents who fear the flu and kids who hate shots. Doctors now have a nasal spray flu vaccine for children ages 5 and up. “We should be able to increase coverage with this vaccine, since so many kids don’t like getting the shot,” says Paul Glezen, M.D., a Baylor College of Medicine professor who ran the central Texas trials of the vaccine. Younger kids still face shots, though. The nasal vaccine isn’t approved for children under age 5. The Centers for Disease Control and Prevention urges flu vaccinations for all children ages 6 months and above.

“The goal of the task force is to promote programs that help children and their families fight obesity, such as asking the Board of Education to add healthier choices to school vending machines,” says Jeffrey Okamoto, M.D., a Kapi‘olani developmentalbehavioral pediatric specialist and chair of the Childhood Obesity Task Force. “We realize that losing weight is very difficult for adults, so we want to affect nutritional and activity changes starting in childhood.”

For more information about preventing childhood obesity, visit the American Dietetic Association at www.eatright.org or the American Academy of Pediatrics at www.aap.org (click on Health Topics).

Kids’ Smoking Linked to Asthma Childhood smoking and secondhand smoke account for about 15 percent of asthma cases among seventh- and eighth-graders, says a survey by the University of North Carolina at Chapel Hill. “Asthma is the most common chronic childhood illness,” notes co-author Jesse J. Sturm, M.D. Of the asthma cases tied to tobacco, the survey of 128,568 North Carolina kids blamed about 7 percent on youths’ smoking and the rest on secondhand smoke. The link between youths who smoke and asthma had never been shown, the authors say. They urge efforts to curb smoking in children of all ages.

Teens’ Speeding Warns of Other Ills Teens who break the speed limit are more prone than non-speeding teens to gamble, use drugs or drink alcohol, according to a study conducted by the University of Florida.

Researchers based their findings on phone interviews with more than 1,000 Florida teens ages 13 to 17 about gambling, alcohol and drug use, mental health and speeding. “The implications for parents are great,” says Kapi‘olani behavioral health specialist Anthony Guerrero, M.D. “Parents tend to view speeding as a single unrelated event, rather than to say that it is a clue to other behaviors that could help them save their child’s life. Everyone should remember that accidents are the number one cause of teen deaths in this country.

Second is homicides and third is suicides,” adds Dr. Guerrero.

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Jeffrey Okamoto, M.D.

Doctor or ER? continued from page 1

If drowsiness persists or if the child was drowsy or lethargic before the seizure, this is potentially more serious.

Trauma is often serious when it involves a car or high-speed accident (bicycle, skateboard, etc.). Persistent pain, visible deformities, significant swelling, or loss of function or sensation are also serious.

Difficulty breathing is usually an emergency. Abdominal or pelvic pain can be an emergency. Appendicitis or injured internal organs are difficult to distinguish from minor conditions,

such as constipation or stomach flu.

Testicular pain is an emergency. Chest pain is rarely an emergency in children.

Vomiting/diarrhea is more likely to be an emergency if it is severe, accompanied with abdominal pain, or if fluid intake is not keeping up with fluid loss.

Severe pain in general is an emergency since no one should endure pain unnecessarily.

Other conditions that are often emergencies include loss of function or sensation, sudden weakness, significant tingling, rapid change in vision, confusion, agitation, cyanosis (bluish or purplish color to the skin), pale skin color, dramatic skin rashes, swelling, suicidal behavior and

severe depression. A complete list is not possible. Call your physician or seek emergency care if you are unsure.

Kapi‘olani Medical Center’s emergency room is open 24 hours a day, with Loren Yamamoto, M.D., M.P.H., M.B.A. a specially trained pediatric emergency team. If a specialist (such as a surgeon or cardiologist) is required, pediatric subspecialists are on staff and can be contacted to assist with care for your child.

Beware of Supplements for Kids Dietary supplements and herbal mixtures aimed at your children may be a waste of your money — and a threat to their health. Traditionally, the term dietary supplement referred to vitamins and minerals. Currently, it includes herbs and other botanical products, enzymes, animal extracts and so on.

Firms are advertising herbs and supplements as remedies for everything from colds and asthma to attention-deficit hyperactivity disorder.

“We’re very concerned about how some dietary supplements for kids are being portrayed in ads,” says J. Howard Beales, III., director of the Bureau of Consumer Protection for the Federal Trade Commission (FTC).

“In spite of the fact that many of these products may have been used for hundreds of years, we have no systematic scientific data on their use in children,” adds Michael Sia, M.D., pediatrician and chairman, Department of Pediatrics, Kapi‘olani Medical Center for Women & Children.

“It is hard to resist Michael Sia, M.D. supplements promoted as effective treatments for children’s disease,” says Dr. Sia. “Deceptive ads describe the supplement products as ‘natural,’ but that does not necessarily mean ‘safe,’ especially when

compared with prescription medications.

Some herbs, like drugs, can have potent pharmacological effects.” Many dietary supplements are also not held to any federal standards to ensure purity and quality.

“Parents’ fears of giving their children prescription drugs are often exploited by alternative therapies. Our concern with these claims is that parents fall for the products and ignore proven, perhaps essential, treatments for their child’s disorder,” says Dr. Sia. The FTC says consumers should never rely on just one source for information about supplements. If the information is legitimate, your pediatrician or family doctor will know about it.

Pointers for parents ■ Beware of fraudulent promoters’ claims of “scientific breakthroughs,” “miraculous cures,” “exclusive products,” “secret ingredients” or “ancient remedies.” (If a product is so amazing, why would you be reading about it for the first time in an ad?)

■ Beware of money-back guarantees.

■ Avoid products that claim to be available from only one source, and whose payment is required in advance.

■ Check on supplements’ side effects, and potential food and drug interactions — some effects can be especially risky for kids taking medications.

Your best adviser is your child’s pediatrician or another health care provider.

Be sure to check with one or both of them before starting your child on a supplement. Keep them informed of your child’s continuing use of the product.

www.kapiolani.org

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Children’s Hospital Research Saves and Improves Children’s Lives Did you know that a physician at a children’s hospital was the first to identify AIDS in children and that the polio vaccine was first tested at a children’s hospital?

Pediatric research is an essential part of a children’s hospital’s mission. The National Association of Children’s Hospitals and Related Institutions (NACHRI) supports research conducted by children’s hospitals across the country by increasing public awareness of the benefits that pediatric research offers to all children.

One-third of children’s hospitals operate child health research centers that have advanced lifesaving discoveries

NACHRI National Association of Children’s Hospitals and Related Institutions

such as vaccines, gene therapies and specialized surgical techniques. Virtually all children’s hospitals participate in lifesaving clinical trials, and 70 percent perform basic science and health services research.

Children’s hospitals have also made important advances in fetal surgery, bone marrow transplants and the treatment of birth defects and heart conditions. That’s why NACHRI encourages continued federal funding for pediatric research in children’s hospitals.

But research into pediatric illnesses and conditions doesn’t just help children. Children’s hospital research has resulted in prevention and treatment discoveries for high-cost adult diseases that begin in childhood, such as osteoporosis, diabetes and obesity.

Children’s hospitals are also working together to test, study and increase the number and variety of drugs that are

approved for use in children. Without these studies, children are vulnerable to improper drug dosages and may miss out on new and more effective cuttingedge therapies that are being developed.

Pediatric research enables children’s hospitals to better serve all children with the latest discoveries and treatments taken out of the laboratory and provided directly to the young patients they serve.

For more information on what research the children’s hospital community is working on now, visit the NACHRI Web site at www.childrenshospitals.net. ❖

Articles in this newsletter are written by professional journalists or physicians who strive to present reliable, up-to-date information. But no publication can replace the care and advice of medical professionals, and readers are cautioned to seek such help for personal problems. ©2004 Health Ink & Vitality Communications, 780 Township Line Road, Yardley, PA 19067, 267-685-2800.

Some images in this publication may be provided by ©2004 PhotoDisc, Inc. Some illustrations in this publication may be provided by ©2004 The Staywell Company; all rights reserved.

Request Your FREE Newsletter To be added to the permanent mailing list for Kapi‘olani Kids (published twice a year), please call 808-535-7000 or visit www.kapiolani.org.

Kapi‘olani also publishes a free Women’s Health newsletter three times a year covering a variety of health topics from nutrition and staying fit to issues of concern to women, including heart disease, breast cancer, osteoporosis, menopause and more. To be added to the permanent mailing list, call 808-535-7000 or visit www.kapiolani.org.

We welcome your input!

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