By Elizabeth Cooney
Globe Correspondent

The nation's obesity crisis has hit Massachusetts hard -- just not as hard as the rest of the country, according to a study that takes the measure of the nation's waistline.

About 21 percent of adults in the state are obese, a figure that, while alarming, is among the lowest in the country (only Colorado is lower). But the state's children do not share that distinction: At 30 percent -- a rate that combines overweight and obesity -- they are among the middle of the pack nationally as the state prepares to begin screening children to determine if they weigh too much.

The troubling numbers come from an annual analysis released today by the Trust for America's Health and the Robert Wood Johnson Foundation, a philanthropy focused on health. The report, based on federal data gathered differently for adults and children, also sounds an alarm about aging and overweight Baby Boomers.

"Although we are ranked relatively well for our adults, it's an issue we are very concerned about," said John Auerbach, commissioner of the state Department of Public Health. "We have about 60 percent of adults who are overweight and that's not a statistic we are proud of, even if we look better than most of the country. That's not a good statistic, and obviously we are concerned about the percentage of children who are overweight."

Children's Hospital Boston came in first in three out of 10 pediatric specialties in rankings compiled by U.S. News & World Report. Massachusetts General Hospital for Children made the top 10 for one specialty and the top 30 for four others.

Children's placed first in heart and heart surgery, neurology and neurosurgery, and orthopedics. It was second in cancer, diabetes and endocrine disorders, and urology; third in digestive disorders and in neonatal care; fourth in respiratory disorders; and fifth in kidney disorders.

MGH was 6th in kidney disorders, 11th in diabetes, 21st in respiratory disorders, and 22nd in both digestive disorders and in neurology and neurosurgery.

Children's is among 10 pediatric hospitals out of 56 in the country that were ranked in all 10 specialties and one of two hospitals -- the other is Children's Hospital of Philadelphia -- to rank in the top five in all 10 specialties.

The rankings are based on reputation, outcomes, and care-related measures. The orthopedics, diabetes, and kidney categories are new this year and general pediatrics has been dropped.

HealthMap, the online disease-surveillance system created by Children's Hospital Boston researchers, is getting faster. Now the real-time disease tracker is posting Twitter messages on the current swine flu outbreak.

HealthMap already bolsters official reports with the early warning that Internet searches, chat rooms, or news stories can give about emerging infectious diseases. Sometimes these unofficial sources predate expert alerts, a potentially important asset when diseases can quickly circle the globe via international air travel.

A month ago HealthMap added Twitter to the mix. So far the short-message service has grown from 50 to 1,800 users, serving up "tweets" about cases from Lowell to New Zealand.

"I think that probably a lot of users coming to the site were specifically looking for that type of information -- show me a list of the latest on this outbreak," HealthMap co-founder Clark Freifeld said in an interview. "Twitter is ready to do that."

HealthMap itself is drawing 50,000 unique visitors a day, a level it used to reach in a month. Regular users include the World Health Organization, the US Centers for Disease Control, and the European Centre for Disease Prevention and Control.

Informatics experts John Brownstein and Freifeld founded the service after the SARS outbreak in 2002. In last month's Canadian Medical Association Journal, Brownstein reported that Google searches for a food-borne disease spiked almost a month before the official announcement of an outbreak linked to a Canadian deli meat plant, providing an early warning of the fatal outbreak.

When traffic about swine flu exploded on HealthMap on Saturday, they tracked its earliest mention back to a local newspaper in Veracruz, Mexico, on April 1.

"The reality is we are combing through hundreds of outbreaks at the same time," Brownstein said. "Avian flu in Egypt was a major concern then so we were following it more closely."

More cases emerged through the month, bringing swine flu into the same WHO category as avian flu and SARS: outbreak of international significance.

State winners of the Environmental Protection Agency's Earth Day honors include a famed pediatric toxicologist and a hospital that stepped up its recycling.

A posthumous Environmental Merit Award for 2009 went to Dr. Michael Shannon of Childrens' Hospital Boston for his work in pediatric environmental health, particularly lead poisoning and appropriate drug formulation. Shannon died suddenly last month. He was 55.

Dana-Farber Cancer Institute was singled out for its conservation, reduction, reuse, and recycling programs. In 2008 Dana-Farber collected 262.65 tons of various materials for recycling or reuse.

Childhood obesity researchers have begun looking back to infancy for clues to explain why some children become overweight while others don't.

A baby's birth weight and weight gain in the first days and weeks of life can predict obesity, studies have shown. A new Boston study in Pediatrics that factored in weight as well as length -- a baby's Body Mass Index -- says it's not just how much a newborn weighs, but how quickly weight is gained in the first six months that raises the risk of obesity at age 3.

Health information technology is hot right now, with President Obama's stimulus package steering $19 billion toward a plan to computerize healthcare records. How successful any national system will be depends on how flexible its architects make it, two Boston doctors say in today's New England Journal of Medicine.

Flexibility is critical because the system will be expected to function in a new healthcare world not yet created with technologies yet to emerge, Dr. Kenneth D. Mandl and Dr. Isaac S. Kohane of Children's Hospital Boston write. Another article in the journal, described in this story in today's Globe, reports that only 1.5 percent of US hospitals have a comprehensive electronic health records system in place.

Health IT can look to new products like Apple's iPhone or old ones like ATMs to see how a basic platform that anyone can use or write applications for works better than isolated products that don't talk to one another or allow for programs to be swapped out for new and different uses. The World Wide Web may be the best example of interoperability of software applications.

A former Children's Hospital Boston doctor accused of molesting young patients will no longer practice medicine in North Carolina under an agreement reached today, The News and Observer reports.

Dr. Melvine D. Levine, a nationally known pediatrician and best-selling author, had been chief of ambulatory pediatrics at Children's until 1985. He later moved to North Carolina, where he ran a clinic at the University of North Carolina-Chapel Hill and founded a research institute called All Kinds of Minds. His Massachusetts license expired in 1989, a spokesman for the Massachusetts Board of Registration in Medicine said today.

A lawsuit filed in Boston in April accused Levine of abusing at least seven boys who came to him for treatment between 1980 and 1985. After the lawsuit was filed, Levine voluntarily stopped seeing patients at the UNC clinic and changed his license status to "inactive."

The North Carolina Medical Board launched an investigation into the lawsuit's allegations. Today's action will keep Levine's license inactive, the Observer story says. The board held no hearing and did not resolve whether Levine did or did not behave inappropriately.

"Our greatest discipline we could mete out on any licensee would be revocation or indefinite suspension," board chairman Dr. George Saunders told the Observer. "This actually goes further than that."

Levine has consistently denied any wrongdoing. His lawyer, Alan Schneider, told the Observer today that Levine wanted to put the episode behind him, and had agreed to a keep his license inactive permanently.

"For a man who is innocent of these charges, these allegations have been very disheartening," Schneider said in the story.

The lawsuit in Massachusetts is still pending, the story says.

Google searches for a food-borne disease spiked almost a month before the official announcement of an outbreak linked to a Canadian deli meat plant, providing an early warning of the fatal outbreak, a Boston researcher reports.

The finding suggests a potential role for online disease-search surveillance.

In the Canadian Medical Association Journal, John Brownstein of Children's Hospital Boston describes an increase in Google searches for "listeriosis" that began in mid-July and peaked before mid-August, when authorities publicized the outbreak. Twenty people died in the outbreak last summer.

Brownstein and his colleagues at Children's and Harvard Medical School are the creators of Healthmap.org, a free, interactive disease alert map that distills a variety of information sources on infectious disease outbreaks around the world into one free Web-based system, as this item noted last year.

Brownstein and his co-author, Dr. Kumanan Wilson of the University of Ottawa, also cite other Web-based tools in their article looking back at the listeriosis searches.

"A question that arises from this analysis is whether knowledge of this information, either by public health officials or members of the public, could have prompted an earlier response that may have reduced exposure to the contaminated products," they write. "Internet scanning represents an important advancement in health surveillance and search term surveillance is a provocative new tool that has much potential."

Dr. Michael Shannon, a prominent pediatrician who strived to improve the health and safety of children as an emergency medicine specialist at Children's Hospital Boston and Harvard Medical School, has died, the hospital confirmed today.

Shannon, 55, died suddenly while returning from a trip to Argentina, according to an internal message sent this afternoon to Children's staff by hospital CEO Dr. James Mandell.

"We are nothing short of devastated by this news and this incredible loss," Mandell said.
"Michael was an incredibly personable, highly talented clinician, researcher and person."

Shannon pushed for better formulations of drugs for children and testified in Washington on the unproven value of cold medicines for children. A clinician and a researcher, his interests also included substance abuse and environmental health as well as drug interactions.

The first African-American to be named a full professor of pediatrics at Harvard Medical School, he had been chief of emergency medicine and chief of clinical pharmacology since joining Children's in 1983.

Shannon was also a modern dancer, who began dancing while an undergraduate at Washington University in St. Louis and later while at Duke University School of Medicine. He danced professionally and also appeared in local productions of "Black Nativity" and "Urban Nutcracker."

"Michael was a true Renaissance man, both in the field of medicine and in his personal life," Mandell's message said. "The loss to this community, both inside and outside the walls of Children’s, is enormous. His quiet, gentlemanly ways will be greatly missed."

Shannon leaves his wife, Elaine, and two young-adult children, Mandell's memo said. Further details about his death were not immediately available.

A Cambridge research organization created to improve the safety of pediatric medicines has won a grant to tailor medicines for children in Africa.

The Institute for Pediatric Innovation has received $550,000 from the World Health Organization to "make medicines child size," according to the institute. The research will be conducted with Unicef in Tanzania and other African countries. The goal is to develop children's medicines and dosing guidelines for such diseases as tuberculosis.

The institute was founded by former Children's Hospital Boston technology-transfer executive Donald Lombardi and is headed by Dr. Stephen Spielberg, the former dean of Dartmouth Medical School. Its five-year Pediatric Pharmaceutical Reformulation Program builds on the growing recognition that children are not just a smaller version of adults who can safely take reduced doses of drugs.

Five US children's hospitals are partners in the institute's efforts: The Children's Hospital, Denver in Aurora, Colo., Children's Hospital of Wisconsin in Milwaukee, University Hospitals Rainbow Babies and Children's Hospital in Cleveland, Lucile Packard Children's Hospital at Stanford in Palo Alto, Calif., and Children's Mercy Hospitals and Clinics in Kansas City, Mo..

Causes of the current obesity epidemic read like a conspiracy theorist's dream.

"Many of our policies seem almost designed to promote obesity," Dr. David S. Ludwig, director of the Optimal Weight or Life Program at Children's Hospital Boston, said in an interview.

Consider:

-Farm subsidies support high-calorie commodities made into processed foods while more nutritious fruits and vegetables become more expensive.
-Fast food meals promote overeating while physical activity plummets.
-Federal spending builds highways instead of public transportation or bike paths.
-Neighborhoods in cities are too dangerous to play in and suburbs with no sidewalks put everybody in cars.
-Parents spend more time commuting and less time cooking at home while children watch more TV and use computers more.
-Gym classes and recreational sports programs get cut while children grow heavier than ever.

And the nation's troubled economy will only make matters worse, Ludwig and co-author Harold A. Pollack of the University of Chicago write in tomorrow's Journal of the American Medical Association.

"When the economy gets tight, it's very common for people to cut back on the quality of food they are eating," Ludwig said. "One of the few companies that have done well in the stock market collapse of late 2008 have been fast food companies like McDonald's."

Ludwig and Pollack see a vicious cycle, but they also sense an opportunity to break it.

A research program investigating immune and inflammatory diseases will work more closely with a hospital in a new collaboration announced this week.

The Immune Disease Institute, formerly called the Center for Blood Research, will become affiliated with Children's Hospital Boston under an agreement to be completed this year, the hospital said in a statement yesterday. The institute will then be called the Program in Cellular and Molecular Medicine.

An affiliate of Harvard Medical School, the nonprofit research institute employs about 200 people in three locations in the Longwood Medical Area. Its 19 principal investigators include institute scientific director Frederick Alt, who studies developmental immunology, cancer, and aging, and Dr. Judy Lieberman, whose research focuses on viruses, cancer, and RNA interference.

Children's Hospital's funding power will help the institute, the hospital said. The institute attracts about $38 million in annual research support; Children's receives about $225 million a year.

Children's Hospital Boston did not win “charitable immunity” in a lawsuit filed against a former pediatrician who is accused of sexually abusing boys in his care, the Harvard Crimson reports.

The state Superior Court decision rejected the motion Wednesday in a lawsuit filed against Dr. Melvin D. Levine, former chief of ambulatory pediatrics at Children's and a Harvard Medical School professor, according to the paper. Levine, who left the hospital for North Carolina in 1985, has denied the accusations.

In Massachusetts, charitable immunity caps damages against nonprofit institutions that receive donations to do charitable work at $20,000.

By Elizabeth Cooney, Globe Correspondent

Researchers studying teens and risky behaviors have followed young people onto social networking sites, where more than half of them are at least talking about sex, substance use, and violence, according to a new survey of MySpace.com profiles. A second part of the researchers' study showed that the online behavior of those presumed teens can be changed relatively easily.

When a doctor who also had a profile on the social networking site sent a message to 18- to 20-year-olds warning them about risky behaviors based on their public descriptions, a significant proportion changed their profiles.

Dr. Megan A. Moreno, lead author of both studies appearing in the Archives of Pediatrics and Adolescent Medicine, and her colleagues at the University of Washington first tried to determine the prevalence of health risk behaviors being described on MySpace.com. Online communities such as MySpace and Facebook allow users to create personal Web profiles that they can use to communicate with designated friends.

Some information can be barricaded behind privacy walls, but their July through September 2007 survey looked at 500 public profiles of self-described 18-year-olds. The researchers found that 54 percent of the profiles contained references to sexual activity, drinking or drug use, or violence. Substance use led the list, mentioned on 41 percent of profiles, followed by sexual activity on 24 percent of profiles and violence on 14.4 percent.

Children's Hospital Boston placed second in a survey of pediatric medical centers conducted for Parents magazine.

The Children's Hospital of Philadelphia finished first in the overall rankings compiled from answers to a 250-question survey sent to members of the National Association of Children's Hospitals and Related Institutions.

The magazine also ranked the top five children's hospitals in cancer, emergency, heart, neonatal, orthopedic, and pulmonary care. Children's Hospital Boston was first in heart and orthopedic care, third in cancer and pulmonary care, and not in the first five in the other categories.

Children's Hospital Boston has named Sandra Fenwick its new president in a restructuring of senior management, the hospital said.

Fenwick will remain chief operating officer and Dr. James Mandell will continue as chief executive officer. He had been both president and CEO. Cardiologist Dr. Kathy Jenkins was appointed senior vice president of patient safety and quality, reporting to both Fenwick and Mandell.

A chief administrative officer will be hired to take on day-to-day operations while Fenwick concentrates on long-term strategy, Mandell said in a statement announcing the new roles for the hospital administrators. He remains responsible for patient care, research, training new physicians, community services, and managing federal and state reimbursement issues.

Fenwick came to Children's in 1999 after 20 years in healthcare administration and strategic planning at Beth Israel Hospital and its parent CareGroup.

A former Children's Hospital Boston pediatrician accused of molesting young boys during physical examinations is leaving the North Carolina institute he established, the New York Times reports.

Dr. Melvin D. Levine, a best-selling author who left Children's and his academic post at Harvard Medical School in 1995, has resigned from All Kinds of Minds, which trains teachers of children with learning disabilities.

A lawsuit filed in Suffolk Superior Court in April accused Levine of abusing at least seven boys who came to him for treatment, a Globe story reported. The suit was filed by an unnamed plaintiff who was 8 years old when the alleged abuse began between 1980 and 1985.

Levine has denied ever touching a patient sexually.

Medical residents -- typically in their late 20s -- are training to become doctors just when they are also considering becoming parents.

Part-time pediatrics residency programs have sprung up in response, but few residents are choosing them, a Newsweek story says, even though 17 percent of pediatricians later practice part-time.

Out of 10,000 pediatrics residents in the country, only 10 have chosen the part-time option. Five of them are in Boston, according to the story.

"We're asking people to do this training right at the time they would normally be starting families," Dr. Ted Sectish, codirector of the combined pediatrics residency at Children's Hospital Boston and Boston Medical Center, tells Newsweek. "There is an intense commitment to them being well trained—but there also has to be a commitment to them having a life."

By Stephen Smith, Globe Staff

One of the nation's biggest healthcare foundations announced today that it is committing $1 million to curb teen violence in Boston by teaching adolescents to forge healthier relationships.

The grant from the Robert Wood Johnson Foundation was awarded to the Boston Public Health Commission for a four-year campaign focusing on violence in Dorchester and Roxbury. The Boston health agency was one of 11 nationwide to receive grants designed to combat teen violence.

"By taking proactive steps to educate our teens about healthy relationships, we are encouraging them to respect not just their peers, but their community in general," Boston Mayor Thomas M. Menino said in a statement.

As part of the initiative, known as "Building Healthy Teen Relationships: Boston," up to 1,500 middle-school students will be taught lessons in the classroom about safer behaviors. And at the Roxbury Multi-Service Center, teen peer mentors will craft a social marketing campaign to address dating abuse.

Another city agency, the Boston Centers for Youth & Families, will also be involved, as well as Children's Hospital Boston.

Children's Hospital Boston has won a $25 million grant to create a center devoted to research on orphan diseases.

The Manton Foundation of New York has made the gift, one of the largest in the hospital's history, to establish the Manton Center for Orphan Disease Research. Orphan diseases -- called that because they are so rare that no treatment has been developed for them -- affect fewer than 200,000 people nationwide, according to the federal government. They tend to attract less attention from government and the pharmaceutical industry.

The Manton grant will support Children's and Harvard Medical School scientists studying rare diseases, including genetic syndromes, immune system problems, and metabolic and neuromuscular disorders, the hospital said in a statement.

Adolescents with asthma and other high-risk conditions aren't getting the flu shots they need to avoid potentially severe illness, a Harvard study says.

Researchers analyzed the health records of more than 18,000 high-risk children 11 to 17 years old who got their medical care at Harvard Vanguard Medical Associates and their insurance from Harvard Pilgrim Health Care. Their illnesses included asthma, heart disease, immune-suppressing disorders or treatments, sickle cell anemia, and diabetes.

From 1992 through 2002, influenza immunization rates in this group rose only from 8 percent to 15 percent, despite being recommended for vulnerable children for more than a decade, according to the study appearing in the November issue of Pediatrics. High-risk children who contract the flu are hospitalized two to four times as often as healthy children who get it.

"This was even worse than what we suspected," lead author Dr. Mari M. Nakamura of Children's Hospital Boston and Harvard Medical School said in an interview. "We also were surprised. It wasn't because these adolescents weren't coming in for visits, but because they had missed opportunities when they had come in."

Two groups working on ways to detect disease outbreaks around the world have received further support to find disease hot spots.

HealthMap, a project of Children’s Hospital Boston and Harvard Medical School, and ProMED-mail, an electronic disease-reporting tool of the International Society of Infectious Diseases, together have won a three-year, $3 million grant from Google.org to improve disease detection and prediction.

ProMED relies on a online network of global health experts and HealthMap, described earlier this year, analyzes official and unofficial sources of information, from clinical reports to blogs to give early warning of disease outbreaks.

Dr. Judith Palfrey of Children's Hospital Boston has been elected president of the American Academy of Pediatrics, taking office for 2009-2010. She is the director of the Children's International Pediatric Center and the principal investigator of Opening Doors, a project directed at improving access for children and youth from traditionally underserved communities with special health care needs.

Richard Clapp, a professor of environmental health at the Boston University School of Public Health, has won the 2008 Research Integrity Award from the International Society for Environmental Epidemiology. He is being honored for his fight to study cancer deaths among IBM employees and have the results published despite resistance from IBM and a journal publisher, the organization said.

Six Boston-area experts in healthcare, medicine, and science have been elected to a national advisory group on human health.

The Institute of Medicine, created by the National Academy of Science as an independent source of scientific analysis, has named 65 new members chosen for their professional achievement and commitment to service. The Boston and Cambridge members are:

Maureen A. Bisognano, executive vice president and chief operating officer, Institute for Healthcare Improvement

Dr. Phyllis Jean Kanki, professor, department of immunology and infectious diseases, Harvard School of Public Health

Raju S. Kucherlapati, professor of genetics, Harvard Medical School, and scientific director, Harvard Medical School-Partners HealthCare Center for Genetics and Genomics, Brigham and Women's Hospital

Marsha A. Moses, professor of surgery, Harvard Medical School; and interim director, vascular biology program, Children's Hospital Boston

Dr. David C. Page, director, Whitehead Institute, and professor of biology, Massachusetts Institute for Technology

Louise M. Ryan, chair of the department of biostatistics, Harvard School of Public Health

Federal regulators tomorrow will explore setting new standards for over-the-counter cough and cold remedies intended for children.

A year after manufacturers voluntarily pulled the medicines for children under 2 off store shelves, the Food and Drug Administration is holding a hearing in Washington to guide testing for safety and effectiveness that has never been done. Like many drugs for children, the cough and cold medicines were approved based on trials in adults, a practice now discredited by research that shows children are more complicated than "miniature adults."

Dr. Michael Shannon, a pharmacologist and chief of emergency medicine at Children's Hospital Boston, will testify at the hearing, which will consider what types of studies need to be done to evaluate the drugs, whether the drugs should require a prescription, and how dosages should be calculated. The process could lead to removing the drugs from the market, making them available by prescription only, or restricting combinations of different ingredients, among other possibilities.

"The FDA gave a clear message that they don't feel they can give carte blanche in reference to cough and cold medicines as safe and effective in the absence of data," Shannon said in an interview this week. "I interpret this as a strong and clear message from the FDA that these products need to be examined more closely than they were when they were first approved."

Two Boston pediatric obesity experts were puzzled by the rash of media reports on cholesterol-lowering drugs being recommended for children as young as 8.

After all, the Children's Hospital Boston specialists write in a New England Journal of Medicine essay, the American Academy of Pediatrics policy dropping the age to 8 from 10 represents only an incremental change in its guidance. But all the uproar may be a good thing if it focuses attention on the obesity epidemic, according to Dr. Sara de Ferranti, director of preventive cardiology, and Dr. David Ludwig, director of the Optimal Weight for Life Program.

"The recommendation to use statins in childhood seems to have hit a collective nerve, perhaps awakening us to the fuller implications of the obesity epidemic," they write. "It's one thing to treat the rare child who has an inherited defect in cholesterol metabolism and quite another to extend treatment to children who are at risk for cardiovascular disease because of modifiable lifestyle factors."

The Blue Cross Blue Shield of Massachusetts Foundation has distributed grants totalling $637,894 to 10 organizations working to improve healthcare by making it more culturally appropriate.

The grants fund the second half of the foundation's program designed to better serve immigrants and patients who don't speak English.

A quarter of infants who need new heart transplants die before organs can be found for them, 10 times the rate for adults.

Many other children die in hospitals when life support is withdrawn, after their parents and doctors agree that continuing care would be futile. But they are not considered potential organ donors because most of them don't fit the definition of brain death used since the 1960s; their brains still show some activity before they stop breathing and their hearts stop beating.

Now doctors at Denver Children's Hospital have transplanted hearts from three such "cardiac death" donors, prompting a debate about the ethics of the procedure that receives a full airing in this week's New England Journal of Medicine.

The Denver team reports in the journal that it tested the feasibility of using hearts recovered from three babies with severe neurological injuries who died after life support was withdrawn and their hearts stopped beating. They believe their trial is the first to examine heart transplants for children from donors after cardiac death. Such transplants have been done in adults for more than a decade.

Nationally known pediatrician Dr. Melvin D. Levine (left), who worked at Children's Hospital Boston until moving to the University of North Carolina in 1985, vehemently denies accusations of child abuse leveled against him by five former patients in a lawsuit filed earlier this year.

A story in today's New York Times tracks earlier complaints made over the years to Children's and the Massachusetts Board of Registration in Medicine. None was proved in court, but the decisions are not as clear-cut as they may seem, the story says.

"There is little evidence that Children’s Hospital, the University of North Carolina or the medical board ever tried to thoroughly investigate the accusations," the story says. "For instance, in at least two cases, parents and children were never even interviewed. And the institutions did not notify one another about the individual complaints."

Asked about an accusation made in a letter to the president of Children's Hospital and later in a lawsuit after Levine had left Children's, a hospital spokeswoman told the Times an investigation had found that Dr. Levine’s care had been “appropriate within the context of the child’s medical needs.”

The University of North Carolina says Children’s Hospital never relayed information about the complaint.

A Board of Registration spokesman told the Times there was no evidence that the board contacted a man making a similar complaint in 1993, although standards for investigations have changed since then.

Via Reuters: "Having the television on in the background while pre-schoolers play with their toys disrupts their efforts to sustain attention, even when they don't pay much attention to it, and may harm their development, researchers report in current issue the journal Child Development.

Pediatricians recommend no TV for children under age 2, yet studies show that three quarters of very young children in America live in homes where the TV is on most of the time, notes the research team led by Dr. Marie Evans Schmidt of the Center on Media and Child Health at Children's Hospital Boston."

A new article co-authored by Children's Hospital Boston researchers -- and published in the July 10 British Medical Journal -- sheds light on that awkward, age-old question: how do I talk to my kids about sex?

According to a story on the study from the Los Angeles Times, you take a class.

Researchers from Boston have discovered six new genes implicated in autism. The genes normally make new brain connections needed for learning, but their absence or silence apparently places them among many mutations that lead to the devastating disorder, which is marked by trouble with communication and social interaction.

Writing in tomorrow's issue of Science, Dr. Christopher Walsh (left) of Children's Hospital Boston and his co-authors say in some of the genetic mutations they found, the genes were present but the on/off switches they controlled were broken.

"People think of genetic diseases as immutable and untreatable," Walsh said in an interview. "Studies like ours and others give more hope we might not need to replace genes one by one, but find other ways of activating the genes that might be silent."

They call it "surveillance sans frontieres."

Exhibit A is the SARS outbreak and how information on it spread. The deadly respiratory disease was first suspected from Chinese news stories about a steep rise in emergency department visits. Then media reports of healthcare workers suffering from an acute respiratory ailment were picked up by Canadian global health trackers. At the same time traffic about the outbreak was spiking on the ProMED online disease-reporting network. Chinese government reports lagged far behind these unofficial sources.

With that 2002 outbreak in mind, Children's Hospital Boston informatics experts created a way to distill a variety of information sources on infectious disease outbreaks around the world into one free Web-based system called the HealthMap Project. They tested the approach, which mixes local news media reports, international health bulletins, discussion forums, and government data, and report on its successes and remaining gaps in the open-access journal PLoS Medicine.

"Web-based electronic information sources can play an important role in early event detection and support situational awareness by providing current, highly local information about outbreaks, even from areas relatively invisible to traditional global public health efforts," John Brownstein and his co-authors write.

Putting children as young as 8 years old on statin medications to lower their cholesterol levels is worrisome without knowing the long-term effects of the drugs and dismaying when other avenues haven't been exhausted, two Massachusetts doctors say in today's New York Times.

“What are the data that show this is helpful preventing heart attacks?” Dr. Darshak Sanghavi, a pediatric cardiologist and assistant professor at the University of Massachusetts Medical School, asks in the story. “How many heart attacks do we hope to prevent this way? There’s no data regarding that."

The American Academy of Pediatrics released recommendations on Monday that say statins could be used in children as young as 8 to prevent the development of heart disease later in life. Dr. David Ludwig, director of the childhood obesity program at Children’s Hospital Boston, acknowledges the difficulty of treating a child who already shows signs of cardiovascular disease. But he finds the larger picture troubling.

“My concern is what this is saying about society when we are so quick to prescribe drugs for these conditions before having systematically attacked the problem from the public health perspective,” he told the Times.

Dr. Judah Folkman (left) labored for decades before his theories about fighting cancer won support. Now a provision of the state's $1 billion life sciences bill signed today by Governor Deval Patrick will make the way smoother for young researchers faced with shrinking research dollars.

The Dr. Judah Folkman Higher Education Grant Fund, named for the beloved Children's Hospital Boston doctor and researcher who died suddenly in January, will help graduate-level students, doctoral students, and post-doctoral fellows with living expenses while they study or work in the life sciences. Grants of $5,000 to $15,000 will go to Massachusetts residents with a total household income below 300 percent of the federal poverty level, or about $30,000 for a single person.

“One of Judah’s greatest gifts and passions was identifying brilliant young scientists and supporting and investing in them during the early part of their careers," Dr. James Mandell, president and CEO of Children’s, said in a statement. "He was deeply troubled by the recent decline in NIH funding, which has discouraged many young talented people from choosing careers in science. This fund is a great way to honor Judah’s legacy and at the same time help new investigators commit to a career in the life sciences.”

Two scientists from MIT and Children's Hospital Boston are among 20 scholars who today won Pew grants to help them pursue promising research early in their careers.

Laurie A. Boyer (left), assistant professor of biology at MIT, is figuring out how embryonic stem cells orchestrate the genetic programs that transform cells into different kinds of tissues throughout the body, with an eye toward both stem cell therapies and the disruption in development that gives rise to disease.

Richard I. Gregory (left), an assistant professor in biological chemistry and molecular pharmacology at Children’s and Harvard Medical School, is on the trail of microRNAs, tracking how they might be involved in development, both when it proceeds normally and when it goes awry and becomes cancer. He is also studying similar steps in stem cells.

Their $240,000 awards are given over four years. The program is funded by Pew Charitable Trusts through a grant to the University of California at San Francisco.

By Neil Munshi, Globe Correspondent

Worried that sham procedures are endangering patients and giving stem cells a bad name, leading researchers today announced a set of guidelines governing research and treatment.

“Because of the spotlight on stem cells, there’s been a misconception by some patients that the cure is already here,” said Dr. George Q. Daley, president of the International Society for Stem Cell Research, which issued the draft guidelines at their sixth annual meeting in Philadelphia. “We need to be clear that the path to cures is a long and arduous one…it can take years, sometimes decades, and we’re just at the beginning of that process.”

The guidelines – which will provide a basis from which patients, doctors and scientists alike can judge clinics and treatments – deal with the quality control and regulation of cell processing and manufacturing, pre-clinical studies, and clinical research.

“We have the sense that the field is moving very rapidly and stem cell science is moving ahead by leaps and bounds,” said Daley, also the associate director of the Stem Cell Program at Children’s Hospital Boston. “Yet we are concerned as stem cell scientists that there may be a misunderstanding that the clinical relevance is more advanced than it really is – and this creates a potential for the exploitation of patients.”

Doctors and scientists are seeing this, Daley said, in the proliferation of Web sites that purport to provide treatments for everything from neurodegenerative diseases like ALS and Parkinson’s to spinal cord injuries – for a price that can rise above $100,000.

“Patients should be highly suspicious if they are being asked to fly off to far off places that don’t operate under the jurisdiction of any regulatory agency,” Daley said, given that only blood stem cell transplants have demonstrated any proven treatment benefits. “When we move outside that realm, everything becomes highly experimental.”

Risk factors for developing eating disorders are different for girls and boys, and a mother’s history may affect girls differently depending how old they are, a Boston study reports.

Alison E. Field of Children’s Hospital Boston and her colleagues report in the Archives of Pediatric and Adolescent Medicine on their study following more than 12,000 sons and daughters of participants in the Nurses Health Study II to see what influences might predict eating disorders. The girls and boys answered questionnaires every 12 or 18 months for seven years, starting when they were 9 to 15 years old. Their mothers were asked if they themselves had ever had an eating disorder.

After seven years, 10 percent of the girls and 3 percent of the boys said they were binge eating – overeating and feeling out of control -- or purging – vomiting or using laxatives to keep from gaining weight -- at least once a week. For girls, purging was more common than binge eating. For boys, the opposite was true. Few boys or girls did both, the study said.

Children's Hospital Boston took two top honors on US News & World Report ratings of pediatric hospital specialties released this morning. Massachusetts General Hospital for Children placed lower in the rankings of specialty care at 30 hospitals, compiled from pediatrician surveys and hospital data.

Children's placed first in two of seven categories of care: digestive disorders and heart care and heart surgery, the magazine said. It came in second on general pediatrics, cancer, and neurology and neurosurgery; third in neonatal care; and fourth in respiratory disorders.

Mass. General's children's center was rated 21st in general pediatrics, 27th in digestive disorders, 16th in neonatal care, and 17th in respiratory disorders. It did not finish in the top 30 for the other three specialties.

The specialty rankings were based on reputation, outcomes, and other measures such as nursing care and advanced technology. Last fall Children's came in second, behind Children's Hospital of Philadelphia, in a different US News list of pediatric hospitals that included data on mortality, nurse staffing, and advanced care.

In the current rankings, Boston Children's and the Philadelphia hospital flip between first and second place in four categories. Johns Hopkins Children's Center in Baltimore is the only other first-place finisher, in neurology and neurosurgery.

By Kay Lazar, Globe Staff

Boston's three leading medical schools are among 14 nationwide that will receive federal grants aimed at helping scientists more quickly turn their discoveries into treatments for patients.

Under the program, Harvard Medical School has been awarded $117.7 million over the next five years, while Boston University Medical School will receive $23 million and Tufts University School of Medicine $20 million over that time period, the National Institutes of Health announced today.

The awards reflect a sea change in federal funding for scientific research. Schools that have traditionally competed within their own institutions for federal dollars must now form one collaborative center at each medical school to pull together all of its researchers and departments.

The mission of the grant program, called the Clinical and Translational Science Award, is to create a network of medical research institutions across the country that will translate new knowledge into tangible benefits for patients. Launched in 2006, the initiative has awarded money to 24 other medical schools. Total funding for the 14 new recipients will be $533 million over the next five years, the NIH said.

"Everybody knows there is a lot of great research going on but it doesn’t get to public practice," said Dr. Harry Selker, director of Tufts' new Clinical and Translational Science Institute. "This (grant program) is a big deal for the nation."

The childhood obesity epidemic could finally be leveling off, according to new national figures.

A report from the US Centers for Disease Control and Prevention in the current Journal of the American Medical Association found no significant increase in weight problems among more than 8,000 children tracked in four two-year periods starting in 1999. The estimates are based on body mass index, a measure of height and weight, from CDC growth charts. It also found no decrease.

"We need to keep the corks in the champagne bottles," pediatric obesity specialist Dr. David S. Ludwig of Children's Hospital Boston said in an interview. "I think this is the first glimmer of hope after 25 years of overwhelmingly negative information about childhood obesity prevalence, but it's much too soon to know if it's a fundamental change in the nature of the obesity epidemic in children or a temporary lull."

The National Academy of Sciences elected 72 new members today, honoring a total of 15 scientists and engineers from Harvard and MIT.

The private organization, established by Congress while Abraham Lincoln was president, advises the federal government on science and technology.

A national nurses organization has renewed Massachusetts General Hospital's "magnet" hospital designation through 2012.

The American Nurses Credentialing Center today announced the designation for Mass. General, which was the first in the state to receive magnet status in 2003. The name refers to how well hospitals can attract and retain nurses during a shortage. There are five other magnet hospitals in Massachusetts:

-Baystate Medical Center, Springfield
-Children's Hospital Boston
-Dana-Farber Cancer Institute, Boston
-Jordan Hospital, Plymouth
-Winchester Hospital

Remember the fanfare when Fate Therapeutics was launched last year?

The startup's goal is to capitalize on the promise of stem cells. To do that it gathered the leading lights of the field, including founders Dr. David Scadden of the Harvard Stem Cell Institute and Massachusetts General Hospital and Dr. Leonard Zon of Harvard University and Children's Hospital Boston. Robert S. Langer Jr. and Ram Sasisekharan of MIT sit on the scientific advisory board.

Find out on xconomy.com how venture capitalists brought them (and other stem-cell stars) together, including a fateful meeting at a French restaurant near Mass. General.

Hospitalized children who receive medications made for adults are at greater risk for suffering harm, a national organization said today while issuing recommendations on how to avoid drug errors.

The Joint Commission, a private group that accredits US hospitals and other healthcare organizations, is sending out a Sentinel Event Alert urging hospitals to adopt standards for safely calculating the doses of medicine for children and encouraging manufacturers to formulate drugs specifically for children.

Sleep is not expendable.

When children routinely don't get enough sleep or when the sleep they get is disrupted, they are at higher risk for obesity, learning difficulties, and behavioral problems, according to articles in a special issue of the Archives of Pediatrics and Adolescent Medicine. Parents sometimes respond to early troubles getting their children to fall asleep or stay asleep with tactics -- such as nighttime snacks -- that work for a while but lead to other problems later.

"Whenever you have disrupted sleep at night in children, it can adversely affect their attention, neurocognition, and memory in the daytime," Dr. Sanjeev Kothare of the Children's Hospital Boston sleep center said in an interview. He was not involved in the Archives studies.

By David Abel, Globe Staff

A renowned pediatrician and best-selling author who served for 14 years as chief of ambulatory pediatrics at Children's Hospital Boston was accused of sexually abusing at least seven children in his care in a lawsuit filed today in Suffolk Superior Court.

The lawsuit, filed by one unnamed plaintiff, alleges that Dr. Melvin D. Levine "sexually assaulted, battered, and abused" him between 1980 and 1985.

"Levine, during his treatment sessions, under the guise of performing repeated but unnecessary physical examinations, sexually assaulted John No. 5, including numerous acts of genital fondling, masturbation, and other attempted and threatened acts of assault," the lawsuit alleges.

In a statement, Levine’s Boston lawyer Edward Mahoney said the doctor is innocent.

"Dr. Mel Levine has provided pediatric care to more than 15,000 children over 40 years and categorically denies that he has ever been abusive in any way toward any patient," Mahoney said. "He adamantly denies these claims. Dr. Levine is distressed about the distorted or misinterpreted memories from decades past, and questions the motivations. He prefers not to participate further in counsel’s efforts to obtain free advertising for his legal practice."

Children dying of cancer are suffering less as their care focuses more on easing their symptoms than aggressively treating their disease, a Harvard study has found.

Writing in tomorrow’s Journal of Clinical Oncology, Dr. Joanne Wolfe, also of Dana-Farber Cancer Institute and Children’s Hospital Boston, reports that the principles of palliative care, including better communication and better pain control, have contributed to improved quality of care at the end of life.

The study compares 119 children who died between 1997 and 2004 at Dana-Farber or Children’s to 102 children who died there between 1990 and 1997 whose parents were part of an earlier survey. In the later group, hospice was discussed earlier and more often, do-not-resuscitate orders were put in place earlier, and the number of deaths in the intensive care unit dropped, the study found. Parents said their children suffered less from pain and trouble breathing in the later group and more parents said they were prepared for death in the child’s last month of life compared with the earlier group.

By Elizabeth Cooney, Globe Correspondent

The death of a Florida teenager after breast surgery, even though it was triggered by a rare reaction to anesthesia, is raising questions about operations to improve young patients' appearance.

Stephanie Kuleba, 18, died Saturday in an outpatient surgery center in Boca Raton after she suffered a reaction to general anesthesia. She was having surgery to correct inverted nipples and breast asymmetry, which would typically involve placing an implant in the smaller breast to match the bigger one.

While he is not familiar with the case, a spokesman for the American Society of Plastic Surgeons said under the group’s guidelines, almost no one under 18 would get breast augmentation surgery because of the difficulty obtaining truly informed consent. He does few rhinoplasties, or “nose jobs,” in patients under 17 for the same reason, although parents are responsible for medical decisions involving their minor children.

“Young people see only the end results: bigger breasts,” Dr. Richard Ehrlichman, a Wellesley plastic surgeon, said in an interview. “They don’t see the risks, they don’t see what recovery means.”

Melanie Joy McDaniel (left) was nine months old and had already had two operations to remove a malignant brain tumor when her parents chose to enroll her in an experimental drug trial at Dana-Farber Cancer Institute, according to a 2002 story in the New York Times.

Instead of standard chemotherapy, the trial for children with incurable cancer would offer drugs intended to choke off the blood supply to tumors by disrupting the growth of new blood vessels, the story said. The approach, called antiangiogenesis, was developed by Dr. Judah Folkman (left) of Children's Hospital Boston.

Melanie's father, Paul McDaniel, e-mailed the Times again after Folkman's death in January “to celebrate the accomplishments of Dr. Folkman, who faced resistance on his ideas that, by the grace of God, cured my daughter of an incurable brain tumor," a story in today's Times says.

Melanie is now 7 and attending first grade.

“The doctors told us last year that they do not see any residual tumor in her brain," her father told the Times. "Their original diagnosis was that her tumor had no known cure."

A national group of pediatric research institutions is pushing for more federal funding to find cures for children's diseases.

Children's Hospital Boston is one of nine pediatric centers backing a bill introduced last week in the US Senate that would bump up funding and create 20 research networks for basic research and clinical trials. Each network would receive a five-year grant of up to $2.5 million per year, the Coalition for Pediatric Medical Research said. The bill was introduced by Senator Sherrod Brown, D-Ohio, and Senator Christopher Bond, R-Missouri.

A cardiac team from Boston saw this sign when they arrived at a hospital in Ghana last week:

"Free pediatric cardiac surgeries!! In conjunction with the Boston Children's Hospital of the Harvard University, USA," a blog about the trip notes.

Dr. Francis Fynn-Thompson of Children's Hospital Boston is leading a team of 25 doctors, nurses, technicians, and other volunteers who are in the country this week, treating heart disease and surgically repairing heart defects in infants and children at Komfo Anokye Teaching Hospital at the University of Ghana. The group is also offering training on how to care for children with heart problems.

They have plenty of potential patients in their limited time there, team writer and photographer Matt Cyr says on the blog.

By Elizabeth Cooney, Globe Correspondent

Fetal surgeons can heal the tiniest bodies imaginable, repairing heart defects, rerouting circulation, or restoring organs to their proper places before birth. But as imaging, intensive care, and surgical techniques have leapt forward, they have brought new ethical questions with them.

Does the pregnant woman have a duty to allow a medical procedure that might help the fetus she is carrying? How does her risk weigh against any obligation to the future child? What conditions are serious enough to warrant risk to the woman and the fetus?

At a Harvard Medical School forum Wednesday, Dr. Russell Jennings, head of fetal surgery at Children's Hospital Boston, showed about 50 people how far his specialty has come in the past 20 years. He also flatly and firmly stated his opinion on who his patients are.

"Mom isn't just a vessel," he said. "Whatever we do, we have to go through her in some way. It is incumbent on us to minimize the risk."

Depressed doctors-in-training made six times as many medication mistakes as their fellow physicians, according to a Harvard study that also found that burnout did not lead to more errors.

Residency programs have been scrutinized for the mental and physical demands they place on doctors, but this is the first paper to study the relationship between burnout, depression, and medication errors, Dr. Amy Fahrenkopf, lead author of the article appearing online in the British Medical Journal, said in an interview.

The small number of residents in the study, however, means that the results are not conclusive.

The researchers found that one-fifth of the doctors in two pediatric residency programs were depressed, nearly twice the national average for the general population. Just under three-quarters of the residents fit the criteria for burnout, defined as feeling emotionally exhausted and depersonalized at work. Almost all of the depressed residents -- whose symptoms were felt at home and at work -- also reported burnout, but only one-quarter of those with burnout also qualified as depressed.

"Depression seems to be a hidden pitfall of residency," Fahrenkopf of Harvard Medical School and Children's Hospital Boston said. "That is not only a danger for residents but it appears to be a danger for their patients as well."

A state group fostering technological innovation has awarded grants to fund nine research projects, including one proposed by the late cancer investigator Dr. Judah Folkman.

The Massachusetts Technology Transfer Center has given a total of $360,000 for proposals to demonstrate a new technology's commercial viability. In addition to the Folkman grant for work to be done at Children's Hospital Boston, three awards went to Northeastern University, two to the University of Massachusetts, and one each to Boston University, Harvard University, and Massachusetts General Hospital.

A Cambridge nonprofit formed to improve medical products for children is introducing a new program today to develop safer pediatric medicines, naming the former dean of Dartmouth Medical School to lead the initiative.

The Institute for Pediatric Innovation, founded by former Children's Hospital Boston technology-transfer executive Donald Lombardi, has appointed Dr. Stephen Spielberg (left) principal investigator of the five-year Pediatric Pharmaceutical Reformulation Program. Spielberg, who will remain on the Dartmouth faculty, has experience in industry as well as academic medicine.

By Carey Goldberg, Globe Staff

In a key first step from theory to possible help for cancer patients, Boston-based scientists report today that they have managed to beat back a deadly human skin cancer in mice by targeting and destroying stem cells in the tumors.

The findings on malignant melanoma add weight to the growing belief among scientists that many types of cancer recur after treatment because of small, resilient groups of stem cells that survive and start multiplying all over again.

The research, published in tomorrow's Nature, shows that attacking melanoma stem cells is enough to halt a tumor's growth, said Dr. Markus Frank of Children's Hospital Boston, the paper's senior author. It thus offers new hope that this strategy will also work in humans -- perhaps, researchers say, within a few years.

"If this works with melanoma, this may also work with other tumors that are notoriously difficult to treat" once they have spread, said Dr. George Murphy, an author on the paper and chief of dermatopathology at Brigham and Women's Hospital.

By Scott Allen, Globe Staff

Dr. Judah Folkman, a world famous cancer researcher whose insights led to a whole new field of medicine, knew that his relentless pursuit of ideas could wear people out. For 36 years, sometimes in the face of deep skepticism, the renowned Children's Hospital Boston researcher stuck by his belief that tumors could be stopped by cutting off the blood supply they need to grow -- even when his experiments sometimes fizzled.

"If your idea succeeds, everybody says you're persistent," Dr. Folkman liked to joke. "If it doesn't succeed, you're stubborn."

Dr. Folkman, 74, collapsed and died Monday at Denver International Airport while he was awaiting a flight to Vancouver for a medical conference. The cause of death has not yet been determined.

Yesterday, friends and colleagues remembered Moses Judah Folkman as one of the world's most brilliant -- and persistent -- medical researchers, a man whose work has spawned 10 new cancer drugs and launched dozens more into various stages of human testing. Along the way, Dr. Folkman's research into the role of blood vessels in fostering disease also produced breakthrough treatments for a leading cause of blindness. He also made the pivotal discovery in the development of a form of birth control that is implanted under the woman's skin.

"He was indefatigable and unquenchable. There's no such thing in his lexicon as a defeat. It's only a learning point," said Dr. David Nathan, the former president of Dana-Farber Cancer Institute who often debated cancer ideas with Dr. Folkman when Nathan was chief of medicine at Children's. "There are very few Roman candles like him."

By Carey Goldberg, Globe Staff

Boston-based autism researchers have pinpointed a genetic "hot spot" where DNA errors appear to increase a child's chances of developing autism one-hundred-fold.

The discovery, reported on-line in the New England Journal of Medicine this afternoon, stems from the most extensive genome scanning for autism done so far. The scans found that in just over 1 percent of people with autism, a chunk of about 25 genes had been either duplicated or deleted, mainly in spontaneous mutations not carried by their parents.

Some researchers believe such copy-number errors help explain how autism can often crop up in families seemingly out of nowhere. Diagnoses of autism have skyrocketed in recent years, and the disorder now affects an estimated 1 in every 150 American children.

"It's like having a recipe where you take some of the ingredients and use half as much or twice as much," said Dr. David T. Miller of Children's Hospital Boston. "It's going to change how the recipe turns out."

One percent may sound small, Miller said. But "it is significant in terms of getting another piece of the puzzle solved" -- a puzzle that has largely stymied researchers even as parents have pleaded for answers and cures.

The findings also hold the promise that more such hot spots will explain a much larger portion of autism cases, and that studying the genes involved will cast new light on what goes wrong. Autism is seen as a spectrum of social and communication disorders that usually begin in early childhood.

The Muscular Dystrophy Association announced today that it has appointed Louis M. Kunkel, professor of pediatrics and genetics at Harvard Medical School and Children's Hospital Boston, chairman of its scientific advisory committee, which reviews grant applications for basic science research.

In the late 1980s, Kunkel led a team that identified the muscle protein dystrophin and described how its loss is the underlying cause of the most common childhood form of muscular dystrophy.

Kunkel, also a Howard Hughes Medical Institute investigator, has served on the science panel for 15 years.

Romanian children who were placed in orphanages at birth improved their cognitive development significantly if they were moved to foster homes, particularly before turning 2 years old, a Harvard study has found.

Children who live in institutions from a very early age suffer delays in development, from low IQs that would be called mental retardation by US standards, to lags in language and problems with behavior, according to previous research. This new study in Science, by lead author Charles A. Nelson III of Harvard Medical School and Children's Hospital Boston, is the first randomized clinical trial to compare the intellectual and developmental levels of children who remained in orphanages with children who moved to foster homes. Children from the Bucharest area who had never been in institutions were a control group. A story in the Globe last year described the ongoing study.

Children have been weighing progressively more since the 1970s, the first phase of the obesity epidemic that now has entered a second phase of serious health problems related to overweight, Dr. David S. Ludwig of Children's Hospital Boston writes in tomorrow's New England Journal of Medicine.

He warns that we are approaching the point when the medical problems become life-threatenting, as noted in two articles also appearing in the journal that track coronary heart disease in adults who were obese as children. After that comes a fourth phase, when obesity is accelerated from generation to generation.

But it doesn't have to unfold that way, he argues, given what is now known about the power of a healthful diet and physical activity.

"Like global warming, the obesity epidemic is a looming crisis that requires action before all the scientific evidence is in," Ludwig writes. "I believe that obesity differs in one important respect from global warming: simple solutions are available, and with a comprehensive national strategy, we may be able to implement them without great sacrifice."

Some of Boston's heavy hitters in stem cell biology announced today that they have launched a company to commercialize technology that will reprogram mature adult cells into stem cells.

Dr. David Scadden of the Harvard Stem Cell Institute and Massachusetts General Hospital and Dr. Leonard Zon of Harvard University and Children's Hospital Boston are among the founders of Fate Therapeutics. Biomedical engineers Robert Langer and Ram Sasisekharan of MIT will sit on the new biotech's scientific advisory board. The Waltham venture capital company Polaris Venture Partners is a founding investor, with general partner Amir Nashat taking a seat on its board of directors.

The company has a facility in Seattle, and plans to open other offices soon in the Boston area as well as in California.

Dr. David Williams (left) has been appointed chief of hematology/oncology and director of clinical and translational research at Children’s Hospital Boston. He will succeed Dr. Samuel Lux, who was division chief for almost 24 years.

Williams comes to Children’s from Cincinnati Children’s Hospital Medical Center. His wife, Cindy Williams, also of Cincinnati Children’s, will join Boston Children’s as program director for nursing research.

About 1 in 7 teenagers in Massachusetts and Vermont might have a substance abuse problem, according to screening questionnaires filled out during routine doctors’ visits, a study has found. The adolescents' answers were more likely to indicate a problem during an appointment when they were sick or injured than when they were having a checkup.

“Substance abuse screening should occur whenever the opportunity arises, not at well-child care visits only,” wrote Dr. John R. Knight of Children’s Hospital Boston, lead author of the study in this month’s Archives of Pediatrics & Adolescent Medicine.

A Boston group is sharing genetic information from families affected by autism with other researchers to promote understanding of the developmental disorder.

The Autism Consortium, whose members include hospitals, medical schools and universities in the Boston area, will transfer profiles of 500,000 genetic variations found across the genomes of 700 families with two or more children who have autism. The data will be held by the Autism Genetic Resource Exchange, a program of the advocacy organization Autism Speaks. Scientists can apply to the exchange, which gathered DNA from the families. The samples have been scanned for sequences where there are deletions or extra copies of DNA segments. The consortium is sharing the genetic variations it found.

"We returned all of the raw data to AGRE so they can distribute it to any other investigtors who want to begin exploring what may be the genetic underpinnings of autism," Mark Daly, a consortium member from Massachusetts General Hospital and the Broad Institute of MIT and Harvard, said in an interview. "Understanding the genetics underlying a complex disease is not an easy problem to solve. So there's no excuse for hoarding your data when much more can be learned by sharing."

From left, Daley, Engle, Haber and Karumanchi

Four Boston physician-scientists have been selected by the Howard Hughes Medical Institute in an initiative to promote patient-oriented research.

Dr. George Daley and Dr. Elizabeth Engle, both of Children’s Hospital Boston, Dr. Daniel Haber of Massachusetts General Hospital, and Dr. S. Ananth Karumanchi of Beth Israel Deaconess Medical Center are among 15 new HHMI Investigators. Boston has the most winners in this new group.

By Elizabeth Cooney, Globe Correspondent

Pediatric residents in Massachusetts and around the country gathered at noon today to push for expansion of a children's insurance plan that President Bush has threatened to veto.

At Boston Medical Center, about 50 residents, pediatricians, nurses and social workers paused in the hospital's main lobby as part of "Stand Up for SCHIP," the insurance program that covers children who don't qualify for Medicaid. There would have been one more, but that resident stayed behind in the intensive care unit with a child in respiratory distress, chief resident Marie Clark told the group. The child's father couldn't afford the asthma medication prescribed during an office visit on Friday, Dr. Suzanne Steinbach added, as an example of how lack of insurance hurts children.

"All of us here have had the same story," Dr. Barry Zuckerman, chief of pediatrics, said. "All of us are asking the president to do the right thing for children."

At noon today, pediatric residents across the country will join a 15-minute Stand up for SCHIP to urge President Bush not to veto an expansion of coverage for uninsured children who don't qualify for Medicaid.

The action started at Stanford's Lucile Packard Children's Hosptial in California but soon spread to dozens of hospitals, including Boston Medical Center, Children's Hospital Boston and UMass Memorial Medical Center in Massachusetts. The House and Senate have voted to reauthorize and expand the State Children's Health Insurance Plan, but the president has said he would veto it.

"It means children who could be covered won't be and the possibility that some children already covered may lose their insurance," Dr. Barry Zuckerman of Boston Medical Center said in an interview yesterday. "We see the consequences when patients don't get care when they don't have insurance."

A group from Children's Hospital Boston has been hired by a corporate consortium to develop online medical records for their employees.

Dossia, a group of eight major employers including Wal-Mart and Intel, chose the Children's Hospital Informatics Program to adapt its own program called Indivo to provide secure health records for 5 million employees and their dependents and retirees.

The Children's program, which also has ties to Harvard and MIT, has been working for 10 years to create Web-based records for patients that include a lifetime of health information across different doctors and care sites. The Dossia goal is to allow its workers to have access to their medical records, to communicate with their doctors, and to pull together information from different sources, the group said.

Dossia does not disclose details of its contracts, Colette Cote, a spokeswoman for member Pitney-Bowes and Dossia, said when asked about the financial terms of the agreement with Children's. The other companies in Dossia are AT&T, Sanofi-aventis, Applied Materials, BP America Inc. and Cardinal Health.

Indivo will be introduced at Children's this fall and Dossia plans to roll out its version to some members by the end of the year, its statement said.

Attached to a steerable needle, miniaturized instruments
such as this tissue-nibbling device (shown next to a
sharpened pencil) could be used in minimally invasive
heart surgery.

Researchers at Boston University and Children's Hospital Boston have won a five-year, $5 million grant to make complex heart repairs possible without open-heart surgery.

Working with California medical instrument maker Mircofabrica Inc., Pierre Dupont of BU's School of Engineering and cardiac surgeon Dr. Pedro del Nido of Children's will develop robotic instruments that can reach the heart through small incisions in the chest and heart walls.

"The goal is to develop techniques where we are not only making just small incisions but actually working to repair defects inside the heart while the heart is still beating," del Nido said in an interview.

A Harvard Medical School physician-scientist has been named dean of the Duke University School of Medicine, the North Carolina school announced today.

Dr. Nancy C. Andrews (left), dean for basic sciences and graduate studies at Harvard Medical School, is the first woman to fill the position, Duke said. She will succeed Dr. R. Sanders Williams, who was promoted to senior vice chancellor for academic affairs at Duke.

Andrews, 48, is a pediatric hematologist/oncologist at Children's Hospital Boston and the Dana-Farber Cancer Institute. She previously directed the Harvard/MIT MD/PhD program. A member of the Institute of Medicine of the National Academy of Sciences, she was a Howard Hughes Investigator from 1993 to 2006.

Andrews earned bachelor's and master's degrees in molecular biophysics and biochemistry from Yale University, a Ph.D. in biology from MIT, and an MD from Harvard Medical School. She completed her residency at Children's and a fellowship in pediatric hematology/oncology at Children's and Dana-Farber.

By Elizabeth Cooney, Globe Correspondent

Massachusetts adults are the second-leanest in the country, according to a report released today, but the state's younger residents rank in the middle on the overweight scale.

The adult obesity rate was 19.8 percent, placing the state higher than only Colorado. For children age 10 to 17, the rate of being overweight was 13.6 percent, or 27th highest on the national list in the fourth annual "F as in Fat: How Obesity Policies Are Failing in America, 2007" from the Trust for America's Health. Almost a third of American adults are obese, it said.

Beth Israel Deaconess Medical Center will launch two new fellowship programs in medical microbiology, the hospital said.

Both are designed to teach doctors to understand bacterial agents, parasites and viruses and to run academic, hospital or public health laboratories. The fellows will train at Children's Hospital Boston and the Massachusetts Department of Public Health as well as Beth Israel Deaconess.

Children's Hospital Boston came in second in a US News & World Report ranking of pediatric hospitals, the magazine said today.

Children's Hospital of Philadelphia took first place and Johns Hopkins Hospital in Baltimore finished third on a list of 30 pediatric hospitals. This is the first time the magazine has created a separate ranking for pediatric hospitals or children's hospitals within a medical center.

The rankings are based on reputation, death rates and care-related measures such as volume, nursing care, advanced technology and outside recognition.

A Brown University neuroscientist has won Germany's top honor for basic neurological research for creating a device that translates thought into action.

John P. Donoghue, who developed a brain implant called BrainGate that allows paralyzed people to use their thoughts to move a computer cursor, control a wheelchair or operate a robotic arm, will receive one of two K.J. Zulch prizes next week. The other goes to University of Melbourne professor emeritus Graeme Clark, who invented the cochlear implant.

Dr. Robert Ian McCaslin of Children's Hospital Boston has been named director of Mo HealthNet, the Medicaid agency for the state of Missouri, Governor Matt Blunt said. He has been an attending physician in the pediatric emergency department at Children's and an instructor at Harvard Medical School.

Each year MIT's Technology Review names 35 innovators under 35 for its TR35. This year eight technologists and scientists from New England make the list.

David Berry, 29, Flagship Ventures, Cambridge: renewable petroleum from microbes
Adam Cohen, 28, of Harvard University: making molecules motionless
Ali Khademhosseini, 31, Harvard-MIT Division of Health Sciences and Technology: improving engineered tissues
Ivan Kristic, 21, One Laptop per Child (on leave from Harvard): making antivirus software obsolete
Christopher Loose, 27, SteriCoat, Cambridge: beating up bacteria
Anna Lysyanskaya, 31, Brown University: Securing online privacy
Kristala Jones Prather, 34, MIT: reverse-engineering biology
Mehmet Yanik, 29, MIT: stopping light on microchips

By Elizabeth Cooney, Globe Correspondent

Children whose private health insurance does not pay for new recommended vaccines may not be eligible to receive them in public programs, leaving them more vulnerable than if they had no insurance, according to a Harvard study.

These gaps are occurring as the number and cost of new vaccines have escalated. New vaccines recommended for children have doubled in the past five years and the cost to fully vaccinate a child -- about $1,170 -- is 7.5 times higher in 2007 than it was in 1995, Dr. Grace M. Lee of Harvard Medical School and colleagues write in tomorrow’s Journal of the American Medical Association. They surveyed state immunization program managers in 48 states from January to June 2006.

"We assumed kids with health insurance would have coverage for vaccinations, but we found a group of children whose insurance didn’t cover the cost of vaccine. That to me was surprising," Lee said in an interview.

Harvard scientists have answered a question that lingered after Korean scientists retracted their fraudulent claim
that they had cloned the first human embryonic stem cells: Where did the stem cell line they created come from?

Kitai Kim, Dr. George Q. Daley (left) and their colleagues at Children's Hospital Boston and the Harvard Stem Cell Institute report today in Cell Stem Cell that the embryonic stem cells created by the Korean lab resulted not from somatic cell nuclear transfer, a technique in which a person's DNA is injected into a donor egg cell that has had its own DNA removed, but from parthenogenesis, the process of making an embryo from the donor egg alone.

Cells derived from parthenogenesis carry a distinct genetic fingerprint because they have a duplicate set of chromosomes from the egg. Most of the genetic sequences are identical, but some show differences from the donor egg. Investigators looking into the Korean claims last year said parthenogenesis could not explain these different patterns, the paper said.

Kim and Daley's group analyzed the cells further and found that the DNA differences were clustered at certain points, just as they are in experiments on parthenogenesis in mice.

The Koreans appear to have created the first human embryonic stem cells from a woman's egg alone, the paper says.

Daley's lab is studying parthenogenetic cells as another possible source of embryonic stem cells to treat disease.

A Children's Hospital interview with Daley is here.

By Liz Kowalczyk, Globe Staff

The Board of Registration in Medicine, which licenses Massachusetts doctors, yesterday retroactively revoked the medical license of Dr. Thomas Ho, finding that he fell asleep during a surgical procedure in December 2005 and inhaled anesthetic gas while on lunch break at work the following month.

Both incidents occurred during a rotation at Children's Hospital Boston. Ho had taken a prescription drug that caused him to doze off, the board said, and when he fell asleep he was the only anesthesiologist in the operating room.

Ho, who was an anesthesiology resident based at Brigham and Women's Hospital, took a voluntary leave in January 2006. He can apply for a new license if he demonstrates at least 15 months of continuous sobriety, and compliance with a chemical dependency monitoring contract.

A Children's Hospital spokeswoman, Michelle Davis, said today: "No patient was harmed, and as soon as the situation was discovered he was discharged from Children's."

Public reporting campaign meets surgical caution on Running a Hospital today.

In this week's New England Journal of Medicine three Harvard doctors argue that making mortality rates public for individual cardiac surgeons could end up harming patients if the rankings push surgeons to avoid operating on high-risk patients.

Today Paul Levy responds in detail to the White Coat Notes post about the opinion piece in the journal, written by Dr. Thomas H. Lee of Partners Health Care, Dr. David F. Torchiana of Massachusetts General Hospital and Dr. James E. Lock of Children’s Hospital Boston.

As readers of the Beth Israel Deaconess CEO's blog know, Levy is a champion of transparency, urging other hospitals to join his in posting their performance measures. He responds to the doctors' contention that public reporting is too flawed (not adequately adjusted for risk, too small a sample) to be valid. (He also asks many questions -- it's a long entry.)

"So here's our Catch-22: No reporting method is statistically good enough to be made public," he writes. "But if a method is statistically good enough, we won't allow it to be made public."

Dr. Thomas H. Lee knows the headline he wrote is provocative: "Is Zero the Ideal Death Rate?"

But the network president of Partners Health Care and associate editor at the New England Journal of Medicine is concerned that public reporting of mortality rates for individual cardiac surgeons carries unintended, perverse consequences. He fears that surgeons might hesitate to operate on high-risk patients if they are seeking a perfect performance record, he and two colleagues write in tomorrow's issue of the journal.

"If you are being ranked, you may walk away from a patient who’s very sick, even though that patient may be at high risk for surgery but even higher risk with medicine" as treatment, he said in an interview. "When so few patients can swing things for you being ranked, we’re worried about that effect on the decision-making process."

Lee, along with co-authors Dr. David F. Torchiana, a cardiac surgeon at Massachusetts General Hospital, and Dr. James E. Lock, an interventional cardiologist at Children’s Hospital Boston, say that reporting on cardiac surgery by institution makes sense, with individual reports available only to those hospitals. Massachusetts recently joined New York, New Jersey and Pennsylvania in publicly reporting death rates for individual cardiac surgeons.

They’re called "medical futility" cases, when family members and hospitals disagree on whether to continue life support for very sick patients. Although rare, they raise questions about respect for others’ viewpoints, a Children’s Hospital Boston doctor says.

Writing in tomorrow’s New England Journal of Medicine, Dr. Robert D. Truog warns against laws that allow a hospital ethics committee to be "surrogate judge and jury."

He considers the recent case of 19-month-old Emilio Gonzales, whose mother went to court to prevent Austin Children’s Hospital from turning off his respirator. Emilio had a rare, fatal genetic disorder called Leigh’s disease that meant he was in intensive care for five months with declining neurological function. Under the Texas Advance Directives Act, the hospital’s ethics committee decided to withdraw life support despite the objections of his mother, Caterina Gonzales.

"I’m concerned that legislation like that in Texas makes it just too easy for people in the medical profession to override the desires of those who have unpopular views," Truog said in an interview. "We’ve got a beautiful system of laws designed to protect people from the tyranny of the majority. The Texas law just bypasses it."

Cambridge Health Alliance will accept an award today from the National Association of Public Hospitals and Health Systems for its role in medical school curriculum change.

CHA developed a program for third-year Harvard Medical School students to follow patients for a year at one hospital instead of traditional rotations in different settings. The hospital was chosen for the 2007 Chair Award from 64 submissions, NAPH said in a statement.

Dr. Samantha L. Rosman, a third-year resident in pediatrics in Boston, has been re-elected to the American Medical Association's board of trustees. She is a 2004 graduate of Columbia University College of Physicians and Surgeons. After completing her residency, she will begin a fellowship in pediatric emergency medicine at Boston Medical Center.

Dr. Karen Shedlack (left), medical adviser for the mental retardation division of Vinfen, has won a 2007 Distinguished Fellowship from the American Psychiatric Association.

Before joining Vinfen, a private, nonprofit human services organization based in Cambridge, Shedlack was medical director for the adult developmental disabilities program at McLean Hospital and worked in the department of psychology and brain science at the Massachusetts Institute of Technology.

Virgin Life Care has named three Boston academics to its science advisory board.

A subsidiary of the Virgin group headed by Sir Richard Branson, the Boston company develops activity-based health rewards programs.

The board members are Dr. I-Min Lee of Harvard Medical School and the Harvard School of Public Health, Kyle McInnis of UMass-Boston and Jessica Whitely of UMass-Boston and Brown Medical School.

Children's Hospital Boston has honored five doctors with Community Physician Awards for the care they give in pediatric practices and community health centers.

They are Dr. Anthony Compagnone of Hyde Park Pediatrics, Dr. Debra Ann Gfeller of Holliston Pediatrics, Dr. David Holder of the Martha Eliot Health Center, Dr. Richard Marshall of Harvard Vanguard Associates at Copley and Dr. Robert Michaels of Longwood Pediatrics.

Xihong Lin (left), professor of biostatistics at the Harvard School of Public Health, has won a MERIT Award from the National Institutes of Health.

Lin will develop statistical methods for analyzing cancer research data, including long-term and family data as well as genomic and proteomic information in epidemiological studies and population sciences, NIH said in a statement.

Fewer than 5 percent of NIH-funded investigators are selected to receive the awards.

Current MERIT recipients in Massachusetts and their instituions are:

Beth Israel Deaconess Medical Center: Benjamin G. Neel
CBR Institute for Biomedical Research: Timothy R. Springer
Children's Hospital Boston: Michael Klagsbrun and Bruce R. Zetter
Dana-Farber Cancer Institute: Stanley Korsmeyer and David M. Livingston
Harvard: John Blenis, Stephen C. Harrison, Peter M. Howley and Andrew G. Myers
Massachusetts General Hospital: Daniel Haber
MIT: Michael R. Lieber, Stephen J. Lippard and Alexander Rich
Tufts: John M. Coffin
Whitehead Institute for Biomedical Research: Rudolph Jaenisch

Four Boston-area scientists are among the newest class of 20 Pew Scholars in the Biomedical Sciences, the program announced today.

Funded by the Pew Charitable Trusts through a grant to the University of California at San Francisco, the awards give each scientist $240,000 over four years to support research.

Past winners have included Craig C. Mello of the University of Massachusetts Medical School, who shared the 2006 Nobel Prize in medicine or physiology for the discovery of the gene-silencing mechanism know as RNA interference.

Dr. George Q. Daley, associate director of the stem cell program at Children's Hospital Boston, has been named president of the International Institute for Stem Cell Research, the hospital said today.

An associate professor at Harvard Medical School, he is also affiliated with Dana-Farber Cancer Institute and Brigham and Women's Hospital.

The nonprofit stem cell organization, which is meeting in Australia this week, was formed in 2002 to foster the exchange of information on stem cell research. In February the group established ethical guidelines for stem cell research.

"I hope to make these guidelines more relevant to practitioners and stem cell oversight committees worldwide," Daley said in a statement. "As countries debate what sorts of regulations to put in place, we want to take a leadership role, acknowledging the social context of the work while removing unnecessary barriers to scientific progress."

Louis Kunkel, director of the program in genomics at Children's Hospital Boston, has won a one-year $100,000 distinguished investigator award from the Mental Health Research Association to study gene expression in autistic children.

Dr. Mary Jane England, president of Regis College, has been honored as this year's outstanding psychiatrist for lifetime achievement by the Massachusetts Psychiatric Society.

Dr. Suzanne A. Bird, medical director of Cambridge Health Alliance's psychiatric emergency service, has received the annual Irma Bland Award for Excellence in Teaching Residents from the American Psychiatric Association.

Maureen Walsh, a nurse and health teacher at St. Francis Xavier School in South Weymouth, was one of 13 people to receive national recognition from the Food Allergy & Anaphylaxis Network for service to children with food allergies.

US Representative Patrick Kennedy of Rhode Island will be honored with fellow Congressman Jim Ramstad of Minnesota for their Campaign to Insure Mental Health and Addiction Equity at Mental Health America's annual meeting June 6 through 9 in Washington.

Children’s Hospital Boston has named James Cote (left) executive director of the Martha Eliot Health Center, a community health center in Jamaica Plain that is licensed and operated by Children’s.

Cote, who had been the health center's interim leader for the past year, has also worked at Children’s and Boston Medical Center. He holds an MBA with a specialty in health care administration and marketing from UMass-Boston and a bachelor's degree in biology from Saint Joseph’s College in North Windam, Maine.

Dr. Myron Siu, 32, an internist who works at Tufts-New England Medical Center, started house calls last August; he's believed to be the only Cantonese-speaking doctor in Boston with a weekly commitment to see patients in their homes.

Judy Foreman's love affair with vitamins and supplements is over: With a few exceptions -- stay tuned -- she's tossing them out, she writes in Health Sense.

Also in Health/Science, meet psychologist Ed Tronick (left), who probes the emotional life of infants, and find out why people blink their eyes and why we need sunshine.

In Business, Massachusetts is among the leaders nationally in the use of electronic patient records and computerized drug prescribing. But its workforce is not keeping pace: The state lacks enough people who know how computers work and who understand how doctors diagnose and treat diseases.

US women are getting mammograms to screen for breast cancer at declining rates, according to a study describing a trend that some health officials fear may reverse progress against the deadly disease.

Dr. Dorothy (Balzer) Villee, an associate in endocrinology at Children's Hospital in Boston for nearly 30 years who volunteered with patients in their final days at Hospice & Palliative Care of Cape Cod, died of a stroke April 23 in Brigham and Women's Hospital in Boston. She was 79.

If a majority of children are vaccinated, but some are not, the burden of disease can move into these high-risk populations where infection can have severe consequences, Dr. Maria Raven of New York University and Bellevue Hospital Center writes on the op-ed page.

Proposals to build new devices to help premature infants, to inject medicine without breaking the skin and to guide surgeons operating on the brain were among projects to win $5 million in grants from the Center for Integration of Medicine and Innovative Technology, the consortium announced today.

CIMIT, composed of Boston-area teaching hospitals and engineering schools, made 37 grants that range from $40,000 to $100,000. Twenty-two have military applications, acording to CIMIT, which receives support from the US Department of Defense as well as its members.

Dr. Riccardo Barbieri of Massachusetts General Hospital won a grant to develop a computational tool based on a premature infant's heartbeat to predict episodes when they stop breathing.

Mark Horenstein of Boston University will demonstate a way to inject medications through the skin using nanoparticles, leaving no wound behind.

Dr. Nobuyuki Nakajima of Brigham and Women's Hospital will work to improve how instruments can be navigated to diagnose and treat brain injury or disease.

"Our goal ... is to bring life-changing technology to patients as quickly as possible," Dr. John Parrish, CIMIT founder and director and Vietnam War battlefield surgeon, said in a statement. "We are especially aware of the needs of soldiers wounded on the battlefield."

There's no shortage of weight loss books, but few are designed for children, Dr. David M. Ludwig thought. So he set out to condense lessons learned from the Optimal Weight for Life program at Children's Hospital Boston and put them between the covers of a new book.

"What works for adults won't necessarily work for kids, especially when there's conflict about food at home," he said in an interview. "We start with the right eating program, bring in the right amount of physical activity, and then we need the right parenting program."

Doctors at Children's Hospital Boston began this weekend prescribing medications by computer, and nurses are entering into the system when they give the drugs to patients, replacing paper records.

Lab results and pharmacy information were computerized in an earlier effort, along with other documentation from doctors and nurses.

"The whole project is centered around creating an integrated electronic clinical information system, but this is probably the biggest in terms of how our clinicians act in the hospital," Dr. Daniel Nigrin (left), the hospital's chief information officer, said yesterday.

This week's Science includes a special section on germ cells -- the reproductive cells of an organism.

George Q. Daley of Children's Hospital Boston, Brigham and Women's Hospital and the Harvard Stem Cell Institute asks whether the cup is half empty or half full for embryonic stem cells.

David C. Page of the Whitehead Institute and MIT considers the mysteries of sexual identity from the germ cell's perspective.

Alexander F. Schier of the Broad Institute of Harvard and MIT writes about the death and birth of RNAs during the maternal-zygotic transition.

Also in Science, Rachael L. Neve of Harvard and McLean Hospital is an author of a new study in mice about neurons competing to encode a memory in the brain.

By Liz Kowalczyk, Globe Staff

Children's Hospital Boston and Caritas Christi Health Care today announced an affiliation agreement in which Children's Hospital doctors will provide care at three Caritas nurseries for sick babies.

Children's physicians will staff the neonatal intensive care unit at Caritas St. Elizabeth’s Medical Center in Boston and the special care nurseries at Caritas Good Samaritan Medical Center in Brockton and Caritas Holy Family Hospital and Medical Center in Methuen.

The agreement provides a guarantee to Caritas that it won't encounter a shortage of specialists to staff its nurseries and the opportunity to associate itself with the prestigious Harvard teaching hospital.

Children's, which will care for the sickest children at its own neonatal intensive care unit, extends its reach to a new group of potential patients.

Slate's Book Club features a conversation between Dr. Jerome Groopman, professor of medicine at Harvard Medical School and author of "How Doctors Think," and Dr. Darshak Sanghavi, an assistant professor of pediatrics at the University of Massachusetts Medical School who met Groopman when he was a fellow at Children's Hospital Boston.

"Algorithms and treatment guidelines are based on prototypes," Groopman writes. "They are not substitutes for individual thinking. And they break down when cases are atypical or complex."

Sanghavi, an occasional contributor to the Globe, summarizes their different points of view:

"This ultimately returns to our disagreement about standardizing medical care," he writes. "You feel it often constricts good medical practice; I think we don't have enough of it."

Random urine tests for drug use have a high error rate even when performed in adolescent substance abuse programs, researchers from Children's Hospital Boston report in the April issue of Pediatrics.

Dr. Sharon Levy and her colleagues at the hospital's Center for Adolescent Substance Abuse Research took 710 random urine tests from 110 patients who were 13 to 21 years old and enrolled in a drug program. Comparing the results with those obtained from confirmed laboratory tests, they found that 12 percent of the random tests had results that could be misinterpreted.

Some of the samples were too diluted to interpret reliably. Of the samples confirmed to show Oxycontin use, two-thirds had tested negative at first.

Cancer researchers from Boston and around the world have gathered in Houston for a symposium today and tomorrow to talk about metastasis -- how cancer spreads -- and to honor Dr. Isaiah J. Fidler, the scientist who confirmed a 100-year-old theory of how cancer kills.

Speakers at the symposium include Dr. M. Judah Folkman of Children's Hospital Boston and Harvard Medical School, Robert Weinberg of the Whitehead Institute for Biomedical Research at the Massachusetts Institute of Technology, Dr. Harold Dvorak of Beth Israel Deaconess Medical Center and Harvard, and Richard Hynes of Howard Hughes Medical Institute and MIT.

Fidler, whose recent research focuses on prostate and pancreatic cancer, is stepping down as chair of cancer biology at The University of Texas M. D. Anderson Cancer Center in September.

Children's Hospital Boston has won a grant from the Robert Wood Johnson Foundation to bring mental-health services to Somali refugee families, the hospital announced today.

The $300,000 award will fund mental health programs at the Lilla G. Frederick Pilot Middle School in Dorchester over the next three years. The project is expected to serve 700 people, including children and their families, the hospital statement said.

The Boston University Graduate School of Social Work is offering two full scholarships to their Master’s of Social Work program to Somali individuals who will provide services as part of their training during the three-year grant period.

Other organizations involved are the Boston Public Schools, Refugee and Immigrant Assistance Center, Somali Development Center, The Alliance for Inclusion and Prevention, The Boston Healing Landscape Project and the Boston Center for Refugee Health and Human Rights.

Politicians and children's health advocates pushed for renewal of federal funding for children's health insurance in an event at Children's Hospital today, citing a poll that says 90 percent of Massachusetts voters favor providing health coverage to all uninsured children.

U.S. Sen. Edward M. Kennedy, U.S. Sen. John F. Kerry and Boston Mayor Thomas M. Menino joined Diluvina Vasquez Allard of the Massachusetts Communities Action Network and Dr. James Mandell, president and CEO of Children's, in calling for passage of the law authorizing the State Children's Health Insurance Program.

SCHIP pays for part of the state's MassHealth program.

The poll was conducted by New England Alliance for Children's Health, which found similar levels of support for SCHIP in the other five New England states, the group said in a statement.

Drug testing of adolescents at home or in school is unreliable and lacks scientific proof of effectiveness, the American Academy of Pediatrics says in its journal Pediatrics today. Simple conversations with a school counselor are more effective and cost far less, according to the study.

In 1996 the AAP published a policy statement opposing testing adolescents for drugs without their consent. Since then two US Supreme Court decisions have upheld random testing, first for student athletes and then for any student participating in extracurricular activities. At the same time, drug-testing companies have begun marketing kits to parents for use at home. The current policy addendum was written in response to these two trends.

"Testing can be a very powerful tool when it is used properly in a clinical population," Dr. John R. Knight, associate professor of pediatrics at Harvard Medical School and director of the Center for Adolescent Substance Abuse Research at Children's Hospital Boston, said in an interview. He is the lead author of the article. "It's just a really bad screening test."

Violence gets our attention, in movies, video games, television, music, print, or on the Internet, especially if our children are watching.

The Center on Media and Child Health at Children's Hospital Boston has created a database of research findings and chose violence as the first topic they would make available free to parents, clinicians and researchers who want to know what peer-reviewed studies can tell them.

They can ask a question, read a summary in lay language or search 700 research articles to find answers.

"Our goal was to gather all of the studies in a single location and present them in a standardized form to create the first interdisciplinary library of research on media effects," Brandy King, librarian for CMCH, said in a statement from Children's. "We chose violence as our first research topic because it is the most thoroughly investigated area of media effects."

Interesting suggestion from Blog, MD, the blog of Dr. Samuel C. Blackman, a Boston pediatric oncologist. He discusses a recent study in the British Medical Journal, which looked at whether mothers of infants in the ICU were able to recall information better when given audiotapes of their conversations with doctors.

"A couple of years ago, when I was a relatively new 1st year fellow, a family brought a tape recorder into the room and set it down right in front of me," he writes. "I can’t remember whether or not they asked me if I would mind being taped (I think they did), but I remember being weirded out by it and telling them that I’d prefer not to have my every word recorded."

But he's had a change of heart. "One would think that a tool as simple as a tape recorder would be more widely used for complex discussions such as informed consent for chemotherapy," he writes. "I believe that offering parents the opportunity to tape one’s important discussions with them telegraphs a message of confidence and trust, and would go a long way to establish rapport at a very important moment in a family’s life."

He's eager for comments from parents of children with cancer and from cancer patients themselves.

Young people feel better after sex.

Not earth-shattering news, you say?

Children's Hospital Boston researcher Dr. Lydia A. Shrier, lead author of a study that reached that conclusion, understands why you'd react that way, but hear her out. She says that until we know what adolescents really think about sex, anyone trying to help them have safer sex -- or no sex -- might be wasting their time.

"If we don't understand exactly how they feel around the time of sex, we're going to miss the boat with our risk reduction or abstinence messages," said Shrier, whose study appears in the Journal of Adolescent Health. "We all know that feelings are very much connected to how we behave."

Children with Kawasaki disease are at risk for developing
coronary-artery aneurysms. Standard therapy includes giving these children intravenous immune globulin and aspirin. A study in the New England Journal of Medicine, led by Dr. Jane W. Newburger of Children's Hospital Boston and Harvard Medical School, shows that adding a single pulsed dose of intravenous methylprednisolone did not produce better outcomes than the standard therapy.

Three-quarters of Massachusetts physicians being monitored for substance abuse or mental and behavioral health problems successfully completed their programs while continuing to practice, a study by the Massachusetts Medical Society's Physician Health Services program found.

The success rate was nearly identical for both types of disorders, showing that techniques developed for helping physicians with substance abuse can be applied to other problems, the authors reported in the Journal of Psychiatric Practice. But they also found that women fared worse than men.

"We thought men and women would do equally well," said Dr. John R. Knight of Harvard Medical School and Children's Hospital Boston. "We don't know the exact reasons the women did so poorly. It's really going to require a new look at our program, and I think we've got to consider offering new services for women physicians."

To develop more successful drugs, you have to look at both the winners and the losers. But that means drug companies need to share their gold mine of information on unsuccessful medicines, two researchers from Children's Hospital Boston's Informatics Program say.

Based on information about failed drugs, Dr. Asher D. Schachter and Marco F. Ramoni say they can predict which drugs in early development will be safe and effective.

They make that case in the February Nature Reviews Drug Discovery, saying their model could help save $283 million per approved drug.

"Suppressing negative data harms everyone," Schachter said. "Companies could reduce drug development costs and pass on some of those savings to the consumer."

Dr. Michael F. Epstein, executive vice president and chief operating officer of Beth Israel Deaconess Medical Center, is leaving the hospital after five years.

Before coming to Beth Israel to work with CEO Paul Levy on a recovery plan for the then financially troubled hospital, he was a neonatologist and later COO and chief medical officer at Children's Hospital Boston.

The goals of the recovery plan have been achieved with Beth Israel's return to financial stability, he said in a memo to employees. His resignation will be effective May 1.

"There is no other position or job offer that would have lured me away from BIDMC," he wrote. "But the celebration of my 60th birthday a little over a year ago reminded me that there are important connections to family members and friends to nurture, places to visit, books to read, gardens to plant, and marathons to run, and since that birthday, the clock seems to be running a bit more rapidly. So, while the work continues to be exciting and engaging, I have decided it is now time to move on."

Epstein is "a terrific person," Levy said. "I was incredibly lucky to have him with us."
with us.

Scientists have released the most comprehensive set of rules yet to govern the ethically charged field of embryonic stem cell research.

The guidelines, put together by the International Society for Stem Cell Research (ISSCR) under the direction of Children’s Hospital Boston scientist Dr. George Q. Daley, calls for special oversight of embryonic stem cell research.

Dr. George Q. Daley, Children's Hospital Boston

The guidelines are very similar to a report issued in 2005 by the U.S. National Academy of Sciences, but are designed to apply to scientists around the world, not just American scientists.

The rules include bans on: growing human embryos in a dish for more than 14 days; breeding animals which might have human eggs or sperm; and, using cloning technology in an attempt to create a live human child. All are widely viewed as anathema by stem cell researchers today.