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Research Roundup

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December 20, 2011, Volume 58, No. 16

Antibiotics for Acne Linked to Sore Throat

Oral antibiotics used to treat acne are linked to symptoms of sore throat, according to a study by researchers with the Perelman School of Medicine at the University of Pennsylvania published in Online First in the Archives of Dermatology, one of the JAMA/Archives journals.

"Our studies show that the odds of developing self-reported pharyngitis (sore throat) is more than three times baseline in patients receiving oral antibiotics for acne versus the odds for those who are not receiving oral antibiotics," the authors conclude. "The true clinical importance of these findings needs to be evaluated further by prospective studies."

Dr. David J. Margolis, professor of dermatology and epidemiology, and colleagues at the Perelman School of Medicine conducted two concurrent studies of students (a cross-sectional study and a longitudinal study) to examine the association between antibiotics used to treat acne and sore throats. The authors also examined the association between oral antibiotics and colonization rates of group A streptococcus, a form of bacteria responsible for most cases of streptococcal illness, as previous research has shown a link between oral antibiotics and higher rates of group A strep.

The authors found that the use of oral antibiotics was strongly associated with a health care evaluation for sore throat. Of students receiving oral antibiotic treatment, 11.3 percent reported having a sore throat. Conversely, sore throats were reported by 3.3 percent of students not receiving oral antibiotics. Additionally, no association with sore throat was noted for those who used a topical antibiotic for acne. The authors found that less than 1 percent of participants were colonized by group A strep, indicating that it was not associated with sore throat in this setting.

Previous studies from Dr. Margolis and colleagues at Penn found that long-term use of antibiotics to treat acne counter-intuitively decreased the prevalence of colonization of another bacteria, S. aureus, by nearly 70 percent, and didn't cause increased resistance to medications.

Asking for Help in Elementary School: Middle-Class vs. Working-Class Students

Middle-class children ask their teachers for help more often and more assertively than working-class children and, in doing so, receive more support and assistance from teachers.

The findings from the University of Pennsylvania are reported in the December issue of the American Sociological Review (ASR) in a paper entitled "'I Need Help!' Social Class and Children's Help-Seeking in Elementary School" by Jessica McCrory Calarco, a PhD candidate in sociology in the School of Arts and Sciences.

For three years, she followed a cohort of students from third to fifth grade, observing them regularly in school and interviewing teachers, parents and students to show that children's social-class backgrounds shaped when and how they sought help in the classroom.

Her study showed that middle-class children regularly approached teachers with questions and requests and were much more proactive and assertive in asking for help. Rather than wait for assistance, the middle-class children called out or approached teachers directly, even interrupting to make requests. Working-class children, on the other hand, rarely asked for help from teachers, doing so only as a last resort.

Furthermore, when working-class children did ask for help, they tended to do so in less obvious ways, for example, hanging back or sitting with their hand raised, meaning that they often waited longer for teachers to notice and respond.

"Teachers want kids to ask for help if they are struggling, but they rarely make those expectations explicit. That leaves kids to figure out when and how to ask for help," Ms. Calarco said.

In another related project, Ms. Calarco found that children learn whether and how to ask for help at school, in part, through the training that they receive from their parents at home.

She noted that, "unlike their working-class counterparts, middle-class parents explicitly encourage children to feel comfortable asking for help from teachers and also deliberately coach children on the language and strategies to use in making these requests."

As a result, middle-class children came to school better equipped to secure the support that they needed to complete their assignments quickly and correctly and also appeared more engaged in the learning process.

Ms. Calarco said that while teachers don't mean to favor some children over others, they tend to be more responsive to middle-class children's help-seeking styles, giving those who ask for help more attention and support in the classroom and also seeing them as more proactive learners.

The ASR study concludes that inequalities in education are not just the product of differences in the resources that families and schools provide for children; they also reflect differences in the resources that children can secure for themselves in the classroom.

Penn Nursing's Autism Research Tops in TIME

TIME magazine has named Penn Nursing's pioneering research on autism and low birthweight one of the "Top 10 New Findings in Parenting" of 2011. In October, Penn Nursing Professor Jennifer Pinto-Martin, and colleagues reported in Pediatrics that premature infants are five times more likely to have autism than children born at normal weight.

The children, some born as small as about a pound, were followed for 21 years, making this study one of the most remarkable of its kind. The infants were born between September 1984 and July 1987 in Middlesex, Monmouth, and Ocean counties in New Jersey at birthweights from 500 grams to 2000 grams or a maximum of about 4.4 pounds.

"As survival of the smallest and most immature babies improves, impaired survivors represent an increasing public health challenge," wrote Dr. Pinto-Martin, who directs the Center for Autism and Developmental Disabilities Research and Epidemiology at Penn Nursing. "Emerging studies suggest that low birthweight may be a risk factor for autism spectrum disorders."

Links between low birthweight and a range of motor and cognitive problems have been well-established for some time, but this is the first study to prove that these children are also at increased risk for autism spectrum disorders (ASD).

The researchers, including a team at The Children's Hospital of Philadelphia, followed 862 children from birth to young adulthood finding that five percent of the children were diagnosed with autism, compared to one percent of the general population.

Shopper's Channel Usage

About three-quarters (76%) of all purchases still occur at bricks and mortar stores, according to "Understanding the Multi-Channel Shopper," a new survey-based study by the Jay H. Baker Retailing Center at the Wharton School of the University of Pennsylvania and the Verde Group. While the web, catalogs, and mobile phones generate just 22%, 1.4%, and 0.6%, respectively, of all purchases, these channels are important in the shopping process, for example to browse for items and research prices.

The study also identified four types of shoppers, based on their channel usage: the Tech-Savvy Multi-Channel Shopper, the Discerning Online Shopper, the Experiential Bricks and Mortar Shopper, and the Retailer-Loyalist Multi-Channel Shopper.

"In spite of all the attention on online shopping, 76% of purchases are still made offline. This is a great opportunity for retailers to differentiate themselves through a unique in-store experience," said Barbara Kahn, Patty and Jay H. Baker Professor, and director of the Jay H. Baker Retailing Center at the Wharton School. "Retailers with well-designed omni-channel strategies should do better because they reach all four segments."

"This study reminds retailers that when designing and delivering channel experiences; 'know thy customer' remains the critical principle," said Paula Courtney, President of the Verde Group. "Different channels attract different types of customers who demand experiences that are specific to their needs and preferences."

Key findings of the study are available in the News Releases section of Wharton's website, www.wharton.upenn.edu/news/news-releases.cfm

Almanac - December 20, 2011, Volume 58, No. 16