User:Keshi.kiruba/sandbox

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This is place to practice clicking the "edit" button and practice adding references (via the citation button). Please see Help:My_sandbox or contact User_talk:JenOttawa with any questions.

Link: Project Homepage and Resources


 * Note: Please use your sandbox to submit assignment # 3 by pasting it below. When uploading your improvements to the article talk page please share your exact proposed edit (not the full assignment 3).


 * Talk Page Template: CARL Medical Editing Initiative/Fall 2019/Talk Page Template

Assignment 2:
I identified the lack of information on caffeine consumption in vulnerable populations specifically children. Wikipedia cites Health Canada and American Psychiatric sources to derive the facts and numbers. I used the U.S. Food & Drug Administration website as FDA information is thorough and reliable. My search strategy followed a schema: FDA.gov --> Home --> For Consumers --> Consumer Updates --> Caffeine and Kids: FDA Takes a Closer Look. I searched Cochrane reviews for systematic reviews on caffeine consumption in children and found a few articles. These articles relate to caffeine consumption in pregnant women and the long-term effects on consumption in children. I am primarily interested in children’s’ consumption of caffeine post-birth, so I discarded these articles. I also searched for the DSM-5 manual for guidelines regarding pediatric caffeine consumptions. Guidelines included recommendations for children and dosages, however, they failed to make a connection between the acute and chronic effects of drinking caffeine in children. This led me to search the FDA regarding caffeine consumption and its effects on children. The FDA source meets Wikipedia’s reliable medical sources criteria for three reasons. First, The Food and Drug Administration (FDA) is an agency within the U.S. Department of Health and Human Services responsible for protecting the public health by assuring the safety, effectiveness, and quality of human and veterinary products. Second, it is a secondary source that analyzes literature and practice guidelines to make recommendations. Finally, it is current and up to date with the literature in order to ensure public safety. FDA has cited 400 mg/day of caffeine use for healthy adults; however, it has not set a level for children. Interestingly, the American Academy of Pediatrics discourages the consumption of caffeine by children and adolescents all together. These findings contradict that of Wikipedia and prompt a closer look to analyze the credibility of information found under the page. I plan to use this source as a guide to revamping the caffeine usage section for a vulnerable population, specifically children. This can help the readers be aware of the different recommendations available.

Assignment # 3
Proposed Changes:

The American Society of Pediatrics recommends that caffeine consumption is not appropriate for children and adolescents and should be avoided. This recommendation is based on a clinical report released by American Society of Pediatrics in 2011 with a review of 45 publications from 1994 to 2011 and includes inputs from various stakeholders (Pediatricians, Committee on nutrition, Canadian Pediatric Society, Center for Disease Control & Prevention, FDA, Sports Medicine & Fitness committee, National Federations of High School Associations).

'''Rationale for Proposed Changes: ''' Rigorous review and analysis of the literature reveal that caffeine and other stimulant substances contained in energy drinks have no place in the diet of children and adolescents (American Academy of Pediatrics). Most recent literature information used to form recommendations (Published & Edited: 2011). Includes various & widespread stakeholders; pediatricians, committee on nutrition, Canadian Pediatric Society, Center for Disease Control & Prevention, FDA, Sports Medicine & Fitness committee, National Federations of High School Associations.

Reference: Sports Drinks and Energy Drinks for Children and Adolescents: Are They Appropriate? (2011). American Academy of Pediatrics, 127(6), 1182–1189. doi: 10.1542/peds.2011-0965

Health Canada includes recommendations on maximum caffeine intake for children ages 4 to 12 and is last updated on 2017. However, the information derived is from old sources between 1990 and 2003. One of the sources used is Nutrition recommendations by Health & Welfare Canada from 1990. The source is 19 years old so information from it should be viewed critically. Reference: “Health and Welfare Canada, 1990. Nutrition Recommendations.”

The other source is a review article published in 2003 with recommended values for caffeine intake in children. Interestingly, the review article proposed values from WHO recommendations in 1991. References: 1. Review article - Effects of Caffeine on Human Health, P. Nawrot, S. Jordan, J. Eastwood, J. Rotstein, A. Hugenholtz and M. Feeley, Food Additives and Contaminants, 2003, Vol. 20, No. 1, pg. 1-30. 2. WHO IARC Recommendation - IARC Monographs evaluate drinking coffee, maté, and very hot beverages. (1991). Retrieved from https://www.iarc.fr/wp-content/uploads/2018/07/pr244_E.pdf.

Although these sources are contradictory, they have their own merits. Health Canada based its recommendation on old literature and AAP based its recommendation on recent literature. It is important for Wikipedia consumers to have access to both information in order to make a sound judgment on caffeine consumption in children. Furthermore, it is necessary for clinicians to be aware of different literature results in order to properly counsel patients on safe usage/abstinence of caffeine.

Comments:

1.

''The American Society of Pediatrics recommends that caffeine consumption is not appropriate for children and adolescents and should be avoided. This recommendation is based on the review of recent literature and includes inputs from various stakeholders.''

'''You showed that you understood the task and your sentences add an important and missing information to the Wikipedia article. The language, syntax, and grammar meet the requirements. With a few minor edits, you could make it clear why those recommendations were made. As we discussed in the group, it is of paramount importance to understand the scientific basis of recommendations/guidelines (in medicine we don’t want to simply belief stuff, we owe it to the patients that we know why we tell them the things we tell them = evidence-based medicine) and therefore it would be very helpful to include (a) how many articles/papers/reviews were reviewed (instead of "recent literature"; it makes a difference if the recommendation is based on 2 case reports or on 6000 Randomized Controlled Trials); (b) who were those "various stakeholders"?. The last thing that would be great to add is the year this recommendation was published since recommendations/guidelines tend to change quite a bit over the years. Overall, you did a very good job understanding and summarizing this really important point.'''

2.

''Rigorous review and analysis of the literature reveal that caffeine and other stimulant substances contained in energy drinks have no place in the diet of children and adolescents (American Academy of Pediatrics). Most recent literature information used to form recommendations (Published & Edited: 2011). Includes various & widespread stakeholders; pediatricians, committee on nutrition, Canadian Pediatric Society, Center for Disease Control & Prevention, FDA, Sports Medicine & Fitness committee, National Federations of High School Associations.''

''Reference: Sports Drinks and Energy Drinks for Children and Adolescents: Are They Appropriate? (2011). American Academy of Pediatrics, 127(6), 1182–1189. doi: 10.1542/peds.2011-0965''

''Health Canada includes recommendations on maximum caffeine intake for children ages 4 to 12 and is last updated on 2017. However, the information derived is from old sources between 1990 and 2003. One of the sources used is Nutrition recommendations by Health & Welfare Canada from 1990. The source is 19 years old so information from it should be viewed critically. Reference: “Health and Welfare Canada, 1990. Nutrition Recommendations.”''

''The other source is a review article published in 2003 with recommended values for caffeine intake in children. Interestingly, the review article proposed values from WHO recommendations in 1991. References: 1. Review article - Effects of Caffeine on Human Health, P. Nawrot, S. Jordan, J. Eastwood, J. Rotstein, A. Hugenholtz and M. Feeley, Food Additives and Contaminants, 2003, Vol. 20, No. 1, pg. 1-30. 2. WHO IARC Recommendation - IARC Monographs evaluate drinking coffee, maté, and very hot beverages. (1991). Retrieved from https://www.iarc.fr/wp-content/uploads/2018/07/pr244_E.pdf .''

''Although these sources are contradictory, they have their own merits. Health Canada based its recommendation on old literature and AAP based its recommendation on recent literature. It is important for Wikipedia consumers to have access to both information in order to make a sound judgment on caffeine consumption in children. Furthermore, it is necessary for clinicians to be aware of different literature results in order to properly counsel patients on safe usage/abstinence of caffeine.''

'''I really like that you point out how different guidelines have completely different recommendations in regard to the same topic, and you are absolutely right that this is valuable information for lay persons as well as for health care workers. The following points might be helpful to present your findings in a more convincing way:'''

'''When we talk about papers and scientific results, we want to use scientific vocabulary and avoid very strong and almost emotionally charged words and expressions: For example, you might want to replace "rigorous" with "thorough" or "...have no place..." with "are potentially harmful" or "are not recommended because..." This helps us to stay factual and maintain our critical mind.'''

'''Make sure that your citations are correct and cited consistently in the same way. I think for the first reference, the proper citation is: Sports Drinks and Energy Drinks for Children and Adolescents: Are They Appropriate? Committee on Nutrition and the Council on Sports Medicine and Fitness, Pediatrics Jun 2011, 127 (6) 1182-1189; DOI: 10.1542/peds.2011-0965.'''

'''" Although these sources are contradictory, they have their own merits. Health Canada based its recommendation on old literature and AAP based its recommendation on recent literature." That might be true, but it would be helpful to elaborate what merits they actually have. If you put it this way, I think everybody would conclude that the newer guideline is the one to go with, because it has newer evidence in it.'''

'''With the above outlined few changes, you could convert your great and absolutely valid ideas into a convincing argumentation. It was very nice to see that you understand the concept of critically questioning scientific content.'''