bluuebunny/crossref_metadata_2025 huggingface dataset:
Pediatric Environmental Health
Authors:   AAP Council on Environmental Health
Published: November 2021

Completely revised and expanded, the new 3rd edition is an extremely information environmental health AAP guide that helps to identify, prevent, and treat pediatric environmental health problems. This comprehensive guide puts critical children's health information and answers to parents' questions at your fingertips. From asbestos to radiation, ultraviolet rays, pesticides, asthma, lead, tobacco, childcare and school environments - plus new chapters on global climate change, plasticizers, developmental disabilities, environmental disasters, and more - current information on an exhaustive range of environmental health issues is included.
Food Fights
Authors: Jana Laura A. , Shu Jennifer
Published: November 2021

This revised 2nd edition includes new chapters on healthy breakfasts, what's lacking in snacking, the big picture (obesity stats, the role of sleep on weight, the Let's Move Campaign, risk of diabetes) as well as the most-up-to-date information on organic foods, recipes for success, and phone apps that help families stay on track with good nutrition while on the go. The authors bring together the science of nutrition with the practical insight of parents who have been in your shoes, offering simplle solutions for your daily nutritional challenges.
2012-2013 Nelson's Pediatric Antimicrobial Therapy
Authors: Nelson John D.
Published: November 2021

Practical, evidence-based recommendations from the experts in antimicrobial therapy. This bestselling and widely used resource on pediatric antimicrobial therapy provides instant access to reliable, up-to-the-minute recommendations for treatment of all infectious diseases in children.

For each disease, the authors provide a commentary to help health care providers select the best of all antimicrobial choices. The inquiring physician can immediately link to the evidence for the recommendation in the ebook or mobile version. Drug descriptions cover all antimicrobial agents available today and include complete information about dosing regimens.
AM:STARs: Advances In Health Promotion for Adolescents and Young Adults, Volume 22, Number 3
Authors:   American Academy of Pediatrics
Published: November 2021

Adolescent Medicine: State of the Art Reviews is the official journal of the AAP Section on Adolescent Health Care. This volume highlights achievements in adolescent health research and practice that are advancing the state of the art. These researchers are taking advantage of a vulnerable period in the lifespan and wisely using it as a time to promote public health. The literature collected here shares the insight of a broad range of professionals throughout the country ready to advise policy-makers and practitioners on how to build a healthy society.

Topics in Advances in Health Promotion for Adolescents and Young Adults include:

Critical Junctures: Assuring Healthy Outcomes for Adolescents in the new Millennium

The Economic Impact of Adolescent Health Promotion Policies and Programs

Social Marketing: An Underutilized Tool for Promoting Adolescent Health and much more.
Red Book (2012)
Authors: Diseases AAP Committee on Infectious
Published: November 2021

The definitive source for pediatric infectious disease solutions providing point-of-care access to diagnosis and treatment.
Autism Spectrum Disorders
Authors:   American Academy of Pediatrics, Yu Winnie
Published: November 2021

Autism Spectrum Disorders: What Every Parent Needs to Know is an invaluable resource for parents and caregivers of children who have been diagnosed with an autism spectrum disorder (ASD). Prepared under the editorial direction of 2 distinguished pediatricians who are autism experts--one of whom is also the parent of a son with autism--this book helps you understand how ASDs are defined and diagnosed and provides you with information on the most current types of behavioral and developmental therapies.
Guidelines for Perinatal Care
Authors:   AAP Committee on Fetus and Newborn
Published: November 2021

Here’s the first and best place to look for authoritative guidance on high-quality care of pregnant women, their fetuses, and their neonates. Jointly developed by the AAP and ACOG, the new 7th edition gives you a single place to look for the most recent recommendations on quality care of pregnant women, their fetuses, and their neonates.
Pediatric Preparedness Resource Kit
Authors:   AAP Disaster Preparedness Advisory Council
Published: November 2021

Tools and resources for pediatric practices to develop strategies and action plans, promote collaborative discussions, increase state- and community-level preparedness efforts to best address children's needs in times of emergency, pandemic, outbreak, or disaster.
Pediatric Obesity
Authors: Hassink Sandra G.
Published: November 2021

Significantly revised and updated, the new 2nd edition of this popular, user-friendly guide offers the latest tools and practice recommendations from the AAP needed to tackle childhood obesity.

The new 2nd edition brings you the latest point-of-care recommendations and ready-to-use tools including

- Step-by-step health supervision visit guidance spanning birth through youhg adulthood

- Numerous real-life case studies illustrating family intervention strategies

- Newly expanded, easy-to-use format

- New chapter titled, "Before Birth: Maternal Health"

- Patient education handouts, self-assessment forms, and counseling for pediatric patients and families

- Coding fact sheets for obesity-related health care services and template letter for handling carrier denials

- Growth charts for boys and girls including the new WHO growth charts

- And more!
Coding for Pediatrics, 2014
Authors:   AAP Committee on Coding
Published: November 2021

In its 19th edition, Coding for Pediatrics is the signature publication in a comprehensive suite of coding products offered by the American Academy of Pediatrics (AAP). Written by coding experts for coders and physicians, this manual is a product of the AAP Committee on Coding and Nomenclature and is extensively reviewed each year by the AAP Coding Publications Editorial Advisory Board.

This edition has been fully updated and revised to include all changes to the 2014 Current Procedural Terminology (CPT®) and International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes, complete with accompanying guidelines for their application.
Breastfeeding Telephone Triage and Advice
Authors: Bunik Maya
Published: November 2021

Created by a leading breastfeeding and phone care practitioner, this newly revised problem-solver helps nurses, lactation professionals, and other medical staff confidently advise breastfeeding mothers. It is ideal for use with the acclaimed AAP Pediatric Telephone Protocols.
The Picky Eater Project: 6 Weeks to Happier, Healthier Family Mealtimes
Authors: Muth Natalie Digate , Sampson Sally
Published: November 2021

Parents will love this one-of-a-kind book that can transform even the most finicky eaters into fledgling foodies. Focusing on kids’ participation, interactive strategies, kitchen experiments, and delicious kid-friendly recipes, the book is based on a six-week plan that makes shopping and cooking fun. The Picky Eater Project addresses both the importance of healthy childhood nutrition and family harmony. It offers tips and troubleshooting, recognizing that it takes planning and perseverance to make behavior changes stick, but that it can happen.
Your Baby's First Year, 4th Ed - Spanish
Authors:   American Academy of Pediatrics
Published: November 2021

The one guide pediatricians most recommend is now completely revised, updated and available in Spanish. From the American Academy of Pediatrics, the nation's most trusted name in child care, comes El primer año de su bebe , the definitive all-in-one resource that provides authoritative advice on every aspect of infant care. Featuring new and expanded content, including the latest reports on cutting-edge research into early brain development, Your Baby's First Year includes

Guidelines for prenatal care, with spotlights on maternal nutrition, exercise, and screening tests during pregnancy

Growth and developmental milestones through the first twelve months of a child's life, including physical, emotional, and cognitive development

An updated chapter on developmental disabilities

A complete health encyclopedia covering injuries, illnesses, and congenital diseases

Breastfeeding discussion, including its benefits, techniques, and challenges, as well as nutritional needs and vitamin/iron supplementation

Recommendations for choosing child care programs

Updated safety standards: the very latest AAP recommendations, including immunizations, childproofing, and toy safety

Safety checks for home, including bathing, preventing drowning, poisoning, choking, burns, and falls

Car safety, including information on car safety seats

And much more
Caring for the Hospitalized Child
Authors:   American Academy of Pediatrics Section on Hospital Medicine
Published: November 2021

Get immediate, on-the-spot help for safe, effective, confident inpatient care! Developed by top pediatric hospitals, the all-new Caring for the Hospitalized Child: A Handbook of Inpatient Pediatrics is sure to become your go-to resource from initial evaluation through hospital discharge management.
Pediatric Clinical Practice Guidelines & Policies
Authors:   American Academy of Pediatrics
Published: November 2021

Clinical practice guidelines and policies from the American Academy of Pediatrics covering more than 40 clinical practice guidelines, plus every AAP policy statement, clinical report, and technical report through December 2017.
Achieving a Healthy Weight for Your Child: An Action Plan for Families
Authors: Hassink Sandra G.
Published: November 2021

Help children with weight concerns by giving their parents the clear-cut information on nutrition and fitness that they need. Dr. Hassink's plan will help families meet their goals with details on diet and physical activity for at home, in school, and in the community.
AM:STARs: Advances in Adolescent Eating Disorders
Authors:   American Academy of Pediatrics Section on Adolescent Health
Published: November 2021

AM:STARs is the official publication of the AAP Section on Adolescent Health. Published 2 times a year, it offers adolescent specialists and primary care physicians timely information on matters relating to adolescent health and wellness.

https://shop.aap.org/amstars-advances-in-adolescent-eating-disorders-paperback/
An Integrated Approach to Eating Disorders and Obesity Prevention: What Has the Research Taught Us?
Authors: Neumark-Sztainer Dianne , Loth Katie A.
Published: November 2021

The broad spectrum of weight-related problems, including obesity, eating disorders, and disordered eating, is of great public health concern for adolescents, given the high prevalence and potentially harmful consequences of these problems. Traditionally the fields of obesity and eating disorders have been separate, but there has been a shift toward integration given conceptual support, empirical findings regarding shared risk factors, and practicalities related to limited time and resources. This article summarizes key research findings providing justification for an integrated approach to the prevention of obesity, eating disorders, and disordered eating behaviors. In addition, opportunities for integration within various settings are described.
Atypical Anorexia Nervosa
Authors: Saldanha Nadia E. , Itriyeva Khalida
Published: November 2021

Atypical anorexia nervosa is defined in the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) as a disorder that shares the same diagnostic criteria as anorexia nervosa (AN), including dysmorphic body image, intense fear of weight gain, and restriction of energy intake, with the exception that patients with atypical AN present at a weight that is at or above the normal range despite a significant weight loss. Patients with atypical AN share many of the same medical and psychological complications and comorbidities as those with AN but with some differences in the way they are manifested. Treatment for these patients includes medical, nutritional, and psychological aspects of care, but choosing the appropriate goal weight and understanding the expected prognosis for these patients remain areas of research and discussion.
Challenging Old Concepts in the Diagnosis and Medical Management of Adolescents With Eating Disorders
Authors: Golden Neville H. , Fisher Martin M.
Published: November 2021

Since the last edition on eating disorders was published in Adolescent Medicine: State of the Art Reviews 15 years ago, there have been a number of important changes in the approach to the diagnosis and medical management of adolescents with eating disorders. This article provides an overview of these advances, many of which challenge old concepts. The body of knowledge pertaining to the medical management of eating disorders is rapidly evolving, and the future looks bright.
Recent Advances in Neuroimaging Studies in Adolescents and Young Adults With Eating Disorders
Authors: Frank Guido K. W.
Published: November 2021

Brain imaging research in adolescents and young adults with eating disorders has shown a steep increase over the past 5 years. Findings include alterations in cortical and subcortical circuits in patients with anorexia nervosa and bulimia nervosa noted during reward processing, decision-making, body perception, and emotion and social stimulus processing. Those cortical and subcortical brain structures and functional circuits may be mechanistically involved in eating disorder behaviors. Although studies in youth with binge eating or avoidant/restrictive food intake disorder are largely still lacking, there is promise that studies that cut across diagnoses will identify neurobiologic circuits that can become targets for intervention.
Sex Differences in Eating Disorders
Authors: Nagata Jason M. , Golden Neville H.
Published: November 2021

This article highlights sex differences in epidemiology, clinical presentation, medical complications, psychiatric comorbidity, and outcomes in adolescents with eating disorders (EDs). Although EDs were historically considered female disorders, new diagnostic categories may have a relatively larger proportion of males. Disordered eating, body image dissatisfaction, and exercise among females may be more related to the desire for thinness, whereas in males it may be more related to the desire for muscularity. Medical complications are similar in males and females, but females may also present with amenorrhea. High levels of psychiatric comorbidity and high mortality rates are observed in both sexes.
Global Child Health Populations: A Community Pediatrics Framework and Relevance to Education and Research
Authors: Laraque-Arena Danielle , Wilentz James R. , Robinson Owen
Published: November 2021

This chapter reviews global health education and research within a community-oriented framework emphasizing social accountability of these 2 academic spheres. The rationale for this approach is the understanding that in low-, lower-middle–, upper-middle–, and high-income/ resource countries throughout the world, research should be guided by translational steps that ultimately lead to improvement in the care of individuals and contribute to the health of populations locally and globally. Additionally, professional education, profoundly affected by the available environment for clinical training, must display alignment with a valid and socially responsible clinical venue; for example, one based on ethical practice, responsiveness to health needs,1 and broad epidemiological principles of community pediatrics.
Evolution of Our Understanding of the Concept and Challenges of Global Health Research and Education
Authors: Stanton Bonita F.
Published: November 2021

As our understanding of the interdependence of the world’s nations has evolved, greater attention and scrutiny have been focused on the goals of improved national and international health and the processes for achieving these outcomes. The rationales for action in support of health within a country, within a region, and across the globe have changed over the last half century, as has our understanding of the consequences of these approaches. This chapter reviews the evolution over the course of the 20th and 21st centuries of our understanding of international and global health and how this evolution has been reflected in and changed the training of the medical workforce. The chapter describes the emergence of multiple forces and agencies aligned toward the goal of a global perspective on health and well-being with resources and training reflective of this overarching vision. The chapter concludes with a discussion of the critical components of continued progress toward realization of global health, especially as they relate to evidence-based training and research and deployment of the global medical workforce.
Global Health Clinical Competencies
Authors: Domachowske Joseph B. , Stewart-Ibarra Anna M. , Domachowske Elizabeth T. , Asiago-Reddy Elizabeth
Published: November 2021

The combined use of interprofessional models for research, education, administration, and clinical practice sets a framework for advancing public health. For the clinician, the pursuit of a career in global health often begins with a desire to establish or enhance patient care in countries or communities considered by many measures to be far less economically stable or technologically advanced than one’s own. Improving the treatment for or identifying novel strategies to prevent a specific disease motivates others. The successful development of the clinical aspects of a global health collaboration depends on adhering to the basic core principles of public health. Faculty practicing in settings outside of their home country need to develop, refine, and practice many of the skills acquired during training and through clinical practice experience but in the new context of understanding the unique aspects of clinical work in a new culture, usually with fewer or different resources than those to which they are accustomed. Competencies for global health faculty are grouped and discussed under 4 categories or domains: values and ethics, roles and responsibilities, communication, and team building and teamwork. Beyond these specific categories, additional special considerations merit discussion.
Implication of a Community-Based Participatory Research Model in a Behavioral Intervention Project in China
Authors: Li Xiaoming , Qiao Shan
Published: November 2021

Community-based participatory research (CBPR), as a research paradigm emphasizing principles of participation, action, and empowerment, has been widely applied in public health areas to address health needs of local communities and reduce health disparities across ethnic, geographic, socioeconomic, and cultural groups. In this chapter, we briefly introduce the core concepts and main components of the CBPR approach, review its theoretical roots, and highlight its significance in connecting academic scholars and local partners and bridging research and practice. We illustrate the concepts through an adapted CBPR theoretical model with a focus on 4 dimensions—contexts, group dynamics, intervention, and outcomes—considered in developing and implementing a CBPR intervention project. We conclude with a case study of a behavioral intervention project in China to demonstrate how to apply CBPR principles in the context of global health and make several recommendations based on experiences gained from this and other projects.
Field Guide for Air and Ground Transport of Neonatal and Pediatric Patients: A Quick Reference for Transport Teams
Authors:   American Academy of Pediatrics Section on Transport Medicine
Published: November 2021

The guide is written by clinicians with extensive transport expertise and is a must for every clinician in the field of neonatal and pediatric transport.

https://shop.aap.org/field-guide-for-air-and-ground-transport-of-neonatal-and-pediatric-patients-paperback/
Pediatric ICD-10-CM Coding 2019, 4th Ed
Authors:   American Academy of Pediatrics Committee on Coding and Nomenclature
Published: November 2021

For the pediatric provider, coder, and biller, here's the most helpful and easy-to-use manual on ICD-10-CM yet.
Coding for Pediatrics 2019, 24th Ed
Authors:   American Academy of Pediatrics Committee on Coding and Nomenclature (COCN)
Published: November 2021

The book's many clinical vignettes and examples, as well as the many coding pearls throughout, provide added guidance needed to ensure accuracy and payment.

https://shop.aap.org/coding-for-pediatrics-2019-paperback/
Caring for Your Adopted Child: An Essential Guide for Parents
Authors: Schulte Elaine , Michaelson Robin
Published: November 2021

This comprehensive resource offers trusted parenting advice from a leading adoption medicine expert and the American Academy of Pediatrics, focusing on the physical and emotional well-being of children.

https://shop.aap.org/caring-for-your-adopted-child-paperback/
E-Cigarettes, Cigarettes, and the Prevalence of Adolescent Tobacco Use
Authors: Barrington-Trimis Jessica L. , Urman Robert , Leventhal Adam M. , Gauderman W. James , Cruz Tess Boley , Gilreath Tamika D. , Howland Steve , Unger Jennifer B. , Berhane Kiros , Samet Jonathan M. , McConnell Rob
Published: November 2021

BACKGROUND

Use of electronic cigarettes (e-cigarettes) among adolescents has increased since their introduction into the US market in 2007. Little is known about the role of e-cigarette psychosocial factors on risk of e-cigarette or cigarette use in adolescence.

METHODS

Information on e-cigarette and cigarette psychosocial factors (use and attitudes about use in the home and among friends) was collected from 11th- and 12th-grade participants in the Southern California Children’s Health Study during the spring of 2014.

RESULTS

Of 2084 participants, 499 (24.0%) had used an e-cigarette, including 200 (9.6%) current users (past 30 days); 390 participants (18.7%) had smoked a combustible cigarette, and 119 (5.7%) were current cigarette smokers. Cigarette and e-cigarette use were correlated. Nevertheless, 40.5% (n = 81) of current e-cigarette users had never smoked a cigarette. Psychosocial factors (home use of each product, friends’ use of and positive attitudes toward e-cigarettes and cigarettes) and participant perception of the harm of e-cigarettes were strongly positively associated both with e-cigarette and cigarette use. Most youth who reported e-cigarette use had friends who used e-cigarettes, and almost half of current users reported that they did not believe there were health risks associated with e-cigarette use.

CONCLUSIONS

Longitudinal studies of adolescents are needed to determine whether the strong association of e-cigarette psychosocial factors with both e-cigarette and cigarette use will lead to increased cigarette use or dual use of cigarettes and e-cigarettes, or whether e-cigarettes will serve as a gateway to cigarette use.
E-Cigarettes and National Adolescent Cigarette Use: 2004—2014
Authors: Dutra Lauren M. , Glantz Stanton A.
Published: November 2021

BACKGROUND

E-cigarette use is rapidly increasing among adolescents in the United States, abstract with some suggesting that e-cigarettes are the cause of declining youth cigarette smoking. We hypothesized that the decline in youth smoking changed after e-cigarettes arrived on the US market in 2007.

METHODS

Data were collected by using cross-sectional, nationally representative school-based samples of sixth- through 12th-graders from 2004–2014 National Youth Tobacco Surveys (samples ranged from 16 614 in 2013 to 25 324 in 2004). Analyses were conducted by using interrupted time series of ever (≥1 puff) and current (last 30 days) cigarette smoking. Logistic regression was used to identify psychosocial risk factors associated with cigarette smoking in the 2004–2009 samples; this model was then applied to estimate the probability of cigarette smoking among cigarette smokers and e-cigarette users in the 2011–2014 samples.

RESULTS

Youth cigarette smoking decreased linearly between 2004 and 2014 (P = .009 for ever smoking and P = .05 for current smoking), with no significant change in this trend after 2009 (P = .57 and .23). Based on the psychosocial model of smoking, including demographic characteristics, willingness to wear clothing with a tobacco logo, living with a smoker, likelihood of smoking in the next year, likelihood of smoking cigarettes from a friend, and use of tobacco products other than cigarettes or e-cigarettes, the model categorized <25% of current e-cigarette–only users (between 11.0% in 2012 and 23.1% in 2013) as current smokers.

CONCLUSIONS

The introduction of e-cigarettes was not associated with a change in the linear decline in cigarette smoking among youth. E-cigarette–only users would be unlikely to have initiated tobacco product use with cigarettes.
High School Students’ Use of Electronic Cigarettes to Vaporize Cannabis
Authors: Morean Meghan E. , Kong Grace , Camenga Deepa R. , Cavallo Dana A. , Krishnan-Sarin Suchitra
Published: November 2021

BACKGROUND AND OBJECTIVES

Electronic cigarette (e-cigarette) use is increasing rapidly among high abstract school (HS) students. Of concern, e-cigarettes can be used to vaporize cannabis, although use rates among adolescents are unknown. We evaluated lifetime rates of using e-cigarettes to vaporize cannabis among all lifetime e-cigarette users (27.9%), all lifetime cannabis users (29.2%), and lifetime users of both e-cigarettes and cannabis (18.8%); common means of vaporizing cannabis including hash oil, wax infused with D-9-tetrahydrocannabinol (THC), and dried cannabis; and demographic predictors of using e-cigarettes to vaporize cannabis.

METHODS

In the spring of 2014, 3847 Connecticut HS students completed an anonymous survey assessing e-cigarette and cannabis use.

RESULTS

Vaporizing cannabis using e-cigarettes was common among lifetime e-cigarette users, lifetime cannabis users, and lifetime dual users (e-cigarette 18.0%, cannabis 18.4%, dual users 26.5%). Students reported using e-cigarettes to vaporize hash oil (e-cigarette 15.4%, cannabis 15.5%, dual users 22.9%) and wax infused with THC (e-cigarette 10.0%, cannabis 10.2%, dual users 14.8%) and using portable electronic vaporizers to vaporize dried cannabis leaves (e-cigarette 19.6%, lifetime cannabis 23.1%, lifetime dual users 29.1%). Binary logistic regression indicated that male students (odds ratio [OR] = 2.05), younger students (OR = 0.64), lifetime e-cigarette users (OR = 5.27), and lifetime cannabis users (OR = 40.89) were most likely to vaporize cannabis using e-cigarettes. Rates also differed by HS attended.

CONCLUSIONS

Rates of vaporizing cannabis using e-cigarettes were high. These findings raise concerns about the lack of e-cigarette regulations and the potential use of e-cigarettes for purposes other than vaping nicotine.
Pediatric Exposure to E-Cigarettes, Nicotine, and Tobacco Products in the United States
Authors: Kamboj Alisha , Spiller Henry A. , Casavant Marcel J. , Chounthirath Thiphalak , Smith Gary A.
Published: November 2021

OBJECTIVES

To investigate the epidemiologic characteristics and outcomes of exposures to electronic cigarettes (e-cigarettes), nicotine, and tobacco products among young children in the United States.

METHODS

A retrospective analysis of exposures associated with nicotine and tobacco products among children younger than 6 years old was conducted by using National Poison Data System data.

RESULTS

From January 2012 through April 2015, the National Poison Data System received 29 141 calls for nicotine and tobacco product exposures among children younger than 6 years, averaging 729 child exposures per month. Cigarettes accounted for 60.1% of exposures, followed by other tobacco products (16.4%) and e-cigarettes (14.2%). The monthly number of exposures associated with e-cigarettes increased by 1492.9% during the study period. Children <2 years old accounted for 44.1% of e-cigarette exposures, 91.6% of cigarette exposures, and 75.4% of other tobacco exposures. Children exposed to e-cigarettes had 5.2 times higher odds of a health care facility admission and 2.6 times higher odds of having a severe outcome than children exposed to cigarettes. One death occurred in association with a nicotine liquid exposure.

CONCLUSIONS

The frequency of exposures to e-cigarettes and nicotine liquid among young children is increasing rapidly and severe outcomes are being reported. Swift government action is needed to regulate these products to help prevent child poisoning. Prevention strategies include public education; appropriate product storage and use away from children; warning labels; and modifications of e-cigarette devices, e-liquid, and e-liquid containers and packaging to make them less appealing and less accessible to children.
E-Cigarettes and “Dripping” Among High-School Youth
Authors: Krishnan-Sarin Suchitra , Morean Meghan , Kong Grace , Bold Krysten W. , Camenga Deepa R. , Cavallo Dana A. , Simon Patricia , Wu Ran
Published: November 2021

BACKGROUND

Electronic cigarettes (e-cigarettes) electrically heat and vaporize e-liquids to produce inhalable vapors. These devices are being used to inhale vapors produced by dripping e-liquids directly onto heated atomizers. The current study conducts the first evaluation of the prevalence rates and reasons for using e-cigarettes for dripping among high school students.

METHODS

In the spring of 2015, students from 8 Connecticut high schools (n = 7045) completed anonymous surveys that examined tobacco use behaviors and perceptions. We assessed prevalence rates of ever using e-cigarettes for dripping, reasons for dripping, and predictors of dripping behaviors among those who reported ever use of e-cigarettes.

RESULTS

Among 1080 ever e-cigarette users, 26.1% of students reported ever using e-cigarettes for dripping. Reasons for dripping included produced thicker clouds of vapor (63.5%), made flavors taste better (38.7%), produced a stronger throat hit (27.7%), curiosity (21.6%), and other (7.5%). Logistic regression analyses indicated that male adolescents (odds ratio [OR] = 1.64), whites (OR = 1.46), and those who had tried multiple tobacco products (OR = 1.34) and had greater past-month e-cigarette use frequency (OR = 1.07) were more likely to use dripping (Ps < .05).

CONCLUSIONS

These findings indicate that a substantial portion (~1 in 4) of high school adolescents who had ever used e-cigarettes also report using the device for dripping. Future efforts must examine the progression and toxicity of the use of e-cigarettes for dripping among youth and educate them about the potential dangers of these behaviors.
Hospitalizations Due to Firearm Injuries in Children and Adolescents
Authors: Leventhal John M. , Gaither Julie R. , Sege Robert
Published: November 2021

BACKGROUND AND OBJECTIVE

Despite recent national attention on deaths from firearms, little information exists about children and adolescents who are hospitalized for firearm injuries. The objective was to determine the national frequency of firearm-related hospitalizations in the United States in children, compare rates by cause and demographics, and describe hospitalized cases.

METHODS

We used the 2009 Kids’ Inpatient Database to identify hospitalizations from firearm-related injuries in young people <20 years of age; International Classification of Diseases, Ninth Revision, Clinical Modification, and external-cause-of injury codes were used to categorize the injuries and the causes as follows: assault, suicide attempt, unintentional, or undetermined. Incidences were calculated by using the weighted number of cases and the intercensal population. Risk ratios compared incidences.

RESULTS

In 2009, 7391 (95% confidence interval [CI]: 6523–8259) hospitalizations were due to firearm-related injuries. The hospitalization rate was 8.87 (95% CI: 7.83–9.92) per 100 000 persons <20 years of age. Hospitalizations due to assaults were most frequent (n = 4559) and suicide attempts were least frequent (n = 270). Of all hospitalizations, 89.2% occurred in males; the hospitalization rate for males was 15.22 per 100 000 (95% CI: 13.41–17.03) and for females was 1.93 (95% CI: 1.66–2.20). The rate for black males was 44.77 (95% CI: 36.69–52.85), a rate more than 10 times that for white males. Rates were highest for those aged 15 to 19 years (27.94; 95% CI: 24.42–31.46). Deaths in the hospital occurred in 453 (6.1%); of those hospitalized after suicide attempts, 35.1% died.

CONCLUSIONS

On average, 20 US children and adolescents were hospitalized each day in 2009 due to firearm injuries. Public health efforts are needed to reduce this common source of childhood injury.
Alcohol and Marijuana Use and Treatment Nonadherence Among Medically Vulnerable Youth
Authors: Weitzman Elissa R. , Ziemnik Rosemary E. , Huang Quian , Levy Sharon
Published: November 2021

BACKGROUND AND OBJECTIVE

Adolescents face peak risks for onset and intensification of alcohol and marijuana use. However, we know little about these behaviors and their associations with knowledge or treatment adherence among chronically ill youth, a medically vulnerable group.

METHODS

Cross-sectional assessment of consented youth ages 9 to 18 years receiving care for asthma/cystic fibrosis, type 1 diabetes, arthritis, or inflammatory bowel disease (IBD) by using a self-administered online tool. Prevalence and correlates of risk behaviors and associations with knowledge and treatment adherence were estimated using descriptive statistics and logistic regression, controlling for demographics, mental health, and the multiclinic sampling frame.

RESULTS

Of 403 consented youth (75.8% response), 51.6% were girls, 75.1% were white, and average age was 15.6 years. Of high school youth, 36.5% and 12.7% reported past-year alcohol use and binge drinking, respectively; 20% reported past-year marijuana use. Among high school youth, 53.1% and 37.2% answered correctly that alcohol can interfere with their medications and laboratory tests; youth answering incorrectly were 8.53 and 4.46 times more likely to drink and binge drink, respectively (P values < .001). Thirty-two percent and 8.3% of high school youth reported regularly forgetting or skipping their medications in the past 30 days; compared with past-year nondrinking youth, drinkers were 1.79 and 1.61 times as likely to report regularly missing or skipping medications (P values < .05).

CONCLUSIONS

Alcohol and marijuana use are common among youth with chronic medical conditions. Alcohol use is associated with treatment nonadherence. Education and preventive interventions are warranted to ameliorate risk.
Counseling Parents and Teens About Marijuana Use in the Era of Legalization of Marijuana
Authors: Ryan Sheryl A. , Ammerman Seth D.
Published: November 2021

Many states have recently made significant changes to their legislation making recreational and/or medical marijuana use by adults legal. Although these laws, for the most part, have not targeted the adolescent population, they have created an environment in which marijuana increasingly is seen as acceptable, safe, and therapeutic. This clinical report offers guidance to the practicing pediatrician based on existing evidence and expert opinion/consensus of the American Academy of Pediatrics regarding anticipatory guidance and counseling to teenagers and their parents about marijuana and its use. The recently published technical report provides the detailed evidence and references regarding the research on which the information in this clinical report is based.
Health Risk Behaviors With Synthetic Cannabinoids Versus Marijuana
Authors: Clayton Heather B. , Lowry Richard , Ashley Carmen , Wolkin Amy , Grant Althea M.
Published: November 2021

BACKGROUND AND OBJECTIVES

Data are limited on the behavioral risk correlates of synthetic cannabinoid use. The purpose of this study was to compare the behavioral risk correlates of synthetic cannabinoid use with those among marijuana users.

METHODS

Data from the 2015 Youth Risk Behavior Survey, a cross-sectional survey conducted in a nationally representative sample of students in grades 9 through 12 (N = 15 624), were used to examine the association between self-reported type of marijuana use (ie, never use of marijuana and synthetic cannabinoids, ever use of marijuana only, and ever use of synthetic cannabinoids) and self-report of 36 risk behaviors across 4 domains: substance use, injury/violence, mental health, and sexual health. Multivariable models were used to calculate adjusted prevalence ratios.

RESULTS

Students who ever used synthetic cannabinoids had a significantly greater likelihood of engaging in each of the behaviors in the substance use and sexual risk domains compared with students who ever used marijuana only. Students who ever used synthetic cannabinoids were more likely than students who ever used marijuana only to have used marijuana before age 13 years, to have used marijuana ≥1 times during the past 30 days, and to have used marijuana ≥20 times during the past 30 days. Several injury/violence behaviors were more prevalent among students who ever used synthetic cannabinoids compared with students who ever used marijuana only.

CONCLUSIONS

Health professionals and school-based substance use prevention programs should include strategies focused on the prevention of both synthetic cannabinoids and marijuana.
The Impact of Marijuana Policies on Youth: Clinical, Research, and Legal Update
Authors:   COMMITTEE ON SUBSTANCE ABUSE, COMMITTEE ON ADOLESCENCE
Published: November 2021

This policy statement is an update of the American Academy of Pediatrics policy statement “Legalization of Marijuana: Potential Impact on Youth,” published in 2004. Pediatricians have special expertise in the care of children and adolescents and may be called on to advise legislators about the potential impact of changes in the legal status of marijuana on adolescents. Parents also may look to pediatricians for advice as they consider whether to support state-level initiatives that propose to legalize the use of marijuana for medical and nonmedical purposes or to decriminalize the possession of small amounts of marijuana. This policy statement provides the position of the American Academy of Pediatrics on the issue of marijuana legalization. The accompanying technical report reviews what is currently known about the relationships of marijuana use with health and the developing brain and the legal status of marijuana and adolescents’ use of marijuana to better understand how change in legal status might influence the degree of marijuana use by adolescents in the future.
Strategies for Improving Vaccine Delivery: A Cluster-Randomized Trial
Authors: Fu Linda Y. , Zook Kathleen , Gingold Janet A. , Gillespie Catherine W. , Briccetti Christine , Cora-Bramble Denice , Joseph Jill G. , Haimowitz Rachel , Moon Rachel Y.
Published: November 2021

OBJECTIVE

New emphasis on and requirements for demonstrating health care quality have increased the need for evidence-based methods to disseminate practice guidelines. With regard to impact on pediatric immunization coverage, we aimed to compare a financial incentive program (pay-for-performance [P4P]) and a virtual quality improvement technical support (QITS) learning collaborative.

METHODS

This single-blinded (to outcomes assessor), cluster-randomized trial was conducted among unaffiliated pediatric practices across the United States from June 2013 to June 2014. Practices received either the P4P or QITS intervention. All practices received a Vaccinator Toolkit. P4P practices participated in a tiered financial incentives program for immunization coverage improvement. QITS practices participated in a virtual learning collaborative. Primary outcome was percentage of all needed vaccines received (PANVR). We also assessed immunization up-to-date (UTD) status.

RESULTS

Data were analyzed from 3, 147 patient records from 32 practices. Practices in the study arms reported similar QI activities (∼6 to 7 activities). We found no difference in PANVR between P4P and QITS (mean ± SE, 90.7% ± 1.1% vs 86.1% ± 1.3%, P = 0.46). Likewise, there was no difference in odds of being UTD between study arms (adjusted odds ratio 1.02, 95% confidence interval 0.68 to 1.52, P = .93). In within-group analysis, patients in both arms experienced nonsignificant increases in PANVR. Similarly, the change in adjusted odds of UTD over time was modest and nonsignificant for P4P but reached significance in the QITS arm (adjusted odds ratio 1.28, 95% confidence interval 1.02 to 1.60, P = .03).

CONCLUSIONS

Participation in either a financial incentives program or a virtual learning collaborative led to self-reported improvements in immunization practices but minimal change in objectively measured immunization coverage.
Recognition and Management of Iatrogenically Induced Opioid Dependence and Withdrawal in Children
Authors: Galinkin Jeffrey , Koh Jeffrey Lee
Published: November 2021

Opioids are often prescribed to children for pain relief related to procedures, acute injuries, and chronic conditions. Round-the-clock dosing of opioids can produce opioid dependence within 5 days. According to a 2001 Consensus Paper from the American Academy of Pain Medicine, American Pain Society, and American Society of Addiction Medicine, dependence is defined as “a state of adaptation that is manifested by a drug class specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing blood level of the drug, and/or administration of an antagonist.” Although the experience of many children undergoing iatrogenically induced withdrawal may be mild or goes unreported, there is currently no guidance for recognition or management of withdrawal for this population. Guidance on this subject is available only for adults and primarily for adults with substance use disorders. The guideline will summarize existing literature and provide readers with information currently not available in any single source specific for this vulnerable pediatric population.
Safe Storage of Opioid Pain Relievers Among Adults Living in Households With Children
Authors: McDonald Eileen M. , Kennedy-Hendricks Alene , McGinty Emma E. , Shields Wendy C. , Barry Colleen L. , Gielen Andrea C.
Published: November 2021

OBJECTIVES

To describe safe storage practices and beliefs among adults who have used a prescription opioid pain reliever (OPR) in the past year; to compare practices and beliefs among those living with younger (<7 years) versus older children (7–17 years).

METHODS

A survey was administered to a nationally representative sample of adults reporting OPR use in the previous 12 months and who had children <18 years old living with them. We used Health Belief Model–derived items to measure beliefs. Safe storage was defined as locked or latched for younger children and as locked for older children. Regression models examined the association between beliefs and safe storage practices.

RESULTS

Among 681 adults who completed our survey and reported having children in their home, safe storage was reported by 32.6% (95% confidence interval [CI], 21.4–43.8) of those with only young children, 11.7% (95% CI, 7.2–16.2) among those with only older children, and 29.0% (95% CI, 18.3–39.8) among those with children in both age groups. Among those asked to answer survey questions thinking about only their oldest child, the odds of reporting safe storage decreased by half as perceived barriers increased (0.505; 95% CI, 0.369–0.692), increased twofold as efficacy increased (2.112; 95% CI, 1.390–3.210), and increased (1.728; 95% CI, 1.374–2.174) as worry increased.

CONCLUSIONS

OPRs are stored unsafely in many households with children. Educational messages should address perceived barriers related to safe storage while emphasizing how it may reduce OPR access among children.
Breastfeeding and Risk of Kawasaki Disease: A Nationwide Longitudinal Survey in Japan
Authors: Yorifuji Takashi , Tsukahara Hirokazu , Doi Hiroyuki
Published: November 2021

BACKGROUND AND OBJECTIVES

Kawasaki disease (KD) is the most common cause of childhood-acquired heart disease in developed countries. However, the etiology of KD is not known. Aberrant immune responses are considered to play key roles in disease initiation and breastfeeding can mature immune system in infants. We thus examined the association between breastfeeding and the development of KD.

METHODS

We used a nationwide population-based longitudinal survey ongoing since 2010 and restricted participants to a total of 37 630 children who had data on their feeding during infancy. Infant feeding practice was queried at 6 to 7 months of age, and responses to questions about hospital admission for KD during the period from 6 to 30 months of age were used as outcome. We conducted logistic regression analyses controlling for child and maternal factors with formula feeding without colostrum as our reference group.

RESULTS

A total of 232 hospital admissions were observed. Children who were breastfed exclusively or partially were less likely to be hospitalized for KD compared with those who were formula fed without colostrum; odds ratios for hospitalization were 0.26 (95% confidence interval: 0.12–0.55) for exclusive breastfeeding and 0.27 (95% confidence interval: 0.13–0.55) for partial breastfeeding. Although the risk reduction was not statistically significant, feeding colostrum only also provided a protective effect.

CONCLUSIONS

We observed protective effects of breastfeeding on the development of KD during the period from 6 to 30 months of age in a nationwide, population-based, longitudinal survey in Japan, the country in which KD is most common.
Impact of Prolonged Breastfeeding on Dental Caries: A Population-Based Birth Cohort Study
Authors: Peres Karen Glazer , Nascimento Gustavo G. , Peres Marco Aurelio , Mittinty Murthy N. , Demarco Flavio Fernando , Santos Ina Silva , Matijasevich Alicia , Barros Aluisio J D
Published: November 2021

BACKGROUND

Few studies have assessed the effect of breastfeeding, bottle feeding, and sugar consumption on children’s dental caries. We investigated whether the duration of breastfeeding is a risk factor for dental caries in the primary dentition, independently of sugar consumption.

METHODS

An oral health study (n = 1303) nested in a birth cohort study was carried out in southern Brazil. The average number of decayed, missing, and filled primary tooth surfaces (dmfs) and severe early childhood caries (S-ECC: dmfs ≥6) were investigated at age 5 years. Breastfeeding was the main exposure collected at birth and at 3, 12, and 24 months of age. Data on sugar consumption were collected at 24, 48, and 60 months of age. Marginal structural modeling was used to estimate the controlled direct effect of breastfeeding (0-12, 13-23, and ≥24 months) on dmfs and on S-ECC.

RESULTS

The prevalence of S-ECC was 23.9%. The mean number of dmfs was 4.05. Children who were breastfed for ≥24 months had a higher number of dmfs (mean ratio: 1.9; 95% confidence interval: 1.5–2.4) and a 2.4 times higher risk of having S-ECC (risk ratio: 2.4; 95% confidence interval: 1.7–3.3) than those who were breastfed up to 12 months of age. Breastfeeding between 13 and 23 months had no effect on dental caries.

CONCLUSIONS

Prolonged breastfeeding increases the risk of having dental caries. Preventive interventions for dental caries should be established as early as possible because breastfeeding is beneficial for children’s health. Mechanisms underlying this process should be investigated more deeply.