bluuebunny/crossref_metadata_2025 huggingface dataset:
School Health, Policy & Practice
Authors:   AAP Committee on School Health
Published: November 2021

Provides pediatric health care professionals with guidelines for developing health programs for school-aged children. The link between a child’s health and his or her performance in school has been firmly established. What isn’t always clear are the best ways to promote student health to improve student success. This AAP manual provides pediatric health care professionals with guidelines for communicating with schools and developing health programs for school-aged children, with a focus on health and illness management as they relate to a child’s educational problems and potential. Specific health issues are also addressed, including obesity, learning and discipline problems, chronic illness, school sports, STDs, pregnancy, child abuse, drug abuse, and more. Highlights include: definitions, scope, and goals of school health programs, recent AAP policy statements and guidelines school health services and education, nutrition, dietary practices, and school food service, preschool and special needs health issues, evaluation of school health programs, childhood obesity and nutrition education. Important topics include: Health Services, Special Education, Populations with Unique Needs, School-based Health Centers, Counseling, Psychological, and Social Services, Nutrition, Dietary Practices, Injury Prevention and School Safety, Physical Education, Physical Activity, Sports Comprehensive Health Education, The School Environment, Program Evaluation, School Health Program Models, School Health Online Resources.
CyberSafe
Authors: O'Keeffe Gwenn Schurgin
Published: November 2021

Dr. Gwenn provides the tools parents need to help their child navigate the digital world with insight and intelligence. Children today are growing up in a world far different from the one in which their parents were raised. Between the Internet, gaming systems, mp3 players, and cell phones, today's kids are nearly always connected to something digital. And, because it's developing so fast, it's hard for parents to stay on top of the technology--and even harder to figure out how to help their kids make good decisions when it comes to these things. This informative book will guide parents through the landscape of the digital world, helping them better understand things like:
The Joys of Pediatrics
Authors:   American Academy of Pediatrics
Published: November 2021

Take a break from the stresses of your practice with this collection of anecdotes collected from pediatricians. Ranging from “kids say the darndest things” to the courageous statements of terminally ill children, the collection will make you laugh, cry, and remember why you chose a career in pediatrics.
Nutrition
Authors:   American Academy of Pediatrics
Published: November 2021

Nutrition: What Every Parent Needs to Know, 2nd Edition, gives parents all the information and strategies they need to meet the dietary needs of children from birth through adolescence, as well as the facts about standards of weight and height; eating disorders and special dietary needs, alternative diets and supplements; allergies; dealing with outside influences such as grandparents, neighbors, and television; and concerns over food safety. This new second edition provides updated growth charts and the new USDA MyPlate model for healthy eating, as well as updated information on topics such as: BPA, Breastfeeding, Constipation, Fish, mercury, Omega-3 fatty acids, Hiding foods, Obesity, Organic Foods, Physical activity, Picky eaters, Sodium, Vitamins, and much more.
AM:STARs: Ethical and Legal Issues in Adolescent Medicine, Volume 22, No. 2
Authors:   American Academy of Pediatrics
Published: November 2021

This issue of Adolescent Medicine State of the Art Reviews (AM:STARs) focuses on a variety of ethical and legal issues that practitioners may encounter during the delivery of adolescent health care. A panel of authors has been assembled that not only explores these issues, but also provides the reader with sound reasoning and proposed solutions.
PCEP Book II: Maternal & Fetal Care
Authors: Kattwinkel John , Boyle Robert J. , Chisholm Christian A. , Clarke Susan B.
Published: November 2021

New 2nd edition features step-by-step skill instruction, and practice-focused exercises. Developed by a distinguished editorial board, the Perinatal Continuing Education Program (PCEP) is a comprehensive, self-paced education program in four volumes.
AM:STARs: Nutrition and Physical Activity, Vol. 23, No. 3
Authors:   AAP Section on Adolescent Health
Published: November 2021

This volume of articles focuses on nutrition, eating, and physicial activity issues and concerns of adolescents and offers strategies for improving the nutritional health of young people, increasing physical activity, and preventing and treating weight-related disorders.
Model Child Care Health Policies
Authors:   Pennsylvania Chapter American Academy of Pediatrics
Published: November 2021

Significantly revised and updated, the new Model Child Care Health Policies, 5th Edition is a must-have tool to foster adoption and implemenation of best practices for health and safety in group care settings for young children. These settings include early care and education as well as before and after school child care programs. These model policies are intended to ease the burden of writing site-specific health and safety policies from scratch. They cover a wide range of aspects of operation of early education and child care programs.

Child care programs of any type can use Model Child Care Health Policies by selecting relevant issues for their operation and modifying the wording to make selected policies appropriate to the specific settings. These settings include early education and child care centers, small and large family child care homes, part day-programs for ill children, facilities that serve children with special needs, school-age child care facilities, and drop-in facilities. The model policies can be adapted for public, private, Head Start, and tuition-funded facilities.

All of the most commonly covered health and safety topics the National Association of Child Care Resource and Referral Agencies found in state regulations are included in this guide.
Procedural Sedation for Infants, Children, and Adolescents
Authors:   American Academy of Pediatrics Section on Anesthesiology and Pain Medicine
Published: November 2021

New! Invasive and noninvasive procedures are a common and necessary component in the management of infants and children with acute and chronic diseases. As technology continues to expand, there are an increasing number of techniques that require procedural sedation outside of the operating room.

Authored by experts in a variety of specialties, Procedural Sedation for Infants, Children, and Adolescents is a comprehensive guide for the initial design and implementation of a procedural sedation program and a tool to educate pediatric health professionals on medications used for sedation, associated adverse events, and the treatment of these adverse effects.

Contents include:

Pre-sedation evaluation

Documentation and parental instructions

Monitoring for procedural sedation

Medications

Specific clinical scenarios

Non-pharmacologic interventions

Topical and local anesthetic agents

Quality improvement and assurance

and more
AM:STARs: Sports Medicine and Sports Injuries, Vol. 26, No. 1
Authors:   American Academy of Pediatrics Section on Adolescent Health
Published: November 2021

With more than 30 million US children and teenagers participating in both recreational and team sports, the adolescent physician is faced with many medical, parental and community questions and concerns regarding diagnosis, treatment and prevention of youth sports injuries.

This issue provides the adolescent physician with comprehensive, practical and up-to-date information regarding diagnosis and treatment of acute and chronic sports injuries, sports concussion, the pre-participation physical evaluation (PPE), mental health concerns, the female athlete, bone health, nutrition, travel, performance enhancing substances, injury rehabilitation, the role of the team physician and injury prevention in youth sports.

Contents in Sports Medicine and Sports Injuries include

Being a Team Doctor

Preparticipation Physical Evaluation

Concussion in Teenage Athletes

Musculoskeletal Injuries Not to Miss in Teens

Overuse and Overtraining Injuries in Teenage Athletes

Rehabilitation of Musculoskeletal Injuries in Young Athletes

The Female Athlete Triad: Energy Deficiency, Physiologic Consequences, and Treatment

The Adolescent Dancer: Common Medical Concerns and Relevant Anticipatory Guidance

Mental Health and Pressures in Teen Sports

Performance-Enhancing Substances

Extreme Sports and the Adolescent Athlete
Your Baby's First Year
Authors:   American Academy of Pediatrics
Published: November 2021

Your Baby's First Year is the definitive all-in-one resource that provides authoritative advice on every aspect of infant care.
2016 Nelson's Pediatric Antimicrobial Therapy, 22nd Ed
Authors: Bradley John S. , Nelson John D.
Published: November 2021

This best-selling resource on pediatric antimicrobial therapy provides instant access to reliable, up-to-the-minute recommendations for treatment of all infectious diseases in children.
My Child Is Sick!, 2nd Ed
Authors: Schmitt Barton D.
Published: November 2021

Prevent unnecessary calls to your office when you share the wisdom of My Child Is Sick! with your parents. The well-organized chapters, condition-specific charts, and clear advice will empower parents to make the right decisions when confronted by common childhood illnesses. Dr. Schmitt's proven guidelines will help parents figure out whether to treat their child at home, call the doctor, or head to the emergency department. The newly updated and revised second edition has been rewritten to a sixth grade reading level, so the content is easily accessible for all parents. New topics in this edition include earwax buildup, mosquito bites, strep throat infections, and wound infections.
AM:STARs: LGBTQ Youth: Enhancing Care For Gender and Sexual Minorities
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.
Avoidant/Restrictive Food Intake Disorder in Children and Adolescents
Authors: Kapphahn Cynthia J. , Derenne Jennifer
Published: November 2021

Avoidant/restrictive food intake disorder (ARFID) is a new diagnostic category in the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition), which replaces the “feeding disorder of infancy and childhood” category in Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition). The term avoidant/restrictive food intake more effectively describes restrictive disordered eating that causes psychological distress and medical complications, but does not meet the criteria for anorexia nervosa or bulimia nervosa. This article reviews the prevalence, differential diagnosis, and etiology of ARFID, and describes the various presentations of the disorder (primarily acute and chronic presentations) and common comorbid conditions. Finally, it details the medical and psychological assessment of ARFID, and outlines the multidisciplinary treatment approach, including medical monitoring, psychotherapy, psychopharmacology, and nutrition counseling.
Bone Health and Eating Disorders
Authors: Ziv Adi , Gordon Catherine M.
Published: November 2021

As the incidence of eating disorders continues to rise, secondary bone disease is increasingly being diagnosed among affected children and adolescents. Wide evidence-based data support the long-lasting deleterious effect of eating disorders that arise during adolescence on bone accretion and fracture risk. Although novel treatment strategies show promising results, early recognition and management of eating disorders and their consequences on bone health are essential for preservation of skeletal integrity among adolescents. This review summarizes recent data regarding the various factors contributing to impaired bone health, the appropriate clinical assessment, and the available imaging modalities for evaluation of bone health and targeted therapeutic strategies.
Residential Programs in the Treatment of Eating Disorders
Authors: Fisher Martin M.
Published: November 2021

Approximately 20 years ago, in response to restrictions in insurance coverage that were limiting the length of stay for patients with eating disorders who required treatment on inpatient units, alternate levels of care were proposed. Residential programs, which are more intensive than outpatient care but less intensive than inpatient care, were developed as a result. There are currently more than 75 such programs in the United States. This article reviews the literature on these programs, discusses how the programs function, includes a series of questions that have been raised about the care they provide, and gives an account of the author’s recent experiences in working with a large residential program.
The Role of the Adolescent Health Provider and Nutritionist in Family-Based Therapy
Authors: Katzman Debra K. , Turrini Tania , Grewal Seena
Published: November 2021

Adolescent health providers (AHPs) and nutritionists each have a unique role in the care of adolescents with eating disorders. Their respective roles and responsibilities are especially refined in the context of family-based therapy (FBT). The role of the AHP and nutritionist in the context of FBT requires a fundamental change in how these members of the interdisciplinary team think about and provide care to young people with eating disorders. This article focuses on the distinct roles of the AHP and nutritionist in FBT in the care of adolescents with eating disorders and their families.
Purposeful and Mindful Leadership: An Educational Framework for Global Child Health
Authors: Ludwig Stephen , Nichols David G.
Published: November 2021

Purposeful and mindful leadership for global health incorporates the same principles as any leadership endeavor. Purposeful leadership requires a core dedication to the organizational mission. There cannot be purposeful leadership without authenticity of purpose—a true desire to lead for a reason, not just leadership for the sake of leadership. Mindful leadership requires attention to the many nuances found in a particular setting, culture, and system of care or organizational structure. In global leadership, mindfulness is critical to securing success. All leadership requires the blend of the drive of purpose seasoned with the humility of mindfulness. In the United States, medical education has been shaped by the confluences of accreditation and certification. Accreditation refers to the standardization of training programs. Certification refers to the demonstrated competence of individuals to practice their profession. It is a system of checks and balances that does not exist in many other global settings but one that might serve as an effective framework for others. Central to any leadership position is the ability to promote change. In the context of global health leadership in education, change is not the replication of the US system but the preservation and adaptation of the concepts of programmatic and individual improvement efforts.
The Role of Simulation in Health Education Globally: A Review of the Neonatal Resuscitation Program and Helping Babies Breathe
Authors: Kamath-Rayne Beena D. , Visick Michael K. , Berkelhamer Sara K.
Published: November 2021

In 2010, the Neonatal Resuscitation Program became the first life support resuscitation program to formally incorporate simulation- based training with debriefing as an educational methodology. Concurrently, a simplified simulation-based neonatal resuscitation program called Helping Babies Breathe (HBB) was created, with the goal of providing low-cost, portable programming to teach basic neonatal resuscitation to birth attendants in low- and middle-income countries. Early studies evaluating the efficacy of HBB demonstrated that facility- based implementation has the potential to reduce rates of early (<24 hour) neonatal mortality and stillbirth. Subsequent investigations that have coupled HBB training with quality improvement efforts, ongoing practice, and refresher training have shown even greater effect on neonatal mortality and stillbirth rates. However, the ideal frequency of skills practice and refresher training required to retain resuscitation skills remains poorly defined. Challenges exist in defining optimal practices, as recommendations may vary by the cadre of health care professional, education level, and access to ongoing delivery room experience.

While simulation-based strategies have been shown to be effective at improving educational and clinical outcomes, the use of simulation in global health settings is challenged by hurdles such as resource limitations (complex equipment, supply chain, and expense), time intensity, dependence on skilled educators, and acceptance of simulation as a teaching strategy.
The GHESKIO Centers for Research in Haiti: An Education and Research Model in Action
Authors: Rouzier Vanessa , Young Virginia , Pape Jean William
Published: November 2021

GHESKIO (Groupe Haitien d’Etude du Sarcome de Kaposi et des Infections Opportunistes/The Haitian Group for the Study of Kaposi’s Sarcoma and Opportunistic Infections) Centers, founded in 1982, is one of the oldest institutions dedicated to the fight against HIV/AIDS. GHESKIO has 3 main objectives: patient care, training of medical personnel and community leaders, and operational research. GHESKIO efforts are focused on 4 of the most important diseases in Haiti: diarrheal diseases, HIV/AIDS, other sexually transmitted infections (STIs), and tuberculosis (TB). The emphasis is on the family because the diseases that the GHESKIO Centers are concerned with are likely to be spread in the family setting. From its inception, GHESKIO Centers have been affiliated with Cornell University Weill Cornell Medical College and the Haitian Ministry of Public Health and Population (MOPHP). GHESKIO is an official nongovernmental organization recognized by the Haitian government and working in close collaboration with the Haitian MOPHP, which has provided GHESKIO with facilities at the university hospital and at the National Institute Research Laboratory. GHESKIO is the country’s referral center and the Caribbean-leading institution for treatment and research in HIV/AIDS, STIs, TB, and diarrheal diseases.

In the 36 years since its inception, the GHESKIO Centers have continued to evolve and grow despite the challenging sociopolitical and economic conditions of the country. Haiti is the poorest nation in the western hemisphere, with 80% of the population living under the poverty line and 54% in abject poverty.1–3 Haiti has the most significant HIV and TB epidemics outside of Africa. In addition, in the past 6 years, Haiti has weathered 3 of the most devastating natural catastrophes in recent times, including a magnitude 7.0 earthquake in 2010, the largest and deadliest cholera epidemic that same year, and a devastating category-5 hurricane, Matthew, in 2016.

The GHESKIO model offers integrated preventive and curative services for HIV, TB, STIs, and diarrheal diseases in 2 campuses located in the north and south of Port-au-Prince. This approach has been expanded to include other notable diseases and services. All services are offered at each site to facilitate access to comprehensive care in a “one-stop shop” approach because the poor often cannot afford to travel to different health facilities for all their families’ needs. In addition to health services for HIV/AIDS, including the provision of antiretroviral therapy, treatment for STIs, TB treatment, psychological care, and reproductive health, support is provided with microcredit opportunities, primary and vocational school scholarships, and community outreach interventions that complete the global health model of GHESKIO. The story of GHESKIO is a model of success despite adversity, addressing significant public health problems and making a difference locally and internationally.
Breastfeeding Telephone Triage, 3rd ed
Authors: Bunik Maya
Published: November 2021

Created by a leading breastfeeding and phone care practitioner, this problem-solver helps nurses, lactation professionals, and other medical staff confidently advise breastfeeding mothers.
ADHD: What Every Parent Needs to Know
Authors: Wolraich Mark , MD Joseph F. Hagan Jr.
Published: November 2021

Parents will find the latest recommendations for the treatment and care of children with ADHD in the fully revised and updated edition of this award-winning guide. Available for purchase at https://shop.aap.org/adhd-paperback/
Autism Spectrum Disorder: What Every Parent Needs to Know
Authors: Rosenblatt Alan I. , Carbone Paul S.
Published: November 2021

This fully updated and revised guide offers authoritative, accessible advice about autism that parents can trust. Available for purchase at https://shop.aap.org/autism-spectrum-disorder-paperback/
Adolescent Risk Behaviors and Use of Electronic Vapor Products and Cigarettes
Authors: Demissie Zewditu , Jones Sherry Everett , Clayton Heather B. , King Brian A.
Published: November 2021

BACKGROUND

Adolescent use of tobacco in any form is unsafe; yet the use of electronic cigarettes and other electronic vapor products (EVPs) has increased in recent years among this age group. We assessed the prevalence and frequency of cigarette smoking and EVP use among high school students, and associations between health-risk behaviors and both cigarette smoking and EVP use.

METHODS

We used 2015 national Youth Risk Behavior Survey data (N = 15 624) to classify students into 4 mutually exclusive categories of smoking and EVP use based on 30-day use: nonuse, cigarette smoking only, EVP use only, and dual use. Prevalence of cigarette smoking and EVP use were assessed overall and by student demographics and frequency of use. Prevalence ratios were calculated to identify associations with health risk-behaviors.

RESULTS

In 2015, 73.5% of high school students did not smoke cigarettes or use EVPs, 3.2% smoked cigarettes only, 15.8% used EVPs only, and 7.5% were dual users. Frequency of cigarette smoking and EVP use was greater among dual users than cigarette-only smokers and EVP-only users. Cigarette-only smokers, EVP-only users, and dual users were more likely than nonusers to engage in several injury, violence, and substance use behaviors; have ≥4 lifetime sexual partners; be currently sexually active; and drink soda ≥3 times/day. Only dual users were more likely than nonusers not to use a condom at last sexual intercourse.

CONCLUSIONS

EVP use, alone and concurrent with cigarette smoking, is associated with health-risk behaviors among high school students.
Flavored Electronic Cigarette Use and Smoking Among Youth
Authors: Dai Hongying , Hao Jianqiang
Published: November 2021

BACKGROUND AND OBJECTIVE

Flavored electronic cigarettes (e-cigarettes) are not prohibited in the United States, and e-cigarette flavors proliferate on the market. This study sought to examine flavored e-cigarette use and its association with smoking among youth.

METHODS

Estimates of flavored e-cigarette use from the 2014 National Youth Tobacco Survey were investigated. A logistic regression model was used to assess whether flavored e-cigarette use was associated with (1) intention to initiate cigarette use among never-smoking youth (n = 16 471), (2) intention to quit tobacco use among current-smoking youth (n = 1338), and (3) perception of tobacco’s danger among all respondents (n = 21 491).

RESULTS

A total of 2017 respondents reported using e-cigarettes in the last 30 days, of whom 1228 (60.9%) reported using flavored e-cigarettes. Among never-smoking youth, 55.6% (288) of current e-cigarette users reported using flavored e-cigarettes. Among current smokers, 68.4% (495) of current e-cigarette users reported using flavored e-cigarettes. Compared with not using e-cigarettes in the past 30 days, using flavored e-cigarettes was associated with higher odds of intention to initiate cigarette use among never-smoking youth (adjusted odds ratio [aOR] = 5.7; P < .0001), lower odds of intention to quit tobacco use among current-smoking youth (aOR = 0.6; P = .006), and a lower prevalence of perception of tobacco’s danger among all respondents (aOR = 0.5; P < .0001).

CONCLUSIONS

Flavored e-cigarette use is associated with increased risks of smoking among youth. Comprehensive tobacco control and prevention strategies that address flavored e-cigarette products are critically needed to reduce tobacco use among youth.
Psychosocial Factors Associated With Adolescent Electronic Cigarette and Cigarette Use
Authors: Barrington-Trimis Jessica L. , Berhane Kiros , Unger Jennifer B. , Cruz Tess Boley , Huh Jimi , Leventhal Adam M. , Urman Robert , Wang Kejia , Howland Steve , Gilreath Tamika D. , Chou Chih-Ping , Pentz Mary Ann , 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.
Risk Factors for Exclusive E-Cigarette Use and Dual E-Cigarette Use and Tobacco Use in Adolescents
Authors: Wills Thomas A. , Knight Rebecca , Williams Rebecca J. , Pagano Ian , Sargent James D.
Published: November 2021

OBJECTIVE

To describe electronic cigarette (e-cigarette) use and cigarette use among adolescents abstract and determine whether established risk factors for smoking discriminate user categories.

METHODS

School-based survey of 1941 high school students (mean age 14.6 years) in Hawaii; data collected in 2013. The survey assessed e-cigarette use and cigarette use, alcohol and marijuana use, and psychosocial risk and protective variables (eg, parental support, academic involvement, smoking expectancies, peer smoking, sensation seeking). Analysis of variance and multinomial regression examined variation in risk and protective variables across the following categories of ever-use: e-cigarette only, cigarette only, dual use (use of both products), and nonuser (never used either product).

RESULTS

Prevalence for the categories was 17% (e-cigarettes only), 12% (dual use), 3% (cigarettes only), and 68% (nonusers). Dual users and cigarette-only users were highest on risk status (elevated on risk factors and lower on protective factors) compared with other groups. E-cigarette only users were higher on risk status than nonusers but lower than dual users. E-cigarette only users and dual users more often perceived e-cigarettes as healthier than cigarettes compared with nonusers.

CONCLUSIONS

This study reports a US adolescent sample with one of the largest prevalence rates of e-cigarette only use in the existing literature. Dual use also had a substantial prevalence. The fact that e-cigarette only users were intermediate in risk status between nonusers and dual users raises the possibility that e-cigarettes are recruiting medium-risk adolescents, who otherwise would be less susceptible to tobacco product use.
Characteristics of Youth Seeking Emergency Care for Assault Injuries
Authors: Cunningham Rebecca M. , Ranney Megan , Newton Manya , Woodhull Whitney , Zimmerman Marc , Walton Maureen A.
Published: November 2021

OBJECTIVE

To characterize youth seeking care for assault injuries, the context of violence, and previous emergency department (ED) service utilization to inform ED-based injury prevention.

METHODS

A consecutive sample of youth (14–24) presenting to an urban ED with an assault injury completed a survey of partner violence, gun/knife victimization, gang membership, and context of the fight.

RESULTS

A total of 925 youth entered the ED with an assault injury; 718 completed the survey (15.4% refused); 730 comparison youth were sampled. The fights leading to the ED visit occurred at home (37.6%) or on streets (30.4%), and were commonly with a known person (68.3%). Fights were caused by issues of territory (23.3%) and retaliation (8.9%); 20.8% of youth reported substance use before the fight. The assault-injured group reported more peer/partner violence and more gun experiences. Assault-injured youth reported higher past ED utilization for assault (odds ratio [OR]: 2.16) or mental health reasons (OR: 7.98). Regression analysis found the assault-injured youth had more frequent weapon use (OR: 1.25) and substance misuse (OR: 1.41).

CONCLUSIONS

Assault-injured youth seeking ED care report higher levels of previous violence, weapon experience, and substance use compared with a comparison group seeking care for other complaints. Almost 10% of assault-injured youth had another fight-related ED visit in the previous year, and ∼5% had an ED visit for mental health. Most fights were with people known to them and for well-defined reasons, and were therefore likely preventable. The ED is a critical time to interact with youth to prevent future morbidity.
Gun Violence Trends in Movies
Authors: Bushman Brad J. , Jamieson Patrick E. , Weitz Ilana , Romer Daniel
Published: November 2021

BACKGROUND

Many scientific studies have shown that the mere presence of guns can increase aggression, an effect dubbed the “weapons effect.” The current research examines a potential source of the weapons effect: guns depicted in top-selling films.

METHODS

Trained coders identified the presence of violence in each 5-minute film segment for one-half of the top 30 films since 1950 and the presence of guns in violent segments since 1985, the first full year the PG-13 rating (age 131) was used. PG-13–rated films are among the top-selling films and are especially attractive to youth.

RESULTS

Results found that violence in films has more than doubled since 1950, and gun violence in PG-13–rated films has more than tripled since 1985. When the PG-13 rating was introduced, these films contained about as much gun violence as G (general audiences) and PG (parental guidance suggested for young children) films. Since 2009, PG-13–rated films have contained as much or more violence as R-rated films (age 171) films.

CONCLUSIONS

Even if youth do not use guns, these findings suggest that they are exposed to increasing gun violence in top-selling films. By including guns in violent scenes, film producers may be strengthening the weapons effect and providing youth with scripts for using guns. These findings are concerning because many scientific studies have shown that violent films can increase aggression. Violent films are also now easily accessible to youth (eg, on the Internet and cable). This research suggests that the presence of weapons in films might amplify the effects of violent films on aggression.
Longitudinal Predictors of Synthetic Cannabinoid Use in Adolescents
Authors: Ninnemann Andrew L. , Choi Hye Jeong , Stuart Gregory L. , Temple Jeff R.
Published: November 2021

BACKGROUND

Synthetic cannabinoids (SCs) are a large, heterogeneous group of chemicals that are structurally similar to δ-9-tetrahydrocannabinol. Many SCs are high-efficacy full agonists of the CB1 and/or CB2 cannabinoid receptors, resulting in a potent group of chemicals with a variety of negative health effects, including death. SCs are available to adolescents at convenience stores and smoke shops and on the Internet. However, little is known about the risk factors that contribute to eventual use of SCs in adolescents, and no research has examined the psychiatric, personality, and substance-use risk factors that prospectively predict SC use. On the basis of extant cross-sectional research, we hypothesized that anxiety, depression, impulsivity, and marijuana use would prospectively predict eventual SC use.

METHODS

Data were collected across 2 time points 12 months apart on adolescents attending multiple public high schools in southeast Texas (n = 964).

RESULTS

Path analysis indicated that depressive symptoms, marijuana use, alcohol use, and SC use at baseline were predictive of SC use at 1-year follow-up, whereas anxiety symptoms and impulsivity were not. In addition, SC use at baseline was not predictive of marijuana use at the 1-year follow-up. Females and African Americans were less likely to use SCs than males or those of other ethnicities.

CONCLUSIONS

SC-use prevention programming should consider depressive symptoms, marijuana use, and alcohol use as risk factors for SC use. Of particular significance, traditional marijuana use was predictive of subsequent SC use, but SC use was not predictive of later marijuana use.
Effectiveness of Vaccination During Pregnancy to Prevent Infant Pertussis
Authors: Baxter Roger , Bartlett Joan , Fireman Bruce , Lewis Edwin , Klein Nicola P.
Published: November 2021

BACKGROUND

Vaccination against pertussis during pregnancy is recommended to protect newborns, yet there is limited information about the effectiveness of maternal tetanus toxoid, reduced diphtheria toxoid, acellular pertussis (Tdap) vaccine before the first infant dose of diphtheria, tetanus and acellular pertussis (DTaP) vaccine and during the first year of life in infants who have received DTaP.

METHODS

In a retrospective cohort study of infants born at Kaiser Permanente Northern California from 2010 to 2015, we estimated the effectiveness of maternal pertussis vaccination for protecting newborns against pertussis in the first 2 months of life and in the first year of life accounting for each infant DTaP dose.

RESULTS

Among 148 981 newborns, the vaccine effectiveness of maternal Tdap was 91.4% (95% confidence interval [CI], 19.5 to 99.1) during the first 2 months of life and 69.0% (95% CI, 43.6 to 82.9) during the entire first year of life. The vaccine effectiveness was 87.9% (95% CI, 41.4 to 97.5) before infants had any DTaP vaccine doses, 81.4% (95% CI, 42.5 to 94.0) between doses 1 and 2, 6.4% (95% CI, −165.1 to 66.9) between doses 2 and 3, and 65.9% (95% CI, 4.5 to 87.8) after infants had 3 DTaP doses.

CONCLUSIONS

Maternal Tdap vaccination was highly protective against infant pertussis, especially in the first 2 months of life. Even after infant DTaP dosing, there was evidence of additional protection from maternal Tdap vaccination for the first year of life. This study strongly supports the United States’ current recommendation to administer Tdap during each pregnancy.
Prevalence of HPV After Introduction of the Vaccination Program in the United States
Authors: Markowitz Lauri E. , Liu Gui , Hariri Susan , Steinau Martin , Dunne Eileen F. , Unger Elizabeth R.
Published: November 2021

BACKGROUND

Since mid-2006, human papillomavirus (HPV) vaccination has been recommended for females aged 11 to 12 years and through 26 years if not previously vaccinated.

METHODS

HPV DNA prevalence was analyzed in cervicovaginal specimens from females aged 14 to 34 years in NHANES in the prevaccine era (2003–2006) and 4 years of the vaccine era (2009–2012) according to age group. Prevalence of quadrivalent HPV vaccine (4vHPV) types (HPV-6, -11, -16, and -18) and other HPV type categories were compared between eras. Prevalence among sexually active females aged 14 to 24 years was also analyzed according to vaccination history.

RESULTS

Between the prevacccine and vaccine eras, 4vHPV type prevalence declined from 11.5% to 4.3% (adjusted prevalence ratio [aPR]: 0.36 [95% confidence interval (CI): 0.21–0.61]) among females aged 14 to 19 years and from 18.5% to 12.1% (aPR: 0.66 [95% CI: 0.47–0.93]) among females aged 20 to 24 years. There was no decrease in 4vHPV type prevalence in older age groups. Within the vaccine era, among sexually active females aged 14 to 24 years, 4vHPV type prevalence was lower in vaccinated (≥1 dose) compared with unvaccinated females: 2.1% vs 16.9% (aPR: 0.11 [95% CI: 0.05–0.24]). There were no statistically significant changes in other HPV type categories that indicate cross-protection.

CONCLUSIONS

Within 6 years of vaccine introduction, there was a 64% decrease in 4vHPV type prevalence among females aged 14 to 19 years and a 34% decrease among those aged 20 to 24 years. This finding extends previous observations of population impact in the United States and demonstrates the first national evidence of impact among females in their 20s.
The Impact of Social Networks on Parents’ Vaccination Decisions
Authors: Brunson Emily K.
Published: November 2021

BACKGROUND AND OBJECTIVE

Parents decide whether their children are vaccinated, but they rarely reach these decisions on their own. Instead parents are influenced by their social networks, broadly defined as the people and sources they go to for information, direction, and advice. This study used social network analysis to formally examine parents’ social networks (people networks and source net-works) related to their vaccination decision-making. In addition to providing descriptions of typical networks of parents who conform to the recommended vaccination schedule (conformers) and those who do not (nonconformers), this study also quantified the effect of network variables on parents’ vaccination choices.

METHODS

This study took place in King County, Washington. Participation was limited to US-born, first-time parents with children aged ≤18 months. Data were collected via an online survey. Logistic regression was used to analyze the resulting data.

RESULTS

One hundred twenty-six conformers and 70 nonconformers completed the survey. Although people networks were reported by 95% of parents in both groups, nonconformers were significantly more likely to report source networks (100% vs 80%, P < .001). Model comparisons of parent, people, and source network characteristics indicated that people network variables were better predictors of parents’ vaccination choices than parents’ own characteristics or the characteristics of their source networks. In fact, the variable most predictive of parents’ vaccination decisions was the percent of parents’ people networks recommending nonconformity.

CONCLUSIONS

These results strongly suggest that social networks, and particularly parents’ people networks, play an important role in parents’ vaccination decision-making.
Opioid Addiction
Authors:   American Academy of Pediatrics
Published: November 2021

The opioid crisis has become far more serious than some of the other epidemics the country has faced. This collection of timely AAP journal articles, blog posts, and policy explores the risks and possible solutions.

https://shop.aap.org/pediatric-collections-opioid-epidemic-paperback/
A Qualitative Study of Family Experience With Hospitalization for Neonatal Abstinence Syndrome
Authors: Atwood Emily C. , Sollender Grace , Hsu Erica , Arsnow Christine , Flanagan Victoria , Celenza Joanna , Whalen Bonny , Holmes Alison V.
Published: November 2021

BACKGROUND AND OBJECTIVES

Although the incidence of neonatal abstinence syndrome (NAS) in the United States quintupled between 2000 and 2012, little is known about the family perspective of the hospital stay. We interviewed families to understand their experiences during the newborn hospitalization for NAS and to improve family-centered care.

METHODS

A multidisciplinary team from 3 hospital units composed open-ended interview questions based on a literature review, clinical experience, and an internal iterative process. Trained investigators conducted semi-structured interviews with 20 families of newborns with NAS at hospital discharge. Interviews were recorded and transcribed verbatim. Two investigators independently analyzed each transcript, identified themes via an inductive qualitative approach, and reached a consensus on each code. The research team sorted the themes into broader domains through an iterative process that required consensus of 4 team members.

RESULTS

Five domains of family experience were identified: parents’ desire for education about the course and treatment of NAS; parents valuing their role in the care team; quality of interactions with staff (supportive versus judgmental) and communication regarding clinical course; transfers between units and inconsistencies among providers; and external factors such as addiction recovery and economic limitations.

CONCLUSIONS

Families face many challenges during newborn hospitalization for NAS. Addressing parental needs through improved perinatal education, increased involvement in the care team, consistent care and communication, and minimized transitions in care could improve the NAS hospital experience. The results of this qualitative study may allow for improvements in family-centered care of infants with NAS.
Risk Stratification for Opioid Misuse in Children, Adolescents, and Young Adults: A Quality Improvement Project
Authors: Thienprayoon Rachel , Porter Kelly , Tate Michelle , Ashby Marshall , Meyer Mark
Published: November 2021

BACKGROUND

The Pediatric Palliative and Comfort Care Team (PACT) at Cincinnati Children’s Hospital Medical Center (CCHMC) provides opioids to a large population of patients in the ambulatory setting. Before this project, PACT had no reliable system to risk stratify patients for opioid misuse.

METHODS

The global aim was safe opioid prescribing by the palliative care team. The specific, measurable, achievable, realistic, and timely aim was as follows: “In patients who present for follow up with PACT, we will use the “opioid bundle” to increase risk stratification for opioid misuse from 0% to 90% over 5 months.” The opioid bundle includes a urine drug screen, Ohio Automated Rx Reporting System report, pill count, and screening history for drug abuse and mental health disorders. The setting was multiple CCHMC ambulatory clinics. Participants included all PACT members.

RESULTS

Since implementing the new system, we have increased risk stratification for opioid misuse among outpatients from 0% to >90%. Results have been sustained for 12 months. Key processes have become reliable: obtaining informed consent and controlled substance agreements for all new patients and obtaining the opioid bundle to enable risk stratification in a consistent and timely fashion. A total of 34% of patients have been stratified as high risk, and an additional 27% have been stratified as moderate risk.

CONCLUSIONS

A system to ensure safe opioid prescribing practices to all patients is critical for providers. Identifying key processes and executing them reliably has enabled the palliative care team at CCHMC to risk stratify >90% of patients receiving opioids in the ambulatory setting for opioid misuse.
Nonmedical Prescription Opioid and Heroin Use Among Adolescents Who Engage in Sports and Exercise
Authors: Veliz Philip , Boyd Carol J. , McCabe Sean Esteban
Published: November 2021

OBJECTIVES

Previous research has found that adolescent athletes may be at increased risk of nonmedical prescription opioid use (NPOU) due to injuries. Although adolescent athletes are at an increased risk of engaging in NPOU, it has yet to be determined if they are also at greater risk for heroin use. The major purpose of this study was to examine both the trends in prevalence rates and patterns of initiation in lifetime NPOU and lifetime heroin use among adolescents who engage in sports and exercise.

METHODS

Eighteen cross-sections of eighth and 10th graders were used from the Monitoring the Future study. The sample consisted of 191 682 respondents who answered questions on past-year participation in sports and exercise, lifetime NPOU, lifetime heroin use, age of NPOU onset, and age of heroin onset.

RESULTS

The trends in NPOU and lifetime heroin use among adolescents who engage in sports and exercise has declined between 1997 and 2014. Logistic regression analyses found that adolescents who engage in sports and exercise had lower odds of reporting lifetime NPOU and heroin use compared with adolescents who did not engage in these activities during the past year. Analyses among lifetime heroin users found that adolescents who engage in sports and exercise had lower odds of initiating NPOU before heroin when compared with their peers who did not engage in these activities in the past year.

CONCLUSIONS

Daily participation in sports and exercise may serve as a protective factor with respect to NPOU and heroin use.
Persistent Opioid Use Among Pediatric Patients After Surgery
Authors: Harbaugh Calista M. , Lee Jay S. , Hu Hsou Mei , McCabe Sean Esteban , Voepel-Lewis Terri , Englesbe Michael J. , Brummett Chad M. , Waljee Jennifer F.
Published: November 2021

BACKGROUND

Despite efforts to reduce nonmedical opioid misuse, little is known about the development of persistent opioid use after surgery among adolescents and young adults. We hypothesized that there is an increased incidence of prolonged opioid refills among adolescents and young adults who received prescription opioids after surgery compared with nonsurgical patients.

METHODS

We performed a retrospective cohort study by using commercial claims from the Truven Health Marketscan research databases from January 1, 2010, to December 31, 2014. We included opioid-naïve patients ages 13 to 21 years who underwent 1 of 13 operations. A random sample of 3% of nonsurgical patients who matched eligibility criteria was included as a comparison. Our primary outcome was persistent opioid use, which was defined as ≥1 opioid prescription refill between 90 and 180 days after the surgical procedure.

RESULTS

Among eligible patients, 60.5% filled a postoperative opioid prescription (88 637 patients). Persistent opioid use was found in 4.8% of patients (2.7%–15.2% across procedures) compared with 0.1% of those in the nonsurgical group. Cholecystectomy (adjusted odds ratio 1.13; 95% confidence interval, 1.00–1.26) and colectomy (adjusted odds ratio 2.33; 95% confidence interval, 1.01–5.34) were associated with the highest risk of persistent opioid use. Independent risk factors included older age, female sex, previous substance use disorder, chronic pain, and preoperative opioid fill.

CONCLUSIONS

Persistent opioid use after surgery is a concern among adolescents and young adults and may represent an important pathway to prescription opioid misuse. Identifying safe, evidence-based practices for pain management is a top priority, particularly among at-risk patients.