bluuebunny/crossref_metadata_2025_split huggingface dataset:
On Listening to Parents: The Sudden Infant Death Syndrome Over 25 Years
Authors: Tonkin Shirley 
Published: December 2021

I have been watching the sudden infant death syndrome (SIDS) epidemic in New Zealand over 25 years. I've seen it both coming and going.
As a medical officer with the government Department of Health, I had access to official statistics from 1960. New Zealand has a small, circumscribed, stable population, a good universal public health system, a good standard of infant health, and almost full employment. However, in 1970, because New Zealand had a high postneonatal infant mortality rate in comparison with other countries such as the United States, I decided to home visit each family in Auckland (population 500 000) where an infant's death had occurred. I expected to learn of such deaths from hospital records, and although I had learned that there were approximately 80 such deaths in Auckland annually, the hospital could supply me with the names of only 10. This lack of deaths occurring in hospital explains why pediatricians were unaware of the situation. "The coroner may know of some deaths that have happened in people's homes," I was told. The coroner gave me a long list. In that year over 70 babies had died unexpectedly in their own homes, unattended by any medical practitioner. I checked the death certificates. Twenty of these home deaths were inevitable from severe congenital defects, 25 had died of unrecognized infections, but the other 25 had not been sick. They had been well cared for. They had simply been found dead after having been put down for sleep in the usual manner.
Lead in Breast Milk
Authors: Baum Carl R. , Shannon Michael W. 
Published: December 2021

Continued efforts are needed to identify all environmental sources of lead, a potent neurotoxin. In recent decades, lead has been removed from gasoline and from food containers, resulting in dramatic falls in the blood lead of American children. Although this has left paint and lead dust as primary sources of lead, it also elevates the importance of identifying other potential sources (eg, soil, water).1,2
Questions have arisen in the past regarding the excretion of maternal lead into breast milk.
A Cohort Study on Childhood Asthma Admissions and Readmissions
Authors: To Teresa , Dick Paul , Feldman William , Hernandez Rod 
Published: December 2021

Background. Admissions to hospitals for childhood asthma seem to be increasing, even though admissions for other childhood conditions are decreasing. We studied admissions and readmissions for childhood asthma in Ontario in an attempt to uncover factors relating to the admission patterns.
Methods. Using the hospital discharge data from the Canadian Institute for Health Information, 28 646 children with diagnoses of asthma were identified from April 1, 1989, to March 31, 1992.
Results. The admission rates for asthma among children in Ontario showed a 14.8% decrease from 1987 to 1992. This decline was observed primarily in 5- to 17-year-olds. Younger children had a fourfold risk of hospital admission for asthma. In the 4 years studied, 10 427 children (36.4%) were readmitted at least once, representing 22 114 readmissions, 16 196 (73.2%) of which were for asthma. The 6-month probabilities of readmission for asthma were 20.0% (0- to 4-year-olds) and 11.7% (5- to 17-year-olds). The estimated relative risks (RRs) indicated that younger children had a significantly higher risk of readmission for asthma (RR, 1.38;95% confidence interval, 1.30 to 1.46) or asthma-related causes (RR, 5.02; 95% confidence interval, 4.16 to 6.05).
Conclusions. The observed increasing trend in admissions for asthma among children in the 1970s and 1980s leveled off in the early 1990s. The declining admission rates were largely caused by the lower admission rates among school-aged children from 5 to 17 years. The relatively high admission and readmission rates of preschool children are still a concern. Further research is necessary to examine factors that influence admissions for asthma among young children.
Male Adolescents Involved in Pregnancy: Associated Health Risk and Problem Behaviors
Authors: Spingarn Roger W. , DuRant Robert H. 
Published: December 2021

Objective. Little is known about male high school students who have been involved in a pregnancy. This study was undertaken to determine whether male involvement with a pregnancy during adolescence is associated with other risk and problem behaviors.
Methods. The 1993 Massachusetts Youth Risk Behavior Survey was conducted on a random sample of 3054 9th- through 12th-grade students. The use of tobacco, alcohol, and other drugs, early and multiple sexual experiences, fighting resulting in injury, and demographic variables were compared between sexually active young men who reported being involved in pregnancy (n = 82) and their counterparts who reported not ever causing a pregnancy (n = 537). Associations were measured using x2 analyses and Kruskal-Wallis analysis of variance. Stepwise logistic regression was used to further analyze those variables significantly associated with involvement with a pregnancy.
Results. Based on logistic regression, older age and earlier ages of onset of cocaine use, initial sexual intercourse, and regular use of cigarettes were associated with being involved with a pregnancy. An increased lifetime frequency of cocaine use, lifetime frequency of alcohol use, and an increased number of lifetime sexual partners were also associated with having caused a pregnancy. Those who reported involvement with a pregnancy reported a higher frequency of being injured in a fight during the past year, drinking while driving, and having multiple sexual partners during the previous 30 days than those who had not gotten someone pregnant.
Conclusions. A history of being involved with a pregnancy clustered with other health risk and problem behaviors to form a "risk behavior syndrome." These findings suggest that when risk behaviors are encountered during the routine comprehensive screening of male adolescents, strategies for pregnancy prevention among young men should also be emphasized.
Pinhole Occluder
Authors: Risser William L. 
Published: December 2021

This issue of Pediatrics includes an American Academy of Pediatrics policy statement titled "Protective Eyewear for Young Athletes." I have begun using these guidelines and have found that one of the requirements-that athletes obtain an eye evaluation before clearance for participation in sports if their visual acuity is worse than 20/40 in either eye-often results in indigent athletes not playing sports because they cannot afford these services.
After the policy statement was approved for publication, too late to alter it, the AAP Committee on Sports Medicine and Fitness became aware of a device called a pinhole occluder.
Need for Bedtime Dose of Ritalin
Authors: Rogers William B. 
Published: December 2021

Congratulations to Dr Jeffrey D. Kent and co-workers for their article on methylphenidate dosing in the late afternoon (Pediatrics. 1995;96;320-325). They deserve extra praise for publicizing that many children with attention deficit disorder with hyperactivity (ADDH) need more than an AM and noon dose of that psychoenergizer.
As a full-time, private practicing pediatrician for 47 years, and one who has, in the past decade, developed a special interest in treating ADDH, I can heartily support their findings.
QUALITY OF CARE FOR PRESCHOOL CHILDREN WITH ASTHMA: THE ROLE OF SOCIAL FACTORS AND PRACTICE SETTING
Authors: Tracy James M. , Koabayshi Roger H. 
Published: December 2021

Racial minorities admitted for asthma were less likely to have received maximally effective preventive therapy. Marked differences in the quality of care planned after hospital discharge differed significantly when comparing white patients with black and Hispanic patients. In an era of health care reform, attention should focus on the area of high quality care for underserved children who are already at high-risk for asthma-related morbidity.
[See table in the PDF file]
The Impact of Physical Activity on Lipids, Lipoproteins, and Blood Pressure in Preadolescent Girls
Authors: Craig Suzanne B. , Bandini Linda G. , Lichtenstein Alice H. , Schaefer Ernst J. , Dietz William H. 
Published: December 2021

Objective. Inconsistent findings reported for the effect of physical activity on lipids, lipoproteins, and blood pressure in children may be due to errors inherent in the methods used to measure physical activity, lack of control for other cardiovascular risk factors, or both. The purpose of this study was to evaluate the association between physical activity assessed using direct measures of energy expenditure and cardiovascular risk factors, controlling for dietary intake and percent body fat.
Methods. Nonresting energy expenditure was determined in 49 8- to 11-year-old girls from measurements of daily energy expenditure (using doubly-labeled water, 2H218O) and resting metabolic rate (using indirect calorimetry). Self-reported recall of the hours of participation in physical activities of at least moderate intensity (energy expenditure at least four times the resting metabolic rate, METS ≥4) during the previous year was also obtained. Percent body fat was estimated from the measurement of total body water with H218O. Concentrations of total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (apo B), apo A-I, lipoprotein (a), insulin, and estradiol, as well as the waist-to-hip ratio, systolic blood pressure, diastolic blood pressure, and dietary intake from 7-day food records were measured Data were analyzed using Pearson product-moment correlation and stepwise multiple regression.
Results. Self-reported hours of participation in activities with METS (metabolic equivalents) of 4 or greater significantly predicted LDL-C and apo B concentrations, even after adjustment for percent body fat and percentage of dietary energy from saturated fat. Nonresting energy expenditure adjusted for weight, a measure of the energy spent on physical activity, did not predict LDL-C or high-density lipoprotein cholesterol concentrations. Body mass index and insulin concentration predicted systolic and diastolic blood pressure, respectively.
Conclusions. These findings suggest that the intensity of physical activity may be a more important determinant of LDL-C in children than the energy spent on physical activity.
Triathlon Participation by Children and Adolescents
Authors:   Committee on Sports Medicine and Fitness
Published: December 2021

This Policy Statement was retired May 2004.
Triathlon is a sport combining swimming, cycling, and running in one continuous event. It is a relatively new sport for children and adolescents, and participation is growing rapidly. The purpose of this statement is to provide pediatricians and others with information on the participation in triathlons by young athletes. A list of triathlon events is given in the "Resources" section at the end of this statement.
Maternal Postpartum Cognitive Deficits and Early Discharge of Infants
Authors: Eidelman Arthur I. , Kaitz Marsha 
Published: December 2021

In the ongoing debate regarding the appropriate time postparturn to discharge the mother-infant dyad from the hospital,1,2 the focus has rightfully been on the health status of the infant and the need for supervised postdischarge medical services. Less discussion, let alone objective data, has been presented as to maternal factors in the decision for or against early discharge.
Thus, we wish to bring to the attention of the readers of Pediatrics our recent study3 that documented significant cognitive deficits in women on the first postpartum day.
The New Immunization Debate
Authors: Terry William F. 
Published: December 2021

Polio is a disease that has not occurred in the United States in its wild form in the last 17 years and which is likely to be eradicated worldwide in the next decade. Given these facts, it seems excessive to formulate a policy that attempts to achieve high-titer lifelong immunity in 100% of the pediatric population in this country.
Dr Katz's excellent summary1 mentions that the Institute of Medicine and the Centers for Disease Control and Prevention considered five options involving either four doses of polio vaccine in various combinations or no immunization at all.
Letter To The Editor
Authors: Adler Philip 
Published: December 2021

In his argument supporting the Advisory Committee on Immunization Practices-recommended switch to a sequential inactivated polio vaccine/oral polio vaccine (IPV/OPV) immunization schedule (Pediatrics. 1996;98:116-117), Dr Samuel Katz fails to address the enormity of the threat that an untested immunization practice poses to an unprepared public.
Dr Katz theorizes that the proposed sequential schedule may reduce the six to eight cases of vaccine-associated paralytic polio that occur each year. Yet no solid proof exists to support this claim.
Unintended Consequences of Punishment
Authors: McCord Joan 
Published: December 2021

Because punishments are intended to control children's behavior, many people assume that the major—and perhaps the sole—consequence of punishment is teaching children to behave as they ought. Yet the use of punishment is (I will argue) counterproductive. Furthermore, the use of punishment has additional unintended consequences. I will attempt to demonstrate how children perceive punishments and what those unanticipated consequences are. These illustrations rest on the nature of reasoning itself, although they are bolstered by empirical evidence.
Although this conference is about the use of corporal punishment, most of what I have to say applies to using any type of punishment—including, of course, physical punishment.
First, punishments give pain and therefore teach children that at least under some conditions, it is all right to give pain to others.
The law of excluded middle asserts that things must be either of one class or not of that class. I believe this law is fundamental to rational thought. Even very young children come to understand it and can therefore reason that parents are either good or not good when they punish.
Let me begin with the assumption that children believe their parents are good. If good people do good things, then if they punish, it must be good to give pain. If good people do bad things, then even if giving pain is bad, it is all right to do some bad things. That is, if a parent uses punishments, then either the parent is doing something right and it is right to give pain or the parent is doing something wrong and it is all right to do something wrong.
How Can Generative Theories of the Effects of Punishment be Tested?
Authors: Cohen Patricia 
Published: December 2021

For a number of us at this conference who have concluded on the basis of the substantial literature1-17 and their own empirical data18,19 that punishment is a serious risk for poor child and adult outcome, the relative sparsity of studies that provide unambiguous evidence of negative effects of spanking specifically, and corporal punishment as compared with noncorporal punishment,20 comes as a shock. (By unambiguous evidence we require longitudinal investigation with appropriate controls for potential confounding variables, particularly the child's behavioral elicitation of the punishment). Dr McCord has provided a series of theoretically coherent reasons why we would expect such negative outcomes. I would like to focus on some of the reasons why research is still needed on this topic.
It is hard, possibly even impossible, to study spanking or corporal punishment without contamination from the other variables with which it is moderately to strongly correlated, particularly the tendency to use punishment more frequently, and to use a greater variety of punishment methods. Current advocates of spanking propose considerable restrictions as to the age of the child and the circumstances, methods, and frequency of use that can be endorsed. Is it likely ever to be possible to determine whether punishment has positive or negative effects when used within these restrictions? It is useful to consider this question within current paradigms for determining the effects of any treatment on a particular problem.
EFFICACY RESEARCH
When determining the efficacy of a given medical, surgical, or other treatment on a disease or other problem, the preferred model is the randomized trial.
Assessing the Causal Effect of Childhood Corporal Punishment on Adult Violent Behavior: Methodological Challenges
Authors: Bauman Laurie J. 
Published: December 2021

Professor Straus' article addresses a key scientific question in the debate over the use of corporal punishment: whether the practice has harmful consequences to society. In my discussion I have three goals. First, I want to discuss briefly some of the methodological challenges in testing the hypothesis that child corporal punishment causes societal violence. Second, I would like to set Straus' work into a larger framework so we understand its contribution to the debate about corporal punishment, and how the evidence he provides could be used to help settle the question. Last, I will suggest a scientific approach to the study of corporal punishment that would provide a set of decision rules concerning whether accept or reject corporal punishment of children.
METHODOLOGICAL CHALLENGES
The issue of potential short- and long-term harm from corporal punishment is a major theme in the literature, and many studies have been conducted to address this issue. In his article, Straus uses two kinds of evidence: data from studies of societies; and studies comparing children who were spanked and children who were not on rates of violent behavior in adolescence or adulthood. There are several difficulties in using these scientific approaches.
Societal Level Studies
Straus references societal-level data from Montague1 on eight nonviolent societies, all of which raise children without use of corporal punishment, and anthropological studies of over 300 societies archived in the Human Resources Area File. He uses these data to examine whether corporal punishment is associated with violence such as assault, homicide, or wife-beating.
Periconceptional Multivitamin Use and the Occurrence of Conotruncal Heart Defects: Results From a Population-based, Case-Control Study
Authors: Botto Lorenzo D. , Khoury Muin J. , Mulinare Joseph , Erickson J. David 
Published: December 2021

Objective. The preventive efficacy of the periconceptional use of multivitamins is well established for neural tube defects, much less so for other birth defects. We conducted a population-based, case-control study to assess the effects of multivitamin use on the risk for conotruncal defects, a group of severe heart defects that includes transposition of the great arteries, tetralogy of Fallot, and truncus arteriosus.
Methods. From the population-based Atlanta Birth Defects Case-Control Study, we identified 158 case infants with conotruncal defects and 3026 unaffected, randomly chosen control infants, born from 1968 through 1980 to mothers residing in metropolitan Atlanta. Periconceptional multivitamin use was defined as reported regular use from 3 months before conception through the third month of pregnancy. We present the results of the crude analysis, because the multivariate model yielded essentially identical results.
Results. Mothers who reported periconceptional multivitamin use had a 43% lower risk of having infants with conotruncal defects (odds ratio [OR], 0.57; 95% confidence interval [CI], 0.33 to 1.00) than did mothers who reported no use. The estimated relative risk was lowest for isolated conotruncal defects (OR, 0.41; 95% CI, 0.20 to 0.84) compared with those associated with noncardiac defects (OR, 0.91; 95% CI, 0.33 to 2.52) or a recognized syndrome (OR, 1.82; 95% CI, 0.31 to 10.67). Among anatomic subgroups of defects, transposition of the great arteries showed the greatest reduction in risk (OR, 0.36; 95% CI, 0.15 to 089).
Conclusions. Periconceptional multivitamin use is associated with a reduced risk for conotruncal defects. These findings could have major implications for the prevention of these birth defects.
GET REAL!
Authors: L. J. F. 
Published: December 2021

Recent Bulletins from the language wars:
There are no more girdles left in the world-they are all "shapewear."
Nudists have virtually disappeared, though there are many practitioners of clothing-optional lifestyle.
At Stanford University, nobody ever fails a course. Instead, a dedicated campus underachiever gets an NP—no pass.
To the amazement of all, pedophiles and some sex researchers now refer to adult sex with children as "intergenerational intimacy."
Perhaps necrophilia would emerge as "post-terminal intimacy."
Intraventricular Hemorrhage and Hig-frequency Ventilation: A Meta-analysis of Prospective Clinical Trials
Authors: Clark Reese H. , Dykes Francine D. , Bachman Thomas E. , Ashurst James T. 
Published: December 2021

Objective. The association between high-frequency ventilation (HFV) and intraventricular hemorrhage (IVH) and periventricular leukomalacia (PVL) has been debated.
Purpose. To determine if premature neonates treated with HFV are at greater risk for developing IVH and/or PVL than neonates treated with conventional ventilation, we completed a meta-analysis of all prospective randomized control trials comparing HFV and conventional ventilation in the management of respiratory distress syndrome.
Methods. The meta-analysis included nine studies comparing HFV and conventional ventilation in the management of preterm neonates. To summarize the data, we calculated the difference in absolute risk for IVH and PVL between neonates treated with HFV and those treated with standard ventilation. These differences were combined to determine an overall difference in the absolute risk and its confidence interval. We examined the effect of estimated gestational age, birth weight, surfactant, and age at study entry on the results. Because one trial (HIFI study) was much larger than the other studies, it dominated the analysis, so we evaluated the data with and without including data from the HIFI trial.
Results. The occurrences of IVH and PVL ranged from 14% to 47% and 5% to 16%, respectively. This variation may be explained by the difference in the populations of neonates treated. The meta-analysis showed that use of HFV was associated with an increased risk of PVL (odds ratio = 1.7 with a confidence interval of 1.06 to 2.74), but not IVH or severe (≥grade 3) IVH. When the results of the HIFI study were excluded, there were no differences between HFV and conventional ventilation in the occurrence of IVH or PVL.
Conclusions. The association between HFV and adverse neurologic outcomes is primarily influenced by the results of the HIFI trial. Meta-analysis of more recent studies does not confirm the findings of the HIFI trial and suggests that HFV is not associated with increased occurrence of NH or PVL.