bluuebunny/crossref_metadata_2025_split huggingface dataset:
Research in Behavioral-Developmental Pediatrics: New Frontiers and Elusive Boundaries
Authors: Shonkoff Jack P. , Kennell John H. 
Published: December 2021

As an academic discipline, behavioral pediatrics has eluded simple definition. For some, it encompasses the study and management of variations in normative behavior from the newborn period through adolescence. Others prefer the designation "developmental pediatrics" or "developmental psychobiology," and focus primarily on the effects of significant illness, disability, or physiological dysfunction on children and their families. Increasingly, a more inclusive, integrated agenda has been advocated (ie, "behavioral-developmental pediatrics") to address the dynamics of human adaptation within a wide variety of contexts, including those related to biological as well as cultural or socioeconomic variation.
Rooted originally in practical problem-solving and advocacy, contemporary behavioral-developmental pediatrics is evolving into a recognized scientific and clinical discipline. This evolution is reflected in a growing participation in rigorous empirical research, as well as in the pragmatic application of a maturing data base to the care of children and their families. Behavioral-developmental pediatrics encompasses such diverse interests as the promotion of healthy lifestyles, the prevention of injury and developmental dysfunction, the provision of anticipatory guidance and early intervention, therapeutic counseling, and the care of children with chronic health impairment or disability. In each of these areas, child behavior and development are viewed increasingly through a wide-angle lens, to ensure inclusion of the contributions of both nature and nurture.
BOUNDARIES AND TENSIONS
Like other rapidly growing academic disciplines that are inherently multidisciplinary, the broad scope of behavioral-developmental pediatrics often makes its boundaries difficult to define. Generally speaking, a boundary serves as a marker of territorial limits. As such, it demarcates differences and establishes where one domain ends and the other begins.
Fitness, Activity, and Sports Participation in the Preschool Child
Authors:   Committee on Sports Medicine and Fitness
Published: December 2021

A sedentary lifestyle has been linked to the development of coronary artery disease, hypertension, diabetes mellitus, obesity, and other chronic diseases of adulthood. Although these conditions are predominantly diseases of adulthood, they are thought to be lifelong processes with their origins in childhood. The promotion of physical activity in early childhood may be important as the initial step in developing lifelong habits that may help forestall future chronic illness. Although some children may be too sedentary, others are participating in training programs and competitive sports that are inappropriate for the preschool age group. Guidelines for fitness and sports participation for preschool children younger than 6 years must be based on a careful consideration of the physical fitness needs as well as the unique developmental requirements and limitations of this age group.
LEVELS OF CHILDHOOD FITNESS
The results of recent national physical fitness testing of school-aged children have raised the concern that we are in the midst of a youth fitness crisis. It is clear from these studies that school-aged children have more body fat and weight than children had 20 years ago.1,2 However, because of the lack of comparable physical fitness tests done in the past, it has been difficult to determine if there has been a decline in physical fitness. Although national surveys, such as the National Children and Youth Fitness Study, have determined norms for field test measures of physical fitness in school-aged children, no such data exist for children younger than 6 years. In addition, it is unknown whether there has been any change in the level of physical fitness of preschool children in recent years.
Earrings: A Source of Bloodborne Infections?
Authors: WALSON PHILIP D. , BRADY MICHAEL T. 
Published: December 2021

To the Editor.—
We recently became aware of a practice which has potential for transmission of bloodborne diseases: sharing of nonsterilized earrings. Both young adult-aged children of one of us (P. W.) confided that they had shared earrings with friends. Although both children were aware of the risks associated with the sharing of needles and sexual activity, neither associated sharing earrings with any health risk. Questioning of other adolescents and young adults revealed that this practice may be widespread.
Is Ear Pulling Associated With Ear Infection?
Authors: BAKER ROBERT B. 
Published: December 2021

To the Editor.—
I have been impressed over the years by the number of children who were brought to the office by their parents because of a sole complaint of ear pulling. These children had no other symptoms, and their parents were clearly concerned about the possibility of otitis media. I decided to perform a small study within my practice of those children brought in with a chief complaint of ear pulling and to evaluate them for other signs of illness as well as otitis media.
Lack of Money—Barrier to Immunization
Authors: ZIMMERMAN RICHARD K. , GIEBINK G. SCOTT , STREET HEIDI B. 
Published: December 2021

To the Editor.—
Schulte et al1 reported in 1991 that 73% of participating Dallas County, Texas, primary care physicians referred some children to immunization clinics in 1988. As a pilot project, we interviewed 31 of 37 (84%) eligible board-certified primary care physicians in urban/suburban areas across Minnesota. Participants rated the likelihood of referring children with various types of insurance coverage to public clinics for immunization. More physicians (52%) were likely to refer children from economically disadvantaged homes without insurance than either children who had Medicaid coverage (10%, P &lt; .001) or private insurance (0%, P &lt; .001).
α-Fetoprotein and Hypothyroidism in Infants
Authors: MIZEJEWSKI G. J. , PASS K. A. 
Published: December 2021

To the Editor.—
We recently have documented a relationship between serum α-fetoprotein (AFP) and congenital hypothyroidism (CH) in the newborn period. Previous studies in our laboratory and others had reported a relationship between elevated serum AFP and elevated thyroid-stimulating hormone (TSH)/low thyroxine T4 in newborns and infants in the first few months of life.1-4 The New York State Newborn Screening Program for CH routinely screens more than 300 000 specimens per year diagnosing 120 to 140 confirmed cases of CH annually.
Is the Denver II Developmental Test Worthwhile?
Authors: GLASCOE FRANCES PAGE , BYRNE KAREN E. 
Published: December 2021

In Reply.—
We thank Dr Adesman for his timely and insightful comments regarding our research on the Denver II and Dr Dworkin for his accompanying commentary. Our findings, and Dr Adesman's comments, illustrate why it is important for authors to validate their measures prior to publication, whether their instruments are developmental checklists or screening tests. Validation is proof that instruments assess important rather than insignificant aspects of development. Validation enables authors to remove items which fail to concur with diagnostic measures and add items which best predict performance criteria (eg, successful demonstration of kindergarten readiness skills).
Overtreatment of Neonates? A Personal Retrospective
Authors: Silverman William A. 
Published: December 2021

Man's power over Nature is really the power of some men over other men, with Nature as their instrument.
—C. S. Lewis
The question of overtreatment of seriously compromised neonates with life-prolonging hardware is, in the end, a weighing of values—a moral judgment. The most pressing issues of our time, it has been said, are not matters of engineering, but of human values. And, didactic opinion to the contrary notwithstanding, I am prepared to argue that moral judgment is not monolithic. A system of values is not the same everywhere and for everyone. Nor is it an unchanging construct over time—even throughout one's own lifetime.
Piaget,1 Kohlberg,2 and Rest3 have all made a strong case for the view that differences among people, in the way they evaluate moral problems, are determined, largely, by their concepts of fairness. A sense of right grows more discerning with age and is influenced by the amount and the complexity of social experience.
Let me explain what I am getting at, by relating the growth of my own social experience as a rescuer of extremely small neonates. It began 47 years ago, when I was on the housestaff at The Babies Hospital in New York City. On January 27, 1945, a premature neonate was born in a small hospital in the Bronx, at 5½ months of gestation; birth weight was 600 g. The obstetrician was astounded that this extremely small girl breathed spontaneously and he was even more amazed to find her still alive the following day.
Malignant Vasovagally Mediated Hypotension and Bradycardia: A Possible Cause of Sudden Death in Young Patients with Asthma
Authors: GRUBB BLAIR P. , WOLFE DOUGLAS A. , NELSON LOIS ANNE , HENNESSY JAMES R. 
Published: December 2021

Asthma is a common chronic disorder affecting roughly 3% of the population of the United States and producing considerable morbidity.1 However, despite increasing knowledge concerning the pathophysiology of this disease and an expanded therapeutic armamentarium, mortality rates from asthma have increased, particularly in younger patients.2 Although some of the increase can be accounted for by under-treatment, inadequate access to care, and delays in appropriate management,3 a number of episodes of unexpected sudden death have occurred in young patients with asthma without adequate explanation.4
Recent literature provides evidence that severe episodes of vasovagally (autonomic) mediated hypotension and bradycardia (the malignant vasovagal syndrome) may mimic or cause sudden death episodes in young people.5
Pyogenic Granulomas of Infancy Masquerading as Strawberry Hemangiomas
Authors: FRIEDEN ILONA J. , ESTERLY NANCY B. 
Published: December 2021

Pyogenic granuloma (lobular capillary hemangioma) is a neovascular proliferation which is relatively common in children. The development of pyogenic granuloma may follow minor trauma or may occur on undamaged skin. We present five cases of pyogenic granulomas in young infants which were confused with strawberry hemangiomas, and we discuss the differences between these two vascular growths and implications for therapy during early infancy.
CASE REPORTS
Patient 1
A 5-month-old male infant was seen in the Pediatric Dermatology Clinic of the Children's Hospital of Wisconsin for an expanding lesion on the left cheek. The lesion had developed shortly after birth and had enlarged rapidly during the 2 to 3 months before the visit that resulted in a diagnosis of hemangioma of infancy.
Questions about Bilirubin
Authors: VAN DE BOR MARGOT , ENS-DOKKUM MARTINA , SCHREUDER ANNEKE M. , VEEN SYLVIA , VERLOOVE-VANHORICK S. PAULINE , BRAND RONALD 
Published: December 2021

In Reply.—
We agree with Dr Stein that there is ample discussion as to the potential neurotoxicity of bilirubin in relation to the etiology of hyperbilirubinemia. Unfortunately, no data were collected regarding the etiology of hyperbilirubinemia in our study population other than blood group incompatibility. Only two children suffered from blood group incompatibility. The maximal serum total bilirubin concentrations of these two children were between 151 to 200 µmol/L (8.8 to 11.6 mg/dL) and 201 to 250 µmol (11.7 to 14.6 mg/dL), respectively.
New Recommendations Not Very Different from Current Practice
Authors: AHLFORS CHARLES E. 
Published: December 2021

To the Editor.—
After reading the article by Newman and Maisels1 regarding evaluation and treatment of the jaundiced term newborn, I fail to see why their recommendations are substantially different from current practice. They merely point out what everyone has known (and not known) for a long time:
1. The magnitude of blood bilirubin concentration is not a particularly good predictor of bilirubin toxicity except in specific clinical settings such as hemolysis; ie, the total bilirubin concentration is neither a sensitive or specific indicator of the likelihood of bilirubin toxicity in the well, term jaundiced newborn.
Overtreatment of Neonates
Authors: FLEISCHMAN ALAN R. 
Published: December 2021

To the Editor.—
Dr William Silverman's recent article entitled "Overtreatment of Neonates? A Personal Retrospective"1 is a thoughtful and provocative addition to the debate on the method to decide how much treatment is appropriate for critically ill and tiny babies. He basically believes that parents should be the decision makers and that the appropriate decision is the withholding of aggressive treatments from infants at the threshold of viability. He adds his voice to others who would criticize the paternalistic physicians who ignore the values of families and merely fulfill their own "rescue fantasies (New York Times.
Overtreatment of Neonates
Authors: WEIL WILLIAM B. 
Published: December 2021

To the Editor.—
Silverman makes a cogent argument for the role of parents in making decisions regarding the treatment of severely ill newborns. His presentation of his position, both at the APS/SPR meeting on May 4, 1992, and in the accompanying article, is thoughtfully developed, carefully crafted, and elegantly prepared (and delivered).
I would agree wholeheartedly with Dr Silverman's plea for more information, gathered carefully, about the long-term outcomes for the children and their families of decisions made to treat intensively or to forego such intensity in the care of seriously imperiled neonates.
Overtreatment of Neonates
Authors: LANTOS JOHN 
Published: December 2021

To the Editor.—
At a recent meeting of the Society for Pediatric Research, Tyson et al presented an algorithm that correctly predicted outcome or could correctly predict outcome for 78% to 85% of infants.1 A subset of infants could be correctly assigned a mortality rate of &gt;90%. I asked a number of neonatologists who read the poster about the implications. For most, a prediction of &gt;90% mortality rate would not justify a decision to withhold or withdraw treatment.
Day Care for the Child Born Prematurely
Authors: Gross Ruth T. 
Published: December 2021

The Infant Health and Development Program (IHDP) has contributed to our knowledge of the role of high-quality, educational day care in the lives of children with special needs.
The IHDP was a randomized clinical trial to evaluate the efficacy of a comprehensive early intervention program in improving the health and developmental outcomes of low birth weight (LBW), premature infants. One component of this program was the provision of special day-care centers for the children receiving this intervention.
The rationale for the IHDP was based, on the one hand, on documented need. Low birth weight children are known to be at risk for a variety of medical complications in the first year of life.1-3 Thereafter, the major area of risk is delayed cognitive development, which often leads to difficulties in learning and school achievement.4-6 An increased risk for behavior problems might exacerbate these school-related difficulties.7-9 The outcomes of LBW infants have been the subject of several recent reviews.2,10-12
On the other hand, there was some evidence of effectiveness of early interventions for LBW infants, although these tended to be reports of early outcomes at single sites.13,14 More compelling was the evidence of longer-range improvement in cognitive development resulting from comprehensive early interventions for disadvantaged children of normal birth weight14,15
Given the increasing survival of premature infants, including those of very low birth weight, it was considered important to test the efficacy of such an intervention for this at-risk population in a randomized trial. The models for the IHDP were two longitudinal comprehensive programs, Abecedarian and Project CARE,16 which combined home visits, parent support, and a comprehensive educational curriculum within special day-care centers.
Continuity of Supervised Care for School-Age Children
Authors: Seligson Michelle , Allenson Michael 
Published: December 2021

Inappropriate assumptions about schoolchildren's lives can lead us to patently false conclusions. Some of us assume that mothers wait patiently at home for their children to return each day from school, or we assume that, if mothers cannot be home to greet their children, someone else will be there. Otherwise, we assume, the school probably offers some kind of supervised playground.
As authoritative a source as the Bureau of Labor Statistics subscribes to such conventional illogic, positing the notion that 5 hours of school obviates a child's need for any further daily attention. "Once a child reaches age 6," states a Bureau of Labor Statistics economist, "child care arrangements are less necessary, as most children attend school at this age."1
These assumptions do not accurately reflect a grasp of contemporary American realities. The proportion of all American children younger than age 18 with mothers in the labor force rose from 39% in 1970 to 62% in 1990; in the same 20-year period, the proportion of those mothers employed full-time rose from 26% to 46%.2 Despite recessionary pressures on the labor force, these numbers evidence a drastic decline in mothers' accessibility to their children during working hours. While extended-family members—aunts, uncles, grandparents—once reliably provided care and supervision for school-age children, in contemporary America these relatives also work, or they live too great a distance from the children's primary residence to be available, or perhaps they are simply not "into it."
More and more often, American children are left to fend for themselves before and after school.
Employers and Child Care
Authors: Galinsky Ellen , Morris Anne 
Published: December 2021

The issue of employers and child care evokes mixed feelings in the public at large. While some herald corporate involvement in child care as the shot in the arm that will bring about genuine quality improvements, others see it as little more than a public relations ploy aimed at selling the image or product of the company rather than at the well-being of children. While some maintain that corporate involvement is widespread, others are more skeptical, believing that the "noise in the system" has been caused by the efforts of a few highly publicized companies and that this so-called trend is not widespread at all. While some see corporate involvement as a lasting commitment, others suspect that it will be short-lived, a fad doomed to extinction at the first business downturn. Likewise, the effect of corporate involvement is disputed. While some see the effect as radiating out, affecting the total child care delivery system, others suspect that only the employees' children in involved companies truly benefit. Such critics may be, in fact, grateful for a limited impact because they believe that much of corporate action would probably result in quick fixes undertaken without a true appreciation for the complexities of the child care system.
One of the main reasons that the issue of employers and child care arouses such divergent reactions is that there have been few data to use in assessing its prevalence, its predictors, its effect, and its future prognosis. Thus, the public debate has revolved more around rhetoric than fact, on "guesstimates" rather than true estimates.
Scope of Health Care Benefits for Infants, Children, and Adolescents Through Age 21 Years
Authors:   Committee on Child Health Financing
Published: December 2021

All infants, children, and adolescent patients through age 21 years must have access to comprehensive health care benefits that will ensure their optimal health and well-being. The following services should be included in the health benefit plans offered by all private and public insurers. These services should be performed in a cost-effective manner that does not compromise the highest quality of care in a variety of appropriate settings. As these services are physician directed and medically necessary, they should not be limited and should include all of the following:
1. Medical care, including (a) health supervision with its preventive care and immunizations according to the "Recommendations for Preventive Pediatric Health Care"1 of the American Academy of Pediatrics, and, (b) diagnosis and treatment of acute and chronic illness, developmental disabilities, learning disorders, and behavioral problems.
2. Surgical care.
3. Mental health services including those appropriate for treatment of substance abuse and other psychosocial problems, as directed or prescribed by a physician.
4. Emergency and trauma care services.
5. Inpatient hospital services.
6. Specialty and pediatric subspecialty consultations occurring either in the inpatient or outpatient setting.
7. Family planning services.
8. Pregnancy services including: (a) genetic counseling and related services as needed; (b) prenatal care; (c) prenatal consultation with a pediatrician; (d) care of all complications; (e) counseling on all pregnancy options; (f) elective termination of pregnancy; (g) care for the pregnancy of a single dependent of the policy holder.
9. Care of all newborns and infants including: (a) Attendance and management at high-risk deliveries; (b) health supervision; (c) treatment of congenital anomalies and other illnesses on injuries.
Recurrent Hemolytic Uremic Syndrome Secondary to Escherichia coli 0157:H7 Infection
Authors: SIEGLER RICHARD L. , GRIFFIN PATRICIA M. , BARRETT TIMOTHY J. , STROCKBINE NANCY A. 
Published: December 2021

Recurrence of the hemolytic uremic syndrome (HUS) is unusual; most recurrent cases are atypical,1 that is, not preceded by the customary diarrheal prodrome. We report a case in which results of serologic tests and stool culture provided evidence that both the initial episode and the recurrence followed diarrhea caused by Escherichia coli 0157:H7. This child was previously described because of severe ocular involvement that followed the initial HUS episode.2)
CASE REPORT
A 16-month-old white boy from rural Idaho was in good health until about 1 week before admission, when a respiratory tract infection complicated by otitis media developed. He was treated with amoxicillin.
Familial Vesicoureteral Reflux
Authors: ROSCELLI JOHN D. 
Published: December 2021

To the Editor.—
I read with interest a recent article in Pediatrics concerning screening for familial vesicoureteral reflux (VUR).1 The authors found a 46% incidence of VUR in the siblings of index cases. These index cases had VUR diagnosed by voiding cystourethrograms (VCUGs) which were performed because the patients had experienced a urinary tract infection (UTI). This was an interesting and well-done study. It suffers, however, from the same problem as other studies on this subject,2,3 ie, the lack of a control population to define the underlying incidence of VUR in "normal" individuals from "normal" families.
Button Battery Recommendations Questioned
Authors: MARCUS STEVEN M. , HONCHARUK LOIS , RUCK BRUCE , JENNIS THELMA , DENNIS SUSANA 
Published: December 2021

To the Editor.—
We are writing to comment on the article "Ingestion of Cylindrical and Button Batteries, an Analysis of 2382 Cases" and the accompanying commentary on the article that appeared in the April 1992 issue of Pediatrics.1,2
We are concerned with the commentary statement that "the study provides clear and unambiguous data and a well-considered management protocol that should be followed as the standard of care." We have difficulty with an editorial comment that establishes a standard of care because this opens the arena to litigation.