bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Blanket Injunction Against Disciplinary Use of Spanking Is Not Warranted by the Data
Authors: Baumrind Diana 
Published: December 2021

As Dr Larzelere's review of quality studies documents, a blanket injunction against disciplinary spanking by parents is not scientifically supportable. My brief commentary will consist of seven propositions that pertain to his conclusions.
PROPOSITION 1
The effects of parents' disciplinary methods are mediated by children's perception of their legitimacy. Reasoning with a child helps to legitimate parental authority, but to be maximally effective when a child disobeys, reasoning must be backed up periodically by consequences.
Reasoning used in conjunction with power-assertive methods clarifies the behavioral contingencies for the child by specifying what is acceptable and unacceptable behavior. When compliance cannot be obtained by repeating the directive, the addition of aversive consequences, which can include a couple of smart spanks, may be indicated. With defiant children, an additional aversive consequence enhances the effectiveness of time-out.1 Brief explanations prior to or subsequent to punishment convey the purpose behind the rules, simultaneously reinforce their inevitability, and allow the child to evaluate the reasons given. Reasoning broadens the context in which compliance is expected by generalizing from a specific act to a rule governing the larger class of behavior expected of the child. By explaining the objectives of discipline, parents enable their children to control punishment by controlling the behavior on which punishment is contingent.
PROPOSITION 2
The use of reasoning in conjunction with power-assertive methods, including physical punishment, can encourage internalization.
The judicious and limited use of power-assertive methods, including punishment, does not prevent children from internalizing parents' values.2 For example, power assertion together with explanations has been shown to increase rather than to decrease the likelihood that children will share even after instructions to do so are discontinued.3
Subabusive Violence in Child Rearing in Middle-class American Families
Authors: Graziano Anthony M. , Hamblen Jessica L. , Plante Wendy A. 
Published: December 2021

This article will summarize the results of our recent study of subabusive violence in child rearing in middle-class families, and will then discuss the implications of the findings for the questions before us—"What are the short and long term effects of corporal punishment of children?"; "Should we try to reduce its use?"; "If so, can we be advised by these results on how to accomplish that?"
Subabusive violence against children1 consists of those ordinary, everyday acts of violence—spanking, hitting, slapping, etc—that do not rise to the common definitions of abuse. Most parents accept these as proper acts of discipline in the children's best interests.
The pervasiveness of subabusive violence in child rearing is not in doubt. It is rooted solidly in American traditions2 and is supported by commonly held religious beliefs.3 Surveys4-6 indicate that some 90% of parents use corporal punishment in child rearing, and its continued use in public schools has been well-documented.7
Although its pervasiveness is not in doubt, there are questions about its effects on children—intended and unintended, positive and negative effects. Is it an effective set of disciplinary tools? Does it harm children? Do its costs outweigh its benefits? There is no doubt that abusive violence against children has harmful effects, but what about subabuse? It has been argued that subabusive violence may have direct negative effects on child development, may be a risk factor for abuse, may escalate to abuse under some still unknown conditions, may violate humanitarian values, and may contribute to maintaining a general culture of violence.1
Effects of Hypocarbia on the Development of Cystic Periventricular Leukomalacia in Premature Infants Treated With High-frequency Jet Ventilation
Authors: Wiswell Thomas E. , Graziani Leonard J. , Kornhauser Michael S. , Stanley Christian , Merton Daniel A. , McKee Linda , Spitzer Alan R. 
Published: December 2021

Background and Objective. Previous data from our institution indicate that mechanically ventilated premature Infants are at increased risk for cystic periventricular leukomalacia (CPVL), particularly if hypocapnia occurs. High-frequency jet ventilation (HFJV) may produce substantial hypocapnia. We sought to investigate whether hypocapnia during HFJV is associated with the development of CPVL.
Methods. Sixty-seven premature infants (mean gestational age, 27.2 weeks; mean birth weight, 1001 g) underwent HFJV for a mean of 44 (range, 8 to 70) hours during the first 3 days of life. All infants were followed with serial neurosonograms at least weekly until 6 to 8 weeks of age and every 2 to 4 weeks thereafter until discharge. To assess the cumulative effects of hypotension, acidosis, hypoxemia, and hypocarbia during the first 3 days of life on the development of PVL, we developed a quantitative assessment in which we assigned threshold levels at particular critical values of these parameters (such as a mean Paco2 of 20 mm Hg) and calculated an area above the curve between longitudinally connected values of these parameters and the threshold levels.
Results. Nine of the 67 infants died before 21 days of life. Of the 58 who survived beyond 21 days, large CPVL (&gt; 5 mm in size) developed in 18 infants. Infants with cysts were similar in birth weight, gestational age, and virtually all other antepartum, intrapartum, and postpartum parameters compared with the 40 neonates in whom CPVL did not develop. However, infants with CPVL were significantly more likely to have moderate or severe periventricular echodensities preceding development of CPVL and periventricular echodensities that persisted for a longer period. We did not find an effect of hypotension, acidosis, or hypoxemia on the development of CPVL There were no differences in the mean Paco2, the absolute low Paco2 values, the ranges of low Paco2 between groups, or area above the curve measurements at threshold levels of 15 and 20 mm Hg, respectively. However, logistic regression analysis revealed that infants with CPVL were independently significanfly more likely to have greater cumulative hypocarbia below a threshold level of 25 mm Hg during the first day of life (odds ratio, 5.43; 95% confidence interval, 1.33 to 22.2).
Conclusions. Hypocarbia produced by treatment with HFJV during the first 3 days of life is associated with the subsequent development of CPVL. The mechanisms for the development of CPVL among premature infants treated with HFJV need to be established.
Continuity of Pediatric Ambulatory Care in a Universally Insured Population
Authors: Mustard Cameron A. , Mayer Teresa , Black Charlyn , Postl Brian 
Published: December 2021

Objective. To describe the prevalence of continuity of care over a 5-year period in a complete cohort of urban children universally insured for medical care provided under fee-for-service reimbursement.
Method. All children enrolled in the study were born to women living in metropolitan Winnipeg between July 1,1987 and December 31, 1988 (N = 12 590). All ambulatory physician services for this group were enumerated from computerized administrative databases for the period from birth through 60 months. Continuity of care, defined as the proportion of total care provided by the most frequently seen physician or physician practice over time, was calculated for each child. Descriptive analyses include an examination of maternal and household characteristics associated with children receiving 80% or more of total ambulatory care from a single provider source.
Results. From birth to 24 months, 51% of children received at least 80% of ambulatory visits from a single provider practice. This proportion of the children declined to 28% at 25 through 60 months. Children living in low-income neighborhoods had poorer continuity profiles. Other household factors associated with poor continuity included young maternal age, single maternal marital status, residential mobility, and inadequate maternal use of prenatal medical care. Households affiliated with pediatric practices had better continuity profiles than households affiliated with general medical practices.
Conclusion. Despite universal medical insurance, barriers to a longitudinally continuous relationship with a primary care provider remain in this setting. Although this study has emphasized the description of those barriers associated with household characteristics, there is evidence that factors related to the organization and delivery of medical care are also relevant.
Employment in Nursing and Preterm Birth: Are They Linked?
Authors: LUMLEY JUDITH 
Published: December 2021

The possibility that employment itself, with all its rewards, both intrinsic and monetary, could be harmful to maternal and fetal health is always a matter for concern. When that suggestion is made about an archetypical female form of employment (nursing), and a specialist group devoted to the health care of women and infants, it is deeply alarming. So the recent publication which states, "our results show that strenuous working conditions are an important risk factor for preterm birth among US nurses," has been widely reported and discussed.
The study was a case-control study with cases and controls drawn from respondents to a cross-sectional mailed survey of members of the Association of Women's Health, Obstetric and Neonatal Nurses.
Prevention of Hepatitis A Infections: Guidelines for Use of Hepatitis A Vaccine and Immune Globulin
Authors:   COMMITTEE ON INFECTIOUS DISEASES
Published: December 2021

This Policy Statement was retired January 2004.
The licensing of two inactivated hepatitis A vaccines for persons 2 years or older necessitates development of recommendations for pediatric use, as well as a review of the current indications for immune globulin (IG) in hepatitis A prophylaxis. Both vaccines are immunogenic and protective in children and adults. A single dose of vaccine induced antibody in 88% to 96% of subjects by 2 weeks and 97% to 100% by 1 month, and protected against subsequent hepatitis A virus (HAV) disease occurring 21 days after receipt of the dose in a community with endemic hepatitis A infection. However, completion of the full vaccine schedule is recommended to assure high antibody titers and likely long-term protection. The major pediatric indications for vaccine are: (1) travelers to areas with intermediate to high rates of endemic hepatitis A, (2) children living in defined and circumscribed communities with high endemic rates or periodic outbreaks of HAV infection, and (3) patients with chronic liver disease. Immune globulin is recommended for postexposure prophylaxis, as vaccine has not yet been demonstrated to be protective for this purpose. Except for travelers, recommendations for IG use are not changed from those in the current edition of the Red Book, and include contacts of cases in the home, child care centers, and other selected sites.
Financing Pediatric Education in Community Settings
Authors: Weitzman Michael , Garfunkel Lynn C. , Connaughton Suzanne 
Published: December 2021

Increasingly, hospital-based pediatric outpatient departments are recognized as settings that attempt to combine two critical, but not always compatible, mandates: (1) education of medical students and pediatric residents in outpatient pediatrics, and (2) service, often with inadequate resources, to a socially highrisk population with a disproportionately high prevalence of social, family, and psychological dysfunction. Coexistence of these two mandates has raised a number of concerns, because pediatric ambulatory care education and training have historically been based almost exclusively in a hospital setting. Trainees often get a false impression of the types of problems they will be dealing with in pediatric primary care and of how an efficient pediatric practice is managed. In addition, they often are supervised by full-time faculty who have little if any experience in community settings and who practice only part time or not at all. These problems have led to a widespread desire to train pediatric residents outside the hospital, in settings that more closely approximate the places in which they will practice in the future. Residency programs that address this issue also provide residents with the opportunity to be trained by seasoned practitioners whose primary professional responsibility is the outpatient care of children.
To date, little has been written about the cost or the financing of such educational efforts. This article summarizes what is known about the costs. We also attempt to specify the costs that should be anticipated for the various components and steps involved in devising and implementing pediatric community-based educational programs and to describe potential sources of funding for such programs.
Editorial Pediatrics in Review
Authors: H R. J. 
Published: December 2021

First issues of new journals are something like first children. We work harder on them, we expect more of them and we blame ourselves for failures. The first issue of PEDIATRICS IN REVIEW is no exception. The authors, Editorial Board, staff at the Academy and I have worked hard to bring to our readers a new type of review publication. Our goal is simple: to help improve child health by providing information useful to those professionals who provide health services to children. The methods to achieve this goal are more complex.
THE METHODS
In each 32-page edition, which will come with your copy of PEDIATRICS, there will be four to six review articles, and a number of abstracts.
Group B Streptococcal Infections in Neonates
Authors: Baker Carol J. 
Published: December 2021

β-Hemolytic streptococci of Lancefield group B have been causally linked to neonatal disease since 1938, but only in the last decade has the group B Streptococcus become the leading etiologic agent for bacteremia and/or meningitis occurring during the first two months of life. Neither the reasons for the emergence of this organism nor the shifts over the past 40 years in the prevalence of various bacteria responsible for neonatal infection has been adequately explained. However, the importance of the group B Streptococcus as a frequent cause of neonatal mortality and morbidity demands a thorough understanding of the epidemiology and pathogenesis, clinical features, diagnostic methods, and management of these infections by physicians caring for newborn infants.
INCIDENCE
The common occurrence of neonatal group B streptococcal septicemia and meningitis in several geographically distant centers since 1970 has allowed the relatively precise determination of attack rates for early onset type (≤5 days) infection. Reported attack rates have been surprisingly uniform, varying from 1.3/1,000 to 4.0/1,000 live births (Table 1). Because the attack rates for serious neonatal infections associated with Escherichia coli and other maternally acquired coliform organisms have been constant since 1960, the appearance of the group B Streptococcus resulted in an absolute increase in the incidence of neonatal bacterial disease during the past decade in many hospitals in this country.
Kanamycin and Gentamicin Dosage in Newborn Infants
Authors: H. R. J. 
Published: December 2021

An abstract, in the August issue of PIR (1:61, 1979) was entitled Kanamycin and Gentamicin, and yet the dosage schedule was only for kanamycin. The point of the abstract was to indicate that the aminoglycosides can be given safely and effectively by the intravenous route to newborn infants, but should not be given by "push" infusion since this may result in peak serum concentrations, which may result in respiratory depression. What was unclear is that the dose of gentamicin should be lower than that of kanamycin. It should have been made clear that in the newborn the dose of gentamicin is 5 mg/kg/24 hr divided into two doses.
After 7 days of age the dose is 7.5 mg/kg/24 hr divided into three doses every eight hours. The dose given for kanamycin is correct, and is about 3 times what the dose of gentamicin is for the newborn.
Adoption and Foster Care—The Pediatrician' Role
Authors: Sokoloff Burton 
Published: December 2021

The United States now has approximately 2,500,000 adoptees under the age of 21—representing nearly 2% of the population in that age-group. In addition, about 350,000 children live with foster families in this country during any given year. These children and their families have inherent vulnerabilities and problems that pediatricians may overlook. Significant numbers of foster children and adoptees are seen with behavioral, learning, and psychiatric problems. It is important that continuing counseling be available to the adoptive family, commencing prior to the adoption procedure and following throughout the early adulthood of the adoptee.
ADOPTION
Uniqueness of Adoptio
Adoption is a situation with emotions which can be best comprehended by those in the adoptive triad itself: the birth-parents, the adoptee, and the adoptive-parents. In the adoptive procedure a mother has given up a child she has borne; parents adopt the child of an unfamiliar background, and, unlike his peers, the child knows that he was not born to the parents who have reared him. Many adoption agencies have in the past advised the adoptive-parents to raise the child as their own, love him as their own, and concurrently remind him periodically that he is not their own! Frequently no further counseling would be suggested for these families.
Scabies in Childhood
Authors: Hurwitz Sidney 
Published: December 2021

Scabies is an extremely contagious disorder caused by an itch mite, Sarcoptes scabiei, which attacks infants and children as well as adults. Infestation begins with a newly fertilized female mite. She tunnels into the stratum corneum and lives in cutaneous burrows which may measure several millimeters to a few centimeters in length. The parasite favors areas with a low concentration of pilosebaceous follicles and a thin stratum corneum. This seems to account for a difference in the distribution of lesions in infants and young children compared to older children and adults.1
INCIDENCE
Epidemics of scabies occur in 30-year cycles, each one lasting about 15 years. We presently are near the end of a world-wide pandemic which began in 1964 and, if estimates are correct, should last until or beyond 1979 or 1980.2
CASE HISTOR
A 3-month-old white female infant started with a pruritic eruption at 2 months of age. She had a scaly erythematous papular eruption on the trunk, the postauricular areas, and extremities (Fig 1) and was otherwise healthy.3 Microscopic examinations of skin scrapings and fungal cultures were performed, and the eruption was treated as a seborrheic dermatitis with frequent shampoos and topical fluocinolone acetonide cream.
Two weeks later the rash had spread to the back of the head and neck, the entire trunk, and all extremities including the palms and soles.
Pediatric Nuclear Medicine II
Authors: Treves S. , Heyman S. 
Published: December 2021

GENITOURINARY SYSTEM
Radionuclide studies of the genitourinary system have wide application in pediatric patients. They include renal scintigraphy, radionuclide cystography, and testicular scintigraphy.
Renal Scintigraphy
Early diagnosis and treatment of urinary abnormalities in children have made it possible to reduce the morbidity and mortality associated with these disorders. Radionuclide studies of the kidneys have become valuable diagnostic methods which complement radiology and ultrasonography of the genitourinary system. While information about the size, position, and shape of the renal units is available in scintigraphy, its most unique contribution is that of providing quantitative information regarding renal function. The radionuclide evaluation is done with an intravenous injection of a very small volume of radiopharmaceutical and recording with a gamma camera-computer system. Several radiopharmaceuticals can be used. The technetium-99m labeled compounds include those excreted by glomerular filtration, such as 99mTc-Sn-diethylenetriamine pentaacetic acid (DTPA), and also agents Showing varying degrees of retention by tubular cells. These include 99mTc-iron ascorbate DTPA, 99mTc-gluco-heptonate and 99mTc-dimercapto-succinic acid (DMSA). Orthoiodohippurate, labeled with 123I or 131I, is eliminated primarily by tubular excretion and is not normally retained by the kidney (Table 1). The study carries no risk and the radiation dose to the patient is lower than that of intravenous urography.
Perfusion studies are obtained by rapid imaging of the kidneys following the intravenous injection of any of the technetium radiopharmaceuticals.
Acetaminophen Toxicity
Authors: Lovejoy Frederick H. , Goldman Peter 
Published: December 2021

Acetaminophen (paracetamol in the United Kingdom), first used in clinical medicine in 1893, has gained wide usage in recent years as an analgesic and an antipyretic.1 Currently popular proprietary forms of the drug in the United States are Tylenol, Liquiprin, and Datril, but an additional 300 prescription and non-prescription drugs contain acetaminophen. The names of most of these products give no indication that they contain acetaminophen. With its increased therapeutic usage in reducing fever and in relieving pain,1 a large number of serious poisonings due to acetaminophen have been reported. In the last year, one major poison control center reported that calls concerning possible acetaminophen overdose were exceeded in frequency only by those relating to aspirin and Valium. The majority of these exposures were in young children, but a sizable fraction involved adolescents.
TOXICITY
Mechanism of Toxicity of Acetaminophen
Hepatic injury is the most important manifestation of acetaminophen toxicity. There is good evidence that it is not acetaminophen itself but its metabolites that are hepatotoxic. Fig 1 is a schematic representation of the fate of acetaminophen and its postulated mode of toxicity. At therapeutic doses acetaminophen is mainly eliminated, conjugated to sulfate or glucuronic acid; a small amount appears in the form of a mercapturic acid.
Recurrent Bacterial Infections in Children
Authors: Jones James F. , Fulginiti Vincent A. 
Published: December 2021

Recurrent bacterial infections in children are a source of great concern to parents and physicians and range from relatively trivial infections to illnesses that may be indicative of underlying serious disease. Parental concern is often reflected by the seeking of definitive reasons for the child's recurrent illnesses and a definitive form of therapy to terminate them. Professional and parental concern often leads to excessive diagnostic maneuvers or to therapy instituted more from frustration than from the data presented by the child. When confronted with parental concern about repetitive infections, one must evaluate the emotional reactivity of the parents, the nature and severity of the individual episodes, and the environment as well as specific immunodeficiency disease.
The most common recurrent infectious episodes are otitis media, recurrent pharyngitis, repeated episodes of pneumonia, multiple skin infections, or recurrent or persistent urinary tract infection (UTI). (Recurrent UTI will not be addressed in this article.) On rare occasions more serious recurrent infections such as meningitis, bacteremia, septic arthritis, osteomyelitis, draining lymphadenitis, or significant diarrhea may occur.
The most frequent question confronting the physician is that of adequacy of immune function in a child with recurrent infections. It is desirable to identify children with congenital or acquired immunodeficiency states at an early stage in order to provide appropriate therapy and lessen morbidity and mortality.