bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health Consequences of Behaviors: Injury as a Model
Authors: Irwin Charles E. , Cataldo Michael F. , Matheny Adam P. , Peterson Lizette 
Published: December 2021

I always like to make things as simple as possible, but no simpler.
—Einstein
As a model for behavioral pediatric research, injury prevention presents a relatively clear example of how behavior can dramatically and directly impact health status. Approaches to injury prevention range from passive, environmental control to the modification of behavior so thát the consequence is safety not injury. Regardless of the level of intervention, behavioral changes of some form are essential for interventions to reduce injuries. Approaches addressing injury prevention exemplify both challenges and models for the interface of behavior and biology wherein the focus is behavior that produces serious biological outcome.
This article will specifically focus on a developmental-psychosoical approach to children's injuries because it incorporates more than one scientific discipline and knowledge base. Increasingly, behavioral pediatric endeavors involve combining research findings and intervention technologies from a number of disciplines. After briefly reviewing the magnitude of the childhood injury problem, we will use four ongoing research programs to exemplify differing levels of analysis within a developmental-psychosocial approach. Further, these programs and this multidisciplinary approach can have generality to other areas of pediatrics that concern a health-behavior interaction.
THE PROBLEM
Injuries are the most common cause of death and hospitalization in the pediatric population.1 Injuries rank as the third leading cause of death (39.0/100 000) for the total US population. The distribution is U-shaped, with the rates of deaths due to injuries ranging from 25.2/100 000 in the younger than 1-year-old age category to a low of 11.7/100 000 in the 5- through 9-year-old age category, and then rising to a high of 51.4/100 000 in the 20- through 24-year-old age category.
Chronic Fatigue in Children: Illness or Disease?
Authors: VAN AERDE J. 
Published: December 2021

In Reply.—
Carter et al address an important problem in the practice of today's high-technology-driven medicine: the treatment of a diseased organ or system without taking the psychological, social, environmental, and spiritual context of the patient into consideration. In that regard, as suggested by Dr Smith et al,1 different diagnostic criteria may be needed for children than for adults with chronic fatigue syndrome (CFS).2 Unfortunately, Dr Smith's paper does not bring us any closer to that objective.
The Changing Role and Responsibilities of a Chairman—Letters
Authors: DIGEORGE ANGELO M. 
Published: December 2021

To the Editor.—
I enjoyed Dr Brent's article on the role and responsibilities of chairmen in the july issue of Pediatrics (1992;90:50-57). I can't think of a better person to write such a thoughtful essay.
Although the paper was not written primarily for chairmen, I hope that ours will read it.
The Changing Role and Responsibilities of a Chairman—Letters
Authors: HANSON JAMES W. 
Published: December 2021

To the Editor.—
I want to report the pleasure that the recent essay by Robert L. Brent on being a department chairman gave me. I overheard a discussion of this article between some of our other faculty members which was extremely complimentary. As an aside, let me mention that the participants in that discussion felt that article should be read by all department chairmen (and debated whether they should all send copies to relevant individuals at the University of Iowa!).
How Much Resuscitation Is Enough Resuscitation?
Authors: QUAN LINDA 
Published: December 2021

To the Editor.—
In his commentary, "How Much Resuscitation Is Enough Resuscitation?" Dr Orlowski identifies most of the arguments against stopping resuscitations in the field.1 Unfortunately, most of these arguments are assumptions, not supported by data.
As Dr Orlowski states, a possible one victim in eleven could survive a prolonged resuscitation (&gt;25 minutes) with a good outcome. That likelihood, however, is the absolute upper limit of survival. It is much more likely that the outcomes would be closer to the lower limit of survival, the 100% bad outcome where the relative risk was ascertained.
Which Is the Most Appropriate Dosage of Liposomal Amphotericin-B (AmBisome) for the Treatment of Fungal Infections in Infants of Very Low Birth Weight?
Authors: LACKNER H. , URBAN CH. 
Published: December 2021

In Reply.—
We read with great interest the results of Pereira da Silva and co-workers, who successfully treated two premature newborns with disseminated fungal infection using lower doses of liposomal Amphotericin-B (AmBisome) than we have reported in our paper.1 We agree with the authors that the most appropriate dosage of liposomal Amphotericin-B for the treatment of very low birth weight infants is still to be established, and that the main goal of treatment should be to use AmBisome in a dose with maximal effect but minimal toxicity.
Crying an Motor Behavior of Six-Week-Old Infants and Postpartum Maternal Mood
Authors: Miller Anton R. , Barr Ronald G. , Eaton Warren O. 
Published: December 2021

Objective. To determine whether prepartum and postpartum emotional distress in first-time mothers is associated with crying and fussing behavior and activity level in 6-week-old infants, after eliminating potential biases.
Design. Observational study examining predictive and concurrent associations between maternal emotions and infant behaviors.
Setting. General community.
Participants. Expectant primiparas attending obstetricians' offices for routine prenatal care were recruited in the third trimester. Mothers and babies were required to be free of medical complications to complete the study. Of 113 mothers who enrolled, complete crying/fussing data were obtained in 88 dyads. Activity data were obtained in a designated subgroup of 50 infants.
Measurements. Mothers completed a self-report scale of emotional distress, the 28-item General Health Questionnaire, at 34 weeks of gestation and at 6 weeks postpartum. Crying/fussing data were obtained using a previously validated parent diary of infant behavior during the sixth week of life. Motor activity was measured objectively in the home setting with actometers.
Results. Third-trimester distress was not related to either infant crying/fussing or activity. Postpartum distress was significantly related to crying/fussing duration and bout frequency (r[88] = .45 and .28, respectively; both P &lt; .01). These relations were not diminished after controlling statistically for background and/or potential mediating variables, nor could they be accounted for by different diary-recording styles in the mothers. Postpartum distress was not, however, related to activity level (r[50] = -.09; not significant). Furthermore, the pattern of maternal distress was associated differentially with crying levels. Distress levels increased from prepartum to postpartum among mothers of infants who met predefined clinical criteria for "colic," while decreasing in the others ("colic" status x period interaction: F(1,86) = 8.2; P &lt; .01). Also, infant crying varied among four groups of mothers who differed according to presence and timing of clinically significant emotional disturbance (one-way analysis of variance, F (3,86) = 9.4; P &lt; .001). Infants of mothers who became significantly distressed postpartum ("reactive") cried more than those in the other groups, even mothers who had been distressed both prepartum and postpartum ("depressed") (3.7 vs 2.7 h/d; P = .05, post hoc Tukey).
Conclusions. Maternal emotional distress and infant crying behavior are associated in the postpartum period independent of reporting or referral biases. Clinically significant levels of crying (or "colic") are differentially associated with different patterns of clinically significant maternal distress. Reported concern about either maternal mood or infant crying behavior should be taken seriously as a possible indicator of a stressed mother-infant relationship.
International Statistics—Incomparable
Authors: SEPKOWITZ SAMUEL 
Published: December 2021

Howell and Vert are hard-put to compare the incomparable: United States perinatal mortality rates from Michigan and French rates from Lorraine. How can you compare perinatal mortality rates meaningfully between two countries when the definitions of fetal deaths are dissimilar, when there are markedly different registration systems for vital events, and when the United States natality registration system has been in place since 1950 and a French system had to be set up just for this study?
To make the data comparable, 34% of all Michigan deaths were eliminated, that is, all infants weighing &lt;500 g. These deaths were concentrated in 0.47% of all births. How comparable the remaining birth and death events &gt;500 g would be remains open to question.
Safety and Efficacy of a Topical Anesthetic for Neonatal Circumcision
Authors: Weatherstone Kathleen B. , Rasmussen Lynn B. , Erenberg Allen , Jackson Emily M. , Claflin Katherine S. , Leff Richard D. 
Published: December 2021

Objective. Circumcision is a common neonatal surgical procedure routinely performed without the use of anesthesia. The purpose of this study was to evaluate the safety and efficacy of topical lidocaine cream as an anesthetic for circumcision.
Methods. Thirty newborns were studied in a randomized, double-blind, placebo-controlled study; 15 received a topical 30% lidocaine cream and 15 received the cream base alone. Vital signs were recorded, and preoperative and postoperative serum β-endorphin and lidocaine concentrations were measured. A videotape of the newborn was used to score behavioral changes.
Results. Comparisions of the vital signs precircumcision and postcircumcision showed no differences between the placebo and treatment groups, with the exception of mean systolic blood pressure, which significantly increased in the placebo-treated newborns (P &lt; .05). Serum β-endorphin concentrations increased postoperatively in 11 of 15 subjects receiving placebo, but decreased or remained unchanged in 10 of 15 subjects receiving lidocaine (P = .03, Fisher's exact test). When stress-related behaviors in the precircumcision and post-circumcision periods were compared, the mean increase in their occurrence was greater in the placebo than in the treatment group. There was no significant absorption of lidocaine as measured in the serum.
Conclusion. Topical application of a 30% lidocaine cream as used in this study may be a safe and efficacious anesthetic for circumcision.
Prevention of Fetal Alcohol Syndrome
Authors: ALPERT JOEL J. , ZUCKERMAN BARRY S. 
Published: December 2021

To the Editor.—
The recent Academy statement on fetal alcohol syndrome and fetal alcohol effects recommends abstinence from alcohol for women who are pregnant or planning a pregnancy.1 Our position was incompletely quoted in the statement. We have stated that there is no scientific evidence to support abstinence from alcohol during pregnancy in well-nourished women.2
Mills, who is also referred to in the committee statement as finding a substantial risk with the consumption of one to two drinks daily, was also referenced incompletely.
AMERICAN ACADEMY OF PEDIATRICS E. H. CHRISTOPHERSON LECTURESHIP ON INTERNATIONAL CHILD HEALTH—1994
Authors:   Johnson & Johnson Consumer Products, Inc.
Published: December 2021

The American Academy of Pediatrics is requesting nominations for the 1994 E. H. Christopherson Lectureship on International Child Health. Nominees must be internationally recognized individuals (not necessarily physicians) who have made significant contributions to international child health. The nomination deadline is January 31, 1994.
For additional information contact: Jean Dow, MEd, Director of the Division of Medical Journals, or Kyle Ostler, Division Secretary, American Academy of Pediatrics, 141 Northwest Point Boulevard, Elk Grove Village, IL 60007. Tel.:800-433-9016.
SELF-INFLICTED RATIONING
Authors: H. B. 
Published: December 2021

Who said the health service could not resolve its funding crisis? Britain's cardiac surgeons have come up with a solution that will solve the government's problems at a stroke: the withdrawal of treatment for self-inflicted sickness. Surgeons at two separate medical centers were reported last week to have withdrawn non-urgent coronary bypass operations from patients who were refusing to give up smoking. The potential for savings seems unlimited if the same principle is applied to other medical cases: drinkers in need of liver transplantation, HIV patients who acquired the infection through drug addiction or promiscuous sex, heart patients who are overweight, accident victims who had been driving carelessly or under the influence of drink, and those with sports injuries, not to mention smokers with lung cancer...
The debate raises complex philosophical issues that need to be pursued—eg, the right to use statistics that apply to a category of people to deny treatment to an individual. Yet in an age rightly requiring individuals to take more responsibility for the consequences of their behavior, self-inflicted injuries cannot be totally ignored. Doctors themselves may well revolt when they see politicians shifting responsibility for what are basic rationing decisions on to doctors' shoulders. The issues raised are not primarily medical, but political: what criteria should be used for rationing resources?
ADVANCED NURSING PRACTICES ARE INVADING DOCTORS' TURF
Authors: L. J. F. 
Published: December 2021

When Margaret Manchester was training to be a nurse, she was taught to stand up whenever a doctor entered the room and to offer him her chair.
But nurses are no longer handmaidens to the medical profession...
Pat Moccia, chief executive of National League for Nursing, said: "What I think we're going to see in the future is that the family doctor is going to be a nurse practitioner. That's where we're headed, as doctors get more specialized, and advanced-practice nurses take over more routine care...
But what the nursing groups see as the natural evolution of health care the American Medical Association sees as a growing danger...
A 1986 report by the Office of Technology Assessment, an investigative arm of Congress, estimated that 60 to 80 percent of the basic health care performed by doctors could be done by nurses with the same results, at a lower cost.
And earlier this year the American Nurse Association released a study comparing care by doctors and nurse practitioners, finding that nurse-practitioners offered better-quality care, as assessed by the accuracy of diagnoses and the completion of comprehensive medical histories, and at a lower cost.
Not surprisingly, the A.M.A. challenged those findings.
MERCY ON US ALL
Authors: H. B. 
Published: December 2021

Here's a country with 90 million grown-ups who can't write a coherent letter or do simple arithmetic. It's a country where "Everything I Need to Know I learned in Kindergarten" inevitably becomes a huge best seller ...
The President's people last week started serious leaking about what kind of program they would like to install.
The immediate impulse is to smite the forehead with flat of hand and cry, "What country do these dreamers think they live in?" ...
The 37 million now with health insurance obviously include a good percentage of the 90 million who can't read much or figure shrewdly, and some of whom can't read or figure at all ...
They are designing another nightmare as complicated as the tax law, with the same kind of opportunities for finagling and corruption.
Province-Based Study of Neurologic Disability Among Survivors Weighing 500 Through 1249 Grams at Birth
Authors: Robertson Charlene , Sauve Reginald S. , Christianson Heather E. 
Published: December 2021

Background. As the mortality of children weighing 500 through 1249 g at birth decreases, the published rates of neurologic disability among survivors have caused concern. Outcome information from a province-based study in which perinatal/neonatal regional care is well developed and includes high-risk identification, early referral, organized transport, and outreach education, provides data from a Canadian source for comparison with epidemiologic reports.
Methods. Neurologic disability rates among 2- to 3-year-old survivors weighing 500 through 1249 g at birth is provided based on all live births/neonatal survivors/1-year survivors born in Alberta, Canada to Alberta residents in 1990.
Results. Corrected survival to 1-year was 163 of 229 or 71% of live births of the total group weighing 500 through 1249 g. Of 168 live births, 143 or 85% weighing 750 through 1249 g, free from lethal anomalies, survived. Based on 1-year survival, disability rates were: cerebral palsy, 67/1000; vision loss (acuity in the best seeing eye after correction, &lt;20/60), 12/1000; neurosensory hearing loss (loss of ≥30 dB binaurally), 12/1000; and trainable/profound mental retardation, 18/1000. No survivor had a convulsive disorder. No vision loss or mental retardation as defined by this study occurred in survivors of ≥750 g. All children with cerebral palsy were or were projected to become ambulatory.
Conclusions. Neurologic disability among small preterm surviving infants can occur less frequently than suggested by published reports. We believe this provincial study supports the value of well developed regional perinatal programs.
Objections to AAP Statement on Homosexuality and Adolescence
Authors: Nicolosi Joseph 
Published: December 2021

I would like to point out some objectionable assumptions in "Homosexuality and Adolescence,"1 by the American Academy of Pediatrics Committee on Adolescence.
The Statement advises pediatricians that "therapy directed specifically at changing sexual orientation is contraindicated, because it can provoke guilt and anxiety while having little or no potential for achieving change in orientation." This advice ignores the vast body of literature on successful treatment for unwanted homosexuality.
There can be tragic consequences when an uninformed physician assists in prematurely identifying an adolescent as "gay," especially if the youth expresses dissatisfaction with his/her homosexual feelings.
Job Lewis Smith and the Germ Theory of Disease
Authors: Yankauer Alfred 
Published: December 2021

"If these doctrines (evolution and germ theory of disease with its concomitant disproof of spontaneous generation) are true, all talk of creation or methods of creation becomes absurdity; for just as certainly as they are true, God Himself is impossible. . . . No, if this after all is the best that science can give me, give me then, I pray, no more science."1
These are not the words of a modern-day creationist, but those of the President of Columbia College, F.A.P. Barnard, speaking at the first meeting of the American Public Health Association in 1873. Barnard was no religious fanatic but a sophisticated scientist who had summarized the work of Pasteur and Lister earlier in his talk.
PROLONGED APNEA AND THE SUDDEN INFANT DEATH SYNDROME: CLINICAL AND LABORATORY OBSERVATIONS
Authors: Steinschneider Alfred 
Published: December 2021

A 25-Year Trail to Murder Charges—... The first suspicions were raised in 1985 by Dr. Linda Norton, a former medical examiner for Dallas County, Texas, and an expert on pediatric pathology, who had been a consultant in the VanDerSluys case.
"You may have a serial killer in Syracuse," she told the prosecutor in giving him a copy of an October 1972 article in Pediatrics (1972;50(4)) called "Prolonged Apnea and the Sudden Infant Death Syndrome: Clinical and Laboratory Observations." In the report Dr. Steinschneider described his work with the syndrome and how two children in a family plagued with the affliction had died within hours of their release from his Syracuse research project.
In his paper, Dr. Steinschneider concluded that the family, which he still identifies only as "H," showed that victims suffered from real if almost undetectable physical abnormalities. In a proposal that was radical then but is now accepted, he suggested that the syndrome had a genetic component and was therefore inherited. He suggested that scientists could identify the abnormalities and thereby devise a warning system.
"But the paper indicated a more sinister possibility to Dr. John F. Hick of Minnesota. In a letter to the journal, he wrote that the case offered "circumstantial evidence suggesting a critical role for the mother in the death of her children." (See below.)
But his warning was dismissed, until Mr. Fitzpatrick read the paper 15 years later.
"The medical records described two happy, healthy, perfectly normal kids," he said. "It convinced me that these children were murdered."
BABIES' EARS SOUND EARLY WARNING OF DEAFNESS
Authors: L. J. F. 
Published: December 2021

Under a law being prepared in the US, all newborn babies will have to be screened for defective hearing with a device that picks up sounds that emanate from their ears. Brenda Lonsbury-Martin, director of research at the University of Miami Ear Institute, told the AAAS meeting that the test could ensure that children with serious hearing difficulties do not miss out on the first vital years of education
The new screening test is quick and simple to perform, and can identify the degree of impairment at all audible frequencies. The device needed to carry it out is relatively cheap at about $10 000, said Lonsbury-Martin.
The test is based on an effect known as "otoacoustic emission," which was first detected by a British physicist, Dave Kemp. In 1979, Kemp found that a few microseconds after sound enters a healthy ear, the same sound—amplified up to 10 times—can be detected emanating from the ear. If the ear is defective, the signal is not as strong.
The device used for the test looks like a hearing aid. As well as generating sounds, it picks up and records the emissions from the inner ear that are produced in response.
Letter to the Editor
Authors: Bailey Robert , McGill Leigh , Bergeson Paul S. , Piatt Janice P. , Hopkin Robert 
Published: December 2021

The inconspicuous penis encompasses a number of different entities. Over the years, this problem has engendered much controversy and endless discussion by urologists but has remained surprisingly unknown among other medical practitioners. Dr Little raises some of the issues that have led to the controversy concerning the buried penis. (The buried penis is but one of the entities comprising the inconspicuous penis).
Our paper describes the different types of inconspicuous penis so that pediatricians can recognize the physical manifestation and make the appropriate referral to specialty care.