Siblings and other contacts of abused children, especially twins, are thought to be at higher risk for abuse than other children. However, the rate at which screening tests identify injuries in contacts is currently unknown.

Contacts of abused children with serious injuries have fractures identified on skeletal survey at significant rates. Twins are at substantially increased risk for fracture. Physical examination findings were not sensitive for fractures. (Read the full article)

Adolescent dating violence has been studied from the perpetrators' and survivors' perspectives. The risk and protective factors have been explored, and the strength of the association of these factors with adolescent dating violence has been adequately described.

This study assessed the perceptions and practices of school counselors on adolescent dating violence. Knowing school personnel’s practices and perceptions may help researchers and practitioners gain insights into possible ways to alleviate the problem of dating violence in adolescents. (Read the full article)

Children without any underlying medical condition who walk on their toes are referred to as idiopathic toe-walkers. The prevalence and early course of idiopathic toe-walking are unknown.

This study establishes the prevalence and early spontaneous course of idiopathic toe-walking in a large, well-defined cohort of 5.5-year-old children. (Read the full article)

Children’s mastery of fundamental movement skills is correlated with a number of health benefits, including higher levels of physical activity, cardiorespiratory fitness, perceived scholastic and athletic competence, and lower levels of overweight.

This is the first study to examine the associations between low skill competence (a new and novel way to report motor skills) and a range of health-related and sociodemographic factors in a large representative sample of children and youth. (Read the full article)

Exergaming offers a physical activity (PA) alternative for youth that may be attractive in our increasingly technophilic society. Exergaming increases PA and decreases sedentary time, but most exergame studies are clinically based and focus on measuring energy expenditure during exergaming.

One-quarter of adolescents exergamed at intensity levels that could help them achieve PA recommendations. Exergamers were more likely to be female, play nonactive video games, watch ≥2 hours of television per day, be stressed about weight, and be nonsmokers. (Read the full article)

Some groups of children are especially prone to develop overweight and obesity. Overweight in children affects their physical and psychological health and shortens life expectancy. Overweight in children with Down syndrome (DS) is attributed to their commonly found comorbidities.

This study provides prevalence rates of overweight and obesity in a nationwide sample of otherwise healthy children with DS. Overweight is observed from young ages in healthy children with DS and those with severe congenital heart defects. (Read the full article)

Osteopathy of prematurity continues to occur in preterm infants. Osteopathy of prematurity can cause rib fractures in ex-preterm infants.

Rib fractures in ex-preterm infants are often posterior and multiple. Posterior rib fractures may not be diagnostic of nonaccidental injury in ex-preterm infants. (Read the full article)

Although a number of cross-sectional studies have documented associations between teen dating violence victimization and adverse health outcomes, including sexual risk behaviors, suicidality, substance use, and depression, longitudinal work examining the relationship between victimization and outcomes is limited.

This study is the first to demonstrate the longitudinal associations between teen dating violence victimization and multiple young adult health outcomes in a nationally representative sample. Findings emphasize the need for screening and intervention for both male and female victims. (Read the full article)

The prevalence of asthma and associated urgent medical visits vary dramatically across neighborhoods in New York City. Some, but not all, children with asthma wheeze when they exercise.

Exercise-induced wheeze was more common for asthmatic children living in neighborhoods with higher versus lower asthma prevalence. Because exercise-induced symptoms indicate a propensity for rapid-onset symptoms, this increased prevalence may contribute to the observed increase in urgent medical visits. (Read the full article)

Adequate vitamin D is essential for skeletal health in developing children. Although excess body weight is associated with risk of vitamin D deficiency, the national prevalence of vitamin D deficiency in overweight and obese children is unknown.

Vitamin D deficiency is highly prevalent in overweight and obese children, and severely obese and minority children are disproportionately affected. There are many modifiable factors associated with vitamin D deficiency in overweight and obese children. (Read the full article)

Among youth with asthma, tobacco smoke exposure causes increased asthma morbidity. Little is known about changes over time in tobacco smoke exposure among youth with asthma in a national sample.

Our analysis reveals a decrease in environmental tobacco smoke exposure among children and adolescents with current asthma in the United States from 1988–1994 to 2005–2010, but a majority of youth with asthma remain exposed to environmental tobacco smoke. (Read the full article)

Celiac disease is increasing in several countries and has emerged as a public health problem. Infant feeding has been suggested to affect celiac disease development and/or clinical expression. However, evidence-based complementary feeding strategies are limited.

Significant difference in celiac disease prevalence between 2 cohorts of 12-year-olds indicates an option for disease prevention. The cohorts differed in infant feeding, and our findings suggest that gradual introduction of gluten in small amounts during ongoing breastfeeding is favorable. (Read the full article)

Failure to thrive (FTT) is a common and vexing pediatric problem. Evaluation has historically involved large batteries of tests, multiple consultations, radiologic studies, and prolonged hospital admissions, resulting in significant costs and inconsistent results.

Scheduled failure to thrive (FTT) admissions on weekends result in increased lengths of stay and health care costs compared with weekday admissions of similar levels of complexity. Reduction in planned weekend admissions for FTT could significantly reduce health care costs. (Read the full article)

Adherence to infant feeding recommendations in the United States is low. The prevalence of early introduction of solid foods (<4 months of age) in the United States has been estimated to range from 19% to 29%.

Mothers’ most commonly cited reasons for early solid food introduction include perception of readiness, hunger, wanting to feed something in addition to breast milk or formula, perception of interest in solids, advice from a clinician, and to improve infant’s sleep. (Read the full article)

The American Academy of Pediatrics recommends neonates born at <37 weeks’ gestation receive a predischarge Infant Car Seat Challenge, meaning up to 500 000 infants qualify annually. However, little is known about incidence and risk factors for failure in this group.

This is the largest study to date to examine incidence and risk factors for failure of the Infant Car Seat Challenge. We sought to identify infants most at risk for failure to narrow the scope of testing. (Read the full article)

The American Academy of Pediatrics recommends that all preterm infants receive human milk; however, little is known about the use of human milk in US advanced care neonatal units.

Routine use of human milk and use of donor milk in neonatal advanced care units increased from 2007 to 2011, particularly among units providing intensive care. There is geographic variation in the use of human milk in these units. (Read the full article)

Wrapping very preterm newborns in polyethylene bags in the delivery room reduces hypothermia on admission to the NICU, but many infants remain cold despite their use. Placing polyethylene-wrapped infants on exothermic mattresses may reduce hypothermia but increase hyperthermia.

Placing polyethylene-wrapped very preterm infants on exothermic mattresses in the delivery room results in more infants with abnormal temperature and more hyperthermia on admission to the NICU. (Read the full article)

Monovalent rotavirus vaccine was introduced for infants in the United States in 2008. Previous US evaluations have not specifically assessed the performance of this vaccine under routine use.

Using the same methodology and covering the same time period, high effectiveness (~90%) was demonstrated for the monovalent and the pentavalent rotavirus vaccine series against rotavirus disease resulting in emergency department/inpatient care, in children up to 2 years of age. (Read the full article)

Pneumococcal conjugate vaccines are effective in preventing pneumococcal disease but are also costly. Although the current US immunization schedule recommends 4 doses, many countries have adopted 3-dose schedules that have worked well, but may provide less protection against pneumococcal disease.

Changing the US 13-valent pneumococcal conjugate vaccine schedule from 3 to 2 primary doses while keeping a booster dose would save $412 million annually but might lead to moderate increases in pneumococcal disease, especially otitis media and pneumonia. (Read the full article)

It has previously been shown that exposure to intimate partner violence and/or parental depression or anxiety may increase a child’s risk for specific adverse health outcomes.

By using a large pediatric primary care sample, this study examined associations of child exposure to intimate partner violence and parental psychological distress with developmental milestone attainment by analyzing their combined and separate effects while adjusting for other family factors. (Read the full article)

Previous research has shown the following: the mere presence of weapons can increase aggression, dubbed the "weapons effect"; violence in films has increased over time; and violent films can increase aggression.

This study examines a potential source of the "weapons effect": the presence of guns in films. In just 20 years, gun violence in PG-13 films (age 13+) has increased from the level in films rated G/PG to the point where it exceeds the level in R films. (Read the full article)

Violence from school staff toward children is anecdotally widespread, but there are few empirical data on prevalence and health consequences, especially in low-income settings.

Despite a ban on corporal punishment, just over 52% of children in Luwero District experienced physical violence from school staff members in the previous week. This was associated with poor mental health in boys and girls and poor educational performance in girls. (Read the full article)

Youth are frequent consumers of movies that contain high levels of violence, and violent content in films, especially those rated PG-13, has been increasing over time.

Content analyses seldom examine how violence is portrayed with other health risk behaviors, such smoking, drinking, and sex. This study presents an innovative way to characterize on-screen violent content and demonstrates the extent to which risk behaviors co-occur within films. (Read the full article)

Children with congenital heart disease demonstrate a high prevalence of low-severity developmental problems in the areas of language, motor skills, attention, and executive function. Systematic evaluation has been recommended to promote early detection of problems and ensure appropriate intervention.

This study presents results of longitudinal testing in early childhood. Developmental delays were common. Feeding difficulty and medical and genetic comorbidities increased risk for delays. Exposure to risk and prevalence of delay change over time; therefore, repeated evaluations are warranted. (Read the full article)

Violence is a leading cause of death. The emergency department (ED) can prevent violence through proven interventions; however, these interventions are not broadly implemented. There is little evidence to inform decision-makers of the costs associated with preventing violence.

We report the costs of a brief violence prevention intervention in the ED. We highlight the economic impact of implementation, showing that brief interventions in the ED are an inexpensive way the health care system can prevent violence in adolescents. (Read the full article)

Diabetic ketoacidosis (DKA) is a life-threatening condition and often the presenting symptom of newly diagnosed type 1 or type 2 diabetes in youth. SEARCH previously reported that the prevalence of DKA at diagnosis was 25.5% in 2002–2003.

DKA in youth with type 1 diabetes remains a problem, with almost one-third presenting with DKA. Among youth with type 2 diabetes, DKA was less common and decreased by ~10% per year, suggesting improved detection or earlier diagnosis. (Read the full article)

In the United States, given the high burden of disease, influenza vaccine is recommended for all children from age 6 months. The paucity of vaccine effectiveness data in children <2 years has led some to argue against routine vaccination in this age group.

This study reveals the effectiveness of trivalent influenza vaccine in young children and supports the current Advisory Committee on Immunization Practices recommendation. This study provides the strongest evidence to date confirming the effectiveness of trivalent influenza vaccine in children <2 years of age. (Read the full article)

Chorioamnionitis (CAM) is a major risk factor for early-onset neonatal sepsis. The Committee on the Fetus and Newborn recommends extending the duration of antimicrobial therapy in neonates exposed to CAM and intrapartum antibiotics if laboratory data are abnormal, even if culture results are sterile.

When managed by using a strategy similar to recent Committee on the Fetus and Newborn guidelines, a large number of term and late-preterm infants exposed to CAM who had sterile blood culture findings were treated with prolonged antibiotic therapy, subjected to additional invasive procedures, and had prolonged hospitalization. (Read the full article)

Central line–associated bloodstream infections (CLABSI) are common types of hospital-acquired infections associated with high morbidity and cost. In recent years, quality improvement initiatives have demonstrated how to reduce the incidence of CLABSI.

This study presents nationally representative estimates of the cost and length of stay attributable to pediatric CLABSI. We make the business case to justify quality improvement prevention initiatives and the adoption of strategies for cost-effective management of CLABSI. (Read the full article)

The US health care system transition to the ICD-10-CM will occur in October 2015. The logistical and financial impact of the transition for billing codes frequently used by pediatricians has not been studied.

The findings of this study evaluate the government-provided mappings from ICD-9-CM to ICD-10-CM for accuracy and provide the diagnostic codes used by pediatricians, which may be adversely affected by the transition to ICD-10-CM. (Read the full article)

Poor health in children is associated with exposure to family violence and disruption. Telomere length has been hypothesized to be a lasting biological indicator of exposure to early adversity and potentially predictive of negative health outcomes throughout the life course.

Telomere length reflects exposure to family violence and disruption and may be an early indicator of the biological impact of early adversity. Children exposed to interpersonal violence and family disruptions had significantly shorter telomeres. Gender moderated these associations. (Read the full article)

Invasive pneumococcal disease causes enormous morbidity in children. The spectrum and severity of illness caused by pneumococcal serotypes not present in the current vaccine, and whether the clinical profile and severity of disease have changed, are largely unknown.

Initial data suggest that nonvaccine serotypes are more common in children with underlying conditions, who have greater morbidity from disease. In the post-PCV13 era, a larger proportion of patients are hospitalized, but mortality rates are unchanged. (Read the full article)

The short-term immunogenicity and safety of a HPV4 vaccine have been previously evaluated in preadolescents and adolescents. To date, no long-term studies of the safety, effectiveness, and immunogenicity of the HPV4 vaccine have been reported in this age group.

The HPV4 vaccine administered to adolescents demonstrated durability in clinically effective protection and sustained antibody titers over 8 years. These data, along with extensive postapproval safety surveillance data, should help reinforce national recommendations for HPV vaccination of preadolescents and adolescents. (Read the full article)

Partner violence victimization is associated with mental and behavioral health effects linked to weight gain. Childhood maltreatment is directly linked to obesity and associated with neuroanatomic and psychosocial changes, which heighten vulnerability to subsequent stressors.

This study finds that dating violence victimization is associated with greater increases in BMI from adolescence to young adulthood among women. Women with previous exposure to childhood sexual abuse are especially vulnerable to dating violence–related increases in BMI. (Read the full article)

Many pediatric acute respiratory tract infections (ARTI) are viral and do not require antimicrobial treatment. Recent estimates of antimicrobial overprescribing for these infections, defined based on the published bacterial disease prevalence among all ARTI, are not available.

Based on the published bacterial prevalence rates for pediatric ARTI, antimicrobial agents are prescribed almost twice as often as expected to outpatients nationally, amounting to an estimated 11.4 million potentially preventable antimicrobial prescriptions annually. (Read the full article)

Movie ratings designed to warn parents about violence and sexual content have permitted increasing amounts of each in popular films. One potential explanation for this "ratings creep" is parental desensitization to this content as it becomes more prevalent in movies.

This study adds experimental evidence that parents become desensitized to movie violence and sex and are more willing to allow children to view such content. (Read the full article)

Most studies of fetal alcohol syndrome and fetal alcohol spectrum disorders (FASD) prevalence in the general population of the United States have been carried out using passive methods (surveillance or clinic-based studies), which underestimate rates of FASD.

Using active case ascertainment methods among children in a representative middle class community, rates of fetal alcohol syndrome and total FASD are found to be substantially higher than most often cited estimates for the general US population. (Read the full article)

Menu labels depicting physical activity calorie equivalents may lead to ordering of fast food meals totaling fewer calories for adults. The effects of physical activity calorie equivalent labeling on parents’ fast food decisions for their children have not been examined.

Parents shown menus with any type of caloric content label may order fast food meals totaling fewer calories for their children. Menu labels showing physical activity equivalents may be more likely to influence parents to encourage their children to exercise. (Read the full article)

Worldwide prevalence estimates of Duchenne and Becker muscular dystrophies (DBMD) vary, likely due to differences in diagnostic criteria, ascertainment, and survival. To date, no population-based prevalence data for DBMD by race/ethnicity have been published in the United States.

Approximately 2 per 10 000 boys, ages 5 to 9 years, in 6 sites in the United States have DBMD; prevalence remained rather constant across 4 birth cohorts that spanned 2 decades. Prevalence differed among selected racial/ethnic groups across the time period examined. (Read the full article)

Preterm infants are at an increased risk of infections; therefore, vaccination is of particular importance. Because immune response data reported for preterm infants may vary according to gestational age and vaccination timing, vaccine responses in this population warrant additional research.

This study evaluated 13-valent pneumococcal conjugate vaccine in preterm infants. Results suggest that this vaccine was well tolerated and immunogenic; most subjects achieved serotype-specific immunoglobulin G antibody levels and functional antibody responses likely to correlate with protection against invasive disease. (Read the full article)

Firearm violence is a leading cause of death among US youth aged 14 to 24. The emergency department is a key setting for interacting with high-risk assault-injured youth and remains an underused but important setting for violence prevention programs.

High-risk youth seeking emergency department care for assault have high rates of firearm violence over the subsequent 2 years. Higher severity substance use, combined with negative retaliatory attitudes and access to firearms, increases this risk for involvement with firearm violence. (Read the full article)

Prophylactic vaccination of young women 16 to 26 years of age with the 9-valent human papillomavirus (HPV)–like particle (9vHPV) vaccine prevents infection and disease with vaccine HPV types.

These data support bridging the efficacy findings with 9vHPV vaccine in young women 16 to 26 years of age to girls and boys 9 to 15 years of age and implementation of gender-neutral HPV vaccination programs in preadolescents and adolescents. (Read the full article)

Attitudes and knowledge about appropriate management of common childhood illnesses may lead parents to mistakenly believe antibiotics are needed. Differences existed in antibiotic knowledge and attitudes between parents of Medicaid- and commercially insured children and according to other sociodemographic variables.

Despite efforts to decrease unnecessary antibiotic use, misconceptions about antibiotic use persist and continue to be more prevalent among parents of Medicaid-insured children. Tailored efforts for socioeconomically disadvantaged populations remain warranted to decrease parental drivers of unnecessary antibiotic prescribing. (Read the full article)

Weak recommendations exist to guide emergent neuroimaging decisions in children with first, unprovoked seizures. The prevalence of and risk factors associated with clinically relevant abnormalities on neuroimaging have not been well defined in prospective studies.

Clinically relevant intracranial abnormalities on neuroimaging occur in 11% of children with first, unprovoked seizures. Emergent/urgent abnormalities, however, occur in <1%, suggesting that most of these children do not require emergent neuroimaging. Specific clinical findings identify patients at higher risk. (Read the full article)

The routine childhood immunization schedule is crowded during the first 2 years, leading to deferred doses and limiting the addition of new vaccines. Combination vaccines can reduce the "shot burden" and improve coverage rates and timeliness.

Antibody response rates to antigens contained in an investigational hexavalent vaccine (DTaP5-IPV-Hib-HepB) were noninferior to licensed comparator vaccines when given as a 3-dose infant series. The safety profile was similar to control except for increased rates of mild-to-moderate, self-limited fever. (Read the full article)

Previous studies have shown that concomitant administration of the quadrivalent human papillomavirus vaccine with MCV4 and Tdap was generally well tolerated and did not interfere with the immune responses to the respective vaccines.

Concomitant administration of the novel 9-valent human papillomavirus vaccine with MCV4 and Tdap, 2 vaccines that are currently recommended for routine vaccination of adolescents, did not compromise the safety, tolerability, and immunogenicity of the individual vaccines. (Read the full article)

Previous studies found that 2010–2011 trivalent inactivated influenza vaccine (TIV) and 13-valent pneumococcal conjugate vaccine (PCV13) were associated with statistically significant increased risks of febrile seizures (FS) in the United States.

Estimated FS relative risks after TIV or PCV13 adjusted for DTaP were >1, although not statistically significant and lower than previous estimates. Same-day administration of TIV and PCV13 did not result in more FS compared with separate-day vaccination. (Read the full article)

Maternal–child relationships among women raising children from sexual violence-related pregnancies (SVRPs) are not well understood. Limited case reports suggest widely varied and complex relationships. The determinants of these relationships are unknown.

With its large sample size, this article quantifies and analyzes maternal–child relationships among women raising children from SVRPs, and assesses the impact of stigma, acceptance, and maternal mental health on these relationships. (Read the full article)

Makeda Brome, Pia Hansen, Linda Gojak, Marian Small, Kenneth Baum and David Krulwich share their thoughts on the biggest challenges facing math teachers.

All posts from the past seven years on race & gender challenges - in one place!