Preterm infants from 33 gestational weeks can detect specific shape features (prism and cylinder) by touch (without visual control), and remember them; however, nothing is known about such abilities earlier in development.

The preterm infant, even when very immature (from 28 gestational weeks), is endowed with tactile sensory abilities: the exploration and memorization of an object by touch, the discrimination of a novel object, and the recognition of a familiar object after interference. (Read the full article)

Comprehensive lifestyle interventions for adolescent weight management, including diet, physical activity, and behavioral intervention, have been found to demonstrate modest, short-term success. However, very little is known about the long-term effectiveness of adolescent behavioral weight management trials.

This randomized controlled trial demonstrates that two 16-week group-based behavioral weight loss programs, when combined with either aerobic exercise or peer-based adventure therapy, produced sustained improvements in BMI among overweight/obese adolescents through 24 months. (Read the full article)

Late preterm infants are at risk for a variety of developmental impairments; however, little is known about developmental differences among children born within the term range of 37 to 41 weeks’ gestation.

This study links comprehensive birth record data from 128 050 term births to children’s school records 8 years later. Analyses establish that, even among the "normal term" range, gestational age is an important independent predictor of academic achievement. (Read the full article)

Physical punishment is associated with aggression, delinquency, and internalizing conditions in childhood, as well as a range of Axis I mental disorders in adulthood. More research is needed on the possible long-term relationship between physical punishment and mental health.

To our knowledge, this is the first nationally representative examination of physical punishment and a range of Axis I and II disorders, gender interactions, and proportion of mental disorders in the general population that may be attributable to physical punishment. (Read the full article)

Moderately preterm-born children (32–35^6/7 weeks’ gestation) are at risk for both neonatal morbidities after birth and developmental delays in early childhood. It is unknown whether neonatal morbidities contribute to the developmental delays of this particular group.

Of all neonatal morbidities commonly seen in moderately preterm-born children, only hypoglycemia increased the risk of developmental delay after moderately preterm birth. A concerted effort to prevent hypoglycemia after birth might enhance developmental outcome in this group. (Read the full article)

Respiratory infectious symptoms are common during the first year of life. Day care attendance, older siblings, and lack of breastfeeding have been considered as possible factors influencing early respiratory tract infections.

Children with early dog contacts seem to have fewer infectious respiratory symptoms and diseases, especially otitis, during the first year of life. (Read the full article)

In humans, evidence for an association between maternal caffeine intake during pregnancy and alterations in fetal brain development with persistent alterations in the offspring’s brain and behavior in later life is inconclusive.

Prenatal caffeine intake is not associated with a higher risk for behavior problems in young children. Results do not provide evidence to advise pregnant women to reduce their caffeine intake to prevent problem behavior in their children. (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)

A dose-response relationship exists between light irradiance and decrease of total serum bilirubin concentration (TsB) at relatively low irradiances. It has been questioned whether by increasing irradiance a "saturation point" exists, above which no further decrease of TsB is seen.

We found a linear relation between light irradiance in the range of 20 to 55 μW/cm²/nm and decrease in TsB after 24 hours of therapy, with no evidence of a saturation point. (Read the full article)

Although the impact of changes in the economy on child physical abuse rates is not well understood, there is concern that increased numbers of children may have been victims of physical abuse as a result of the recent economic recession.

Results of this study demonstrate that the rate of admissions for physical abuse to pediatric hospitals has increased during the past 10 years and suggest an association between that increase and the housing mortgage crisis. (Read the full article)

Among adolescents, weight status has been inversely associated with sports participation but not active commuting or physical education. Studies of each form of physical activity have not included adequate adjustments for other physical activities, previous body weight, or diet quality.

Estimates indicate overweight/obesity and obesity prevalence would decrease by 11% and 26%, respectively, if adolescents played on at least 2 sports teams per year; obesity prevalence would decrease by 22% if adolescents walked/biked to school 4–5 days per week. (Read the full article)

Dental composites composed of bisphenol A (BPA) derivatives are common alternatives to amalgam, but may release BPA. Gestational BPA exposure has been associated with poorer behavior in children. A safety trial of amalgam found worse psychosocial outcomes for children randomized to composites.

In the trial, greater exposure to bisphenol-A-glycidyl-methacrylate-based dental composite in children aged 6 to 10 years was associated with worse self-reported psychosocial functioning at 5-year follow-up. There were no such associations with exposure to dental amalgam or urethane-dimethacrylate-based polyacid-modified composite (compomer). (Read the full article)

Persistent facial nerve palsy is a well-described neurologic deficit after Lyme neuroborreliosis and occurs in 13% to 20% of children. Other neurologic deficits are less closely described. Nonspecific subjective symptoms are reported as often among patients as controls in previous short-term follow-up studies.

Persistent neurologic deficits, other than facial nerve palsy, were found in 14% of patients, causing impaired fine motor skills, poor balance, or persistent pain. Nonspecific subjective symptoms were reported as often among patients as controls in this long-term follow-up study and should not be considered as sequelae after Lyme neuroborreliosis. (Read the full article)

Eating disorder not otherwise specified (EDNOS) is the most common eating disorder diagnosis. Binge eating disorder, 1 type of EDNOS, is associated with obesity among adults. Little is known about the health outcomes associated with other types of EDNOS.

This is the first study to evaluate the prospective association of full and subthreshold bulimia nervosa, binge eating disorder, purging disorder, and other EDNOSs with specific mental and physical health outcomes. (Read the full article)

Many drugs are not approved for use in pediatric patients and there is limited evidence on their safety and efficacy in children. Furthermore, there is concern that the quality of pediatric trials is inferior compared with adult trials.

For conditions with a high disease burden in children, only a small proportion of clinical drug trials study pediatric patients. Most pediatric trials are not funded by industry, and the deficiency of evidence is largest in developing countries. (Read the full article)

Trisomy 13 and 18 are conditions with 1-year survival rates of less than 10% and have traditionally been treated with palliative care. There are increasing reports of ethical dilemmas caused by parental requests for clinical interventions.

Parents who belong to social networks report an enriching family experience and describe surviving children as happy. Many of these parents describe challenging encounters with health care providers. (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)

Because most childhood tuberculosis cases are sputum smear-negative, diagnosis relies largely upon clinical presentation, tuberculin skin testing, and chest radiograph. Diagnostic limitations contribute to treatment delays and high mortality. However, childhood tuberculosis (TB) mortality risk factors are not well documented.

This study demonstrates that false-negative TST is common in children with active TB and is associated with increased risk of death. A negative TST should not delay anti-TB therapy. Improved diagnostic modalities are urgently needed in resource-limited settings. (Read the full article)

Percentile charts for birth weight are used to assess the somatic development of neonates (small, appropriate, or large for gestational age).

A systematic error was identified in the majority of birth weight percentile charts. As a consequence, small for gestational age rates are overestimated and large for gestational age rates are underestimated; ~5% of neonates are misclassified. (Read the full article)

The American Academy of Pediatrics prioritized detection of mental illness in children presenting to emergency departments (ED) by using standardized clinical tools. Only a minority of ED physicians indicate that they use evidence-based screening methods to assess mental health concerns.

This study presents the psychometrics of the HEADS ED (home, education, activities/peers, drugs/alcohol, suicidality, emotions/behavior, discharge resources), a brief, standardized screening tool for pediatric EDs. This tool ensures key information is obtained for decision-making, determining acuity level, and areas of need. (Read the full article)

Children with obstructive sleep apnea (OSA) are usually treated by surgical removal of their upper airway lymphadenoid tissue. Recently, medications were offered to patients with nonsevere OSA. Montelukast, for this indication, had never been studied in a randomized controlled manner.

Montelukast effectively reduced polysomnographic findings, symptoms, and the size of the adenoidal tissue in children with nonsevere OSA. The findings support the potential of a leukotriene modifier as a novel, safe, noninvasive alternative for children with mild to moderate OSA. (Read the full article)

Childhood obesity is already prevalent by preschool age, particularly among Latinos. Parents have tremendous influence on factors that contribute to childhood obesity (eg, diet, physical activity); thus, family plays a crucial role in pediatric obesity prevention.

This randomized controlled trial examined the effect of a behavioral intervention involving Latino-American parent–preschool-aged child dyads. The intervention resulted in reductions in absolute BMI across the 3-month study period, with patterns suggesting the largest effect for obese children. (Read the full article)

Loud snoring, which spikes at ~2 to 3 years of age, has been associated with behavior problems in school-aged children in cross-sectional studies, but no longitudinal studies have quantified predictors and the behavioral impact of persistent snoring in preschool-aged children.

Persistent loud snoring, which occurs in 9% of children 2 to 3 years of age, is linked with behavior problems. Higher socioeconomic status and a history of breastfeeding were associated with lower rates of transient and persistent snoring in young children. (Read the full article)

Childhood obesity occurs in 20% of children before they enter kindergarten. Treatment is difficult, making prevention desirable, but little is known about effective methods using anticipatory guidance to prevent obesity in pediatric primary care.

This study provides a comparison of 2 approaches versus usual care using anticipatory guidance to improve infant feeding during the first year of life, and demonstrates positive specific feeding behavior differences at 1 year in the intervention groups. (Read the full article)

Computerized provider order entry (CPOE) has been recognized to enhance the efficiency, safety, and quality of medical work. Yet vendors and organizations have not determined best practices for customizations, resulting in systems that have poor usability and unintended consequences of use.

This study demonstrated that systematically developed order sets reduce cognitive workload and order variation in the context of improved system usability and guideline adherence. The concept of cognitive workload reduction is novel in the setting of computer order entry. (Read the full article)

There is evidence from both developed and developing countries that antiretroviral treatment significantly reduces mortality in HIV-infected children. However, in sub-Saharan Africa, numerous health system, financial, and human resource obstacles make delivering quality pediatric HIV care a challenge.

We describe the experience of the Baylor International Pediatrics AIDS Initiative in Malawi, Lesotho, and Swaziland. Despite challenges delivering pediatric treatment in these countries, mortality and clinical outcomes approaching those from developed countries are feasible. (Read the full article)

Immunization recall systems have been found effective in increasing immunization rates in younger children and adults; however, there have been only a few studies in adolescents and they have produced mixed results.

In this randomized controlled trial, immunization rates were significantly higher 4 weeks after a recall intervention in which both the adolescent’s parents and the adolescent were contacted, but this effect did not persist 1 year after the intervention. (Read the full article)

The outcome of status epilepticus in children depends on the etiology. In otherwise normal children who have ≥1 episodes of unprovoked status epilepticus as part of the evolution of their epilepsy, the seizure and intellectual outcome is unclear.

Based on population-based data and 20 to 30 years’ follow-up of normal children with focal epilepsy, one-third with status epilepticus had recurrence of status. Reassuringly, intelligence, seizure control, and rate of remission were not altered compared with those without status epilepticus. (Read the full article)

Birth defects are associated with preterm birth and are a major contributor to infant mortality. There are persistent black-white differences in overall infant mortality and infant mortality attributable to birth defects.

Among infants delivered at 37 to 44 weeks, blacks and Hispanics had significantly higher neonatal and postneonatal mortality attributable to birth defects than whites. Among infants delivered at 20 to 33 or 34 to 36 weeks, neonatal mortality attributable to birth defects was significantly lower among blacks. (Read the full article)

A growing number of epidemiologic studies suggest that individuals with lower vitamin D levels are at higher risk of acute respiratory tract infection. Randomized controlled trials are needed to determine if vitamin D supplementation would decrease this risk.

In a randomized controlled trial of 247 Mongolian children with vitamin D deficiency in winter, with double-blinding and 99% follow-up, vitamin D supplementation significantly reduced the risk of acute respiratory tract infections. (Read the full article)

Adolescents living in lower-poverty neighborhoods have better mental health than youth in high-poverty contexts, but it is unclear if associations are causal. Furthermore, it is unknown why some youth benefit more than others from moving to more advantaged neighborhoods.

Using an experimental study that randomly assigned families to receive vouchers to move to lower-poverty neighborhoods, we found that recent violent crime victimization adversely modified the mental health effects of moving to better neighborhoods. (Read the full article)

The higher the predischarge bilirubin percentile reading on the hour of life–specific nomogram, the higher becomes that infant's risk of developing significant hyperbilirubinemia. Neonates in the low-risk zones (≤75th percentile) have a low risk of developing hyperbilirubinemia.

Thirty-two percent of newborns readmitted for hyperbilirubinemia had low-risk zone predischarge bilirubin percentile values, predominantly in the intermediate low-risk zone (41st–75th percentile). The intermediate low-risk zone may not be as low risk as previously thought. (Read the full article)

Forearm fractures are unique injuries which are associated with lower bone mineral density in adults and white children. The relationships among bone mineral density, 25-hydroxyvitamin D status, and risk for forearm fracture have not been investigated in African American children.

Our data support an association between both lower bone mineral density and vitamin D deficiency and increased odds of forearm fracture in African American children. Promotion of bone health is indicated in this population. (Read the full article)

Evaluation of neonatal surgical outcomes is necessary to guide improvements in the quality of care. Meaningful comparisons must adjust for factors that alter outcomes independent of the surgical procedures.

Herein is described a method that permits risk adjustment for the broad range of noncardiac neonatal surgery, regardless of gestational age, to permit useful comparisons for quality improvement. (Read the full article)

The 2009 influenza A (H1N1) pandemic caused illness in all age groups, but children were disproportionately affected. Children with underlying neurologic disorders were at high risk of influenza-related complications, including death.

This study provides the first detailed description of underlying neurologic disorders among children who died of influenza A (H1N1)pdm09 virus infection. (Read the full article)

Sleep disordered breathing (SDB) and behavioral sleep problems (BSPs) affect cognitive, behavioral, and language development. No studies have examined associations between SDB and BSPs across early childhood, and later special education need (SEN), on a population basis.

A history of SDB through 5 years of age was associated with ~40% increased odds of SEN at 8 years, among >11 000 children. BSPs were associated with 7% increased odds of SEN, for each additional ~12 months of reported BSPs. (Read the full article)

Little is known about how communication during pediatric asthma visits is associated with child control medication adherence 1 month after the visit.

When providers asked for caregiver input into the asthma treatment plan during the visit, caregivers reported significantly higher child medication adherence to control medications 1 month later. (Read the full article)

Previous studies suggest that abnormal findings on conventional EEG during the neonatal period are associated with death or severe brain injury in preterm infants. However, large cohort studies on preterm EEG for predicting later neurodevelopmental outcome remain scarce.

This study demonstrates precise prognostic values of conventional EEG for predicting neurodevelopmental outcome in the current perinatal care setting. Additionally, its prognostic values are independent of severe injury on neuroimaging and clinical risk factors. (Read the full article)

Pyloric stenosis is the most common condition requiring surgery in infants. It is typically not present at birth but develops within the first weeks after birth. The etiology is largely unknown, but bottle-feeding has been suggested as a risk factor.

This study demonstrated that bottle-fed infants had a 4.6-fold increased risk of developing pyloric stenosis compared with infants who were not bottle-fed. The result adds to the evidence supporting the advantage of exclusive breastfeeding in the first months after birth. (Read the full article)

There are no studies to support the clinical awareness of persistent Tanner stage (TS) 4 breast development in adulthood, and forensic experts continue to use TS 4 as evidence of age <18 years in cases of alleged child pornography.

One-fourth of nonclinical images of women over 18 years of age could be considered by a single forensic expert to represent TS 4. This observation, and substantial discordance in interpretation by pediatric endocrinologists, renders testimony based on this distinction invalid. (Read the full article)

Childhood obesity is a public health concern. Although determinants of childhood overweight have been identified and their effect sizes have been calculated, prevention as well as treatment have had limited success.

We have calculated the population-based relevance of determinants of childhood overweight by using attributable risks, which can be interpreted as maximum success rates of preventive measures. New concepts were applied to estimate the relative contribution of each risk factor. (Read the full article)

Approximately 80% of all preterm children are born moderately preterm (32–36 weeks’ gestation). Moderately preterm children are at increased risk for developmental delays, but the specific neuropsychological functions that may underlie these delays are unknown.

Moderately preterm birth is associated with poorer performance in intelligence, attention, visuospatial reasoning, and executive functioning. Using gender-specific norms, our data suggest that preterm boys catch up, whereas preterm girls lag behind their peers at 7 years of age. (Read the full article)

Critics argue that pediatric research without the potential for clinical benefit treats children as mere means to benefit others. Yet, there are no data to assess whether adolescents who participate in research, or their parents, agree with this view.

Respondents felt that by participating in research the adolescents were making important contributions to help others, and the adolescents felt proud to be doing so. These findings support the view that nonbeneficial pediatric research involves a type of charitable activity. (Read the full article)

The relationship between energy intake and obesity in children has yielded inconsistent results. Efforts to improve dietary intake as a means of improving weight status have largely yielded disappointing results.

Self-reported energy intake for younger, but not older, overweight/obese children is higher than healthy-weight peers. In early childhood, higher (or excessive) energy intake may lead to onset of obesity, but other mechanisms may be important to maintain obesity through adolescence. (Read the full article)

Changes in resident work hours are believed to have an impact on resident education and patient safety.

This study provides an understanding of the impact of changes in resident work hours on the staffing strategies of children’s hospitals. (Read the full article)

Pediatric osteoarticular infections can be treated with successful microbiologic and clinical outcomes with a transition from parenteral to oral therapy. The best way to determine the timing of this transition is neither well studied nor standardized.

A total of 193 (99.5%) of 194 pediatric patients with acute bacterial osteoarticular infections were successfully transitioned to oral therapy, determined by using a combination of clinical findings and C-reactive protein levels, representing the largest single-center data set analyzed. (Read the full article)

Mortality of very low birth weight infants varies widely between regions and countries; however, the variation in morbidities after adjusting for confounders has not been adequately studied.

Composite outcome of mortality or short-term morbidity for very low birth weight infants was lower in Japan than in Canada. However, marked variations in mortality and individual morbidity exist, revealing areas for improvement in each country. (Read the full article)

A 2001 survey of pediatric residency training directors indicated that few programs prepared residents to intervene on tobacco. A decade later, it is not known whether programs are doing more to prepare residents to intervene effectively with patients and parents.

Despite the need for pediatricians to play a leadership role in tobacco prevention and control, most pediatric residency training programs focus more on health effects of tobacco use and smoke exposure than on how to intervene with patients and parents. (Read the full article)

Fever phobia is a ubiquitous problem throughout the world. As a result, fever is pharmacologically overtreated, and medical attention is frequently sought by worried parents.

Most Canadian parents fear their child’s fever, resulting in aggressive surveillance and treatment. Parents expect information about fever etiology and how to care for their ill child. Few parents expect antibiotics and satisfaction with care is high. (Read the full article)

Iatrogenic medical errors are an important medical care issue in the United States. Errors may be particularly important in children with chronic health conditions, especially as the prevalence of chronic conditions is increasing in children.

In a nationally representative sample, we found that pediatric inpatients with chronic conditions were at a significantly higher risk for medical errors than inpatient children without chronic conditions, controlling for severity of illness, length of stay, and other potential confounders. (Read the full article)