The fourth issue of the Journal of the Ambulatory Pediatric Association covers a diverse set of areas in academic general pediatrics and initiates a new annual series on the health and health care of children and youth in the United States, directed by Associate Editor Marie McCormick. This issue begins with Kathi Kemper's APA Presidential Address, her review of holistic pediatrics, and the interesting challenges faced in child health. Charlotte Heidenreich and colleagues from the Medical College of Wisconsin provide a thoughtful review of teaching methods in ambulatory care, and Elizabeth Morrison (University of California, Irvine) and Janet Hafler (Harvard Medical School) overview efforts to improve the teaching skills of pediatric residents.
Tom Newman (University of California, San Francisco) and Jeffrey Maisels (Michigan) provide an important view of changes in newborn bilirubin screening and underlying policy questions, stimulating issues that have implications for policy related to many aspects of child health. Dimitri Christakis and colleagues (University of Washington) provide interesting findings relating to tradeoffs of benefits and complications from newborn circumcision. Anne Duggan (Johns Hopkins University) and colleagues describe further the important Hawaii experience in home visiting and help clarify social and clinical factors associated with long-term use of home visiting services. Jonathan Finkelstein and colleagues (Harvard Pilgrim Health Care) make imaginative use of the data from a large managed care organization to describe both the occurrence and variations in management of fever in infants. Judith Groner and colleagues (Ohio State University) describe an intervention to change maternal smoking behavior. Although the intervention did not appear to decrease maternal smoking, it may have changed where mothers smoked and hopefully lessened their children's secondary exposure. Jill Halterman and colleagues (University of Rochester) use national survey data to describe patterns of care for children with asthma, documenting (again) the large opportunities for improvement. One nonfinding of interest was the lack of improvement in long-term care at the time of the promulgation of national asthma care guidelines. Ellen Perrin and colleagues (University of Massachusetts) document large differences in defining unmet needs of children with chronic conditions, when viewed by fathers, mothers, and pediatricians. Christopher Forrest and colleagues (also Johns Hopkins University) apply the relatively new adolescent version of the Child Health and Illness Profile to compare incarcerated adolescent males with an apparently well control group, documenting the wide burden of health, mental health, and psychosocial issues in the incarcerated group.
This issue represents the completion of the first year of operation of the Journal of the Ambulatory Pediatric Association. We have appreciated the help of many members of the Association, as reviewers, authors, and advisers in the development of the Journal. In the second year, we plan to institute editorials and commentaries to accompany some articles and expect to develop several themes of particular interest to APA members. As always, we appreciate and value your advice.