http://pediatrics.aappublications.org PEDIATRICS RSS feed -- recent FROM THE AMERICAN ACADEMY OF PEDIATRICS articles 1098-4275 PEDIATRICS 0031-4005 http://pediatrics.aappublications.org/icons/banner/title.gif http://pediatrics.aappublications.org http://pediatrics.aappublications.org/cgi/content/abstract/124/5/1474?rss=1 Tobacco use and secondhand tobacco-smoke (SHS) exposure are major national and international health concerns. Pediatricians and other clinicians who care for children are uniquely positioned to assist patients and families with tobacco-use prevention and treatment. Understanding the nature and extent of tobacco use and SHS exposure is an essential first step toward the goal of eliminating tobacco use and its consequences in the pediatric population. The next steps include counseling patients and family members to avoid SHS exposures or cease tobacco use; advocacy for policies that protect children from SHS exposure; and elimination of tobacco use in the media, public places, and homes. Three overarching principles of this policy can be identified: (1) there is no safe way to use tobacco; (2) there is no safe level or duration of exposure to SHS; and (3) the financial and political power of individuals, organizations, and government should be used to support tobacco control. Pediatricians are advised not to smoke or use tobacco; to make their homes, cars, and workplaces tobacco free; to consider tobacco control when making personal and professional decisions; to support and advocate for comprehensive tobacco control; and to advise parents and patients not to start using tobacco or to quit if they are already using tobacco. Prohibiting both tobacco advertising and the use of tobacco products in the media is recommended. Recommendations for eliminating SHS exposure and reducing tobacco use include attaining universal (1) smoke-free home, car, school, work, and play environments, both inside and outside, (2) treatment of tobacco use and dependence through employer, insurance, state, and federal supports, (3) implementation and enforcement of evidence-based tobacco-control measures in local, state, national, and international jurisdictions, and (4) financial and systems support for training in and research of effective ways to prevent and treat tobacco use and SHS exposure. Pediatricians, their staff and colleagues, and the American Academy of Pediatrics have key responsibilities in tobacco control to promote the health of children, adolescents, and young adults.

]]> Mon, 26 Oct 2009 04:02:04 PDT info:doi/10.1542/peds.2009-2114 American Academy of Pediatrics 5 124 1487 2009-11-01 1474 FROM THE AMERICAN ACADEMY OF PEDIATRICS http://pediatrics.aappublications.org/cgi/content/abstract/124/5/1488?rss=1 Music plays an important role in the socialization of children and adolescents. Popular music is present almost everywhere, and it is easily available through the radio, various recordings, the Internet, and new technologies, allowing adolescents to hear it in diverse settings and situations, alone or shared with friends. Parents often are unaware of the lyrics to which their children are listening because of the increasing use of downloaded music and headphones. Research on popular music has explored its effects on schoolwork, social interactions, mood and affect, and particularly behavior. The effect that popular music has on children's and adolescents' behavior and emotions is of paramount concern. Lyrics have become more explicit in their references to drugs, sex, and violence over the years, particularly in certain genres. A teenager's preference for certain types of music could be correlated or associated with certain behaviors. As with popular music, the perception and the effect of music-video messages are important, because research has reported that exposure to violence, sexual messages, sexual stereotypes, and use of substances of abuse in music videos might produce significant changes in behaviors and attitudes of young viewers. Pediatricians and parents should be aware of this information. Furthermore, with the evidence portrayed in these studies, it is essential for pediatricians and parents to take a stand regarding music lyrics.

]]> Mon, 26 Oct 2009 04:02:04 PDT info:doi/10.1542/peds.2009-2145 American Academy of Pediatrics 5 124 1494 2009-11-01 1488 FROM THE AMERICAN ACADEMY OF PEDIATRICS http://pediatrics.aappublications.org/cgi/content/abstract/124/5/1495?rss=1 Exposure to violence in media, including television, movies, music, and video games, represents a significant risk to the health of children and adolescents. Extensive research evidence indicates that media violence can contribute to aggressive behavior, desensitization to violence, nightmares, and fear of being harmed. Pediatricians should assess their patients' level of media exposure and intervene on media-related health risks. Pediatricians and other child health care providers can advocate for a safer media environment for children by encouraging media literacy, more thoughtful and proactive use of media by children and their parents, more responsible portrayal of violence by media producers, and more useful and effective media ratings. Office counseling has been shown to be effective.

]]> Mon, 26 Oct 2009 04:02:04 PDT info:doi/10.1542/peds.2009-2146 American Academy of Pediatrics 5 124 1503 2009-11-01 1495 FROM THE AMERICAN ACADEMY OF PEDIATRICS http://pediatrics.aappublications.org/cgi/content/abstract/124/5/e1017?rss=1 Secondhand tobacco smoke (SHS) exposure of children and their families causes significant morbidity and mortality. In their personal and professional roles, pediatricians have many opportunities to advocate for elimination of SHS exposure of children, to counsel tobacco users to quit, and to counsel children never to start. This report discusses the harms of tobacco use and SHS exposure, the extent and costs of tobacco use and SHS exposure, and the evidence that supports counseling and other clinical interventions in the cycle of tobacco use. Recommendations for future research, policy, and clinical practice change are discussed. To improve understanding and provide support for these activities, the harms of SHS exposure are discussed, effective ways to eliminate or reduce SHS exposure are presented, and policies that support a smoke-free environment are outlined.

]]> Mon, 26 Oct 2009 04:02:05 PDT info:doi/10.1542/peds.2009-2120 American Academy of Pediatrics 5 124 e1044 2009-11-01 e1017 FROM THE AMERICAN ACADEMY OF PEDIATRICS http://pediatrics.aappublications.org/cgi/content/abstract/124/5/e1045?rss=1 Tobacco use is the leading preventable cause of morbidity and death in the United States. Because 80% to 90% of adult smokers began during adolescence, and two thirds became regular, daily smokers before they reached 19 years of age, tobacco use may be viewed as a pediatric disease. Every year in the United States, approximately 1.4 million children younger than 18 years start smoking, and many of them will die prematurely from a smoking-related disease. Moreover, there is recent evidence that adolescents report symptoms of tobacco dependence early in the smoking process, even before becoming daily smokers. The prevalence of tobacco use is higher among teenagers and young adults than among older adult populations. The critical role of pediatricians in helping to reduce tobacco use and addiction and secondhand tobacco-smoke exposure in the pediatric population includes education and prevention, screening and detection, and treatment and referral.

]]> Mon, 26 Oct 2009 04:02:05 PDT info:doi/10.1542/peds.2009-2121 American Academy of Pediatrics 5 124 e1053 2009-11-01 e1045 FROM THE AMERICAN ACADEMY OF PEDIATRICS http://pediatrics.aappublications.org/cgi/content/abstract/124/4/1216?rss=1 The purpose of this statement is to update current recommendations for routine use of trivalent seasonal influenza vaccine and antiviral medications for the prevention and treatment of influenza in children.

]]> Mon, 28 Sep 2009 04:02:15 PDT info:doi/10.1542/peds.2009-1806 American Academy of Pediatrics 4 124 1226 2009-10-01 1216 FROM THE AMERICAN ACADEMY OF PEDIATRICS http://pediatrics.aappublications.org/cgi/content/abstract/124/4/1227?rss=1 As advocates for children and their families, pediatricians can support and guide expectant parents in the prenatal period. Prenatal visits allow the pediatrician to gather basic information from expectant parents, offer them information and advice, and identify high-risk conditions that may require special care. In addition, a prenatal visit is the first step in establishing a relationship between the family and the pediatrician (the infant's medical home) and in helping the parents develop parenting skills and confidence. There are several possible formats for this first visit. The one used depends on the experience and preference of the parents, the style of the pediatrician's practice, and pragmatic issues of reimbursement.

]]> Mon, 28 Sep 2009 04:02:15 PDT info:doi/10.1542/peds.2009-1785 American Academy of Pediatrics 4 124 1232 2009-10-01 1227 FROM THE AMERICAN ACADEMY OF PEDIATRICS http://pediatrics.aappublications.org/cgi/content/abstract/124/4/1233?rss=1 Children who require emergency care have unique needs, especially when emergencies are serious or life-threatening. The majority of ill and injured children are brought to community hospital emergency departments (EDs) by virtue of their geography within communities. Similarly, emergency medical services (EMS) agencies provide the bulk of out-of-hospital emergency care to children. It is imperative, therefore, that all hospital EDs have the appropriate resources (medications, equipment, policies, and education) and staff to provide effective emergency care for children. This statement outlines resources necessary to ensure that hospital EDs stand ready to care for children of all ages, from neonates to adolescents. These guidelines are consistent with the recommendations of the Institute of Medicine's report on the future of emergency care in the United States health system. Although resources within emergency and trauma care systems vary locally, regionally, and nationally, it is essential that hospital ED staff and administrators and EMS systems' administrators and medical directors seek to meet or exceed these guidelines in efforts to optimize the emergency care of children they serve. This statement has been endorsed by the Academic Pediatric Association, American Academy of Family Physicians, American Academy of Physician Assistants, American College of Osteopathic Emergency Physicians, American College of Surgeons, American Heart Association, American Medical Association, American Pediatric Surgical Association, Brain Injury Association of America, Child Health Corporation of America, Children's National Medical Center, Family Voices, National Association of Children's Hospitals and Related Institutions, National Association of EMS Physicians, National Association of Emergency Medical Technicians, National Association of State EMS Officials, National Committee for Quality Assurance, National PTA, Safe Kids USA, Society of Trauma Nurses, Society for Academic Emergency Medicine, and The Joint Commission.

]]> Mon, 28 Sep 2009 04:02:15 PDT info:doi/10.1542/peds.2009-1807 American Academy of Pediatrics 4 124 1243 2009-10-01 1233 FROM THE AMERICAN ACADEMY OF PEDIATRICS http://pediatrics.aappublications.org/cgi/content/abstract/124/4/1244?rss=1 Many children who take medications require them during the school day. This policy statement is designed to guide prescribing health care professionals, school physicians, and school health councils on the administration of medications to children at school. All districts and schools need to have policies and plans in place for safe, effective, and efficient administration of medications at school. Having full-time licensed registered nurses administering all routine and emergency medications in schools is the best situation. When a licensed registered nurse is not available, a licensed practical nurse may administer medications. When a nurse cannot administer medication in school, the American Academy of Pediatrics supports appropriate delegation of nursing services in the school setting. Delegation is a tool that may be used by the licensed registered school nurse to allow unlicensed assistive personnel to provide standardized, routine health services under the supervision of the nurse and on the basis of physician guidance and school nursing assessment of the unique needs of the individual child and the suitability of delegation of specific nursing tasks. Any delegation of nursing duties must be consistent with the requirements of state nurse practice acts, state regulations, and guidelines provided by professional nursing organizations. Long-term, emergency, and short-term medications; over-the-counter medications; alternative medications; and experimental drugs that are administered as part of a clinical trial are discussed in this statement. This statement has been endorsed by the American School Health Association.

]]> Mon, 28 Sep 2009 04:02:15 PDT info:doi/10.1542/peds.2009-1953 American Academy of Pediatrics 4 124 1251 2009-10-01 1244 FROM THE AMERICAN ACADEMY OF PEDIATRICS http://pediatrics.aappublications.org/cgi/content/abstract/124/4/1252?rss=1 Congenital or acquired hearing loss in infants and children has been linked with lifelong deficits in speech and language acquisition, poor academic performance, personal-social maladjustments, and emotional difficulties. Identification of hearing loss through neonatal hearing screening, regular surveillance of developmental milestones, auditory skills, parental concerns, and middle-ear status and objective hearing screening of all infants and children at critical developmental stages can prevent or reduce many of these adverse consequences. This report promotes a proactive, consistent, and explicit process for the early identification of children with hearing loss in the medical home. An algorithm of the recommended approach has been developed to assist in the detection and documentation of, and intervention for, hearing loss.

]]> Mon, 28 Sep 2009 04:02:15 PDT info:doi/10.1542/peds.2009-1997 American Academy of Pediatrics 4 124 1263 2009-10-01 1252 FROM THE AMERICAN ACADEMY OF PEDIATRICS http://pediatrics.aappublications.org/cgi/content/full/124/4/1264?rss=1 Mon, 28 Sep 2009 04:02:15 PDT info:doi/10.1542/peds.2009-1954 American Academy of Pediatrics 4 124 1264 2009-10-01 1264 FROM THE AMERICAN ACADEMY OF PEDIATRICS http://pediatrics.aappublications.org/cgi/content/abstract/124/3/992?rss=1 Most children will engage in sexual behaviors at some time during childhood. These behaviors may be normal but can be confusing and concerning to parents or disruptive or intrusive to others. Knowledge of age-appropriate sexual behaviors that vary with situational and environmental factors can assist the clinician in differentiating normal sexual behaviors from sexual behavior problems. Most situations that involve sexual behaviors in young children do not require child protective services intervention; for behaviors that are age-appropriate and transient, the pediatrician may provide guidance in supervision and monitoring of the behavior. If the behavior is intrusive, hurtful, and/or age-inappropriate, a more comprehensive assessment is warranted. Some children with sexual behavior problems may reside or have resided in homes characterized by inconsistent parenting, violence, abuse, or neglect and may require more immediate intervention and referrals.

]]> Mon, 31 Aug 2009 04:01:39 PDT info:doi/10.1542/peds.2009-1692 American Academy of Pediatrics 3 124 998 2009-09-01 992 FROM THE AMERICAN ACADEMY OF PEDIATRICS