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Home Reading Environment and Brain Activation in Preschool Children Listening to Stories

The American Academy of Pediatrics recommends parent-child reading from infancy through at least kindergarten, the span of maximal brain growth. Home literacy environment, including reading behaviors and access to books, has been shown to promote oral language and print concepts.

Home reading environment is positively associated with activation of brain areas supporting narrative comprehension and mental imagery in preschool children. This offers novel insight into the neurobiological foundations of emergent literacy and potential effect of shared reading during early childhood. (Read the full article)




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Preterm Cognitive Function Into Adulthood

Children born very preterm (VP) or with very low birth weight (VLBW) are at risk for cognitive deficits and low IQ in childhood. Recent evidence indicates that IQ discrepancies between VP/VLBW and term-born individuals are still found in adulthood.

Development of cognitive function is more stable for VP/VLBW than term-born individuals from infancy into adulthood and can be predicted fairly well from age 20 months onward. However, when adults with cognitive impairment are excluded, group differences in stability disappear. (Read the full article)




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Global Health Education in US Pediatric Residency Programs

In response to growing demand from trainees, many pediatric residency programs offer global health (GH) experiences for their residents. There is diversity in what is offered at programs across the country.

This is the most comprehensive assessment of US pediatric residency training opportunities in GH. These opportunities are prevalent and increasingly formalized as tracks. However there remain gaps in universal pretravel preparation and coordination across GH partnerships nationally. (Read the full article)




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Costs of Venous Thromboembolism, Catheter-Associated Urinary Tract Infection, and Pressure Ulcer

In adults, there is significant increased length of stay, cost, and/or resource use associated with hospital-acquired conditions. Less is known about the epidemiology and impact of many hospital-acquired conditions in pediatric populations.

We find increased pediatric length of stay and costs due to venous thromboembolism and catheter-associated urinary tract infections. This is essential information for hospital administrators and safety departments who are planning interventions to reduce harm associated with these hospital-acquired conditions. (Read the full article)




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The Impact of Rudeness on Medical Team Performance: A Randomized Trial

Rudeness is routinely experienced by hospital-based medical teams. Individuals exposed to mildly rude behavior perform poorly on cognitive tasks, exhibit reduced creativity and flexibility, and are less helpful and prosocial.

Rudeness had adverse consequences on diagnostic and procedural performance of members of the NICU medical teams. Information-sharing mediated the adverse effect of rudeness on diagnostic performance, and help-seeking mediated the effect of rudeness on procedural performance. (Read the full article)




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Congenital Heart Defects and Receipt of Special Education Services

Poor neurocognitive outcomes are associated with some types of congenital heart defects (CHDs). Guidelines for developmental screening for children with CHDs have been published. Population-based information on special education services needed among children with CHDs is limited.

Children in metropolitan Atlanta with congenital heart defects (CHDs) received special education services more often than children without birth defects. These findings highlight the need for special education services and the importance of developmental screening for all children with CHDs. (Read the full article)




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Eye Protection and Risk of Eye Injuries in High School Field Hockey

A previous national study conducted over 2 seasons by this group of authors demonstrated the effectiveness of mandated protective eyewear in reducing eye/orbital, concussive, and head/facial injuries in high school girls' field hockey.

Data collected from regional/national high school sports injury surveillance databases by certified athletic trainers over 4 seasons has shown that nationally mandated protective eyewear results in a greater than 3-fold reduced risk of eye/orbital injuries in girls playing high school field hockey. (Read the full article)




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Infection-Related Hospitalization in Childhood and Adult Metabolic Outcomes

Childhood inflammatory mediators are associated with adult obesity, but the stimuli that initiate and perpetuate chronic inflammation start in early life are largely unknown.

Childhood infection-related hospitalization was independently associated with adverse adult metabolic variables, which suggests that infections and/or their treatment in childhood may contribute to causal pathways leading to adult cardiometabolic diseases. (Read the full article)




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Risk of Sensorineural Hearing Loss and Bilirubin Exchange Transfusion Thresholds

High bilirubin levels are associated with sensorineural hearing loss. Exchange transfusions are recommended when bilirubin levels reach certain thresholds. However, the relative and excess risks of hearing loss in infants with bilirubin levels at/above exchange transfusion thresholds are unknown.

In this Northern California population of term and late preterm infants, elevated bilirubin levels were not associated with an increased risk of sensorineural hearing loss unless the levels were at least 10 mg/dL above exchange transfusion thresholds. (Read the full article)




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Concurrent Respiratory Viruses and Kawasaki Disease

Making a diagnosis of Kawasaki disease (KD) is often a diagnostic dilemma. This dilemma is confounded when children present with symptoms consistent with known, common respiratory viruses and/or with KD symptoms that could potentially be attributed to a respiratory virus.

Patients with KD commonly have a concurrent respiratory viral infection. Clinicians should not dismiss the diagnosis of KD based on the presence of respiratory symptoms. Furthermore, a positive respiratory virus test result should not be used to exclude the diagnosis of KD. (Read the full article)




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Parent/Adolescent Weight Status Concordance and Parent Feeding Practices

Research has shown that parent feeding practices are associated with adolescent weight status and dietary intake. It is unknown whether certain factors such as parent and child weight status concordance or discordance influence parents’ use of specific feeding practices.

Findings from the current study suggest that parents use the highest levels of pressure-to-eat feeding practices when parents and adolescents are both nonoverweight and the highest levels of food restriction when parents and adolescents are both overweight/obese. (Read the full article)




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Outcome of Patients Initiating Chronic Peritoneal Dialysis During the First Year of Life

Historically, children with end-stage renal disease who initiated chronic dialysis during the first year of life were far less likely to survive or successfully receive a kidney transplant compared with those who initiated chronic dialysis at older ages.

In recent years, survival has improved markedly among children who initiate chronic peritoneal dialysis at <1 year of age. Among those infants who initiate dialysis after the neonatal period and later undergo kidney transplantation, graft survival has improved as well. (Read the full article)




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Incidence, Trends, and Survival of Children With Embryonal Tumors

Embryonal tumors occur almost exclusively in children. The group is heterogeneous and includes relatively common pediatric tumors as well as rare tumors. The incidence rate for hepatoblastoma has been increasing in some countries.

This population-based study is the first comprehensive study on embryonal tumors in German children. Incidence rates, trends, and survival for 1991 through 2012 are presented. A statistically significant increasing trend for hepatoblastoma was detected for the first time in Europe. (Read the full article)




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Preterm Birth and Poor Fetal Growth as Risk Factors of Attention-Deficit/Hyperactivity Disorder

Infants born very prematurely or with a very low birth weight are known to have an increased risk of attention-deficit/hyperactivity disorder (ADHD). Results concerning late preterm children are controversial and studies examining fetal growth represented by weight for gestational age are scarce.

We demonstrate that each declining week of gestation increases the risk of ADHD. Also, late preterm infants have an increased risk. Furthermore, as weight for gestational age becomes smaller than 1 SD below the mean, the risk of ADHD increases. (Read the full article)




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Alcohol and Marijuana Use and Treatment Nonadherence Among Medically Vulnerable Youth

Increasing percentages of youth are living with chronic medical conditions. Although adolescents face peak risks for onset and intensification of alcohol and marijuana use, we know little about these behaviors and their associations with treatment adherence among chronically ill youth.

This study quantifies alcohol and marijuana use behaviors among a heterogeneous sample of chronically ill youth in aggregate and by condition, and measures associations between alcohol use/binge drinking and knowledge about alcohol interactions with medications/laboratory tests and also treatment nonadherence. (Read the full article)




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Sensitivity of the Automated Auditory Brainstem Response in Neonatal Hearing Screening

Adding second-stage automated auditory brainstem response (ABR) testing for infants who failed the initial OAE test in a two-stage neonatal hearing screening has been shown to reduce false referrals to the hearing clinic.

Infants with hearing loss may be missed by a 2-stage hearing screening because they pass the automated ABR test. In our study, a significant number of infants with hearing loss >45 decibel hearing level passed screening with automated ABR. (Read the full article)




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High School Students' Use of Electronic Cigarettes to Vaporize Cannabis

Electronic cigarette use among youth is rising exponentially. Among other concerns, modified electronic cigarettes can be used to vaporize cannabis. However, no scientific data have been published on the rates of using electronic cigarettes to vaporize cannabis among youth.

This study presents rates of vaporizing cannabis among a sample of high school students (N = 3847). Rates of vaporizing cannabis were high among lifetime e-cigarette users (18.0%), lifetime cannabis users (18.4%), and lifetime dual cannabis and e-cigarette users (26.5%). (Read the full article)




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Two-Year Outcomes of a Population-Based Intervention for Preschool Language Delay: An RCT

Preschool language delay predicts poorer academic performance, employment opportunities, and social relationships. Language for Learning, a systematic, population-based intervention for 4-year-olds with low language, is feasible, acceptable and has short-term benefits, but long-term benefits are unknown.

Population ascertainment at age 4 followed by a yearlong, one-on-one home program benefited phonological skills (an important literacy determinant) at age 6, but not the primary language outcomes. To be cost-effective, future follow-up would need to demonstrate lasting academic benefits. (Read the full article)




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Disorders in Children With Congenital Cytomegalovirus Infection

Congenital cytomegalovirus infection is the leading infectious cause of neurologic disabilities and sensorineural hearing loss in children. Little is known concerning the frequency and impact of vestibular disorders induced by cytomegalovirus infection.

This study reports on the largest cohort of vestibular assessment of children congenitally infected with cytomegalovirus, demonstrating vestibular damages, and analyzes the correlations between vestibular dysfunction and hearing impairment or severity of infection. Cytomegalovirus infection affects postural development in children. (Read the full article)




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Trends in Emergency Department Visits for Unsupervised Pediatric Medication Exposures, 2004-2013

Unsupervised medication exposures increased during the previous decade, despite child-resistant packaging and caregiver education. To achieve the Healthy People 2020 objective of reducing emergency department visits for unintentional pediatric medication overdoses, targeted interventions including improved safety packaging may be needed.

Since 2010, emergency department visits for unsupervised medication exposures started to decrease. Most visits involved solid dose medications, typically for adult use. Most liquid medication exposure visits involved 4 over-the-counter pediatric products and may be more readily amenable for interventions. (Read the full article)




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Sources of Infant Pertussis Infection in the United States

The source of infant pertussis infection is typically identified ~50% of the time. Historically, mothers have been identified as the most common source of pertussis transmission to infants.

This analysis of 8 years of enhanced pertussis surveillance data has uncovered a shift in the most common source of infant pertussis infection in the United States from mothers to siblings. (Read the full article)




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Alcohol Interventions Among Underage Drinkers in the ED: A Randomized Controlled Trial

Intervention strategies are needed to reduce underage drinking. Meta-analyses of youth alcohol brief interventions (BIs) conclude that therapist-delivered BIs are efficacious; however, to maximize public health impact, recommendations include using technology to streamline intervention delivery, for which evidence is lacking.

A single-session BI, delivered by a computer or therapist in the emergency department, shows promise for underage drinkers. Findings for the stand-alone computer BI are particularly appealing given the ease of future implementation. (Read the full article)




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Lung Function in Very Low Birth Weight Adults

Children born preterm at very low birth weight have reduced lung function. Reduced lung function may extend to adult life, but to what extent this outcome is attributable to bronchopulmonary dysplasia and other prenatal and neonatal conditions is not known.

Young adults born preterm at very low birth weight had impaired airflow. This finding suggests an increased risk of later obstructive airways disease and was observed also among those with no bronchopulmonary dysplasia, regardless of other prenatal and neonatal complications. (Read the full article)




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Dexamethasone Therapy for Septic Arthritis in Children

Two prospective studies of children with septic arthritis have shown that the addition of dexamethasone to antibiotic therapy contributes to clinical and laboratory improvement. Nevertheless, the mainstay of treatment remains antibiotics alone.

This study, which was conducted outside a randomized controlled trial, demonstrates that children with septic arthritis treated early with a short course of adjuvant dexamethasone show earlier improvement in clinical and laboratory parameters than children treated with antibiotics alone. (Read the full article)




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Implementation of a Neonatal Abstinence Syndrome Weaning Protocol: A Multicenter Cohort Study

Use of a standard treatment protocol with stringent weaning guidelines for infants with neonatal abstinence syndrome supports improved outcomes including shorter duration of opioid exposure and length of hospital stay.

We demonstrate generalizability of a protocol-driven weaning strategy for improvement in hospital outcomes for neonatal abstinence syndrome. After adoption, adherent protocol-adopting centers improved outcomes and eliminated differences in outcomes compared with centers with preexisting stringent weaning protocols. (Read the full article)




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Timing of the Diagnosis of Attention-Deficit/Hyperactivity Disorder and Autism Spectrum Disorder

Many studies have suggested that autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) are commonly co-occuring neurodevelopmental conditions.

In children with co-occurring ASD and ADHD, an initial ADHD diagnosis may be associated with delayed ASD diagnosis and a higher likelihood of ASD diagnosis older than 6 years of age. Clinicians should consider ASD when evaluating young children presenting with ADHD symptoms. (Read the full article)




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Effects of Genotype and Sleep on Temperament

Sleep disturbances in infants associate with individual differences in temperament. However, little is known about interindividual differences and potential moderating factors, such as genotype.

The results suggest that the cumulative effect of total sleep duration during the first 3 years of life on temperament is moderated by child 5-HTTLPR genotype following a differential susceptibility model. (Read the full article)




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Reasons for Rehospitalization in Children Who Had Neonatal Abstinence Syndrome

Infants with neonatal abstinence syndrome are hospitalized for longer after birth and are more likely to be from highly vulnerable families. Determining long-term outcomes is difficult because this is a large and chaotic population.

(Read the full article)




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Weight Gain, Executive Functioning, and Eating Behaviors Among Girls

Executive functioning and excess weight have been associated in both cross-sectional and prospective studies, but mechanisms explaining this relationship are unclear.

Impulsivity and planning at age 10 predicted age 10 to 16 BMI changes, and age 12 binge-eating tendencies mediated the relation between impulsivity at age 10 and changes in BMI change through age 16. (Read the full article)




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Chronic Neuromotor Disability After Complex Cardiac Surgery in Early Life

Neurodevelopmental outcomes after cardiac surgery in early life provide critical information for understanding and improving care. Studies show these children are at risk for arterial ischemic stroke and acquired brain injury; further characterization of motor impairment is needed.

This study focuses on the presence of chronic neuromotor disabilities including cerebral palsy and motor impairments after acquired brain injury in children surviving early complex cardiac surgery, providing information on the frequency, characteristics, and predictors that may assist in prevention. (Read the full article)




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Fruit Consumption by Youth in the United States

Although whole fruit intake has increased among US youth from 2003 to 2010, little is known about the specific types of fruits youth consume and whether consumption varies by age, poverty status, gender, and race or Hispanic origin.

Twelve discrete fruits and fruit juices contribute almost 90% of total fruit consumed by US youth. Consumption of specific fruits and 100% fruit juices was associated with age and race or Hispanic origin but not gender or poverty status. (Read the full article)




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Parental Supervision and Alcohol Abuse Among Adolescent Girls

Minimal parent supervision and early pubertal maturation independently forecast alcohol misuse among adolescent girls. It is not known if pubertal timing amplifies risks associated with inadequate supervision during the formative years when youth are first exposed to alcohol.

Early maturing girls who enter secondary school with high levels of behavioral autonomy report a dramatic increase in alcohol abuse. The etiology of their problems with alcohol can be traced, in part, to heightened risks arising from low parent supervision. (Read the full article)




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A Model for Predicting Significant Hyperbilirubinemia in Neonates From China

Guidelines for postdischarge monitoring of hyperbilirubinemia for neonates of white descent are available from the American Academy of Pediatrics; however, such information for healthy term and late preterm Chinese neonates is lacking.

A classification model for predicting the risk of significant hyperbilirubinemia in Chinese neonates was developed that combines a transcutaneous bilirubin–based nomogram with clinical risk factors. It classified newborns into 6 risk groups, which can guide clinicians in planning appropriate follow-up strategies. (Read the full article)




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Maternal Versus Infant Vitamin D Supplementation During Lactation: A Randomized Controlled Trial

The vitamin D concentration in breast milk of women taking 400 IU vitamin D per day is relatively low, leading to vitamin D deficiency in breastfeeding infants. As a result, the American Academy of Pediatrics recommends breastfeeding infant vitamin D supplementation within days after birth.

Maternal vitamin D supplementation alone with 6400 IU/day safely supplies breast milk with adequate vitamin D to satisfy the requirement of her nursing infant and offers an alternate strategy to direct infant supplementation. (Read the full article)




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Intraurethral Lidocaine for Urethral Catheterization in Children: A Randomized Controlled Trial

Urethral catheterization is a painful, yet common procedure to obtain a sterile urine sample in young children. There are conflicting results regarding the effectiveness of lidocaine to reduce pain, and it is unclear if it should be routinely used.

In young children, combined topical and intraurethral lidocaine does not reduce pain during urethral catheterization and is associated with more pain than nonanesthetic lubricant during instillation. Clinicians should use noninvasive methods of analgesia during this painful procedure. (Read the full article)




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Preterm Infant Attendance at Health Supervision Visits

Premature infants are at risk for medical and neurodevelopmental sequelae. Close monitoring is an important role for primary care providers. Premature infants have high use of health care services; however, little is known about the role of health supervision visits.

This study explores the utilization and value of health supervision visits for premature infants. Fewer than half were found to be fully adherent to the health supervision visit schedule, resulting in preventive care gaps and immunization delays. (Read the full article)




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Bladder Function After Fetal Surgery for Myelomeningocele

Urologic outcomes of prenatal myelomeningocele closure have previously been reported. This study, however, represents a large, prospectively followed cohort of these patients and presents detailed findings of urologic outcomes. To our knowledge, this is the largest study of this type.

Our study is the only trial to compare urologic outcomes in children with myelomeningocele having undergone prenatal closure with those who had postnatal repair in a prospective and systematic manner. We report our findings at 12 and 30 months. (Read the full article)




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Effectiveness and Cost of Bidirectional Text Messaging for Adolescent Vaccines and Well Care

Adolescent vaccination rates lag behind other childhood vaccines. Text messaging to improve uptake of adolescent vaccines has been shown to be effective in academic centers but has not been studied in other settings.

This study, done in 5 private and 2 safety-net practices, used a bidirectional text message as a behavioral prompt and showed text messaging was effective at increasing uptake of all adolescent vaccines. Costs were similar to other reminder/recall methods. (Read the full article)




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Hospital Use in the Last Year of Life for Children With Life-Threatening Complex Chronic Conditions

Children with life-threatening complex chronic conditions (LT-CCCs) experience high hospital use.

Hospital use in the last year of life for these children varies by type and number of LT-CCCs. Most children with ≥3 LT-CCCs are admitted to the hospital for more than 2 months in the last year of life. (Read the full article)




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Deferred Consent for Randomized Controlled Trials in Emergency Care Settings

Deferral of consent avoids delaying emergency interventions while ensuring consent to ongoing participation and use of data. Deferred consent is particularly important for enabling trials in pediatric settings, where many medicines and devices are unlicensed and untested for use.

Approaches for seeking deferred consent should balance the potential burden of obtaining consent against risk of bias due to outcome-related attrition. Ethics committees could consider approving data use when best efforts to obtain deferred consent are met with no response. (Read the full article)




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Incidence of Dravet Syndrome in a US Population

De novo mutations of the sodium channel gene SCN1A are the major cause of Dravet syndrome, an infantile-onset epileptic encephalopathy. The incidence of this genetic disorder in the United States is unclear.

Dravet syndrome due to SCN1A mutation is twice as common in the United States as previously thought. Genetic testing should be considered in children with ≥2 prolonged febrile seizures by 1 year of age. (Read the full article)




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Hospital Variation in Health Care Utilization by Children With Medical Complexity

Children with medical complexity require a disproportionate amount of health services due to a multitude of chronic severe illness, and their impact on the health care system appears to be increasing.

This study provides one of the first comparisons of health care utilization patterns for children with medical complexity between medical centers in a population-based cohort. (Read the full article)




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Stigma and Parenting Children Conceived From Sexual Violence

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)




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Use of a Metronome in Cardiopulmonary Resuscitation: A Simulation Study

The frequency of cardiac arrest is significantly lower in children than in adults, rendering the delivery of high-quality cardiopulmonary resuscitation more difficult. Metronome-based studies in adults showed improvement in adequate compression rate, with a detrimental effect on the depth of chest compressions.

This is the first pediatric study to confirm that the use of a metronome during cardiopulmonary resuscitation significantly improves the delivery of adequate rate without affecting the compression depth. This effect was more prominent among medical students and pediatric residents and fellows than nurses. (Read the full article)




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Outpatient Visits and Medication Prescribing for US Children With Mental Health Conditions

Seven percent of children in the United States receive mental health services each year. There are more pediatric outpatient mental health care visits to primary care physicians (PCPs) than to psychiatrists. Mental health utilization patterns regarding different conditions and medication prescribing are unknown.

One-third of children with mental health conditions see PCPs only. A greater proportion of children with attention-deficit/hyperactivity disorder see PCPs for this than do those with anxiety/mood disorders. Children seeing PCPs are prescribed psychotropic medications more often than those seeing psychiatrists. (Read the full article)




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Early-Onset Neutropenia in Small-for-Gestational-Age Infants

Small for gestational age neonates (weight <10th percentile) are at risk for neutropenia during the first days after birth. However, the duration, responsible mechanism, and outcomes of this variety of neonatal neutropenia are not precisely known.

Six percent of small for gestational age neonates had neutrophils <1000/μL, with an average neutropenia duration of 7 days. Neutropenia was more closely linked with small for gestational age status than maternal hypertension. This neutropenia is associated with elevated nucleated red blood cell count and increased odds of necrotizing enterocolitis. (Read the full article)




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Lithium in the Acute Treatment of Bipolar I Disorder: A Double-Blind, Placebo-Controlled Study

Strictly-defined pediatric bipolar I disorder (BP-I) is a serious condition. Although lithium is a benchmark treatment and has shown effectiveness in adults for decades, no definitive efficacy or long-term safety studies had been performed in pediatric patients with BP-I.

This study provides evidence to support the efficacy of lithium in the acute treatment of youths with BP-I who are currently in a manic or mixed state. Lithium had an adverse effect profile that was acceptable for most patients. (Read the full article)




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Racial and Regional Differences in Rates of Invasive Pneumococcal Disease

Previous studies have shown racial differences in invasive pneumococcal disease (IPD) rates. Recent studies demonstrated a national decline in IPD rates after 13-valent pneumococcal conjugate vaccine (PCV13) introduction. The impact of PCV13 on racial and regional differences in IPD rates among Tennessee children is unknown.

After introduction of PCV13, pediatric IPD rates, including disease due to antibiotic-resistant strains, declined substantially. Racial and regional differences in IPD rates were no longer significant. Our study illustrates the impact of PCV13 and the importance of continued IPD surveillance. (Read the full article)




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Long-term Effects of Pediatric Burns on the Circulatory System

Systemic responses occur after burn injury that lead to widespread changes to the body, including the heart. Elevated levels of catecholamines and stress hormones have been found up to 3 years after severe burns. Little is known about the longer-term effects.

Children with burns had 1.3 times as many admissions and 2.3 times the number of days in hospital for circulatory diseases compared with uninjured children. Children with minor burns had an increased risk of incident admissions for circulatory diseases. (Read the full article)




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Safety of Botulinum Toxin Type A for Children With Nonambulatory Cerebral Palsy

Children with marked cerebral palsy (CP) are considered at greater risk of adverse events (AEs) after intramuscular injections of BoNT-A. To date there has been no randomized controlled trial examining safety of intramuscular BoNT-A injections in children with marked CP.

Children with nonambulatory CP had no greater risk of moderate or serious AEs after intramuscular injections of BoNT-A compared with a sham/control group. There was no greater risk of AEs for children receiving 2 compared with 1 episode of BoNT-A. (Read the full article)