JUVENILE DETENTION CENTERS NOT MAKING THE GRADE

Despite an AAP recommendation published in 2001, just 53 of the 3,500 juvenile justice residential facilities in the United States received accreditation for adequate facility health care in 2006. Upwards of 1.3 million medically underserved young people pass through these facilities each year. The results from the study, "Can Juvenile Justice Detention Facilities Meet the Call of the American Academy of Pediatrics and National Commission on Correctional Health Care? A National Analysis of Current Practices," determined that the low levels of accreditation indicate substandard care. The study of all 726 U.S. juvenile detention
centers concluded that only 13-18 percent of facilities made vision, dental, or gynecological services available to all adolescents. More alarming is the low level of testing for infectious and communicable diseases. Because these adolescents are at a greater risk for nearly every type of condition, many of which are transmittable and life altering, a Federal Initiative on Juvenile Justice Health is being developed to address the public health importance of providing care to this population.

FIRST-TIME HEAD INJURY MAY PREDICT SUBSEQUENT HEAD INJURIES

Children with an initial head injury were nearly twice as likely to experience another head injury within the next six months, compared to children who sustained a non head-related injury. The study, "Previous Head Injury Is a Risk Factor for Subsequent Head Injury in Children: A Longitudinal Cohort Study," interviewed the parents of 11,867 children ages one to 18 years who were treated for injuries in two Montreal emergency departments. A total of 245 and 386 head-injured children sustained a subsequent head injury within 6 and 12 months, respectively. Most injuries in children are mild and they are able to return to their previous activities. Some, however, are serious and can cause long-term cognitive, physical and emotional problems. The authors assert that since the majority of subsequent head injuries occurred 5 or 6 months after the initial head injury, the standard four-week activity limitation after a head injury may need to be reexamined.

PARENTAL DEPRESSION COSTLY FOR CHILDREN

In "Association Between Parental Depression and Children's Health Care Use," researchers found that having at least one depressed parent increases use of expensive health care services such as emergency department visits and inpatient services. The study examined all healthcare use between 1997-2002 of almost 70,000 children 0-17 years of age, 25,000 of whom had at least one parent with a diagnosis of depression. Teenagers of depressed parent(s) showed a decrease in well-child care visits, but increased visits to emergency departments and specialty clinics. Infants of depressed parent(s) had 14 percent more sick visits than those of parents who were not depressed. Findings indicate conducting routine screening for and treatment of parental
depression will result in fewer emergency department visits and other less costly health care practices for their children.

PNEUMONIA VACCINE DECREASES FREQUENT EAR INFECTIONS AND TUBES

A new study found that after routine use of the pneumococcal conjugate vaccine began in 2000, children were less likely to develop frequent ear infections or need pressure-equalizing tubes inserted in their ears. Authors of the study, "Reduction of Frequent Otitis Media and Pressure-Equalizing Tube Insertions in Children After Introduction of Pneumococcal Conjugate Vaccine," tracked data from birth through age 5 in children enrolled in health insurance programs in Tennessee (150,122)
and in upstate New York (26,409). They found that by age two, the proportion of children who developed frequent ear infections and the proportion who received ear tubes declined by 16 percent in Tennessee and 25 percent in New York.

RACE PLAYS IMPORTANT ROLE IN FATAL INJURIES AMONG CHILDREN

Over 20 years of data shows black and American Indian/Alaskan Native children had significantly higher rates of fatal injuries than white, Hispanic, or Asian/Pacific Islander children. The study "Twenty-Year Trends in Fatal Injuries to Very Young Children: The Persistence of Racial Disparities," examined injury-related mortality data from the National Vital Statistics registration system for all 50 states, by race for infants and children 0-4 years of age from 1981-2003. Disparities narrowed for residential fire, pedestrian, and poisoning, but widened for motor vehicle and suffocation for black and American Indian/Alaskan Native children. Results indicate that injury prevention efforts need to continue, along with new strategies and approaches to address areas
where racial disparities remain.

EDITOR'S NOTE: A related study, "Injury-Prevention Counseling and Behavior Among U.S. Children: Results From the Second Injury Control and Risk Survey," found that children who received injury prevention counseling practiced safer behaviors.

RANDOM DRUG TESTING UNDER THE MICROSCOPE

According to a new study, random drug tests performed at an adolescent substance abuse program are at substantial risk for interpretation error. In "Results of Random Drug Testing in an Adolescent Substance Abuse Program," 710 urine drug tests were collected from adolescents and young adults 13 to 21 years of age between December 2002 and July 2005. Of these, 40 negative tests were too dilute to interpret properly and 45 of 217 positive tests resulted from use of legitimate prescription
medications; in total 85 tests were susceptible to either positive or negative misinterpretation. This study demonstrates that drug testing is a technically complex procedure that must be conducted under rigorously defined criteria for proper collection, screening, and testing.

NEW YORK SCHIP WORKS

The study, "Impact of the State Children's Health Insurance Program (SCHIP) on Adolescents in New York," found that adolescents who enrolled in New York's State SCHIP program had improved access, use, and quality of health care. Adolescents' access to health care is among the worst of all age groups, and relatively few interventions have been effective in improving this situation. Researchers for the study interviewed 970 adolescents and their parents over the phone shortly
after enrollment in SCHIP and again one year later. The proportion of adolescents who reported having a usual source of care increased during SCHIP compared with before (69.9 percent to 87. percent). The study, however, found that SCHIP had the greatest impact on improving health care access and quality for those who were previously uninsured, and resulted in a reduction in disparities and access for black and Hispanic youth.

PEDIATRIC DRUGS URGENTLY NEEDED TO TREAT CHILDREN WITH HIV

A new American Academy of Pediatrics (AAP) policy statement outlines solutions for overcoming barriers that prevent the quick diagnosis and treatment of young children with human immunodeficiency virus (HIV). At least 2.3 million children were living with HIV infection acquired at birth at the end of 2005, most of them in sub-Saharan Africa. According to the statement "Increasing Antiretroviral Drug Access for Children with HIV infection," more readily available HIV tests and drugs in appropriate pediatric formulations are urgently needed to improve therapy for children with HIV, especially in less-developed areas of the world. An unprecedented 19 other international child and health care organizations, including the World Health Organization, endorsed the
statement.

The American Academy of Pediatrics is an organization of 60,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well being of infants, children, adolescents and young adults.