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AAP Department of Communications Contacts: Debbie Linchesky, 847-434-7084; Susan Stevens Martin, 847-434-7131 (Please do not reply directly to this e-mail, as you will not receive a response. Contact Debbie Linchesky at dlinchesky@aap.org or Susan Stevens Martin at ssmartin@aap.org if you have questions about the contents of this mailing.) Information in this mailing is embargoed for release: Monday, Feb. 4, at 12:01 am ET, unless otherwise specified. In this mailing: The Table of Contents (TOC) from the February issue of Pediatrics, the peer-reviewed scientific journal of the American Academy of Pediatrics (AAP), and Pediatrics electronic pages, the Internet extension of Pediatrics. These are available electronically and can be viewed at: Current issue TOC: http://www.pediatrics.org/current.shtml Future issue TOC: http://www.pediatrics.org/future.shtml Also in this mailing: 1. Adverse Events from Cough and Cold Medications in Children 2. Mentors in Foster Care Youth 3. Disparities in U.S. Children’s Health and Dental Care 4. How Risky Are Social Networking Sites? 5. Baby Products: Possible Sources of Infant Phthalate Exposure 6. Alcohol Use Initiation, Suicidal and Violent Behaviors 7. A Meta-analysis of Zinc in Diarrhea 8. Oral Sucrose Decreases Pain During Immunizations 9. Development and Use of Quality Measures NATIONAL CAMPAIGNS 10. February is Children’s Dental Health Month AAP PARENTING TIPS 11. 14 Ways to Show Love for Your Child This Valentine’s Day Note: Please attribute the source as the journal, Pediatrics when covering information from this mailing. =============================================================== Below are news releases and briefs on articles appearing in the February issue of Pediatrics, the peer-reviewed, scientific journal of the American Academy of Pediatrics (AAP). To receive the full text of these articles, contact the AAP Department of Communications. 1. 7,000 PEDIATRIC EMERGENCY DEPARTMENT VISITS LINKED TO COUGH, COLD MEDICATION USE An estimated 7,000 patients, ages 11 and younger, are treated in hospital emergency departments (ED) each year largely from unsupervised ingestions of cough and cold medications. In the new study, “Adverse Events from Cough and Cold Medications in Children,” Centers for Disease Control and Prevention (CDC) researchers reviewed ED visits from the National Electronic Injury Surveillance System – Cooperative Adverse Drug Event Surveillance (NEISS-CADES) project between Jan. 1, 2004, and Dec. 31, 2005. In children <12 years old, an estimated 5.7 percent of medication-related ED visits were due to cough and cold-medications. Most of these visits were in children age 2 to 5 (64 percent), and unsupervised ingestions accounted for 80% of ED visits in this age group. Among all children 11 and younger, unsupervised ingestions of cough and cold products accounted for 66 percent of ingestion-related ED visits, which was significantly higher than ED visits for unsupervised ingestions of other medications. Ninety-three percent of the children did not require hospital admission; however, one-fourth received treatment to prevent further absorption of the medications. The study authors recommend that the data be used to improve product packaging and parent education to prevent adverse events from cough and cold medication among children. 2. MENTORING RELATIONSHIPS HELP YOUTH IN FOSTER CARE A new study reports evidence that mentoring relationships with non-parental adults promote positive outcomes for young people in foster care. In the study, “Youth in Foster Care With Adult Mentors During Adolescence Have Improved Adult Outcomes,” 310 youth were assessed, including 160 mentored and 150 non-mentored youth. Demographic characteristics were similar in both groups. Results showed that in their late teens and early 20s mentored youth were more likely to report very good or excellent health and were less likely to report suicidal thoughts, a recent sexually transmitted infection or that they had hurt someone in a fight during the past year. Study authors suggest these results should be confirmed with additional studies. They also recommend that interventions to support and cultivate mentoring relationships for youth in foster care be explored as a strategy for improving their adult outcomes. 3. MINORITY CHILDREN EXPERIENCE DISPARITIES IN CARE A national survey found significant disparities for minority children in medical and oral health and access to care. In “Racial and Ethnic Disparities in Medical and Dental Health, Access to Care, and Use of Services in U.S. Children,” the authors examined the results from the National Survey of Children’s Health conducted by the U.S. Centers for Disease Control and Prevention between January 2003 and July 2004. Interviews with 102,353 households revealed significant differences among different racial and ethnic groups in rates of insurance coverage, overall health status, overweight, asthma, hearing or vision problems, diabetes, behavior problems, skin allergies, headaches and oral health. Certain health problems were more likely in specific racial or ethnic groups. For example, asthma was more prevalent among African American, multiracial and Native American children. Compared with white children, children in all five minority groups (African American, Latino, Asian/Pacific Islander, Native American and multiracial) were significantly less likely to have visited a doctor or been given a prescription medication in the past year. The study authors suggest awareness of these disparities could help clinicians and policy makers meet the needs of diverse populations. 4. HOW RISKY ARE SOCIAL NETWORKING SITES? Despite the recent focus on restricting access to social networking Web sites to protect children, researchers have found that victimization online is more likely to occur through instant messaging and in chat rooms. The Growing up With Media survey asked nearly 1,600 Internet users between the ages of 10 to 15 about their online experiences over the past year. Fifteen percent reported an unwanted sexual solicitation in that time, with about one-fourth of those occurring on a social networking site. Thirty-three percent reported online harassment, with about one-fourth of the incidents occurring on a social networking site. Among targeted youth, solicitations were reported to be via instant messaging (43 percent of incidents) or in chat rooms (32 percent of incidents). Harassment was more common in instant messaging (55 percent of incidents). The authors suggest that parents should focus on children’s online behaviors and psychosocial issues rather than on restricting use of social networking sites. They also recommend that policy aimed at reducing children’s victimization on the Internet focus on mental health interventions for vulnerable youth, and broad Internet safety education. Information on the following studies is embargoed until Monday, Feb. 4, at 12:01 am ET, unless otherwise specified. 5. USE OF BABY LOTION, POWDER AND SHAMPOO LINKED TO HIGHTER LEVELS OF PHTHALATES IN INFANTS Phthalates are widely used chemicals that recent studies suggest may have toxic effects on the developing endocrine and reproductive systems. A new study found evidence that infants may be absorbing these chemicals through commonly used baby products. In “Baby Care Products: Possible Sources of Infant Phthalate Exposure,” researchers tested urinary concentrations of nine different phthalate metabolites in 163 infants. All of the urine samples contained at least one phthalate at measurable levels, and 80 percent of the samples had measurable amounts of at least seven types of phthalates. Babies whose mothers reported using infant lotion in the past 24 hours had increased concentrations of monoethyl phthalate and monomethyl phthalate. Those who reported using baby powder had increased concentrations of monoisobutyl phthalate. Infant shampoo use was associated with monomethyl phthalate. The associations were strongest in infants younger than eight months old, who may be more vulnerable to developmental and reproductive toxicity of phthalates due to their immature metabolic systems and higher body-surface-area-to-volume ratio. While children likely are exposed to phthalates through multiple sources, including oral ingestion, the study suggests skin absorption may be a major route of exposure. In the U.S., manufacturers are not required to label the phthalate content of products. The authors suggest that if parents want to lower their children’s exposure to these chemicals that they limit the amount of infant care products they use and apply lotions or powders only if medically indicated. 6. ALCOHOL USE AMONG ADOLESCENTS LINKED TO VIOLENT, SUICIDAL BEHAVIORS Many young people initiate alcohol use early in life, and those who do are at an increased risk for numerous problems compared to adolescents who do not drink. In the study, “Age of Alcohol Use Initiation, Suicidal Behavior, and Peer and Dating Violence Victimization and Perpetration Among High-Risk, Seventh-Grade Adolescents,” researchers found that 35 percent of students in a high-risk school district reported using alcohol before age 13. Preteen alcohol use was strongly associated with dating violence victimization, suicidal thoughts and suicide attempts. A number of evidence-based strategies, such as enforcing minimum legal drinking age laws and increasing excise taxes on alcohol, are available but not fully implemented to prevent and reduce alcohol use among minors. Increased support of these strategies will be necessary to prevent alcohol abuse and the many health problems associated with its use among young people. 7. ZINC SUPPLEMENTATION REDUCES THE DURATION AND SEVERITY OF DIARRHEA Diarrhea is a major health problem, especially in the developing world. It is estimated that diarrheal disease is responsible for roughly 21 percent of all deaths in children younger than 5 worldwide. In “A Meta-analysis of the Effects of Oral Zinc in the Treatment of Acute and Persistent Diarrhea,” researchers found the duration of acute and persistent diarrhea was significantly shorter when zinc was used versus placebo. Vomiting appeared to be significantly increased with zinc treatment, though it was less frequent with zinc sulfate and acetate when compared to zinc gluconate. The exact mechanism of zinc on the intestine is not fully known, but it could include inhibition of cAMP-induced chloride dependent fluid secretion, improved absorption of water and electrolytes, improved regeneration of intestinal epithelium , increased levels of brush border enzymes and possibly an enhancement in the immune response allowing for better clearance of pathogens. At this point there may be enough evidence to recommend zinc in the treatment of both acute and persistent diarrhea. The addition of zinc to oral rehydration solution appears to be less effective as also shown by this meta-analysis. This is possibly due to oral rehydration solution already maximizing the small intestinal fluid absorption rates and the addition of zinc not providing any additional benefit. 8.REDUCING PAIN COULD LEAD TO INCREASED IMMUNIZATION RATES Studies have shown that some parents are reluctant to have their children immunized because they fear their children will experience significant pain during and after the injections. The authors of the study, “Analgesic Properties of Oral Sucrose During Routine Immunizations at 2 and 4 Months of Age,” examined how the use of an oral sucrose (sugar) solution may help reduce pain response for children ages two to four months. One hundred infants receiving routine immunizations received either a controlled amount of oral sucrose or a placebo. The group receiving oral sucrose had lower pain scores than those in the placebo group. In fact, over the course of 9 minutes, the oral sucrose group had an average of 78 percent lower pain scores than the control group. The authors conclude that oral sucrose is an inexpensive, short-acting, non-sedating, easily-administered method of reducing pain for infants undergoing minor invasive procedures. 9. DEVELOPMENT AND USE OF QUALITY MEASURES The American Academy of Pediatrics (AAP) is committed to improving the health care system to provide the highest quality and safest health care for children. The new policy statement, “Principles for the Development and Use of Quality Measures,” was developed as a guide for pediatricians on the key criteria for the development and appropriate uses of quality measures. Performance measurement/accountability and quality improvement have become a major force in shaping the health care system for clinicians, families and their children. The AAP offers the following five recommendations for quality measurement: · Measures should address important issues for children; · Measures should be appropriate for children’s health; · Measures should be scientifically valid; · Measures should be feasible; · Measures should address what can be improved. =============================================================== 10. FEBRUARY IS CHILDREN’S DENTAL HEALTH MONTH The AAP has teamed with Oral-B Stages to raise awareness of the importance of children’s oral health during Children’s Dental Health Month. Tooth decay is the most common chronic childhood disease today, five times more common than asthma. Both the U.S. Surgeon General and Congress acknowledge that this “silent epidemic” in oral health needs to be addressed by parents and healthcare providers. Providing parents with resources to teach healthy oral care habits from an early age is an important step in curbing the impact of oral disease on children. “First Steps to a Healthy Smile” is a brochure for parents of young children, available at http://www.aap.org/publiced/BR_firststepshealthysmile.pdf =============================================================== 11. 14 WAYS to Show Love for Your Child This Valentine’s Day The AAP Web site has suggestions for parents of children of all ages. You can download them at the Seasonal Safety Tips section of the Press Room in both English and Spanish at http://www.aap.org/advocacy/releases/febvaltips.cfm =============================================================== The FAAP designation following a pediatrician's name stands for Fellow of the American Academy of Pediatrics. Pediatricians with a FAAP designation have obtained board certification in pediatrics and made an ongoing commitment to lifelong learning and advocacy for children. MEDIA REQUEST FORM To request copies of AAP news releases, briefs, or policy statements and studies from Pediatrics, go to: http://www.aap.org/mediamailing/mediarequestform.cfm?cp1=41brs1 For more information on children’s health, visit the AAP Press Room at: http://www.aap.org/pressroom
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