AAP PRESS ROOM -MARCH 2009 MEDIA MAILING

AAP Department of Communications Contacts: Debbie Linchesky, 847-434-7084, dlinchesky@aap.org or Susan Stevens Martin, 847-434-7131, ssmartin@aap.org

(Please do not reply directly to this e-mail, as you will not receive a response. Contact Debbie Linchesky at dlinchesky@aap.org if you have questions about the contents of this mailing.)

Information in this mailing is embargoed for release: Monday, March 2, 2009 at 12:01 am ET, unless otherwise specified.

PLEASE RESPECT THE EMBARGO DATE.

The Table of Contents (TOC) from the March 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:

STUDIES
1. Gene variant is associated with both autism and gastrointestinal dysfunction
2. Reduced air pollution results in improved breathing for asthmatic children
3. Television and videos for children under 2 may not influence skill development
4. Half of black teens may be deficient in vitamin D
5. Violent video game content more attractive to youth
6. Blood lead levels declining, but children still at risk for lead poisoning
7. Even brief periods without insurance coverage can negatively impact children

AAP REPORT
8. AAP offers guidance in long-term care of childhood cancer survivors

AAP NEWS RELEASES
9. Save the date: 2009 Pediatric Academic Societies meeting in Baltimore
10. New resource toolkit available for hospitals and physicians’ offices
11. Pediatricians can help parents quit smoking

AAP PARENTING TIPS
12. Spring break safety tips
13. Poison prevention and treatment tips

Below are news releases on articles appearing in the March 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.

Note: Please attribute the source as “the journal, Pediatrics,” when covering information from this mailing. Please note this is the March issue of Pediatrics, which is published online March 2.

STUDIES

Autism is a disorder characterized, in part, by deficits in communication abilities. Gastrointestinal conditions are common among individuals with autism, and it may be difficult for some individuals to communicate that they are experiencing gastrointestinal discomfort. Some theories of autism speculate that gastrointestinal dysfunction may impact brain development, while other theories of autism suggest that the altered nervous system development may affect gastrointestinal function. In the study, “Distinct Genetic Risk Based on Association of MET in Families With Co-occurring Autism and Gastrointestinal Conditions,” researchers demonstrate genetic risk may be playing a role in both the brain and the gut. The scientists found that a functional genetic variant in a gene called MET is more strongly associated with autism specifically in those families where an individual had co-occurring autism and a gastrointestinal condition. Independent studies have shown that the MET gene product, a receptor tyrosine kinase protein, functions in both brain development and gastrointestinal repair. These data suggest that altered MET expression may contribute to a syndrome that includes autism and co-occurring gastrointestinal dysfunction.

Better air quality is associated with a significant reduction of airway inflammation in allergic asthmatic children. The study, “Less Air Pollution Leads to Rapid Reduction of Airway Inflammation and Improved Airway Function in Asthmatic Children,” is the first of its kind to adopt a real-life experimental approach to analyze the impact of outdoor air pollution on respiratory health in childhood. In it, 37 untreated children with mild but persistent asthma were recruited from a highly polluted urban environment and relocated to a less polluted rural environment. One week after relocation, researchers discovered that breathing cleaner air was associated in most children with a rapid and highly significant improvement in lung function. The results are consistent with other studies showing that traffic-related exposures are associated with increased airway inflammation, and suggest that this negative influence may be reversible. Study authors conclude that children with chronic respiratory problems may require little or no pharmacological intervention if they breathe cleaner air, and new strategies to further reduce emissions need to be developed to minimize the impact of air pollution on asthma morbidity in children.

EDITOR’S NOTE: Two studies, independent of the one listed above, also focus on asthma. “Antibiotic Use in Children Is Associated With Increased Risk of Asthma,” and “Routine Vaccination Against Pertussis and the Risk of Childhood Asthma: A Population-Based Cohort Study,” will also appear in the March issue of Pediatrics.

3. TELEVISION AND VIDEOS FOR CHILDREN UNDER 2 MAY NOT INFLUENCE SKILL DEVELOPMENT

Exposing infants and toddlers to television does not improve their language and visual motor skills at age 3, but does not appear to harm them either. In the study, “Television Viewing in Infancy and Child Cognition at 3 Years of Age in a US Cohort,” researchers looked at the amount of time 872 children spent watching television or videos from birth to 2 years of age, then assessed their language and visual motor skills at age 3. When researchers adjusted for other factors that could influence these skills, such as maternal education and breastfeeding, the effect of television appeared neutral. Contrary to many parents’ perception that television viewing is beneficial to their children’s brain development, the researchers found no evidence of such a benefit. The authors point out that there are many potential benefits of limiting television exposure in children, including improved diet, lower risk of overweight, less exposure to violent content, and improved sleep quality.

Based on a higher threshold of adequate vitamin D levels, approximately half of non-Hispanic black adolescents were deficient, according to the study “Implications of a New Definition of Vitamin D Deficiency in a Multiracial US Adolescent Population: The National Health and Nutrition Examination Survey III.” Experts differ on optimal vitamin D status, which is measured by plasma 25-hydroxyvitamin D concentration. Currently, individuals with serum levels of <11 ng/mL are considered vitamin D deficient. However, citing evidence that problems may actually manifest at higher levels, many experts have proposed that a better minimum level is 20 ng/mL. Using the higher standard, researchers estimated the national prevalence of vitamin D deficiency was 14 percent. Non-Hispanic black adolescents had 20 times the risk of vitamin D deficiency compared with non-Hispanic white adolescents. The risk of deficiency was more than double for females compared with males, and overweight adolescents had almost twice the risk of deficiency compared with normal-weight adolescents.

Editor’s note: The February issue of Pediatrics also includes the study, “Vitamin D Deficiency in Children with Chronic Kidney Disease: Uncovering an Epidemic.”

Restrictive age and violent-content labels increased the attractiveness of video games for boys and girls of all age groups, according to a new study. In “Age and Violent-Content Labels Make Video Games Forbidden Fruits for Youth,” researchers tested 310 Dutch children in three groups: 7 to 8, 12 to 13 and 16 to 17 years of age. Participants read fictitious video game descriptions and rated how much or how little they wanted to play each game. An important finding for parents, pediatricians and policy-makers is that age and violent-content labels do not prevent young children from playing games with objectionable content. In fact, they have the opposite effect. Study authors suggest that video games should not be forbidden in Europe or the United States because that will only make the games more attractive, and parents should help in selecting appropriate games for their children to play.

Children’s blood lead levels continue to decrease in the United States, but some children continue to be at greater risk for lead poisoning exposure than others. In the study, “Trends in Blood Lead Levels and Blood Lead Testing Among US Children Aged 1 to 5 Years, 1988-2004,” results indicate an 84 percent decline of elevated blood lead levels among children from 1988 to 2004. However, the major risk factors for higher blood lead levels continue to be living in housing built before 1950, poverty, age and being non-Hispanic black. Because children can be exposed to lead from multiple sources, including consumer products and imported toys, health care providers must continue to test children at high risk for lead poisoning, and to identify and control all lead sources that can poison children. Prevention efforts at national, state and local levels will help maintain progress in eliminating elevated blood lead levels in children.

7. EVEN BRIEF PERIODS WITHOUT INSURANCE COVERAGE CAN NEGATIVELY IMPACT CHILDREN

Children who experience short spells of time without health insurance (1 to 4 months) are more likely to experience delays in needed health care than those who are insured year-round. The study, “The Effects of Varying Periods of Uninsurance on Children’s Access to Health Care,” examined the effect of insurance status on health care access. The authors found that children with brief periods of uninsurance were not only less likely to get needed care but also less likely to have a regular source of care. The consequences were worse for children experiencing longer periods without insurance. This group not only experienced the above problems, but was also more likely to miss preventive care and delay obtaining prescription medications. One of the main reasons given for lack of insurance was affordability. The authors hope this study will encourage state policy-makers to use the reauthorization and expansion of the State Children’s Health Insurance Program (SCHIP) eligibility requirements to expand eligibility and improve enrollment and retention efforts for the program, because even very short periods of uninsurance can have negative consequences for children’s access to health care and utilization.

Rapid progress in treating childhood cancers has meant the majority of these patients now survive into adulthood. This growing population is vulnerable to a variety of long-term side effects and complications from treatments such as radiation, chemotherapy and surgery. In the new clinical report, “Long-term Follow-up Care for Pediatric Cancer Survivors,” the American Academy of Pediatrics offers guidance to pediatricians in detecting late treatment effects based on the cancer and treatment history of a patient. The report suggests pediatricians collaborate with each child’s primary oncology subspecialist to develop a comprehensive, individualized survivorship care plan.

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9. SAVE THE DATE: 2009 PEDIATRIC ACADEMIC SOCIETIES MEETING IN BALTIMORE

The annual meeting of the Pediatric Academic Societies (PAS) is May 2 - 5 at the Baltimore Convention Center in Baltimore, Maryland. Top international research and new advancements in pediatrics will be the focus of more than 3,000 presentations to nearly 6,500 leaders in pediatric science, advocacy and patient care from around the world. The conference is co-sponsored by the institutional members of the PAS: the American Pediatric Society, the Society for Pediatric Research, the Ambulatory Pediatric Association and the American Academy of Pediatrics. Several pediatric specialty organizations will also be holding their annual meetings during the conference. For more information, go to http://www.pas-meeting.org

10. NEW RESOURCE TOOLKIT AVAILABLE FOR HOSPITALS AND PHYSICIANS’ OFFICES

The American Academy of Pediatrics (AAP) has developed a new pediatric toolkit, resulting from the work of the Safe and Healthy Beginnings (SHB) improvement project. Safe and Healthy Beginnings: A Resource Toolkit for Hospitals and Physicians’ Offices, was designed for all clinicians and office staff to help provide optimal health care for newborns. More information can be found at: http://www.aap.org/advocacy/releases/jan09toolkit.htm

11. PEDIATRICIANS CAN HELP PARENTS QUIT SMOKING

CHICAGO -- Quitting smoking is one of the best things parents can do for their health and the health of their children. Now they can get assistance from an unexpected source - their child’s pediatrician.

A new resource offers pediatricians the tools they need to screen parents for smoking, offer counseling and enroll parents in a free smoking-cessation helpline. Using the existing state quit line known as “QuitWorks,” Massachusetts is promoting “QuitWorks for Child and Family Health Care Practitioners” statewide this month. The program is based on research from the Clinical Effort Against Secondhand Smoke Exposure (CEASE) program of the American Academy of Pediatrics (AAP), which is also available free to other public health departments and pediatric offices across the nation.

Because of their regular, frequent contacts with families, pediatricians are uniquely positioned to help parents quit smoking, said Jonathan Winickoff, MD, FAAP, assistant professor of pediatrics at MassGeneral Hospital for Children and founder of CEASE.

“Tobacco use is a serious health issue for all members of a family,” Winickoff said. “We’re getting the biggest return on our investment by targeting parents who smoke. Not only do we hope to reduce children’s exposure to second-hand and third-hand smoke, but if more parents quit smoking, fewer children will grow up to be smokers.”

CEASE is available through the AAP Julius B. Richmond Center of Excellence, whose mission is to improve child health by eliminating children’s exposure to secondhand smoke and tobacco. The Massachusetts Department of Public Health worked with the Massachusetts chapter of AAP to incorporate CEASE materials into the QuitWorks program for statewide dissemination.

Carole Allen, MD, FAAP, president of the AAP Massachusetts chapter, said local pediatricians are enthusiastic about implementing parent-focused smoking cessation strategies in their practices. “If you smoke, the best way to protect your child’s health is to quit,” said Allen. “Now pediatricians can do more than just tell you to quit-they can help you to quit. It’s a big difference.”

Massachusetts is the first state to deliver CEASE materials to all pediatric offices. The module can be adapted to suit any state’s smoking cessation program.

“The American Academy of Pediatrics believes that every state should invest some of its tobacco control resources in programs that will help pediatricians help parents protect children from secondhand smoke,” said Dr. David T. Tayloe, Jr., MD, FAAP, president of the AAP, which represents more than 60,000 pediatricians.

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. The AAP Julius B. Richmond Center, a national center of excellence funded by the Flight Attendant Medical Research Institute, is dedicated to the elimination of children’s exposure to tobacco. The center is named for pediatrician and former Surgeon General Julius B. Richmond.

AAP PARENTING TIPS

12. SPRING BREAK SAFETY TIPS
Spring break is a great time for the family to get away from the cold, dark days of winter and have some fun in the sun. Keep your family safe while on your trip by following these tips from the American Academy of Pediatrics. Tips are available in English and Spanish at
http://www.aap.org/advocacy/releases/marspringbreaktips.cfm

13. POISON PREVENTION AND TREATMENT TIPS
Each year, approximately 2.4 million people - more than half under age 6 - swallow or have contact with a poisonous substance. The American Academy of Pediatrics has some important tips to prevent and to treat exposures to poison. Tips are available in English and Spanish at http://www.aap.org/advocacy/releases/poisonpreventiontips.cfm

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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.