Modifiable Lifestyle Activities Affect Cognition in Cognitively Healthy Middle-Aged Individuals at Risk for Late-Life Alzheimer's Disease.

Background: It is now acknowledged that Alzheimer's disease (AD) processes are present decades before the onset of clinical symptoms, but it remains unknown whether lifestyle factors can protect against these early AD processes in mid-life.

Objective: We asked whether modifiable lifestyle activities impact cognition in middle-aged individuals who are cognitively healthy, but at risk for late life AD. Participants (40-59 years) completed cognitive and clinical assessments at baseline (N = 206) and two years follow-up (N = 174).

Primary care provider utilization and satisfaction with a health system navigation program for adolescents with behavioral health needs.

Approximately 49.5% of the adolescents report a mental health disorder; only about half of the children and adolescents with mental health disorders seek treatment from a mental health professional. Stigma and poor access to behavioral health providers are leading barriers to care.

For Better or Worse? Change in Service Use by Children Investigated by Child Welfare Over a Decade.

Background: Children, particularly minority children, referred to child welfare because of suspected maltreatment are vulnerable and need many services. We sought to assess whether service use has improved over the past decade and whether racial-ethnic disparities in service use have decreased.

Methods: We used 2 national data sets (the National Survey of Child and Adolescent Well-Being [NSCAW] I and II) collected a decade apart to assess changes over time in health, education, mental health (MH), and dental services and overall service use.

Adverse Childhood Experiences and Mental Health, Chronic Medical Conditions, and Development in Young Children.

Objective: To determine the relationships between adverse childhood experiences (ACEs) and mental health, chronic medical conditions, and social development among young children in the child welfare system.

Methods: This cross-sectional study used a nationally representative sample of children investigated by child welfare (National Survey of Child and Adolescent Well-Being II) from 2008 to 2009. Our analysis included caregiver interviews and caseworker reports about children aged 18 to 71 months who were not in out-of-home care (n = 912).

Health status and type of out-of-home placement: informal kinship care in an investigated sample.

Objective: To assess the sociodemographic, health, and mental health of children in different types of out-of-home placements after investigation by child welfare agencies; to determine whether there are systematic differences in the children and their caregivers by type of out-of-home placements; and to provide the first description of these characteristics in a nationally representative sample for children in informal kinship care after child welfare involvement.

Methods: Using data from the National Survey of Child and Adolescent Well-being (NSCAW II), we compared children (0-17.5 years) in formal nonkinship foster care, formal kinship foster care, and informal kinship care shortly after a child welfare investigation.

Persistence of mental health problems in very young children investigated by US child welfare agencies.

Objective: To document the persistence and predictors of mental health problems in children aged 12 to 18 months investigated for alleged maltreatment.

Methods: Data came from the second National Survey of Child and Adolescent Well-being (NSCAW II), a longitudinal study of youth 0 to 17.5 years referred to US child welfare agencies.

Chronic conditions among children investigated by child welfare: a national sample.

Objective: To assess the presence of chronic health conditions (CHCs) among a nationally representative sample of children investigated by child welfare agencies.

Methods: The study included 5872 children, aged 0 to 17.5 years, whose families were investigated for maltreatment between February 2008 and April 2009.

Mental health services use by children investigated by child welfare agencies.

Objective: To examine the rates and predictors of mental health services use for a nationally representative cohort of youths who had been investigated for alleged maltreatment.

Methods: Data came from caregiver and caseworker baseline and 18-month interviews in the second National Survey of Child and Adolescent Well-being. These interviews took place from March 2008 to September 2008 and September 2010 to March 2011.

Mental health problems in young children investigated by U.S. child welfare agencies.

Objective: To examine the prevalence/predictors of mental health (MH) problems and services use in 12- to 36-month-old children who had been investigated for maltreatment.

Method: Data came from the second National Survey of Child and Adolescent Well-Being (NSCAW II), a longitudinal study of youth ages 0 to 17.5 years referred to U.

Mothers with positive or negative depression screens evaluate a maternal resource guide.

Introduction: Social isolation is common in mothers with high depressive symptoms. This study tested the hypothesis that a maternal resource guide that provided mothers with links to community human service agencies would be deemed more helpful by mothers with positive depression screens (PDS) compared with mothers with negative depression screens (NDS).

Method: This investigation was a cross-sectional survey study of a convenience sample from a primary care practice-based research network, the Southwestern Ohio Ambulatory Research Network (SOAR-Net).

Effects of food insecurity on asthma outcomes in the pediatric emergency department.

Objectives: Food insecurity is associated with a wide variety of adverse health conditions in adults and children, but its relationship to asthma outcomes in children has not been described. The objectives of this study were to assess and characterize the food security status of an inner-city asthmatic population and to determine whether and to what extent household food insecurity is independently associated with negative clinical outcomes in children presenting to a pediatric emergency department (ED) with asthma exacerbations.

Methods: This study is a cross-sectional survey of a convenience sample of families of children presenting to an urban children's hospital ED for asthma exacerbations.

Characteristics of women who do not seek prenatal care and implications for prevention.

Objectives: To describe characteristics of women without prenatal care and their reasons for not seeking prenatal care.

Design: Retrospective record review.

Setting: Urban, academic medical center.

Disposition and health outcomes among infants born to mothers with no prenatal care.

Objective: This study assessed infant disposition and health outcomes among offspring born to mothers without prenatal care, based on maternal characteristics and the reason for lack of prenatal care (i.e., denial of pregnancy, concealment of pregnancy, primary substance use, financial barriers and multiparity).

Attention-deficit/hyperactivity disorder: how much responsibility are pediatricians taking?

Background: Attention-deficit/hyperactivity disorder, the most common childhood behavioral condition, is one that pediatricians think they should identify and treat/manage.

Objective: Our goals were to explore the relationships between pediatricians' self-reports of their practice behaviors concerning usually inquiring about and treating/managing attention-deficit/hyperactivity disorder and (1) attitudes regarding perceived responsibility for attention-deficit/hyperactivity disorder and (2) personal and practice characteristics.

Methods: We analyzed data from the 59th Periodic Survey of the American Academy of Pediatrics for the 447 respondents who practice exclusively in general pediatrics.

Pediatricians' role in providing mental health care for children and adolescents: do pediatricians and child and adolescent psychiatrists agree?

Background: Many children who have a mental health disorder do not receive mental health services and are seen only in primary care settings. Perceptions of pediatricians and mental health specialists regarding the role that pediatricians should have in diagnosing and managing children's mental health problems have not been studied.

Objective: To examine whether primary care pediatricians (PCPs) and child and adolescent psychiatrists (CAPs) agree about: (1) the pediatrician's role in identification, referral, and treatment of childhood mental health (MH) disorders; and (2) barriers to the identification, referral, and treatment of childhood MH disorders.

Does education influence pediatricians' perceptions of physician-specific barriers for maternal depression?

Pediatric residency reforms have increased emphasis on psychosocial issues, but we do not know whether this has changed pediatricians' perceptions of barriers to addressing maternal depression. A survey of 1600 members of the American Academy of Pediatrics investigated whether training in adult mental health issues and perceived barriers to addressing maternal depression differed for current pediatric residents, pediatricians in practice <5 years, and those in practice >or=5 years. Training did not differ for respondents who were currently in training, in practice <5 years, or in practice >or=5 years.

Do pediatricians think they are responsible for identification and management of child mental health problems? Results of the AAP periodic survey.

Objective: Childhood psychosocial problems have profound effects on development, functioning, and long-term mental health. The pediatrician is often the only health professional who regularly comes in contact with young children, and it is recommended that health care supervision should include care of behavioral and emotional issues. However, it is unknown whether pediatricians believe they should be responsible for this aspect of care.

What factors are important for pediatric residents' smoking cessation counseling of parents?

Pediatricians are expected to discuss the hazards of passive smoking and provide smoking cessation counseling (SCC) because passive smoking is known to have a direct negative effect on children's health. We conducted a cross-sectional survey of pediatric and medicine- pediatric residents at 2 training programs to identify resident-reported factors associated with higher confidence in and frequency of SCC. In this sample of 71 residents, 83% reported asking about parental smoking but only 36% reported counseling parents to quit smoking.

Use of selective serotonin reuptake inhibitors by pediatricians: comparing attitudes of primary care pediatricians and child and adolescent psychiatrists.

To compare attitudes regarding a pediatrician's role in prescribing selective serotonin reuptake inhibitors for children and adolescents, surveys were mailed to 338 primary care pediatricians and 75 child and adolescent psychiatrists; half responded. Child and adolescent psychiatrists were significantly more likely than primary care pediatricians to agree that selective serotonin reuptake inhibitors are safe and effective when used for children and adolescents. Primary care pediatricians were significantly more likely than child and adolescent psychiatrists to agree that black box warnings have changed their prescribing practices.

In the moment: attitudinal measure of pediatrician management of maternal depression.

Objective: Pediatricians are in a good position to identify women who struggle with depression, but studies show low rates of pediatrician identification and management. It is likely that pediatricians' management of maternal depression may vary on the basis of their attitudes, but no instrument has been developed to measure these attitudes. We sought to develop a measure of pediatricians' attitudes about managing maternal depression and to identify characteristics associated with pediatricians' attitudes about managing maternal depression.

Factors associated with identification and management of maternal depression by pediatricians.

Objective: We sought to identify characteristics of pediatricians that were associated with identification or management (referral and/or treatment) of mothers with depression.

Methods: A cross-sectional survey was mailed to a random sample of 1600 of the 50,818 US nonretired members of the American Academy of Pediatrics. Overall, 832 responded, with 745 responses from nontrainee members.

Characteristics of women who deny or conceal pregnancy.

In order to assess characteristics of women with denial or concealment of pregnancy until delivery, the authors conducted a retrospective study of women with no history of prenatal care who presented to their institution for delivery or immediately postpartum. Among these women, 29% had denied pregnancy, and 9% had concealed pregnancy. Authors constructed models predicting denial or concealment of pregnancy and further elucidated subtypes of denial and concealment of pregnancy.

Barriers to the identification and management of psychosocial issues in children and maternal depression.

Context: Child psychosocial issues and maternal depression are underidentified and undertreated, but we know surprisingly little about the barriers to identification and treatment of these problems by primary care pediatricians.

Objectives: The purpose of this work was to determine whether (1) perceived barriers to care for children's psychosocial issues and maternal depression aggregate into patient, physician, and organizational domains, (2) barrier domains are distinct for mothers and children, and (3) physician, patient, and practice/organizational characteristics are associated with different barrier domains for children and mothers.

Methods: We conducted a cross-sectional survey of the 50,818 US nonretired members of the American Academy of Pediatrics.