Dietary energy density is associated with selected predictors of obesity in U.S. Children.

Increasing rates of childhood overweight have been linked to the rising energy density of the diet. We sought to provide temporal profiles of dietary energy density (DED) in a nationally representative sample of U.S.

Prevention of deaths from harmful drinking in the United States: the potential effects of tax increases and advertising bans on young drinkers.

Objective: Harmful alcohol consumption is a leading cause of death in the United States. The majority of people who die from alcohol use begin drinking in their youth. In this study, we estimate the impact of interventions to reduce the prevalence of drinking among youth on subsequent drinking patterns and alcohol-attributable mortality.

Primary language of parent is associated with disparities in pediatric preventive care.

Objectives: To determine whether infants of parents whose primary language is not English are less likely to receive recommended preventive care than infants of parents whose primary language is English.

Study Design: We conducted a retrospective cohort study of all 38,793 1-year-old Medicaid-enrolled infants born in Washington state between January 1, 1999 and September 30, 2000. The main exposure was self-reported primary language of parents.

Risk of death for children with down syndrome and sepsis.

Objective: To determine differences in case fatality rates between children with and without Down syndrome.

Study Design: We used the Pediatric Health Information System (PHIS) database, which includes demographic and diagnostic data from freestanding children's hospitals. Using Poisson regression, we determined the risk of mortality from sepsis for children with Down syndrome, after controlling for potential confounding factors.

Hospital characteristics associated with the management of pediatric splenic injuries.

Context: Despite evidence that more than 90% of children with traumatic injuries to the spleen can be successfully managed nonoperatively, there is significant variation in the use of splenectomy. As asplenic children are at increased risk of overwhelming postsplenectomy infection, nonoperative management may be considered a quality of care indicator.

Objective: To test the hypothesis that children are more likely to undergo splenectomy in general hospitals than in children's hospitals.

Medicaid acceptance and availability of timely follow-up for newborns with Medicaid.

Objective: Decreased physician participation in Medicaid has been shown to affect adversely timeliness of adult acute care and pediatric specialty care, but it is not clear whether this is the case for newborn follow-up. The objectives of this study were to determine whether there is a difference within clinics in the timeliness of follow-up appointments that are given to newborns with Medicaid compared with newborns with private insurance and to determine whether there is a difference between clinics that do and do not accept Medicaid in the timeliness of appointments that are given for newborn follow-up.

Methods: A randomized crossover study was conducted among general pediatric clinics and practices that were identified from the yellow pages and Internet searches of hospitals and health departments in 8 metropolitan areas from September 2003 to March 2004.

The association between television viewing and irregular sleep schedules among children less than 3 years of age.

Background: Regular sleep schedules are an important part of healthy sleep habits. Although television viewing is associated with altered sleep patterns and sleep disorders among children and adolescents, the effect of television viewing on the sleep patterns of infants and toddlers is not known.

Objective: To test the hypothesis that television viewing by infants and toddlers is associated with having irregular naptime and bedtime schedules.

Pediatricians' screening urinalysis practices.

Objective: To determine pediatricians' routine screening urinalysis practices.

Study Design: This was a survey of a nationally representative sample of pediatricians practicing in the U.S.

Association between parental satisfaction and antibiotic prescription for children with cough and cold symptoms.

Background: Providers' interest in satisfying parents may provide an impetus for unnecessary antibiotic use in children.

Objectives: To determine (1) whether receipt of antibiotics at a visit for cough and cold symptoms was associated with increased satisfaction and (2) whether nonreceipt of antibiotics at an initial visit but subsequent receipt of antibiotics in the course of the same illness episode was associated with decreased satisfaction.

Methods: Prospective cohort study of patients 2-10 years of age presenting to a university-affiliated pediatric clinic with cough and cold symptoms.

Parental emotional support and subsequent internalizing and externalizing problems among children.

This study examined the association between early emotional support provided by parents and child internalizing and externalizing problems, using a nationally representative, longitudinal sample of 1361 children. Parental emotional support was assessed using the Home Observation for the Measurement of the Environment, incorporating both parent report and interviewer observation. We found that, controlling for child externalizing problems at age 6 years, parental emotional support at age 6 years was negatively related to child externalizing problems at age 8 years.

Validation of parent self reported home safety practices.

Objectives: To evaluate the validity of parents' self reported home safety practices concerning smoke detectors, bike helmets, car seats, and water heater temperature.

Setting: Parents of children 12 years old and under whose child had made at least one visit to a study clinic in the years 2000-2003.

Methods: As part of a randomized controlled trial to improve patient provider communication and preventive practices, parents' responses to telephone interview were compared with observations of safety practices during a home visit.

Children's television viewing and cognitive outcomes: a longitudinal analysis of national data.

Objective: To test the independent effects of television viewing in children before age 3 years and at ages 3 to 5 years on several measures of cognitive outcomes at ages 6 and 7 years.

Design: Using data from a nationally representative data set, we regressed 4 measures of cognitive development at ages 6 and 7 years on television viewing before age 3 years and at ages 3 to 5 years, controlling for parental cognitive stimulation throughout early childhood, maternal education, and IQ.

Results: Before age 3 years, the children in this study watched an average of 2.

Cigarette tax increase and media campaign cost of reducing smoking-related deaths.

Background: Tobacco use results in 500,000 premature deaths annually. Most smokers begin using tobacco before age 21, so the greatest impact on preventing smoking-related mortality is likely to come from campaigns targeting youths. This study estimates the cost-effectiveness of an anti-smoking media campaign and dollar 1 per pack increase in cigarette taxes on the lifetime decrease in smoking-attributable mortality among the cohort of all 18-year-olds in the United States during the year 2000.

Nonfebrile illness seizures: a unique seizure category?

Purpose: To describe the clinical characteristics of children with a first-time nonfebrile seizure in the setting of mild illness and to test the hypothesis that these seizures are associated with illness characterized by diarrhea.

Methods: This retrospective cohort study was performed in a pediatric emergency department. Patients ages 6 months to 6 years who were evaluated with first-time seizures were eligible for inclusion.

Compliance with guidelines for the medical care of first urinary tract infections in infants: a population-based study.

Background: No population-based studies have examined the degree to which practice parameters are followed for urinary tract infections in infants.

Objective: To describe the medical care of children in their first year of life after a first urinary tract infection.

Methods: Using Washington State Medicaid data, we conducted a retrospective cohort study of children with a urinary tract infection during their first year of life to determine how many of these children received recommended care based on the most recent guidelines from the American Academy of Pediatrics.

Early cognitive stimulation, emotional support, and television watching as predictors of subsequent bullying among grade-school children.

Background: Bullying is a major public health issue, the risk factors for which are poorly understood.

Objective: To determine whether cognitive stimulation, emotional support, and television viewing at age 4 years are independently associated with being a bully at ages 6 through 11 years.

Methods: We used multivariate logistic regression, using data from the National Longitudinal Survey of Youth, to adjust for multiple confounding factors.

Variation in inpatient diagnostic testing and management of bronchiolitis.

Objectives: We know little about the variation in diagnosis and management of bronchiolitis. The objectives of this study were (1) to document variations in treatment and diagnostic approaches, lengths of stay (LOSs), and readmission rates and (2) to determine which potentially modifiable process of care measures are associated with longer LOSs and antibiotic usage.

Methods: We used the Pediatric Health Information System, which includes demographic, diagnostic, and detailed patient-level data on 30 large children's hospitals.

Infection control policies and hospital-associated infections among surgical patients: variability and associations in a multicenter pediatric setting.

Background: Hospital-associated infections are an important cause of patient morbidity and death. Little is known about the variability of infection rates and infection control practices among pediatric hospitals.

Methods: This cross-sectional study was performed with the Pediatric Health Information System database, which includes demographic and diagnostic data for 35 freestanding, noncompeting, children's hospitals, and with data from a survey of the hospitals, which yielded additional information on infection control policies and practices.

Perceptions about computers and the internet in a pediatric clinic population.

Background: A digital divide with respect to computer and Internet access has been noted in numerous studies and reports. Equally important to ownership is comfort with computers and Internet technology, and concerns about privacy of personal data.

Objective: To measure how households in a pediatric clinic vary in their attitudes toward computers, concerns about Internet confidentiality, and comfort using the Internet and whether these views are associated with household income or education.

A systematic review of school-based smoking prevention trials with long-term follow-up.

Background: Several systematic reviews of school-based smoking prevention trials have shown short-term decreases in smoking prevalence but have not examined long-term follow-up evaluation. The purpose of this study was to conduct a systematic review of rigorously evaluated interventions for school-based smoking prevention with long-term follow-up data.

Methods: We searched online bibliographic databases and reference lists from review articles and selected studies.

Emergency department use and perceived delay in accessing illness care among children with Medicaid.

Background: Children covered by Medicaid are at increased risk of emergency department (ED) utilization.Objective.-To examine whether an association exists between ED use and perceived delay in accessing acute care.

Television, video, and computer game usage in children under 11 years of age.

Objective: To conduct a population-based survey of television and other media usage in young children to determine (1) total media usage; (2) the proportion of children who have televisions in their bedrooms and who eat breakfast or dinner in front of the television; and (3) predictors of parental concern about the amount of television their child watches.

Study Design: Telephone survey administered to 1454 parents of children <11 years old derived from a diverse clinic population.

Results: The mean age of the index child was 5.

Mortality attributable to harmful drinking in the United States, 2000.

Objective: Although alcohol has been associated with death from a variety of causes, there are no recent data on the number of deaths in the United States attributable to harmful alcohol use. This study provides updated information on the number of deaths in the United States attributable to harmful drinking.

Method: We used the etiologic-fraction method to calculate alcohol-related mortality by cause of death, using U.