Serum zinc levels in youth with avoidant/restrictive food intake disorder and anorexia nervosa: Clinical correlation with weight and psychopathology.

Background: Avoidant/restrictive food intake disorder (ARFID) and anorexia nervosa (AN) are characterized by restrictive eating and micronutrient deficiencies. While zinc deficiency has been identified in AN, zinc level in ARFID has not been systematically assessed.

Aim: Examine serum zinc levels and their association with eating pathology, psychopathology, and executive functioning in youth with ARFID and AN.

Cocaine Use in Adolescents and Young Adults.

Cocaine use by adolescents and young adults continues to be a significant public health issue and the cause of medical and psychological morbidity and mortality. Although use rates are lower than those seen with alcohol, tobacco, and other illicit substances such as marijuana, cocaine is highly addictive and presents significant acute and long-term medical and psychological effects. This article reviews the epidemiology of cocaine use among adolescents and young adults, discusses the pharmacology and neurobiology of cocaine use and dependence, provides information regarding acute intoxication and systemic effects seen with more chronic use, and describes current assessment and treatment approaches.

Alcohol Use by Youth.

Alcohol use continues to be a major concern from preadolescence through young adulthood in the United States. Results of recent neuroscience research have helped to elucidate neurobiological models of addiction, substantiated the deleterious effects of alcohol on adolescent brain development, and added additional evidence to support the call to prevent and reduce underage drinking. This technical report reviews the relevant literature and supports the accompanying policy statement in this issue of .

Marijuana Use During Pregnancy and Breastfeeding: Implications for Neonatal and Childhood Outcomes.

Marijuana is one of the most widely used substances during pregnancy in the United States. Emerging data on the ability of cannabinoids to cross the placenta and affect the development of the fetus raise concerns about both pregnancy outcomes and long-term consequences for the infant or child. Social media is used to tout the use of marijuana for severe nausea associated with pregnancy.

The Treatment of Dysmenorrhea.

Menstrual disorders and abnormal uterine bleeding are common concerns of young women. Complaints include menses that are: too painful (dysmenorrhea), absent or occur irregularly (amenorrhea or oligoamenorrhea), or prolonged and heavy (menorrhagia, or excessive uterine bleeding). In providing optimal reproductive care, the medical provider must be able to distinguish between normal developmental patterns or symptoms requiring education and reassurance from pathologic conditions requiring prompt assessment and treatment.

Counseling Parents and Teens About Marijuana Use in the Era of Legalization of Marijuana.

Many states have recently made significant changes to their legislation making recreational and/or medical marijuana use by adults legal. Although these laws, for the most part, have not targeted the adolescent population, they have created an environment in which marijuana increasingly is seen as acceptable, safe, and therapeutic. This clinical report offers guidance to the practicing pediatrician based on existing evidence and expert opinion/consensus of the American Academy of Pediatrics regarding anticipatory guidance and counseling to teenagers and their parents about marijuana and its use.

National Trends in Hospitalizations for Opioid Poisonings Among Children and Adolescents, 1997 to 2012.

Importance: National data show a parallel relationship between recent trends in opioid prescribing practices and hospitalizations for opioid poisonings in adults. No similar estimates exist describing hospitalizations for opioid poisonings in children and adolescents.

Objective: To describe the incidence and characteristics of hospitalizations attributed to opioid poisonings in children and adolescents.

Parents' views on human papillomavirus vaccination for sexually transmissible infection prevention: a qualitative study.

Unlabelled: Background Human papillomavirus (HPV) is the most common sexually transmissible infection (STI) in the United States (US) and an important cause of several cancers. Vaccines that prevent HPV infections are now recommended for routine use in adolescents but coverage remains suboptimal in the US. Because they are often promoted as cancer prevention vaccines, little is known about parents' views on vaccination for prevention of an STI.

Testing for drugs of abuse in children and adolescents.

Drug testing is often used as part of an assessment for substance use in children and adolescents. However, the indications for drug testing and guidance on how to use this procedure effectively are not clear. The complexity and invasiveness of the procedure and limitations to the information derived from drug testing all affect its utility.

Screening, brief intervention, and referral to treatment (SBIRT) for alcohol and other drug use among adolescents: evaluation of a pediatric residency curriculum.

The objective of this study was to evaluate the integration of a screening, brief intervention, and referral to treatment (SBIRT) curriculum for alcohol and other drug use into a pediatric residency program. Pediatric and medicine/pediatric residents in an adolescent medicine rotation located in an urban teaching hospital participated in the study. Main outcome measures were pre- and post-training knowledge scores, performance of the Brief Negotiation Interview (BNI), training satisfaction, and adoption of the BNI into clinical practice.

Developing and implementing a multispecialty graduate medical education curriculum on Screening, Brief Intervention, and Referral to Treatment (SBIRT).

The authors sought to evaluate the feasibility and acceptability of initiating a Screening, Brief Intervention, and Referral to Treatment (SBIRT) for alcohol and other drug use curriculum across multiple residency programs. SBIRT project faculty in the internal medicine (traditional, primary care internal medicine, medicine/pediatrics), psychiatry, obstetrics and gynecology, emergency medicine, and pediatrics programs were trained in performing and teaching SBIRT. The SBIRT project faculty trained the residents in their respective disciplines, accommodating discipline-specific implementation issues and developed a SBIRT training Web site.

Short-term persistence of high health care costs in a nationally representative sample of children.

Objectives: Little is known about the persistence of health care costs in children. Determining whether children with high health expenses continue to have high expenses over time can help in the development of targeted programs and policies to decrease costs, plan equitable health insurance strategies, and provide insights into the effects of costly conditions on families. The objectives of this study were to (1) identify the characteristics of children who are in the top 10th percentile for health costs, (2) investigate whether those in the top percentiles for costs in 1 year continue in the same percentiles the next year, and (3) identify factors that predict whether a child stays in the top percentiles.

Prevalence of, and factors associated with, adolescent physical fighting while under the influence of alcohol or drugs.

Purpose: To determine: (a) the prevalence of physical fighting while under the influence of alcohol or drugs, and (b) the associations among demographic factors, other risk behaviors, and physical fighting while under the influence of substances.

Methods: Cross-sectional analysis of The National Longitudinal Study of Adolescent Health (Add Health) 1994-1995, a school-based, nationally representative survey of 6504 7th to 12th graders. The dependent outcome variables of interest were: "The most recent time you got into a fight, had you been drinking?" and "Have you ever gotten into a fight when you had been using drugs?" Independent variables included: demographics, adolescent characteristics and risk behaviors, home environment, and peer substance use.

Visits to complementary and alternative medicine providers by children and adolescents in the United States.

Objective: Determine the prevalence, patterns, costs, and predictors of visits to complementary and alternative medicine (CAM) providers and subsequent remedy use in a nationally representative pediatric sample.

Methods: The 1996 Medical Expenditure Panel Survey provided data on 7371 subjects < or =21 years of age. The primary outcome variable was CAM provider visits as defined by consulting a CAM provider "for health reasons.

Body piercing and high-risk behavior in adolescents.

Purpose: To evaluate the association of body piercing with sociodemographic factors, peer substance use, and high-risk behaviors.

Methods: Cross-sectional analysis using Wave II of the National Longitudinal Study of Adolescent Health (Add Health) Public Use Dataset, a nationally representative, school-based sample of 4337 adolescents, aged 13-18 years, surveyed in 1996. The major predictor variable was body piercing at locations other than the ears.

Demographic, intrinsic, and extrinsic factors associated with weapon carrying at school.

Background: Recent incidents of school violence have heightened the need to identify societal, interpersonal, and adolescent characteristics that contribute to weapon carrying.

Objectives: To assess the prevalence of weapon carrying at school and to determine associated risk factors for adolescent males and females.

Design: A cross-sectional study using the 1994-1995 National Longitudinal Study of Adolescent Health data.

Tattooing and high-risk behavior in adolescents.

Objectives: We sought to determine the prevalence and sociodemographic characteristics of tattooed adolescents in a nationally representative sample and to evaluate the association between tattooing and several high-risk behaviors.

Methods: This is a secondary analysis of the National Longitudinal Survey of Adolescent Health Public Use Dataset, which provides a nationally representative sample of 6072 adolescents collected in 1995 and 1996. The association among permanent tattoos, sociodemographic factors, and high-risk behaviors was evaluated using bivariate and logistic regression analyses using SUDAAN.