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How Often Are Teens Arrested for Sexting? Data

From a National Sample of Police Cases

Media reports suggest that adolescents are being charged with sex crimes and even placed on sex offender registries because of participating in the“sexting”of sexual images, but the nature and outcomes of such incidents have not been de-scribed empirically.

This is theﬁrst study to examine types of sexting cases handled by police. It informs clinicians by identifying characteristics of “aggravated”versus milder incidents andﬁnding that most youth were not arrested. Sex offender registration was rare.

Prevalence and Characteristics of Youth Sexting: A

National Study

Educators, public health authorities, and law enforcement are confronting an increasing number of cases in which youth made sexual images of themselves and other minors and transmitted them via cell phones and the Internet.

This study provides theﬁrst detailed and comprehensive na-tional estimate of the percentage of youth who create and distribute various kinds of sexual images.

Cumulative Prevalence of Arrest From Ages 8 to 23

in a National Sample

Although there is some older literature examining how arrest prevalence accumulates through adolescence and adulthood, there is no contemporary research examining the arrest his-tories of a representative sample of American youth.

Using a contemporary US sample of adolescents and young adults, we estimated the cumulative arrest prevalence through age 23. The results suggest a substantial increase in the cu-mulative prevalence of arrest since the 1960s.

Pediatric Sports-Related Concussion Produces

Cerebral Blood Flow Alterations

The pathophysiology of pediatric sports-related concussion (SRC) is largely unknown. Studies of concussed adults have identiﬁed neuronal and axonal injury and time-limited meta-bolic disruptions. An experimental animal model has also demonstrated physiologic perturbations, including reduced cerebral bloodﬂow (CBF).

Using MRI techniques, we found no evidence of neuronal, axonal, or metabolic disruptions in 12 children with SRC. However, when compared with controls, statistically signiﬁcant alterations in CBF were deﬁned and frequently persisted beyond 30 days after injury.

Computerized Neurocognitive Testing for the

Management of Sport-Related Concussions

Neurocognitive testing is recommended for the assessment of sport-related concussions. Computerized neurocognitive tests are more sensitive and more efﬁcient than traditional neuropsychological testing in assessing sport-related con-cussions.

We describe the current prevalence of computerized neuro-cognitive testing, the relative use of the various computerized programs, the types of clinicians interpreting test scores, and

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intima media thickness in young adults, and this was also shown in neonates.

This study is theﬁrst to show that the effect of smoking during pregnancy on the vasculature of children is (still) visible at the age of 5 years. Pregnancy appears to be the critical period for this damage to occur.

Use of Palivizumab in Primary Practice

Palivizumab administration to well-deﬁned, high-risk groups results in reductions of hospital days, but the intervention is costly. The American Academy of Pediatrics has recommended which groups should be administered palivizumab for the best clinical and cost-effective outcomes.

In a primary practice, palivizumab was frequently used for children outside the recommended groups. Through close oversight and education, the use of palivizumab outside of recommendations was decreased. Palivizumab primary prac-tice usage issues such as proper numbers of doses and timely administration need improvement.

Trends in Preventive Asthma Medication Use Among

Children and Adolescents, 1988

–

2008

Preventive asthma medications (PAMs) are a primary man-agement strategy to control asthma morbidity. Little is known about changes over time in prevalence of PAM use among children and adolescents in the United States.

Our analysis demonstrates an increase in use of PAMs among children and adolescents with current asthma in the United States from 1988–1994 to 2005–2008, but racial and ethnic disparities in use of PAMs persist.

Early Childhood Overweight and Asthma and

Allergic Sensitization at 8 Years of Age

Overweight has been associated with an increased risk of asthma in children, although the published literature is con-tradictory. How change in overweight status during childhood affects asthma risk has not been well studied.

Among children whose weight has normalized, high BMI during theﬁrst 4 years of life does not increase the risk of asthma at school age. Current high BMI is associated with increased risk of asthma and sensitization to inhalant allergens.

bilirubinemia (NH). Visual inspection for jaundice is not reliable at identifying infants with NH in the community.

When compared with visual inspection alone, coordinated TcB screening for NH in acute-care and community settings is associated with signiﬁcant improvements in laboratory utili-zation, patient care, convenience, and safety.

The Value of the Medical Home for Children Without

Special Health Care Needs

The medical home is associated with beneﬁcial outcomes in children with special health care needs and in the entire pe-diatric population. It is unknown if it beneﬁts the majority of the pediatric population (ie, children without special health care needs).

This study is theﬁrst to demonstrate an association between the medical home and beneﬁcial health care utilization, child health, and health-promoting behavior outcomes in children without special health care needs.

Shared Decision-Making and Health Care

Expenditures Among Children With Special Health

Care Needs

Children with special health care needs (CSHCN) account for more than one-third of pediatric health care costs. Little is known regarding the impact of shared decision-making (SDM) over time on child health care expenditures and utilization.

In a national sample, we found that increasing SDM was as-sociated with decreased health care costs and utilization for CSHCN. Results support prospective studies to determine if pediatric interventions to foster SDM reduce the ﬁnancial burden of caring for CSHCN.

Family-centered Program Deters Substance Use,

Conduct Problems, and Depressive Symptoms in

Black Adolescents

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This study demonstrates that participation in a family-centered preventive intervention reduces conduct problems, substance use, and substance use problems among black adolescents by more than 30% compared with adolescents in an attention control condition across nearly 2 years.

Bovine Lactoferrin Prevents Invasive Fungal

Infections in Very Low Birth Weight Infants: A

Randomized Controlled Trial

Lactoferrin is a glycoprotein with anti-infective activities being part of the innate defensive network. Bovine and human lactoferrin share high homology. Bovine lactoferrin can prevent late-onset sepsis in preterm very low birth weight neonates.

In preterm very low birth weight infants, bovine lactoferrin is able to prevent not only late-onset sepsis but also systemic fungal infections. This protection is achieved independently from their colonization status.

Mortality and Adverse Neurologic Outcomes Are

Greater in Preterm Male Infants

Very low birth weight (VLBW) male neonates appear to have increased mortality. VLBW female neonates appear to have better long-term outcomes.

VLBW male neonates have increased mortality and poorer neurological outcome. This gender difference appears to dis-appear at weeks’gestation.

Quality of Early Maternal

–

Child Relationship and

Risk of Adolescent Obesity

The quality of the relationship between mother and child affects the child’s neurodevelopment, emotion regulation, and stress response. Extreme or sustained stress responses are associ-ated with dysregulation of physiologic systems involved in energy balance, which could lead to obesity.

The prevalence of obesity in adolescence was more than twice as high among those youth who in early childhood had poor-quality relationships with their mothers compared with those with better relationships.

Antihypertensive Prescribing Patterns for

Adolescents With Primary Hypertension

Primary hypertension is a growing concern in adolescents due to its association with the obesity epidemic. Recent studies have examined underdetection and underdiagnosis of hypertension in adolescents but medical management of primary hyper-tension in adolescents is not well-described.

Our study describes patterns of antihypertensive prescribing for adolescents with primary hypertension including the use of monotherapy versus combination therapy by physicians of different specialties and factors associated with receipt of antihypertensive therapy over a multi-year period.

Early Intervention Improves Behavioral Outcomes

for Preterm Infants: Randomized Controlled Trial

Prematurely born children have an increased prevalence of behavioral problems in the long term. Knowledge regarding the effects of early intervention programs is sparse, and more randomized controlled trials are warranted.

A modiﬁed version of the Mother-Infant Transaction Program showed beneﬁcial effects on behavioral outcomes reported by both parents of preterm infants with birth weights of,2000 g at a corrected age of 5 years.

Corticosteroid Pulse Combination Therapy for

Refractory Kawasaki Disease: A Randomized Trial

The efﬁcacy of intravenous immunoglobulin and corticosteroid pulse combination therapy for refractory Kawasaki disease has been established. The Egami score can be used to predict which patients are likely to have refractory Kawasaki disease.

As a new strategy for primary treatment, intravenous immu-noglobulin and corticosteroid pulse combination therapy is safe and effective for patients predicted to have refractory Kawasaki disease based on the Egami score.

US Estimates of Hospitalized Children With Severe

Traumatic Brain Injury: Implications for Clinical

Trials

Clinical trials in children with severe traumatic brain injury (TBI) are challenging. To date, no work has been published that permits clinical investigators to estimate the number and compositional features of sites from which to recruit children with severe TBI into clinical trials.

Children with severe TBI are infrequent. Less than 5% of all US hospitals discharged more than 78% of severe TBI cases. To maximize enrollment efﬁciency for future clinical trials, at-tention has to be paid to selecting appropriate hospital sites.

Headache After Pediatric Traumatic Brain Injury:

A Cohort Study

Over 500 000 children in the United States sustain a traumatic brain injury (TBI) each year. Headaches are commonly reported after TBI in adults, but little is known about the ep-idemiology of headache after pediatric TBI.

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Newborns

Although still off-label for newborns, the use of inhibitors of gastric acid secretion continues to increase. Acid-suppressive drugs could facilitate the onset of infections in adults and children. Evidence for efﬁcacy is weak in newborns, particularly if preterm.

This is theﬁrst prospective study demonstrating an association between the use of ranitidine and infections, necrotizing en-terocolitis, and fatal outcome in very low birth weight new-borns. Caution is advocated in using ranitidine in newnew-borns.

Validation of a Clinical Prediction Rule to

Distinguish Lyme Meningitis From Aseptic

Meningitis

Available clinical prediction rules to identify children with cerebrospinalﬂuid pleocytosis at low risk for Lyme meningitis include headache duration, cranial nerve palsy, and percent cerebrospinalﬂuid mononuclear cells. These rules require independent validation.

These clinical prediction rules accurately identify patients at low risk for Lyme meningitis in our large multicenter cohort. Children at low risk may be considered for outpatient man-agement while awaiting Lyme serology.

Trivalent Inactivated In

ﬂ

uenza Vaccine Is Not

Associated With Sickle Cell Crises in Children

Children with sickle cell disease are at high risk of compli-cations from influenza infection and have been recommended to receive annual influenza vaccine since the 1970s. Few safety studies, however, have examined the safety of influenza vaccine in this population.

This large cohort study did notﬁnd an association between inﬂuenza vaccination and hospitalization for sickle cell crises in children with sickle cell anemia.

Human Rhinoviruses in Severe Respiratory Disease

in Very Low Birth Weight Infants

Human rhinovirus infections are common in children. Although historically associated with upper respiratory tract illness, rhinoviruses are increasingly recognized for their role in the

Childhood Cumulative Risk and Obesity: The

Mediating Role of Self-Regulatory Ability

Pediatric weight gain is a critical aspect of the obesity epi-demic. Chronic stress produces physiologic perturbations capable of altering brain mechanisms related to eating as well as those implicated in self-regulatory behaviors.

We show that early childhood risk exposures are associated with weight gain in adolescence, independent of childhood BMI. We alsoﬁnd that deﬁciencies in self-regulatory processes help explain the link between chronic stress and adiposity.

Correlates of Mother-to-Child Transmission of HIV

in the United States and Puerto Rico

Most childhood HIV is acquired through perinatal transmission, some of which is preventable. Practitioners need to understand what proportion of perinatally acquired HIV infections are attributable to missed prevention opportunities.

Missed prevention opportunities include lack of early HIV testing for pregnant women; suboptimal use of antiretroviral medications during pregnancy, labor, or delivery or for the neonate; breastfeeding; and vaginal delivery when maternal viral load was$1000 copies/mL.

Clinical Characteristics and Risk Factors for

Symptomatic Pediatric Gallbladder Disease

Gallbladder disease in children is an evolving entity and studies suggest an increasing frequency of symptomatic pediatric gallbladder disease and resultant cholecystectomies.

Hispanic ethnicity and obesity are epidemiologically signiﬁcant risk factors for symptomatic gallbladder disease in the pedi-atric population.

Preterm Birth Alters the Maturation of Barore

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ex

Sensitivity in Sleeping Infants

Blood pressure and heart rate are altered by sleep state and postnatal age in healthy term and preterm infants. Preterm infants have altered blood pressure responses to head-up tilting during sleep.

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greater vulnerability of preterm infants to sudden infant death syndrome.

Aerobic Capacity and Exercise Performance in

Young People Born Extremely Preterm

Extreme preterm birth is associated with developmental shortcomings that may reduce exercise capacity and partici-pation in physical activities in later life. The number of studies addressing these issues in adolescent populations is limited, test methods differ, and results are diverging.

Exercise capacity after preterm birth was in the same range as in term-born control subjects. Participation in physical activity was lower in preterm subjects compared with control subjects; however, the response to exercise in terms of increased aerobic capacity was similar.

Peer-led Education for Adolescents With

Asthma in Jordan: A Cluster-Randomized

Controlled Trial

The prevalence of asthma and smoking among adolescents in Jordan is high. Well-designed, school-based, peer-led education programs can have a positive impact on asthma self-management in adolescents. Student peer leaders can be useful and responsible partners in health promotion programs.

A peer-led asthma education program—Adolescent Asthma Action—for adolescents developed in Australia was adapted to suit non–English-speaking cultures in the Middle East. Peer-led education led to improved self-management of asthma and motivated students to avoid smoking.

Factors Affecting Health Care Utilization for

Children in Japan

In the United States, the ecology of children’s medical care is similar to that of adults. Health care utilization for children varies signiﬁcantly by age, race, ethnicity, income, and health insurance status.

Compared with data from the United States, children in Japan more frequently visit both community physicians and hospital-based outpatient clinics. Pediatric health care utilization is inﬂuenced signiﬁcantly by age but not affected by income or residence location in Japan.

Prognostic Models for Stillbirth and Neonatal

Death in Very Preterm Birth: A Validation Study

Two UK models predict the risk of mortality in very preterm Western infants (1) alive at onset of labor and (2) admitted

for neonatal intensive care. Prognostic models need temporal and geographic validation to evaluate their performance.

The 2 models showed very good performance in a recent large cohort of very preterm infants born in another Western country. The accurate performance of both models suggests application in clinical practice.

Symptoms and Time to Medical Care in Children

With Accidental Extremity Fractures

A delay in seeking medical care for children with signiﬁcant injury often raises a concern about child abuse, but there are few data describing the range of responses children display after accidental fracture for providers to use in comparison.

This study presents the range of responses exhibited by children after accidental fractures and identiﬁes factors as-sociated with a delay in seeking medical care. No child was asymptomatic, although a minority did not manifest all expected responses after their injury.

Histologic Chorioamnionitis Is Associated

With Reduced Risk of Late-Onset Sepsis

in Preterm Infants

Chorioamnionitis is associated with preterm birth and an in-creased risk of common adverse outcomes of prematurity, including early-onset sepsis and neurodevelopmental impair-ment. The effect of chorioamnionitis on postnatal immune function and risk of late-onset infection is unknown.

Chorioamnionitis, which complicates many preterm births, is independently associated with a significantly reduced risk of late-onset sepsis in preterm infants. Thefindings suggest that chorioamnionitis may modulate the development of postnatal immunity in a clinically significant manner.

Wide Variation in Reference Values for Aluminum

Levels in Children

Aluminum is ubiquitous and exposure is unavoidable. Adverse health effects have been associated with large exposures in workers or those with chronic kidney disease. There are no established age-speciﬁc reference ranges or toxicity data for populations of healthy children.

We demonstrate the wide variability of aluminum reference ranges in biological samples and that the ranges are not based on studies including healthy children. Further research is necessary to establish clinically relevant reference ranges for healthy children.

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DOI: 10.1542/peds.digest1291

2012;129;D1

Pediatrics

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