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This Month in Archives of Pediatrics and Adolescent Medicine
March 2003

This Month in Archives of Pediatrics & Adolescent Medicine

Arch Pediatr Adolesc Med. 2003;157(3):217. doi:10.1001/archpedi.157.3.217
Pediatric-Based Smoking Cessation Intervention for Low-Income Women: A Randomized Trial

The effects of environmental tobacco smoke on children are well known. The prevalence of smoking among low-income, childbearing women is higher than in many other groups. This randomized controlled trial used a brief intervention in a pediatric clinic, with follow-up telephone calls to increase smoking cessation rates in this population. Abstinence rates were twice as great in the intervention, as compared with the control group, at both 3 and 12 months' follow-up. Pediatric clinic-based smoking cessation interventions could potentially have a major influence on the health of children.

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Breastfeeding and the Risk of Hospitalization for Respiratory Disease in Infancy: A Meta-analysis

While breastfeeding is widely acknowledged to protect infants in the developing world from acute infectious disease, the magnitude of its benefit for healthy infants in industrialized countries is not well delineated. In this meta-analysis, the authors pooled 7 longitudinal cohort studies in which infants were exclusively breastfed for 4 months or more. Exclusive breastfeeding was found to lower the risk of respiratory disease, requiring hospitalization of 72%. The risk of severe respiratory infections was tripled in infants who were not breastfed, as compared with those who were exclusively breastfed.

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Stability of Maternal Preferences for Pediatric Health States in the Perinatal Period and 1 Year Later

Currently, physicians are increasingly inviting parents to share in the responsibility of decision making for infants at the margins of viability. However, parental preferences regarding such decisions in the perinatal period are largely unknown. It is also unclear whether such preferences are stable across time. Saigal and colleagues interviewed a cohort of high-risk pregnant women during their pregnancy, during the perinatal period, and 12 months after delivery. Even under stressful conditions, maternal preferences were remarkably stable during this time. The study stresses the obligation of physicians to elicit and consider parental values in decision making.

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Defining the Sudden Infant Death Syndrome

Sudden infant death syndrome (SIDS) is a term that was first proposed in 1969 to describe a distinct subgroup of infant deaths. While the term has played an important role in focusing attention on the problem of infant death, the application of this term has become increasingly controversial. In this article, Dr Beckwith discusses the problems created by the lack of an adequate definition and considers an approach based on some of the most consistent features of SIDS.

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Influence of the News Media on Diagnostic Testing in the Emergency Department

The influence of the mass media on the public is well documented, but no data are available regarding the media's influence on testing in the emergency department. Sharma and colleagues examined the effect of news coverage of a cluster of invasive group A streptococcal (GAS) infections in Kansas City, Mo, on testing in a large pediatric emergency department. The number of tests for GAS nearly doubled in the year, with news coverage and the peak of testing corresponding closely with the peak in news coverage.

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