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This Month in Archives of Pediatrics and Adolescent Medicine
February 7, 2011

This Month in Archives of Pediatrics & Adolescent Medicine

Arch Pediatr Adolesc Med. 2011;165(2):101. doi:10.1001/archpediatrics.2010.284

Maternal Influenza Vaccination and Effect on Influenza Virus Infection in Young Infants

Young infants are at highest risk for influenza complications, yet children younger than 6 months are ineligible for vaccination. In this nonrandomized, prospective study to evaluate the effect of seasonal influenza vaccination during pregnancy on influenza virus infection in infants, 1169 mother-infant pairs were studied over 3 influenza seasons. There was a 41% reduction in the risk of laboratory-confirmed influenza virus infection (relative risk, 0.59; 95% confidence interval, 0.37-0.93) for infants born to influenza-vaccinated women compared with infants born to unvaccinated mothers. There was also a significant association between increasing cord blood titers of hemagglutinin inhibition antibody and decreasing risk of influenza virus infection in the infant. Infants born to influenza-vaccinated mothers had a 39% lower risk of hospitalization for an influenzalike illness (relative risk, 0.61; 95% confidence interval, 0.45-0.84) compared with those born to unvaccinated mothers. There was no difference in the cord blood titers according to trimester of vaccination. The findings of this study underscore the public health importance of maternal influenza vaccination to prevent influenza in both pregnant women and their infants.

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Health Outcomes and Family Services in Kinship Care: Analysis of a National Sample of Children in the Child Welfare System

More than 125 000 US children live in out-of-home kinship care. Sakai and colleagues sought to compare behavioral and mental health outcomes as well as health care access and use of health services for US children placed in kinship care vs foster care 3 years after placement. At the 3-year follow-up, children in kinship care were more likely than children in foster care to be with a permanent caregiver and had at least a 40% lower risk of behavioral problems and social skills problems. However, adolescents in kinship care had nearly a 5-fold greater risk of pregnancy compared with those in foster care. While the rate of clinical depression and posttraumatic stress disorder did not significantly differ between the 2 groups, children in kinship care were half as likely to have outpatient mental health therapy and psychotropic medication use compared with children in foster care. These findings suggest that increased supervision and monitoring of the kinship environment and increased caregiver support services are needed to improve outcomes of children in kinship care.

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Depictions of Tobacco Use in 2007 Broadcast Television Programming Popular Among US Youth

There is a causal relationship between exposure to tobacco depiction in movies and initiation of smoking by youth. Cullen and colleagues quantified the tobacco use depictions in a sample of television programs popular with youth aged 12 to 17 years during the fall 2007 season. Of the 73 episodes examined, 40% included at least 1 depiction of tobacco use, 33% showed 1 or more depictions of cigarette use, and 8% demonstrated at least 1 depiction of cigar use. Most tobacco depictions were of cigarettes, amounting to 270 total incidents in 61.5 total hours of programming analyzed, for a mean of 4.4 incidents per hour. The greatest proportion of episodes with at least 1 tobacco depiction was observed on FOX (44%), followed by The CW (41%). Nationally, the estimated number of youth aged 12 to 17 years who were exposed to tobacco use as a result of the television programming examined in this study was 940 000. Current TV Parental Guidelines do not consider any form of substance use, including tobacco, in determining a program rating.

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Effects of Adverse Events on the Projected Population Benefits and Cost-Effectiveness of Using Live Attenuated Influenza Vaccine in Children Aged 6 Months to 4 Years

While intranasal live attenuated influenza vaccine (LAIV) is more effective in preventing laboratory-confirmed influenza compared with inactivated influenza vaccine (IIV), data also suggest an increase in adverse events, such as wheezing, in children younger than 5 years who receive LAIV compared with IIV. In this decision analysis, costs of vaccination were projected to be higher for LAIV compared with IIV, reflecting both higher costs of the vaccine dose and higher probabilities of adverse events and associated costs for LAIV. However, vaccination with LAIV resulted in health benefits that outweighed vaccine adverse events as measured by quality-adjusted life-years saved.

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