How we raise young children is one of today's most highly personalized and sharply politicized issues, in part because each of us can claim some level of "expertise." The debate has intensified as discoveries about our development-in the womb and in the first months and years-have reached the popular media. How can we use our burgeoning knowledge to assure the well-being of all young children, for their own sake as well as for the sake of our nation? Drawing from new findings, this book presents important conclusions about nature-versus-nurture, the impact of being born into a working family, the effect of politics on programs for children, the costs and benefits of intervention, and other issues. The committee issues a series of challenges to decision makers regarding the quality of child care, issues of racial and ethnic diversity, the integration of children's cognitive and emotional development, and more. Authoritative yet accessible, From Neurons to Neighborhoods presents the evidence about "brain wiring" and how kids learn to speak, think, and regulate their behavior. It examines the effect of the climate-family, child care, community-within which the child grows.

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From Neurons to Neighborhoods: The Science of Early Childhood Development

Evidence of the health-promoting influence of primary care has been accumulating ever since researchers have been able to distinguish primary care from other aspects of the health services delivery system. This evidence shows that primary care helps prevent illness and death, regardless of whether the care is characterized by supply of primary care physicians, a relationship with a source of primary care, or the receipt of important features of primary care. The evidence also shows that primary care (in contrast to specialty care) is associated with a more equitable distribution of health in populations, a finding that holds in both cross-national and within-national studies. The means by which primary care improves health have been identified, thus suggesting ways to improve overall health and reduce differences in health across major population subgroups.

https://www.jhsph.edu/sebin/k/a/2005_MQ_Starfield.pdf

Contribution of Primary Care to Health Systems and Health

This meta-analysis reviewed the literature on socioeconomic status (SES) and academic achievement in journal articles published between 1990 and 2000. The sample included 101,157 students, 6,871 schools, and 128 school districts gathered from 74 independent samples. The results showed a medium to strong SES–achievement relation. This relation, however, is moderated by the unit, the source, the range of SES variable, and the type of SES–achievement measure. The relation is also contingent upon school level, minority status, and school location. The author conducted a replica of White’s (1982) meta-analysis to see whether the SES–achievement correlation had changed since White’s initial review was published. The results showed a slight decrease in the average correlation. Practical implications for future research and policy are discussed.

Socioeconomic Status and Academic Achievement: A Meta-Analytic Review of Research

Statistical Analysis with Missing Data

e w id r as e, se er t st al h r Overweight or obesity in adolescents has reache epidemic proportions in the USA and other industr alized countries. These conditions, although ofte lumped together in research and in commentarie reflect adolescents’ being toward the heavier point a continuum that would range from underweight morbidly obese. The terms may be used interchang ably, but there is no doubt that, in the US a considerable percentage of adolescents suffer fro too much body fat. The prevalence of obesity (bod mass index [BMI] >95th percentile) among adole cents aged 12–19 years is now one in six (17.6%); an one in three (34.9%) US adolescents are overweight obese (BMI>85th percentile) (Story et al. 2009). Oth industrialized countries, such as Canada, Japa Germany, and China also are beginning to experien increasing problems related to obesity (Cornette 2008 Being on the overweight side of the weight continuu means being afflicted with a serious, chronic disea that can cause substantial harm to adolescents’ curre and future health. Although terms may be used loosely, individua only are formally deemed obese by physicians. The are some rules of thumb and formulas that often a used, especially in social science studies, but physician diagnose whether adolescents are obese. Discussion measurements tends to focus on that diagnos A diagnosis of obesity typically involves using a bod mass index (BMI). BMI is a measure of weight propo tionate to height, which is deemed a useful measure the amount of body fat. Although there are other mo precise ways to measure excess fat, experts now recom mend using BMI because it is easily obtained, strong

Obesity and Overweight

https://www.academicpedsjnl.net/article/S1530-1567(05)60327-9/pdf

Evidence that school-age children can self-report on their health.

Young children who experience toxic stress are at high risk for a number of health outcomes in adulthood, including cardiovascular disease, cancers, asthma, and depression. The American Academy of Pediatrics has recently called on pediatricians, informed by research from molecular biology, genomics, immunology, and neuroscience, to become leaders in science-based strategies to build strong foundations for children’s life-long health. In this report, we provide an overview of the science of toxic stress. We summarize the development of the neuroendocrine-immune network, how its function is altered by early life adversity, and how these alterations then increase vulnerability to disease. The fact that early environments shape and calibrate the functioning of biological systems very early in life is both a cautionary tale about overlooking critical periods in development and reason for optimism about the promise of intervention. Even in the most extreme cases of adversity, well-timed changes to children’s environments can improve outcomes. Pediatricians are in a unique position to contribute to the public discourse on health and social welfare by explaining how factors that seem distal to child health may be the key to some of the most intractable public health problems of our generation. We consider the challenges and opportunities for preventing toxic stress in the context of contemporary pediatric practice.

The Science of Early Life Toxic Stress for Pediatric Practice and Advocacy

There are no standard methods for assessing the quality of young children's perceptions of their health and well-being and their ability to comprehend the tasks involved in reporting their health. This research involved three cross-sectional studies using cognitive interviews of 5-11-year-old children (N = 114) to determine their ability to respond to various presentations of pictorially illustrated questions about their health. The samples had a predominance of children in the 5-7-year-old range and families of lower and middle socio-economic status. The research questions in Study 1 involved children's ability to convert their health experiences into scaled responses and relate them to illustrated items (n = 35); Study 2 focused on the type of response format most effectively used by children (n = 19); and Study 3 involved testing children's understanding of health-related terms and use of a specific recall period (n = 60). The results of Study 1 showed that children identified with the cartoon drawing of a child depicted in the illustrated items, typically responding that the child was at or near their own age and of the same gender, with no differences related to race. Study 2 results indicated that children responded effectively to circles of graduated sizes to indicate their response and preferred them to same-size circles or a visual analogue scale. Tests of three-, four-, and five-point response formats demonstrated that children could use them all without confusion. In Study 3, expected age-related differences in understanding were obtained. In fact, the 5-year-old children were unable to understand a sufficient number of items to adequately describe their health. Virtually all children 8 years of age and older were able to fully understand the key terms and presentation of items, used the full five-point range of response options, and accurately used a 4-week recall period. Six- and seven-year-olds were more likely than older children to use only the extreme and middle responses on a five-point scale. No pattern of gender differences in understanding or in use of response options was found. We conclude that children as young as eight are able to report on all aspects of their health experiences and can use a five-point response format. Children aged 6-7 had difficulty with some health-related terms and tended to use extreme responses, but they understood the basic task requirements and were able to report on their health experiences. These results provide the guidance needed to develop and test a pediatric health status questionnaire for children 6-11 years old.

Elementary school-aged children's reports of their health: a cognitive interviewing study

Pediatric Patient-Reported Outcome Instruments for Research to Support Medical Product Labeling: Report of the ISPOR PRO Good Research Practices for the Assessment of Children and Adolescents Task Force

Objectives.To determine the best predictors of the amount of children’s health care use.Research Design. Child health, psychosocial, and family status variables were collected. Families were then followed prospectively for 2 years to gather health care use data. Multivariate regression analysis was

Anne W. Riley

Papers

Evidence that school-age children can self-report on their health.

The Science of Early Life Toxic Stress for Pediatric Practice and Advocacy

Elementary school-aged children's reports of their health: a cognitive interviewing study

Pediatric Patient-Reported Outcome Instruments for Research to Support Medical Product Labeling: Report of the ISPOR PRO Good Research Practices for the Assessment of Children and Adolescents Task Force

Children's health care use: a prospective investigation of factors related to care-seeking.