Entering our 25th year.

Abstract

In this issue of Pediatrics in Review (PIR), we emphasize several aspects of prevention. The article by Belay and colleagues on pediatric precursors of adult diseases emphasizes a new and challenging part of pediatric practice: Identifying children who have no evidence of disease but who are at risk for developing certain diseases as adults and initiating interventions to prevent such problems. The article on smoking prevention, with the linkage to a PREP self-assessment question and critique on the same topic, deals with the single most important modifiable factor in adult health. However, smoking also can be considered a pediatric disease because nearly all who become addicted to tobacco do so before age 18 years, even though the consequences do not appear until later adult life.Our Index of suspicion (IOS) section continues to be valued highly by our readers. However, we receive many more good cases for IOS than we can publish. Unfortunately, from this point onward, we will be accepting fewer cases because of space limitations.We continue to believe that the future of medicine is evidence-based, with systematic evaluation of the evidence relating to the efficacy of medical services. We have published two articles on the method and will continue to recruit review articles that employ this process of evaluation.From its inception, PIR has been linked with The American Board of Pediatrics (ABP) Maintenance of Certification program. Committees of both practicing and academic pediatricians appointed jointly by the American Academy of Pediatrics (AAP) and the ABP have developed “content specifications” that cover the field of general pediatrics. There are more than 4,000 of these, and they are updated annually. A portion of these are used each year as the basis for the maintenance of certification examination. Each year, these content specifications are divided between the PREP Self-assessment program (SA) and PIR; over a 5-year period, almost all are covered by one or both of these vehicles. The 5-year cumulative index published each year in PIR lists all PIR articles, NeoReviews articles, SA exercises, and Update topics for the current plus the previous 4 years. Candidates taking the cognitive examination for maintenance of certification should use the 5-year index and contents of these publications to prepare for the examination. (For a good explanation of the links between the AAP’s educational program and the ABP’s Maintenance of Certification, see PIR. 2003;24:243–244.)Educational vehicles have been added by the AAP over the years; these now include PREP The Course, NeoReviews, and AAP Grand Rounds, as well as PIR, SA, and the Update tapes. This array of offerings allows pediatricians a variety of CME methods for attaining maintenance of clinical competence. We also strive to enhance the linkage between these vehicles by publishing occasional SA exercises in PIR (see pg 26 in this issue) and adding recent publication citations from AAP Grand Rounds and the Update tapes to the Suggested Reading lists at the ends of PIR articles. We believe that the AAP, through these different vehicles, offers the most comprehensive CME program of any clinical specialty, and these different venues provide different styles of learning from which the clinician can choose.Today, PIR has more than 35,000 subscribers in the United States as well as a circulation of nearly 40,000 in six different international editions (Italian, Hungarian, Portuguese, Polish, Spanish, and an English Indian edition), which speaks to the usefulness of the journal for pediatricians worldwide. The electronic version of PIR provides additional multimedia material and often includes peripheral material not covered in the journal’s print version, such as expanded lists of references. The electronic version’s rapid response online allows readers to ask questions and comment on PIR articles, many of which we answer online and often publish in the print version. We get comments from readers throughout the world via this excellent communication tool.I am very pleased to announce that the AAP has appointed Dr. Larry Nazarian to be the new editor of PIR beginning with the January 2005 issue. Larry’s superb role as associate editor of PIR since 1989; his role in developing several of our journal’s new features (especially the “jewel in the crown” IOS); and his long experience as a clinician, teacher, office-based researcher, and editor will ensure the ongoing high standard of quality for PIR. I have no doubt that PIR will continue to improve and provide the cognitive base for the optimum health care of children.