Academy Committee Research Articles

Neonatal Hyperbilirubinemia

We planned to publish a comprehensive review article on neonatal jaundice in this issue. Concurrently, the Academy's Committee on Practice Parameters is developing a statement on this topic. Because it was not complete by the time this issue had to be "put to bed," readers and pediatricians (especially subspecialists) taking the recertification examination in 1995 should look for publication of the parameters, and Pediatrics in Review will publish the review at a later date.

Standardizing Neck Dissection Terminology: Official Report of the Academy's Committee for Head and Neck Surgery and Oncology

The emergence of the multitude of modified techniques for neck dissection procedure has resulted in a nomenclature system that is nonuniform. To eliminate potential misinterpretation, overlap, and lack of standardization, the Academy's Committee for Head and Neck Surgery and Oncology, with input from the Education Committee of the American Society of Head and Neck Surgery, has developed a classification system for these procedures. This has now been adopted by the American Academy of Otolaryngology-Head and Neck Surgery. The classification is based on the following concepts: (1) radical neck dissection is the fundamental procedure with which all other neck dissections are compared, (2) modified radical neck dissection denotes preservation of one or more nonlymphatic structure(s), (3) selective neck dissection denotes preservation of one or more group(s) of lymph nodes, and (4) extended radical neck dissection denotes removal of one or more additional lymphatic and/or nonlymphatic structure(s). Adherence to the principles of this classification system to describe neck dissection techniques should provide an improved method of communication. Furthermore, the system provides a rational framework on which subsequent terminology can be added.

Report of the National Academy Committee on Magnetic Fusion in Energy Policy

Report of the National Academy Committee on Magnetic Fusion in Energy Policy

The Academy's transition years

The year was 1968. In November the Academy would mark its thirtieth anniversary. The Academy's office had moved west, from Evanston, Illinois, to Seattle, Washington. It was a turning point, the beginning of the transition years. Those nine transition years ended in 1977 with the establishment of the Academy's permanent, fully staffed headquarters in Evanston. It was my good fortune to serve on the Academy's staff as executive secretary during the first 5 of those years. From its beginning in 1938 to its move in 1977 to the permanent Evanston office, the Academy situated its headquarters in the home city of the incumbent secretary-treasurer, who was always a practicing dermatologist. The secretary-treasurer's term of office was 5 years, and thus the Academy office moved every 5 years. In the Academy's early years those frequent moves were not as uprooting as one might think because the American Academy of Dermatology (AAD) had only one full-time salaried employee. Temporary help was hired during the hectic weeks that preceded the annual meetings. During most of those years the system worked very well, due in large measure to the competence and dedication of the long-time staff secretary, Geraldine Feeney. Although the Academy office moved every 5 years, it never moved very far. The cities of Cleveland, Chicago, Evanston, and Rochester served as home base during those early years. All of those cities are within easy distance of Chicago's Palmer House Hotel, where the annual Academy meetings were invariably held. But the Academy had grown, not only in membership but in importance. Its annual scientific meeting attracted dermatologists from around the globe, and AAD was recognized as the most significant dermatologic association in the world. The time had come for the Academy to modernize and reorganize its headquarters to conform with its size and stature. The transition period began in 1968 with the election of Dr. Robert A. Pommerening, head of the Department of Dermatology at Virginia Mason Clinic in Seattle, as Secretary-Treasurer. The decision to name as secretary-treasurer a dermatologist from outside the Chicago-Midwest orbit could not have been made without considerable deliberation and some emotional upheaval. After all, members of the Chicago Dermatological Society had been key movers in the establishment of the AAD. Moreover, for most of its 30 years, the Academy had functioned comfortably from its chosen Midwestem hub. In his quest for an administrative secretary to staff the Academy's new Seattle office, Dr. Pommerening contacted me at the University of Texas M.D. Anderson Hospital and Tumor Institute in Houston, where I was then working. He had been shown a copy of my curriculum vitae. Was I interested in the Academy position? Did I want to move back to Seattle? The answer to both questions was yes. Arrangements were made for a personal interview with Dr. Pommerening and to meet the members of the Academy's Committee on Education, who were meeting in Las Vegas in January 1968. I was offered the job. I accepted. For my son Christopher and me it was to be a move back home. Before going to Houston I had been an administrative secretary in a research laboratory at the University of Washington School of Medicine in Seattle. I tried to soothe the emotional wounds of my close relatives living in the Houston area, who could not understand why I preferred rainy Seattle to humid Houston. Christopher and I headed northwest, arriving in Seattle on the last day of February. Early in the morning of March 1, 1968, I arrived

The section “basic sciences” of the international academy of astronautics on a new track

A description is given of the main aims of Section One (Basic Sciences) of the International Academy of Astronautics. In a recent meeting of the Section delibrations took place with the purpose to redefine its functioning, also in relation to the Academy's Committee structure and its main program elements. It is important to have a small executive body, with as main task the preparation and elaboration of working programs of the Section. A first task for the Section is the evaluation of trends in scientific space programs. The importance of a proposed International Space Year (1992) was stressed and the possible involvement of the Section discussed. We outline some ideas on the guidelines of the membership policy of the Section. Some factual information is given in a few Appendices.

Practice styles in periodontics. II.

In 1980 the American Academy of Periodontology published the results of its first major survey of practice characteristics in the Journal of Periodontology. That first study arose from membership concerns about the lack of knowledge about career patterns of periodontists and, more specifically, about employment opportunities for graduating periodontists. Three years later, the Committee on Practice Styles and Opportunities in Periodontics was appointed to replicate the earlier study in order to provide information on recent changes in the practice of periodontics. This decision is commendable since few dental specialty organizations collect data from their membership which can be systematically compared to data from an earlier study. The Academy's Committee contacted David O. Born, PhD, a dental manpower specialist at the University of Minnesota and a technical advisor on the earlier study, for assistance in conducting a replication in 1984. Based on feedback on the first survey and on comments and suggestions from committee members, a revised questionnaire was developed. This questionnaire was, for the most part, a replication of the earlier survey instrument, although several problematic items were deleted or modified and new items, reflecting more recent concerns, were added. The revised questionnaire was distributed in the Spring of 1984 through two mailings to 2937 Active members and 798 Affiliate members. After unusable and undeliverable questionnaires were deleted from the returns, an effective response rate of 55% (N = 2082) was obtained. This report is based on the information supplied by those 2082 members. In the tables and text which follow, the figures reported at the national level refer to "Private practice" periodontists responding to the survey; Academy members who are a part of the Federal services (e.g., Military, Veterans' Administration, Indian Health Service, etc.) are tabulated separately as "District 8" data. While several members from foreign countries responded to the survey, their data have not been included since the information was too dispersed to permit conclusions to be drawn.

Science and society: Asilomar and after: A decade of the new biology

AbstractIn February 1975, in Pacific Grove, California, the Asilomar Conference took place, sponsored by the U.S. National Academy of Sciences and convened by the Academy's Committee on Recombinant DNA Molecules, of which Paul Berg was the Chairman. This conference recommended guidelines for recombinant DNA research, and the history of subsequent sets of guidelines formed the major theme of six articles that appeared in Vol. 1 of BioEssays, authored by Dewitt Stetten, Jr, with the collaboration of William Gartland and Bernard Talbot and entitled ‘The Road to Asilomar: Reminiscences of the Recombinant DNA Story’.1 The U.S. National Research Council recently commissioned for its News Report (volume XXXV, March 1985, 1A–16A) a retrospective article on Asilomar, written by Susan Walton. That article is exerpted here with the permission of the National Research Council.

Swallowed Toothpaste—A Danger or Not

How concerned should we pediatricians be about the fact that young children frequently swallow fluoridated dentifrices while brushing their teeth? The recent recommendation of the Academy's Committee on Nutrition for a decrease from 0.5 to 0.25 mg/day for children less than 2 years of age was "to reduce the possibility of mild fluorosis."1 According to the American Dental Association, the usual amount of dentifrice used on a toothbrush contains approximately 1 mg of fluoride (personal communication from American Dental Association to E. J. Beadle, DDS, 1980).

Energy: a summary of the CONAES report

Two decisions must be crystallized in the near future: the selection of a mix of sustainable energy sources that can be developed and relied upon for a long term; and a viable plan for marshaling resources for a transitional period leading from present technology and primary fuels to those of the future (past 2010). The National Academy Committee on Nuclear and Alternative Energy Systems (CONAES) sees this transitional period as lasting from 30 to 60 years. CONAES deliberated many energy policy issues and Dr. Brooks, as committee chairman, interprets concluding views of CONAES on conservation potential; pricing policy; rapidity and extent of expansion of coal use, nuclear power solar energy use; breeders vs advanced converters; seriousness, timing, and response to the carbon dioxide problem; air pollution regulations for coal; water as a constraint on the expansion of coal and electric power; electrification vs fluid fuels; proliferation and nuclear power; and energy policy and the Third World. For the full CONAES report, see CONS-3784-T1. (MCW)

The British academy committee on oriental documents: the chairman's report on progress

The British academy committee on oriental documents: the chairman's report on progress

The British academy committee on oriental documents

The British academy committee on oriental documents

Letters to the Editor

Dr. Mofenson, for the Academy's Committee on Accident Prevention, comments as follows: Dr. Fugazzotto should be complimented on his astuteness. The alert pediatrician can often identify potential or actual hazards in his practice and inform his colleagues. I would like to mention that the Accident Prevention Committee has a tipsheet on safe toys in its Child Safety Suggestion series, Set No. 2. Recently, two new safety slips have been added on infant furniture, including cribs.

ANIMAL FEEDLOTS—A POLICY STATEMENT WITH BACKGROUND

The Committee on Environmental Health of the Indiana Chapter of the American Academy of Pediatrics sought the assistance of the Academy's Committee on Environmental Hazards regarding a developing health risk to children in Indiana. A cattle feedlot was developed along the shores of a creek which empties into a lake where recreational use included an area specifically designated for swimming. The Environmental Protection Agency estimates that the wastes produced by farm animals in the United States are equivalent to the wastes of 2 billion people, more than half the world population of 3.7 billion people. It has further estimated that more than half of these wastes are produced in feedlots. Feedlots for livestock and poultry are a relatively new industry that has developed since World War II in various parts of the United States. Significant changes are occurring in the increased demand for meats and in the manner of feeding, processing, and marketing livestock. Feedlots are now being established closer to market areas throughout the nation. With the increasing number of animals and the increasing use of feedlots, it is necessary that some wastes management system be required to protect the human population from a number of infectious diseases. Animal wastes from feedlots are more infectious than wastes from grazing farm animals because of naturally occurring epizootics within such confined feeding facilities. Chemical pollution by animal wastes or chemical changes incident to microbiologic or chemical pollution are also a concern. In the interest of our domestic water supply and the safe use of recreational waters, both vital to the health of children, the Committee has approved the following statement:

Gonorrheal Infection and Diagnostic Procedures: A Response to the Statement of the Committee on Youth

The report of the Academy's Committee on Youth on "Venereal Disease and the Adolescent," in your September issue1 is most timely. I would like to comment on the diagnosis of gonorrhea. While the cervix is considered the best site for culture of N. gonorrhoeae, our recent study2 of 1,899 girls yielded positive cultures in 213; 94.2% of these were from the vagina, while subsequent cervical cultures revealed only an additional 13 (5.8%) positive cases. Lucas et al3 found only a similar minor difference, with 92.4% of cervical and 89.5% of vaginal cultures positive in the same patient.

Gonorrheal Infection and Diagnostic Procedures: A Response to the Statement of the Committee on Youth

The report of the Academy's Committee on Youth on "Venereal Disease and the Adolescent," in your September issue1 is most timely. I would like to comment on the diagnosis of gonorrhea. While the cervix is considered the best site for culture of N. gonorrhoeae, our recent study2 of 1,899 girls yielded positive cultures in 213; 94.2% of these were from the vagina, while subsequent cervical cultures revealed only an additional 13 (5.8%) positive cases. Lucas et al3 found only a similar minor difference, with 92.4% of cervical and 89.5% of vaginal cultures positive in the same patient.

The Adoption of Black Children

The American Academy of Pediatrics is to be commended for issuing a statement on the need for adoptive homes for black children (Pediatrics, 48:325, 1971). Although tardy, the Academy's Committee on Adoptions and Dependent Care addressed itself to a pressing problem of child care and welfare. It is indeed unfortunate that the statement is incomplete and misleading. It suffers from a lack of information. In some instances, the lack of information is not the fault of the Committee but should certainly be a concern of the Committee.

Diagnostic and Screening Procedures for Lead Poisoning

As a Fellow of the American Academy of Pediatrics and a Pediatric Consultant to the Maternal and Child Health Service, U.S. Public Health Service, I have noted with interest in the Newsletter (December 15, 1970) that the Academy's Committee on Environmental Hazards has endorsed the U.S. Public Health Service's Statement, "Medical Aspects of Childhood Lead Poisoning," recently released by the Surgeon General. But I am rather surprised at the exceptions the Committee took to the Statement, and I would like to take exception to these exceptions.

Prevention of Lead Paint—or Prevention of Pica?

The otherwise excellent and timely statement on acute and chronic childhood lead poisoning of the Academy's Committee on Environmental Hazards and Subcommittee on Accidental Poisoning of the Committee on Accident Prevention1 has one serious omission. After calling attention to pica as a major factor in lead poisoning in young children, this fundamental cause for most cases of plumbism is disregarded. A basic part of the problem would appear to be how it attacks the reasons why the children eat the paint on the walls in the first place.

Adoptive Homes for "Hard to Place" Children

The Academy Committee statement discussing the need for finding adoptive homes for "hard to place" children1 challenges all child care professionals to support actively the increasing number of public and voluntary agencies seeking to increase their services in the area of transracial adoptions and the placement of children with physical handicaps. Adoptions of this nature require careful evaluation. This necessitates increased funding for staffs of agencies moving in this direction.

NURSES AND PEDIATRICIANS COLLABORATE

The Academy's Committee on Pediatric Manpower was established because of the concerns of Academy membership about the numbers of American children who were not receiving health care and the tremendous pressures for service being placed on practicing pediatricians. The Committee recognized that solutions to these problems would be complex and multifaceted. One of the solutions which it chose to pursue in some depth was that of the interprofessional care of the ambulatory pediatric patient. This concept involves what is often referred to as an "expanded" role of the nurse, working in close collaboration with the pediatrician. The concept is of equal importance to the nursing profession, a large segment of which has come to deplore the increasing separation of nurses, particularly the most highly trained nurses of the profession, from patient caretaking.