Pediatric Textbooks Research Articles

Representation of diverse skin tones in Nelson's Textbook of Pediatrics.

Physicians are trained to visually recognize disease using images. Many pediatric dermatologic conditions are initially identified and treated by pediatricians, who need to diagnose on varied skin tones. The objective was to evaluate if figures depicting cutaneous disease in the preeminent pediatrics textbook reflect diverse skin tones. Figures depicting dermatologic findings in Nelson's Textbook of Pediatrics were assessed using the Fitzpatrick, Massey-Martin, and Color Bar scales. The distribution was compared to the US population using American National Election Survey 2012 data. The three scales were compared for concordance. Statistical analysis included chi square with P < 0.05 significant. Of 515 figures, 484 were classifiable. Light skin tones were depicted in 453 (93.6%) by Fitzpatrick, 364 (75.2%) by Massey-Martin, and 406 (83.9%) by Color Bar, moderate tones in 92 (19.0%) by Massey-Martin and 53 (11.0%) by Color Bar, and dark tones in 31 (6.4%) by Fitzpatrick, 28 (5.8%) by Massey-Martin, and 25 (5.2%) by Color Bar. The textbook skin tone distribution did not reflect the US population: light 75.2% vs. 63.3%, moderate 19.0% vs. 25.8%, dark 5.8% vs. 11.0%, respectively (P < 0.00001). The three scales yielded consistent proportions for light/moderate vs. dark tones (P = 0.71). Certain conditions were mostly depicted on dark (burns, leprosy, urticaria pigmentosa) or light skin (psoriasis, acne, hemangioma, molluscum, herpes, keloid). Figures demonstrating dermatologic manifestations are predominantly depicted on light skin tones, and are not representative of the US population. Certain conditions were more commonly shown on dark or light skin tones, unrelated to epidemiology.

Are paediatric cardiology textbooks obsolete in the current digital era?

With the rise of online references, podcasts, webinars, self-test tools, and social media, it is worthwhile to understand whether textbooks continue to provide value in medical education, and to assess the capacity they serve during fellowship training. A prospective mixed-methods study based on surveys that were disseminated to seven paediatric cardiology fellowship programmes around the world. Participants were asked to read an assigned chapter of Anderson's Pediatric Cardiology 4th Edition textbook, followed by the completion of the survey. Open-ended questions included theming and grouping responses as appropriate. The survey was completed by 36 participants. When asked about the content, organisation, and utility of the chapter, responses were generally positive, at greater than 89%. The chapters, overall, were rated relatively easy to read, scoring at 6.91, with standard deviations plus or minus 1.72, on a scale from 1 to 10, with higher values meaning better results. When asked to rank their preferences in where they obtain educational content, textbooks were ranked the second highest, with in-person teaching ranking first. Several themes were identified including the limitations of the use of textbook use, their value, and ways to enhance learning from their reading. There was also a near-unanimous desire for more time to self-learn and read during fellowship. Textbooks are still highly valued by trainees. Many opportunities exist, nonetheless, to improve how they can be organised to deliver information optimally. Future efforts should look towards making them more accessible, and to include more resources for asynchronous learning.

MANAGEMENT OF AKAKKARAPPAN (A CHILDHOOD DISEASE WITH SKIN AND GIT INVOLVEMENT) IN INFANT- A CASE REPORT

Akakkarappan is a disease mentioned in the Malayalam text- Vaidyatarakam (Regional pediatric ayurveda textbook from Kerala in Malayalam language).The disease is specific for its gastrointestinal symptoms along with skin manifestations. The prevalence is higher in the pediatric age group. Here, an attempt is made to evaluate the clinical efficacy of Ayurvedic formulation in managing Akakkarappan. A 9-month-old male infant was presented with complaints of greenish frothy stool along with fever and skin lesions. The child was treated with the concepts of Agni (digestive fire), Dushi visha (accumulated toxin), Karappan (skin lesions in children) and Atisara (diarrhoea) as per the clinical experience and available reference of Akakkarappan. The child was relieved of all gastrointestinal symptoms and skin lesions with Ayurvedic treatment within seven days. Also, the digestive fire (Agni) was restored within two weeks. Ayurvedic formulations from the contexts of Dushi visha (accumulated toxin), Karappan (skin lesions in children) and Atisara (diarrhoea) were able to provide symptomatic relief and restore the normalcy of Agni in the infant with Akakkarappan.

Treatment Outcomes of Pulpotomy in Primary Teeth with Irreversible Pulpitis: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis aimed to evaluate the success rates of pulpotomy treatment for irreversible pulpitis in primary teeth. This study was registered and conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. Relevant studies published between January 1980 and April 2023 were identified across eight online databases and two paediatric dentistry textbooks. Study selection, data extraction, and quality assessment were conducted by multiple investigators independently. Data analysis involved single-arm and two-arm meta-analyses, leave-one-out sensitivity analysis, meta-regression, and assessment of publication bias. The risks of bias were evaluated using the Cochrane Collaboration's assessment tools. The levels of evidence were determined using the Oxford Centre for Evidence-Based Medicine (OCEBM) tool. Five primary studies were included. The weighted mean overall success rates at 6-month and 12-month follow-ups were 97.2% and 94.4%, respectively. Two-arm meta-analysis revealed no significant difference (p > 0.05) between the use of mineral trioxide aggregate (MTA) and non-MTA bioceramic-based materials as pulpotomy medicaments. The sample size of each study did not affect the degree of data heterogeneity. Egger's test revealed no significant publication bias. Pulpotomy may be regarded as an alternative modality for treating primary teeth with irreversible pulpitis. Nevertheless, future well-designed trials and extended follow-up periods are warranted.

Progression of an Artificial Intelligence Chatbot (ChatGPT) for Pediatric Cardiology Educational Knowledge Assessment.

Artificial intelligence chatbots, like ChatGPT, have become powerful tools that are disrupting how humans interact with technology. The potential uses within medicine are vast. In medical education, these chatbots have shown improvements, in a short time span, in generalized medical examinations. We evaluated the overall performance and improvement between ChatGPT 3.5 and 4.0 in a test of pediatric cardiology knowledge. ChatGPT 3.5 and ChatGPT 4.0 were used to answer text-based multiple-choice questions derived from a Pediatric Cardiology Board Review textbook. Each chatbot was given an 88 question test, subcategorized into 11 topics. We excluded questions with modalities other than text (sound clips or images). Statistical analysis was done using an unpaired two-tailed t-test. Of the same 88 questions, ChatGPT 4.0 answered 66% of the questions correctly (n = 58/88) which was significantly greater (p < 0.0001) than ChatGPT 3.5, which only answered 38% (33/88). The ChatGPT 4.0 version also did better on each subspeciality topic as compared to ChatGPT 3.5. While acknowledging that ChatGPT does not yet offer subspecialty level knowledge in pediatric cardiology, the performance in pediatric cardiology educational assessments showed a considerable improvement in a short period of time between ChatGPT 3.5 and 4.0.

To the 85th anniversary of Vladimir P. Podzolkov

Vladimir P. Podzolkov celebrated his anniversary on November 15. He is an outstanding Russian scientist, cardiac surgeon, one of the founders of pediatric cardiac surgery. His name is associated with the formation and development of surgical treatment of complex congenital heart defects, including abnormalities of the intrathoracic location, which were previously considered inoperable. His fundamental works have formed modern pediatric cardiac surgery, his monographs and textbooks are reference books for the younger generation of cardiac surgeons and recognized professionals.

Diagnostic performance of the classic symptom “abdominal pain before vomiting” for pediatric acute appendicitis

Acute appendicitis is the most common type of acute abdomen that requires surgical intervention in children. According to general pediatric textbooks, the presence of vomiting before abdominal pain is considered a classic patient history item for excluding acute appendicitis. However, its diagnostic performance in the pediatric population has yet to be investigated. This was a single-center retrospective observational study involving 134 children who were admitted to the hospital with both abdominal pain and vomiting. The reference standard for appendicitis was defined by computed tomography scanning. The diagnostic performance of "abdominal pain before vomiting" was calculated and compared to those of the Alvarado score and pediatric appendicitis score. The diagnostic performance of "abdominal pain before vomiting" was as follows: sensitivity of 75.3% (95% confidence interval [CI], 64.7-83.6), specificity of 25.0% (95% CI, 15.5-36.7), positive likelihood ratio of 1.00 (95% CI, 0.82-1.22), negative likelihood ratio of 0.99 (95% CI, 0.54-1.79), and diagnostic odds ratio of 1.02 (95% CI, 0.46-2.25). In contrast, the Alvarado score and pediatric appendicitis score (with a threshold of 4 points) demonstrated favorable sensitivity (98.3% [95% CI, 92.4-99.6]), negative predictive value (94.6% [95% CI, 78.4-98.8]), negative likelihood ratio (0.04 [95% CI, 0.01-0.23]), and diagnostic odds ratio (49.9 [95% CI, 6.88-243.2]). In this study, "abdominal pain before vomiting" was associated with poor diagnostic performance for ruling out acute pediatric appendicitis. Thus, the diagnosis of acute appendicitis in the pediatric population should be made based on existing validated scoring systems such as the Alvarado score and pediatric appendicitis score.

Examination of the Newborn Baby According to Ayurveda and Modern Science

Neonatal examination is important to become aware of any anomaly and delivery harm which may have were given missed out at in advance examination and to educate the mom about care of recent born at home. Care of new born right from simply after delivery till the primary feeding has been described by way of three predominant treatise of Ayurveda, the Brihattrayi it consists of Charaka Samhita, Sushruta Samhita and Astanga Hridaya. The steps covered in neonatal care or Naviata Shishu Paricharya are Prana pratyagamana (neonatal resuscitation), Ulva Parimarjana (cleaning of the vernix caseosa), Naalchedan (reducing of umbilical cord), Snana (neonatal tub), Mukh vishodhan (cleansing of oral cavity), Garbhodak vamana (clearing of neonate’s belly), Jata karma (beginning ceremony), and Raksha karma (safety of infant). This article provides a crucial look at of the methods blanketed in Navjata Shishu Paricharya revealing their medical relevance and application in ok care of recent born according to Ayurveda in addition to cutting-edge science. The materials had been gathered from the classical Ayurvedic literatures, pediatric textbooks, magazines, and studies journals.

Primary neurological manifestations of HIV in children.

Human immunodeficiency virus type 1 (HIV-1) causes various diseases in different age groups. Neurological manifestations of HIV are common and add to morbidity and mortality. It was previously thought that the central nervous system (CNS) was involved only in the advanced stages of the disease. However, recent evidence supports pathological involvement of the CNS from initial viral entry. Some of the CNS manifestations in children share similarities to neurologic disorders of HIV-infected adult patients, while others are unique to the pediatric population. Many HIV-related neurologic complications seen in adults are rarely encountered in children with AIDS and vice versa. However, with recent advances in the treatment, more HIV-infected children are surviving into adulthood. A systematic review of the available literature was performed to study the manifestations, causes, outcomes, and treatment of primary neurologic disorders in children with HIV. Online databases (Ovid Medline, Embase and PubMed), websites from the World Health Organization, commercial search engines, including Google, and chapters on HIV in standard textbooks of pediatrics and medicine were reviewed. HIV-associated neurological syndromes can be classified into four types: primary HIV neurological diseases, treatment-related neurological diseases, adverse neurological effects of antiretroviral therapy and secondary/opportunistic neurological illness. These conditions are not mutually exclusive and may co-exist in a given patient. This narrative review will focus mainly on the primary neurological manifestations of HIV in children.

Use of Self-Study Resources Among Medical Students-Towards Avoiding Death by PowerPoint.

Reliance on PowerPoint (PPT) slides for self-studying may encourage lower-order cognition due to learning by rote dominating the educational process. On anecdotal evidence, PPT slides have become ubiquitous among Saudi medical students as the chief format of self-study material. We present the scale of the problem in Saudi medical colleges and then discuss the relevant potential implications and remedies. Using a piloted, face-validated, web-based, and self-administered questionnaire, we asked 379 medical students from 22 Saudi medical colleges to answer a few questions related to the use of PPT slides (and other resources) to self-study in preparation for the pediatric course final exam. By far, PPT slides represented the dominant format of self-study resources for most students (n = 359; 94.7%). One-third of students (n = 115; 30.3%) reported they had never or only rarely to occasionally used their basic pediatric textbooks for self-study. Most students (n = 260; 68.6%) reported that > 80% of the final written exam questions stemmed from the PPT slides provided by lecturers. As this study's result underscores the notion that PPT slides have become the customary primary self-study material used by Saudi medical students, we tried to discuss the associated threats to learning and teaching and suggest practical solutions.

HF02-05 THE FIRST TEXTBOOKS ON PEDIATRIC UROLOGY

You have accessJournal of UrologyCME1 Apr 2023HF02-05 THE FIRST TEXTBOOKS ON PEDIATRIC UROLOGY Sutchin R. Patel, Ronald Rabinowitz, Richard Hurwitz, and Anthony A. Caldamone Sutchin R. PatelSutchin R. Patel More articles by this author , Ronald RabinowitzRonald Rabinowitz More articles by this author , Richard HurwitzRichard Hurwitz More articles by this author , and Anthony A. CaldamoneAnthony A. Caldamone More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003242.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Early publications in pediatric urology set the stage for the development of the first certified subspecialty in urology. Our objective was to review the history behind these publications as well as their content. METHODS: We review and compare Disease of the Urinary Tract in Children (1930) by Edwin Beer and Abraham Hyman to Pediatric Urology (1937) by Meredith Campbell. We also reviewed the authors of the text and the corpus of knowledge in the field of pediatric urology at that time. RESULTS: Beer and Hyman’s text reviews the pediatric urology experience at Mount Sinai Hospital. In the preface they write "the whole subject dealt with in these pages is… still in the stage of development." Beer, a pioneer in endoscopic technology, describes his invention of the first pediatric cystoscope in the text. The authors describe the style of their text as "each chapter is more or less a separate essay in which the material is not arranged as in the ordinary textbook." The text is comprised of 14 chapters, with "illustrative cases" at the end of nine of the chapters to help the reader recognize how the pediatric patient should be approached differently from the adult patient. Campbell’s text is 2 volumes and is composed of 12 chapters. The end of each chapter has an extensive bibliography citing other studies in the literature that were used in the chapter. In the preface, Dr. Campbell writes, “Pediatric urology is still in its diaper age and as yet comparatively few physicians are experienced in it.” He writes “much of its rapidly increasing literature is in the nature of case reports rather than conclusions drawn from the studies of case series.” Dr. Campbell aims to correct this in his text as he presents data of relatively large case series from his practice. He also includes an extensive necroscopy experience, writing “pathology is the true basis of medicine and for this volume the uropathology as recorded in 26,480 autopsies.” His text chapters are supplemented with organized outlines to help classify disease processes, illustrations used to help teach the etiology of various conditions and anatomic drawings. The strength of Campbell’s text is its systematic approach to and organization of various pediatric disease processes. His last chapter on “Urosurgery” is a mini-surgical atlas. CONCLUSIONS: Beer and Hyman’s text was a collection of essays that illustrated the dearth of knowledge in the field of pediatric urology at the time. Campbell’s text was the first comprehensive pediatric urology textbook as it systematically organized the corpus of knowledge of the time and presented operative and clinical case series with the aim to teach pediatric urology. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e251 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sutchin R. Patel More articles by this author Ronald Rabinowitz More articles by this author Richard Hurwitz More articles by this author Anthony A. Caldamone More articles by this author Expand All Advertisement PDF downloadLoading ...

Race in the Reading: A Study of Problematic Uses of Race and Ethnicity in a Prominent Pediatrics Textbook.

Aspects of medical education and clinical practice continue to reflect the antiquated notion that race is a biologically valid distinction among individuals rather than a social construct. The authors analyzed the use of race and ethnicity in a popular pediatrics textbook to determine if these concepts were being used consistently and correctly. In May 2021, using the search function on the American Academy of Pediatrics (AAP) eBooks platform, the authors searched for 29 race- or ethnicity-related terms (e.g., African, Asian, Black, race) in the AAP Textbook of Pediatric Care, 2nd Edition , which was published in 2016. One researcher extracted direct quotes containing at least one of these search terms. Three researchers independently coded each quote as problematic or nonproblematic with respect to the use of the search terms, excluding examples in which the terms were used in irrelevant contexts (e.g., black box warning). The researchers then identified themes based on the quotes that used race and ethnicity problematically. The search produced 2,167 total results across the search terms, 806 of which were relevant to race or ethnicity and were analyzed. Problematic quotes: (1) used race or ethnicity as a surrogate for social variables, (2) conflated terminology (e.g., conflated socially defined race with genetic ancestry), (3) overgeneralized or made claims based on limited data, (4) lacked clinical relevance, (5) lacked inclusivity, (6) promoted racial stereotypes, or (7) made contradicting claims about race. The use of race and ethnicity in the AAP Textbook of Pediatric Care, 2nd Edition was not always appropriate, as demonstrated by examples that reified race as a biological fact and thereby promoted structural racism. Critical evaluation of the use of race and ethnicity in all current medical textbooks and future revisions is warranted.

Evaluation of nine formulas for estimating the body surface area of children with hematological malignancies.

ObjectivesBody surface area (BSA) is an important parameter in clinical practice for children. To find out the most accurate BSA formula for Chinese children, nine formulas were compared.MethodsThis single-center study comprised children who were diagnosed with acute lymphoblastic leukemia and treated with anticancer agents in a specialized children's hospital in China from January 2017 to December 2020. The BSA values were calculated using the formulas from Boyd, Banerjee and Bhattacharya, Costeff, Fujimoto and Watanabe, Haycock, Gehan and George, Mosteller, Stevenson and a Pediatrics textbook. The arithmetic mean of formulas was calculated as the “gold standard” for comparison.ResultsA total of 666 children (389 males and 277 females) were included. All nine formulas showed a strong positive correlation with the “gold standard.” Underestimation was observed with the Banerjee and Bhattacharya, Fujimoto and Watanabe formulas. The Gehan and George formula showed overestimation. Values estimated from the Haycock and Mosteller formulas were the closest to the mean BSA.ConclusionThe Haycock and Mosteller formulas are the most recommended formulas for Chinese children with hematological malignancies.

Based on the Auxiliary Effect of X-Ray in the Treatment of Severe Pneumonia in Children with Arterial and Venous Blood Gas.

Pediatric severe pneumonia clinical is a conceptual term for the diagnosis and treatment of pediatric clinical diseases. At present, domestic and foreign standards for clinical diagnosis of severe pneumonia, which is a childhood disease, are still inconsistent. At present, the first book of the main pediatric medical textbook in the society interprets the clinical definition of severe pneumonia in children as follows: severe pneumonia refers to pulmonary function in heart failure or other comorbidities in other important organs except the lung. This article is based on X-ray medical film and television examinations, through the analysis of arterial and venous blood gas in children with severe pneumonia to play a certain role in adjuvant therapy for children with pneumonia. Prospective clinical studies have found significant changes in the function of auxiliary coagulation and blood fibrinolysis indicators in patients with severe pneumonia in late childhood. The obvious difference between the pretreatment and the late-stage treatment for 1 week and the direct influence on the blood gas quantitative analysis and liver function of advanced patients provide a scientific basis for the diagnosis of typical advanced childhood severe pneumonia patients with adjuvant anticoagulant therapy. The data analysis of the clinical laboratory found that the blood coagulation and fibrinolysis functions of the typical patients with severe pneumonia in the typical late stage of childhood were significantly activated, and the anticoagulant antibody substances were significantly reduced, fibrinolytic coagulation inhibitors and anticoagulants are significantly increased, fibrinolytic activators are significantly reduced, and the body is in a procoagulant state for a long time. Adjuvant anticoagulation therapy through quantitative analysis of blood gas in patients can not only effectively increase the success rate of early treatment of typical late-stage severe pneumonia in children by 64.28% but also significantly reduce the inflammatory coagulation indexes of patients with late-stage severe pneumonia in children. The functions of coagulation, anticoagulation, and coagulation fibrinolysis have been significantly restored. The advantages of X-ray-based adjuvant treatment of severe pneumonia in children with arteriovenous blood gas are good contrast, clear imaging, and clear development of fine lesions or thick parts, and objective records are kept for comparison during review and consultation and discussion. The disadvantage is that the operation is more complicated, and it is not convenient to observe the activity function of the organ.

Skin of color images in pediatric dermatology textbooks.

Due to globalization, dermatologists routinely see patients of different ethnicities and skin tones. Surveys from the US have shown that dermatologists felt that their training was lacking in diagnosing dermatoses in skin-of-color patients. Underrepresentation of skin of color in dermatology textbooks has been reported. We evaluated clinical images in selected pediatric dermatology textbooks with regard to skin color.

Editorial introductions.

Editorial introductions.

Faulty Traditional Practices in Infant Care

Proper advice regarding home-based care of normal infants is no less important than managing critical diseases. Otherwise parents tend to follow traditional practices running in the family which are often deleterious. Clinicians must also be aware of the faulty traditional practices so that they can actively enquire them in the child’s history. The author enlisted various such faulty traditional practices as experienced by him during his OPD practice in various public and corporate hospitals over a period of five years. Topics relating mainly to the infant age group have been chosen for this article. Relevant search was done on these topics in standard paediatric textbooks, journals, and websites (like WHO, NICE, AAP) to find the validity of these practices as well as the standard recommendations on these topics. It was found that the standard recommendations often differ from the traditional practices. Detailed text was included from various authentic sources regarding few dubious topics related to home-based infant care. Clinicians should be aware of the correct recommended methods regarding the day to day homebased infant care. They should counsel the parents accordingly so as to avoid any harm caused by faulty traditional practices and social beliefs.

Clinical Pediatric Anesthesia: A Case-Based Handbook

Clinical Pediatric Anesthesia: A Case-Based Handbook

Clinical, Paraclinical Characteristics and Pathogens of Pneumonia in Children at the Pediatric Deparment, Bach Mai Hospital

This study describes the clinical, paraclinical characteristics and pathogens of pneumonia in 195 children with pneumonia at the Pediatric Department, Bach Mai Hospital from January to June 2019. According to the study results, most of the cases were aged under five (93.3%) with pneumonia clinical features of tachypnea, 99%; cough, 97.4%; crackling sound, 81.6%; respiratory failure, 80.5%; leukocytosis, 55.9%; and high CRP level in serum, 54.9%. There were 90 cases positive with incubated bacteria with the prevalence of three nasopharyngeal carriages: S.pneumoniae was 48.7%; H.influenzae, 27.8%; and M.catarrhalis, 18.3%. All the bacteria were susceptible to almost all the antibiotics used in treatment, such as Amoxicillin/acid clavunamic, cefotaxim and ceftriason. The study concludes that clinical and paraclinical characteristics in children with pneumonia were fairly various and bacterial pathogens of pediatric pneumonia were similar and susceptible to basic antibiotics.&#x0D; Keywords&#x0D; Pneumonia, Steptococcus pneumoniae, Haemophilus influenzae, antibiotic-resistant.&#x0D; References&#x0D; [1] T.K.P. Nguyen, T.H.Tran, C.L. Roberts et al, Child pneumonia – focus on the Western Pacific Region, Paediatr Respir Rev 21 (2017) 102-110.[2] P.M.M. Yan Jin, Jose Irineu, Rigotti et al, Cause-specific child mortality performance and contributions to all-cause child mortality, and number of child lives saved during the Millennium Development Goals era: a country-level analysis, Glob Health Action 11(1) (2018) 1-20.[3] L. Liu, S. Oza, D. Hogan et al, Global, regional, and national causes of under-5 mortality in 2000–15: an updated systematic analysis with implications for the Sustainable Development Goals, Lancet Child Adolesc Health 16 (2016) 31593-31598.[4] WHO, World Health Statistics, 2015.[5] Bonita F. Stanton and Richard E. Behrman (2016), Overview of Pediatrics, Robert M. Kliegman Nelson Text Book of Pediatrics, 20th Edition, (Elsevier), Philadelphia, 20-39.[6] L.N. Tra, Biologycal constant of Vietnamese in 90th decade, 20th century. Medical Publishing house, Hanoi ( 2004).[7] WHO, Anemia. Global Database on Anaemia, (2015) 4-9.[8] Thomas Bénet, Sánchez Picot, Mélina Messaoudi et al, Microorganisms Associated With Pneumonia in Children &lt;5 Years of Age in Developing and Emerging Countries: The GABRIEL Pneumonia Multicenter, Prospective, Case-Control Study, Clin Infect Dis 65(4) (2018) 604–612.[9] S.E. Katz and D.J. Williams, Pediatric Community-Acquired Pneumonia in the United States Changing Epidemiology, Diagnostic and Therapeutic Challenges, and Areas for Future, Infect Dis Clin North Am 32(1) (2018) 47–63.[10] Yi-Yi Yu, Luo Ren, Yu Deng et al, Epidemiological characteristics of nasopharyngeal Streptococcus pneumoniae strains among children with pneumonia in Chongqing, China, Sci Rep (9) (2019) 1-8.[11] Mohamed M Rashad, Sahar M Fayed and Aly Mona K El-Hag, Iron-deficiency anemia as a risk factor for pneumonia in children, Benha Medical Journal 32(2) (2015) 96-100.[12] Sopio Chochua, Valérie D'Acremont, Christiane Hanke et al, Increased Nasopharyngeal Density and Concurrent Carriage of Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis Are Associated with Pneumonia in Febrile Children, PLoS One 11(12) (2016) 1-12.[13] Le Thi Hong Hanh, Đao Minh Tuan, Nguyen Duy Bo et al, Pneumonia at the Respiratory Department and Allergy Immunology Department of National Children Hospital in 2015, Vietnam Medical Journal 447 (2016) 70-75.[14] Ministry of Health, Guinline diagnosis and treatment pneumonia in children, 2015.[15] A. Zafar, R. Hasan, S. Nizamuddin,, Antibiotic susceptibility in Streptococcus pneumoniae, Haemophilus influenzae and Streptococcus pyogenes in Pakistan: a review of results from the Survey of Antibiotic Resistance (SOAR) 2002–15, J Antimicrob Chemother 71(1) (2016) 103-109.

30 Years of Reach Out and Read: Need for a Developmental Perspective.

* Abbreviation: ROR — : Reach Out and Read In 1989, while one of us (B.Z.) was director of the Division of Developmental and Behavioral Pediatrics at Boston City Hospital (now Boston Medical Center) and the other (R.N.) was a fellow, we began thinking about the role of books in the school readiness of vulnerable young children. Four years earlier, the National Institute of Education had dubbed reading aloud “the single most important activity for building the knowledge required for eventual success in reading.”1 But no pediatric textbook mentioned reading aloud, nor did the early editions of Bright Futures . Reach Out and Read (ROR) began with the idea that doctors have a special opportunity to encourage reading aloud in families that are facing the dual challenges of poverty and limited literacy.2 We recognized the indivisibility of health and education. A recent National Academy of Medicine report highlights the point, showing that the duration of education is a better predictor of health and long life than either cigarette smoking or obesity.3 Shifting forward 30 years, ROR, supported by more than 6000 clinics and practices and backed up by numerous peer-reviewed studies,4–19 now reaches ∼25% of low-income children. A policy statement by the American Academy of Pediatrics has identified literacy promotion as an essential component of primary care.20 And yet, the … Address correspondence to Barry Zuckerman, MD, Department of Pediatrics, Boston Medical Center, School of Medicine, Boston University, 72 E Concord St, Room 324L, Boston, MA 02118. E-mail: barry.zuckerman{at}bmc.org