American Academy of Pediatrics, Oct. 21-25

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The American Academy of Pediatrics National Conference and Exhibition

The annual meeting of the American Academy of Pediatrics was held from Oct. 21 to 25 in San Francisco and attracted approximately 12,000 participants from around the world, including primary care pediatricians, pediatric medical subspecialists, pediatric surgical specialists, and other health care professionals. The conference featured scientific sessions that focused on the latest advances in the care of infants, children, adolescents and young adults, as well as scientific papers, posters, and education exhibits.

In one study, Naveen Poonai, M.D., of Western University in London, Canada, and colleagues found that increased suicidal behavior in children should not be attributed to social networking, and future research should focus on elucidating other reasons for this worrisome trend.

"There has been a general increasing trend in the average monthly emergency department visit rate for suicidal ideation, self-harm, and self-poisoning in Ontario among adolescents since 2010. However, no significant association exists between this rate and a highly profiled suicide on social media," Poonai said. "Clinicians should advocate for initiatives exploring the use of social media and networking activity to support adolescents at risk of suicide."

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In another study, Debby Oh, Ph.D., of the Center for Youth Wellness in San Francisco, and colleagues found that children affected by early adversity manifest alterations in development, physical health, and biology in distinct ways. The investigators identified a total of 15,940 non-duplicate records in their research spanning 15 years (2001 to 2015). Of these, 25 met the inclusion criteria and 14 additional studies were identified from hand searching.

"Early adversity is associated with significant differences in physical and cognitive development. However, studies on adopted children have shown that with appropriate intervention children are able to recover from some of these delays," Oh said. "Household dysfunction affects children's risk of obesity early in childhood, and abuse and neglect affect children's risk of obesity in adolescence. Children exposed to early adversity have increased risk for asthma, infection, somatic complaints, and sleep disruption."

In addition, the investigators also found that maternal mental health issues are associated with elevated cortisol levels, and maltreatment is associated with a blunted cortisol profile.

"Given the wide range of potential consequences to a child's health, clinical practitioners should consider universal screening for adverse childhood experiences within a trauma-informed framework," Oh said. "Early identification is important for children who might benefit from behavioral interventions to help address immediate and future medical needs."

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Yunru Huang, Ph.D. candidate, of the University of California at Davis, and colleagues identified a systematic bias toward admitting children with private medical insurance and transferring those without insurance or with Medicaid. Among non-injured children, 240,620 pediatric emergency department visits at 950 hospitals located in 30 U.S. states, the investigators found that patients who were uninsured or reported as self-pay were almost four times more likely to be transferred relative to admission compared to those with private insurance.

"These findings reinforce ongoing concerns about disparities in the provision of pediatric emergency department and inpatient care, and also call into question the three-decade-old Emergency Medical Treatment and Active Labor Act requiring hospitals to make transfer or admission decisions independent of patient insurance status," Huang said. "The impact of the Affordable Care Act, which has significantly reduced the number of uninsured children, is not yet known. Efforts should be made to reduce the number of medically uninsured as well as to address disparities in insurance payments for care. Emergency departments and hospitals should be monitored for appropriate and inappropriate admissions and transfers based upon patient insurance status."

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AAP: Infants Should Sleep Near Parents, but on Separate Surface

MONDAY, Oct. 24, 2016 (HealthDay News) -- Infants should sleep in the same room as their parents -- but not in the same bed -- to reduce the risk of sudden infant death syndrome (SIDS), according to new guidelines from the American Academy of Pediatrics published online Oct. 24 in Pediatrics. The results were also to be presented at the academy's annual meeting, held from Oct. 22 to 26 in San Francisco.

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AAP: Visits to Pediatric ERs for Headache Pain in Children Rising

MONDAY, Oct. 24, 2016 (HealthDay News) -- A growing number of American children with headaches are being seen at pediatric emergency departments and admitted to the hospital, according to a study presented at the annual meeting of the American Academy of Pediatrics, held from Oct. 22 to 25 in San Francisco.

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