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Discover the most talked about and latest scientific content & concepts.

Journal: Pediatrics

244

Given the pervasive use of screen-based media and the high prevalence of insufficient sleep among American youth and teenagers, this brief report summarizes the literature on electronic media and sleep and provides research recommendations. Recent systematic reviews of the literature reveal that the vast majority of studies find an adverse association between screen-based media consumption and sleep health, primarily via delayed bedtimes and reduced total sleep duration. The underlying mechanisms of these associations likely include the following: (1) time displacement (ie, time spent on screens replaces time spent sleeping and other activities); (2) psychological stimulation based on media content; and (3) the effects of light emitted from devices on circadian timing, sleep physiology, and alertness. Much of our current understanding of these processes, however, is limited by cross-sectional, observational, and self-reported data. Further experimental and observational research is needed to elucidate how the digital revolution is altering sleep and circadian rhythms across development (infancy to adulthood) as pathways to poor health, learning, and safety outcomes (eg, obesity, depression, risk-taking).

Concepts: Diurnality, Adolescence, Digital media, Electronic media, Chronotype, Sleep disorder, Circadian rhythm, Sleep

104

Examine fatal and nonfatal firearm injuries among children aged 0 to 17 in the United States, including intent, demographic characteristics, trends, state-level patterns, and circumstances.

Concepts: Demographics, U.S. state, Poverty in the United States, United States

100

Children need to develop a variety of skill sets to optimize their development and manage toxic stress. Research demonstrates that developmentally appropriate play with parents and peers is a singular opportunity to promote the social-emotional, cognitive, language, and self-regulation skills that build executive function and a prosocial brain. Furthermore, play supports the formation of the safe, stable, and nurturing relationships with all caregivers that children need to thrive.Play is not frivolous: it enhances brain structure and function and promotes executive function (ie, the process of learning, rather than the content), which allow us to pursue goals and ignore distractions.When play and safe, stable, nurturing relationships are missing in a child’s life, toxic stress can disrupt the development of executive function and the learning of prosocial behavior; in the presence of childhood adversity, play becomes even more important. The mutual joy and shared communication and attunement (harmonious serve and return interactions) that parents and children can experience during play regulate the body’s stress response. This clinical report provides pediatric providers with the information they need to promote the benefits of play and and to write a prescription for play at well visits to complement reach out and read. At a time when early childhood programs are pressured to add more didactic components and less playful learning, pediatricians can play an important role in emphasizing the role of a balanced curriculum that includes the importance of playful learning for the promotion of healthy child development.

93

To test the effectiveness of messages designed to reduce vaccine misperceptions and increase vaccination rates for measles-mumps-rubella (MMR).

Concepts: Effectiveness, Efficacy

92

Historically, fruit juice was recommended by pediatricians as a source of vitamin C and as an extra source of water for healthy infants and young children as their diets expanded to include solid foods with higher renal solute load. It was also sometimes recommended for children with constipation. Fruit juice is marketed as a healthy, natural source of vitamins and, in some instances, calcium. Because juice tastes good, children readily accept it. Although juice consumption has some benefits, it also has potential detrimental effects. High sugar content in juice contributes to increased calorie consumption and the risk of dental caries. In addition, the lack of protein and fiber in juice can predispose to inappropriate weight gain (too much or too little). Pediatricians need to be knowledgeable about juice to inform parents and patients on its appropriate uses.

Concepts: Sugar, Vitamin D, Dietary fiber, Vitamin, Vitamin C, Dental caries, Glucose, Nutrition

87

This study examined national trends in 12-month prevalence of major depressive episodes (MDEs) in adolescents and young adults overall and in different sociodemographic groups, as well as trends in depression treatment between 2005 and 2014.

Concepts: Great Depression, Winston Churchill, Treatment for depression, Major depressive episode, Major depressive disorder

84

Sports specialization is becoming the norm in youth sports for a variety of reasons. When sports specialization occurs too early, detrimental effects may occur, both physically and psychologically. If the timing is correct and sports specialization is performed under the correct conditions, the athlete may be successful in reaching specific goals. Young athletes who train intensively, whether specialized or not, can also be at risk of adverse effects on the mind and body. The purpose of this clinical report is to assist pediatricians in counseling their young athlete patients and their parents regarding sports specialization and intensive training. This report supports the American Academy of Pediatrics clinical report “Overuse Injuries, Overtraining, and Burnout in Child and Adolescent Athletes.”

Concepts: Cognitive science, Counseling psychology, Supercompensation, Physician, Medicine, Mind, Philosophy of mind, Psychology

79

There has been little research examining whether e-cigarette use increases the risk of cigarette initiation among adolescents in the transition to adulthood when the sale of cigarettes becomes legal.

Concepts: Cigarette

78

The American Academy of Pediatrics recognizes insufficient sleep in adolescents as an important public health issue that significantly affects the health and safety, as well as the academic success, of our nation’s middle and high school students. Although a number of factors, including biological changes in sleep associated with puberty, lifestyle choices, and academic demands, negatively affect middle and high school students' ability to obtain sufficient sleep, the evidence strongly implicates earlier school start times (ie, before 8:30 am) as a key modifiable contributor to insufficient sleep, as well as circadian rhythm disruption, in this population. Furthermore, a substantial body of research has now demonstrated that delaying school start times is an effective countermeasure to chronic sleep loss and has a wide range of potential benefits to students with regard to physical and mental health, safety, and academic achievement. The American Academy of Pediatrics strongly supports the efforts of school districts to optimize sleep in students and urges high schools and middle schools to aim for start times that allow students the opportunity to achieve optimal levels of sleep (8.5-9.5 hours) and to improve physical (eg, reduced obesity risk) and mental (eg, lower rates of depression) health, safety (eg, drowsy driving crashes), academic performance, and quality of life.

Concepts: Vocational school, Grammar school, Three-tier education, Middle school, Secondary school, Sleep, College, High school

74

Transgender children who have socially transitioned, that is, who identify as the gender “opposite” their natal sex and are supported to live openly as that gender, are increasingly visible in society, yet we know nothing about their mental health. Previous work with children with gender identity disorder (GID; now termed gender dysphoria) has found remarkably high rates of anxiety and depression in these children. Here we examine, for the first time, mental health in a sample of socially transitioned transgender children.

Concepts: Gender role, Third gender, Sexual orientation, Transgender, Homosexuality, Gender, Gender identity disorder, Gender identity