Paediatric cardiologist adherence to American Heart Association neurodevelopmental recommendations for CHD patients.

A 2012 American Heart Association statement concluded that children with CHD are at an increased risk for neurodevelopmental delays. Routine surveillance and evaluation throughout childhood are recommended. To assess paediatric cardiologist compliance with American Heart Association guidelines and developmental referral practices, a survey was distributed to paediatric cardiologists nationwide (n = 129). The majority of participants (69%) stated they were somewhat familiar or not familiar with the American Heart Association statement and were concerned about patients not being properly referred to specialists for developmental evaluation. Forty paediatric cardiologists (31%) indicated that their institution did not have a neurodevelopmental cardiology programme. Of these, 25% indicated they generally did not refer CHD patients for neurodevelopmental evaluation, 45% performed surveillance and referred if warranted, and 30% generally referred all patients for surveillance. Lastly, 43% of paediatric cardiologists did not feel responsible for developmental surveillance, and 11% did not feel responsible for referrals. To ensure all children with CHD are appropriately screened and referred, paediatricians and cardiologists must work together to address differing impressions of accountability for surveillance and screening of children with CHD.

School Readiness of Young Children Enrolled in Preschool in the United States.

OBJECTIVE: As preschool enrollment increases, it is important to know whether children enrolled in preschool are more likely to be "healthy and ready to learn (HRTL)." Our objective was to assess whether there are detectable school readiness differences between children enrolled in preschool and those who are not in a large, cross-sectional, nationally representative US sample. METHODS: Caregivers of 4931 3- to 4-year-old children in the 2016 National Survey of Children's Health indicated whether their child had started school and completed questions forming the "HRTL" School Readiness National Outcome Measure and its domains: early learning skills, self-regulation, social-emotional development, and physical health/motor development. Propensity score-matched logistic regression models estimated prevalence ratios (PRs) comparing children in versus not in preschool. RESULTS: 49.1% of children had started preschool. After matching, children in preschool did not differ from children not in preschool on the composite (PR = 1.21; 95% confidence interval [CI]: 0.92-1.58) or any domains. Children in preschool were more likely to be "on track" with rhyming words (PR = 1.48; 95% CI: 1.11-1.96), writing their name (PR = 2.36; 95% CI: 1.82-3.08), and holding a pencil (PR = 1.55; 95% CI: 1.12-2.14) but less likely with explaining things they have seen/done (PR = 0.59; 95% CI: 0.44-0.79) and overall health (PR = 0.57; 95% CI: 0.33-0.97). Some associations were sex specific. CONCLUSION: The largely null findings of this study underscore the need for further research that incorporates information regarding the extent and quality of preschool exposure when evaluating the developmental benefits of preschool on a national level.

Alternative diets among adolescents: facts or fads?

PURPOSE OF REVIEW: With rising rates of chronic noninfectious diseases across the United States thought to be associated with the average American diet, many have adopted alternative diets. Most of these diets promise weight reduction via adherence to strict dietary guidelines, often removing certain types of food. With access to a plethora of information online, it is easy for adolescents to become confused when making dietary decisions. Although these diets promise benefits, it is important to understand common shortcomings and how to overcome them for safe implementation among adolescents. RECENT FINDINGS: This review discusses the theory, implementation, and risks associated with intermittent fasting as well as vegetarian, vegan, ketogenic, Atkins, Paleolithic, and Mediterranean diets. These considerations are further modified for pediatric populations with a focus on the social influences on dieting. SUMMARY: Although these diets may be promising, successful adherence to them requires addressing possible shortcomings associated with a certain diet. Pediatricians should be aware of how these dietary strategies may be properly implemented in order to prevent any harm to the patient. Empowering the patient and their families through informational resources is recommended. Pediatricians should also discuss motivations underlying their patient's dietary changes in order to determine whether these motivations are healthy.

TikTok, Tide Pods and Tiger King: health implications of trends taking over pediatric populations.

PURPOSE OF REVIEW: With children and adolescents constantly connected to their devices in an ever-changing technological landscape, new and emerging trends in entertainment media have created potential health implications for pediatric patients. The purpose of this review is to provide pediatricians with explanations of specific trends on streaming services, the popular new mobile application TikTok, recent widespread 'Internet Challenges' that include pediatric participants, and new technologies. These emerging trends can pose potential harms to the health and wellbeing of children and adolescents. RECENT FINDINGS: Recent reports and news articles have discussed popular technological trends and the adverse effects that can occur. Although technology provides access to information and social connection for youth, it also creates platforms where children can be exposed to disturbing content, peer pressure, cyberbullying, and encouragement to participate in activities that could cause potential physical harm or even death. SUMMARY: Pediatricians need to be aware of trends to best understand the implications of these technologies, especially in clinical practice. Pediatricians play an important role in educating parents and patients about the risks of these trends, in facilitating conversations about related topics including self-esteem, cyberbullying and peer pressure to promote healthy internet use, and providing necessary resources.