Faculty Bibliography

Rescuing Our Sons From the Myths of Boyhood (Owl Books, 1999), argues that the way we talk to boys and young men about sex often stereotypes them and hurts their feelings. Over time, Dr. Sanders incorporated this conversation into his regular exam room routine, starting with boys around age 12: We'll talk about respect, about whether they feel they are respected in their own families, the respect they have for their mothers, the respect they see other men paying to their own mothers or sisters -- do you think that applies to other girls that you meet?

'The literature really strongly suggests the average early to mid-adolescent needs 9 to 9.25 hours a night,' said Dr. Judith Owens, an associate professor of pediatrics at the Alpert Medical School of Brown University, who directs the Pediatric Sleep Disorders Clinic at Hasbro Children's Hospital. Mary Carskadon, a professor of psychiatry and human behavior at Brown and the director of chronobiology research at E. P. Bradley Hospital, says that in the sleep lab, researchers can assess a child's sleep drive by looking at EEG recordings of the brain, and monitor circadian rhythm by testing saliva

Here are three things I now know I should have done: I didn't tell the mother that bullying can be prevented, and that it's up to the school. I didn't call the principal or suggest that the mother do so. And I didn't give even a moment's thought to the bullies, and what their lifetime prognosis might be. Dr. Robert D. Sege, chief of ambulatory pediatrics at Boston Medical Center and a lead author of the new policy statement, says the [Dan Olweus] approach focuses attention on the largest group of children, the bystanders. 'Olweus's genius,' he said, 'is that he manages to turn the school situation around so the other kids realize that the bully is someone who has a problem managing his or her behavior, and the victim is someone they can protect.' The other lead author, Dr. Joseph L. Wright, senior vice president at Children's National Medical Center in Washington and the chairman of the pediatrics academy's committee on violence prevention, notes that a quarter of all children report that they have been involved in bullying, either as bullies or as victims. Protecting children from intentional injury is a central task of pediatricians, he said, and 'bullying prevention is a subset of that activity.'

The other lead author, Dr. Joseph Wright, senior vice president at Children's National Medical Center in Washington and the chairman of the pediatrics academy's committee on violence prevention, notes that a quarter of all children report that they have been involved in bullying, either as bullies or as victims

Knowledge and research that have accumulated over decades about the effects of physical abuse and sexual abuse are being codified into a curriculum; fellowship training in the field will have to meet certain standards; an expert, testifying in court, can expect to be questioned about being board-certified

OBJECTIVE: To determine whether maternal literacy level accounts for associations between educational level and the cognitive home environment in low-income families. DESIGN: Analysis of 369 mother-infant dyads participating in a long-term study related to early child development. SETTING: Urban public hospital. PARTICIPANTS: Low-income mothers of 6-month-old infants. MAIN EXPOSURE: Maternal literacy level was assessed using the Woodcock-Johnson III/Bateria III Woodcock-Munoz Tests of Achievement, Letter-Word Identification Test. Maternal educational level was assessed by determining the last grade that had been completed by the mother. MAIN OUTCOME MEASURE: The cognitive home environment (provision of learning materials, verbal responsivity, teaching, and shared reading) was assessed using StimQ, an office-based interview measure. RESULTS: In unadjusted analyses, a maternal literacy level of ninth grade or higher was associated with increases in scores for the overall StimQ and each of 4 subscales, whereas a maternal educational level of ninth grade or higher was associated with increases in scores for the overall StimQ and 3 of 4 subscales. In simultaneous multiple linear regression models including both literacy and educational levels, literacy continued to be associated with scores for the overall StimQ (adjusted mean difference, 3.7; 95% confidence interval, 1.7-5.7) and all subscales except teaching, whereas maternal educational level was no longer significantly associated with scores for the StimQ (1.8; 0.5-4.0) or any of its subscales. CONCLUSIONS: Literacy level may be a more specific indicator of risk than educational level in low-income families. Studies of low-income families should include direct measures of literacy. Pediatricians should develop strategies to identify mothers with low literacy levels and promote parenting behaviors to foster cognitive development in these at-risk families

'When I gave a discussion to a group of parents at my daughter's day care,' said my friend Dr. Mitchell H. Katz, the San Francisco public health director, 'I counseled parents who were worried about the risks of vaccination to give their children -- if healthy -- the nasal vaccine, because what don't our children put up their noses? 'Given the variety of viruses that our children are exposed to through their noses, it's very hard to imagine how the vaccination could be that different. There had been some tragic and terrifying deaths; I read the news articles about a kindergartner -- healthy boy, no asthma, no heart disease -- who died at Vanderbilt in early September, and the subsequent meetings held at his school with crowds of worried parents, about the sanitizing of the school and the wiping down of the district's 600 school buses

What price the not-skinny doctor? 'The advice we're supposed to give in pediatric clinic, it boils down to 'Eat less, exercise more,' ' said Dr. Julie C. Lumeng, an assistant professor of pediatrics at the University of Michigan Medical School and an expert in childhood obesity. [...] Dr.\n

OBJECTIVE: To describe pediatricians' self-reported experiences with health literacy, use of basic and enhanced communication techniques, and perceived barriers to effective communication during office visits. DESIGN/METHODS: A national, random sample of 1605 nonretired, posttraining American Academy of Pediatrics members were surveyed in 2007 about health literacy and patient communication as part of the Periodic Survey of Fellows. The response rate was 56% (N = 900). RESULTS: Eight-one percent of the pediatricians were aware of a situation in the previous 12 months in which a parent had not sufficiently understood health information that had been delivered to him or her. In addition, 44% of all pediatricians were aware of a communication-related error in patient care within the previous 12 months. Using simple language (99%), repeating key information (92%), and presenting only 2 or 3 concepts at a time (76%) were the most commonly used communication strategies. Enhanced communication techniques recommended by health literacy experts such as teach-back and indicating key points on written educational materials were used less often (23% and 28%, respectively). The most common reported barriers to effective communication were limited time to discuss information (73%), volume of information (65%), and complexity of information (64%). The majority of physicians rated themselves highly in their ability to identify caregiver understanding (64%), but only 21% rated themselves as very good or excellent in identifying a parent with a literacy problem. Fifty-seven percent of the respondents were interested in training to improve communication skills, and 58% reported that they would be very likely to use easy-to-read written materials, if available from the American Academy of Pediatrics. CONCLUSIONS: Pediatricians are aware of health literacy-related problems and the need for good communication with families but struggle with time demands to implement these skills. Despite awareness of communication-related errors in patient care, pediatricians report underutilizing enhanced techniques known to improve communication