Jay E. Berkelhamer

Overview of the Global Health Issues Facing Children

This first Pediatrics Perspectives column on global health joins the monthly rotation with other columns on medical history, graduate medical education, and medical student education. It makes good sense to add global health to the rotation. After all, the future of our world depends on the health and well-being of all its children. Medical history will be determined by the global health issues facing children today, and surely our education programs must broaden their content to include worldwide issues to meet the demands of future pediatric practice. It has been said by many pediatricians that any disease found on this planet is no farther than a plane ride from your local hospital. Clearly, the world is a very small place for all its inhabitants, and every day, travel continues to bring us closer. Global Health Perspectives will bring issues to the readership that will stimulate our thinking about strategies and initiatives to improve child health in the broadest context. For our initial column, Drs Cabral and Soares de Moura have traced the recent history of global child health, sharing perspectives that should cause each of us to think about the future of humankind.

Scope of Health Care Benefits for Children From Birth Through Age 26

The optimal health of all children is best achieved with access to appropriate and comprehensive health care benefits. This policy statement outlines and defines the recommended set of health insurance benefits for children through age 26. The American Academy of Pediatrics developed a set of recommendations concerning preventive care services for children, adolescents, and young adults. These recommendations are compiled in the publication Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, third edition. The Bright Futures recommendations were referenced as a standard for access and design of age-appropriate health insurance benefits for infants, children, adolescents, and young adults in the Patient Protection and Affordable Care Act of 2010 (Pub L No. 114–148).

Effectiveness of a targeted screening program in identifying infants with positive urine toxicology screening results in a regular neonatal nursery

We compared the effectiveness in identifying infants with positive results on urine screening for drugs of abuse of a universal screening program and a targeted screening program on the basis of clinical suspicion. A carefully run targeted screening program identified 24.3% of the admissions for toxicology testing and would have found all but two of the infants with positive results.

Medicaid Policy Statement

Medicaid insures 39% of the children in the United States. This revision of the 2005 Medicaid Policy Statement of the American Academy of Pediatrics reflects opportunities for changes in state Medicaid programs resulting from the 2010 Patient Protection and Affordable Care Act as upheld in 2012 by the Supreme Court. Policy recommendations focus on the areas of benefit coverage, financing and payment, eligibility, outreach and enrollment, managed care, and quality improvement.

Distorted conceptions of infant nutrition among urban mothers. An illustration of the great need for well-baby health supervision.

From the University of Chicago Pritzker School of Medicine, Department of Pediatrics, Chicago, Illinois. Correspondence to: J. E. Berkelhamer, University of Chicago Hospitals and Clinics, 950 East 59th Street, Box 335, Chicago, IL 60637. FEEDING REGIMENS for infants can vary considerably and still be nutritionally sound. Infants can thrive on breast feedings, bottle feedings, or combinations of the two. Solid foods may be started in the early weeks

To collect a copay for preventive care or not? It’s not always an easy question to answer

![][1] Under the Patient Protection and Affordable Care Act (ACA), “grandfathered” health plans are exempt from requirements to cover certain preventive services without any cost-sharing to the patient (i.e., no copayments, co-insurance or deductibles). But what is meant by

27 PEDIATRIC EMERGENCY ROOM UTILIZATION BY DIAGNOSIS AND SEX

A previous study of utilization patterns in the Wyler Childrens Hospital Emergency Room established that males consistently visit more often than females. Data collected from 1807 consecutive visits from August 1 thru August 15, 1977 were reviewed by diagnosis and sex to determine if particular disease categories account for this difference. 53.2% of the visits studied were male while the population served was 50.5%. This difference was significant at the p <.003 level. Diagnoses reviewed showed a male predominance for simple lacerations with 67 of 107 visits (p=.016) and acute asthmatic episodes with 58 of 84 visits (p <.003). These were the third and sixth most common diagnoses made respectively. None of the other common diagnostic categories demonstrated a statistically significant difference from the population served. Urinary tract infections which accounted for only 14 visits during the study were strongly weighted toward females with 13 (p=.003). These data confirm the observation that males use the emergency room more than females. During the study period, this difference was attributable to the larger number of males requiring treatment for acute asthmatic episodes and simple lacerations.