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Unintentional injuries are the leading cause of death for children older than 1 year. Pediatricians should include unintentional injury prevention as a major component of anticipatory guidance for infants, children, and adolescents. The content of injury-prevention counseling varies for infants, preschool-aged children, schoolaged children, and adolescents. This report provides guidance on the content of unintentional injury-prevention counseling for each of those age groups.

Despite significant reductions in the number of children killed in motor vehicle crashes over the past decade, crashes continue to be the leading cause of death for children 4 years and older. Therefore, the American Academy of Pediatrics continues to recommend inclusion of child passenger safety anticipatory guidance at every health-supervision visit. This technical report provides a summary of the evidence in support of 5 recommendations for best practices to optimize safety in passenger vehicles for children from birth through adolescence that all pediatricians should know and promote in their routine practice. These recommendations are presented in the revised policy statement on child passenger safety in the form of an algorithm that is intended to facilitate their implementation by pediatricians with their patients and families. The algorithm is designed to cover the majority of situations that pediatricians will encounter in practice. In addition, a summary of evidence on a number of additional issues that affect the safety of children in motor vehicles, including the proper use and installation of child restraints, exposure to air bags, travel in pickup trucks, children left in or around vehicles, and the importance of restraint laws, is provided. Finally, this technical report provides pediatricians with a number of resources for additional information to use when providing anticipatory guidance to families.

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ABSTRACT. An estimated 8500 individuals, approximately 45% of them children younger than 15 years, were treated in US hospital emergency departments during 1999 for fireworks-related injuries. The hands (40%), eyes (20%), and head and face (20%) are the body areas most often involved. Approximately one third of eye injuries from fireworks result in permanent blindness. During 1999, 16 people died as a result of injuries associated with fireworks. Every type of legally available consumer (socalled "safe and sane") firework has been associated with serious injury or death. In 1997, 20 100 fires were caused by fireworks, resulting in $22.7 million in direct property damage. Fireworks typically cause more fires in the United States on the Fourth of July than all other causes of fire combined on that day. Pediatricians should educate parents, children, community leaders, and others about the dangers of fireworks.

Background: Abortion care is a core educational objective according to the Association of Professors of Gynecology and Obstetrics (APGO), but clinical exposure is variable in medical education. The authors sought to compare professional competency, attitudes, and knowledge regarding abortion between students who attended a structured clinical experience in abortion care to those who chose a less-structured family planning clinical environment.Methods: All medical students participating in the Obstetrics & Gynecology clerkship from 2014-2015 were invited to complete a pre- and post-clerkship survey and grouped based on their attendance to a structured clinical abortion experience at Planned Parenthood (PPCW) versus an alternative Family Planning Clinic (FPC) experience. Self-assessed competency and attitudes about abortion were measured using a 100-mm visual analog scale (VAS). Authors assessed knowledge about abortion with multiple-choice questions.Results: A total of 89 students completed the surveys (PPCW: 74; FPC: 15). Students attending PPCW were more likely to observe counseling about abortion and ultrasound prior to abortion (PPCW: 67/74, 91%; FPC: 4/15, 27%, p=<0.01). More PPWC students observed a surgical abortion (91% versus 7% of FPC students). Self-assessed competency scores improved with composite mean difference in VAS for PPCW of 42.2 mm and FPC of 27.3 mm (p=0.02). Attitude scores were unchanged in those with initial VAS <80 mm. Knowledge improved overall, with greater changes among the PPCW group.Conclusions: A structured clinical abortion experience met APGO educational objectives more than an alternative experience. Future physicians should universally be exposed to clinical abortion care in order to ensure evidence-based education about abortion.

Drowning is a leading cause of injury-related death in children. In 2006, fatal drowning claimed the lives of approximately 1100 US children younger than 20 years. A number of strategies are available to prevent these tragedies. As educators and advocates, pediatricians can play an important role in the prevention of drowning.

SUMMARY Videotapes of ten children with ‘suspected’ cerebral palsy were used as stimuli to elicit physicians' decisions regarding referral for physical therapy. Respondents were 99 developmental or general pediatricians, orthopaedists, neurologists or physiatrists who were membes of the American Academy of Pediatrics or the American Academy of Cerebral Palsy. They rated their belief in the value of therapy; described their exprience, training and practices relating to management of cerebral palsy; and responded to cases with their assessment of severity, diagnosis and referral decision. The decision to refer was significantly related to perceived severity of the condition, diagnostic certainty, and beliefe in the efficacy of physical therapy. Referral rates did not vary with tendency to use physical therapy for other types of patients, nor with training, experience or self‐rated expertise in cerebral palsy. RÉSUMÉ Corrélations sur les décisions des médecins de demander une rééducation kinésithérapique chez les enfants IMC Des enregistrements vidéo de dix enfants avec suspicion d'IMC ont été utilises pour provoquer les décisions de médecins concernant l'opportunité d'une rééducation kinésithérapique. Les personnes étudiées étaient 99 pediatres généraux ou spécialises dans le dévoloppement, chirurgiens orthopédiques, neurologues ou psychiatres membres de l'Amcrican Academy of Pediatrics ou de l'American Academy of Cerebral Palsy. Iis évaluaient leur croyance dans l'intérêt de la rééducation. décrivaient leur experience, formation et pratique dans l'approche de l'IMC et jugeaient les cas en termes de gravité, de diagnostic et de décision de rééducation. Cette dernière décision était liée à une perception de gravité, une certitude de diagnostique et une croyance dans l'efficacité de la rééducation. Les taux de décision ne variaient pas avec la tendance à faire appel à la rééducation pour d'autres types de patients, avec la formation, l'expeerience ou une auto‐évaluation de competénce en IMC. ZUSAMMENFASSUNG Gründe für die ärztliche Entscheidung, Kinder mil Cerebralparese zur Physiotherapie zu überweisen Von 10 Kindern mit “Verdachf auf Cerebralparese wurden Videotapes benutzt, um ärztliche Entscheidungen hinsichtlich einer Verordnung von Physiotherapie zu überprüfen. Die Ansprechpartner waren 99 Entwicklungs‐ oder Allgemeinpädiater, Orthopäden, Neurologen oder Naturhcilkundler, die Milglicdcr der American Academy of Pediatrics oder der American Academy of Cerebral Palsy waren. Sie begründeten ihr Vertrauen in den Wert der Therapie; beschrieben ihre Erfahrung, Ausbildung und Praxis bei der Behandlung der Cerebralparese; und nahmen Sleliung zu Fällen durch Beurteilung des Schweregrades, der Diagnose und der Überweisungsentscheidung. Die Entscheidung für eine Überweisung korrelierte signifikant mit dem Schweregrad der Erkrankung, der Sicherheit der Diagnose und dem Vertrauen auf den Erfolg der Physiotherapie. Die Überweisungsraten änderten sich weder mit der Tendenz die physikalische Therapie für andere Patientengruppen...