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Arch Pediatr Adolesc Med. 2001;155:542.

The Relationship Between Lead and Homicide
Prior studies have suggested that exposure to lead is associated with delinquency and crime. Currently, one important source of lead is airborne lead particles. This ecological study examined the association of lead concentrations in air in the 3111 counties in the continental United States and the number of homicides in those counties. After adjusting for sociological confounders, counties with the highest lead levels in air had a >4-fold greater number of homicides than counties with the lowest levels of lead in air. These findings may have important public policy implications.

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Randomized Trial of Breastfeeding in Very Low-Birth-Weight Infants
Despite widespread recommendations that premature infants be breastfed, a variety of barriers interfere with successful transition to breastfeeding in these infants. The authors conducted a randomized controlled trial of breastfeeding support and counseling for parents of very low-birth-weight infants. The median duration of breastfeeding in both groups was approximately 4 months. This may reflect the success of breastfeeding in the control group as much as it does the failure of the intervention to increase this further.

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Pediatric Stimulant and Selective Serotonin Reuptake Inhibitor Prescription Trends
1992 to 1998
Stimulants and selective serotonin reuptake inhibitors (SSRIs) are the 2 most common types of psychotropic medications prescribed to children. This study examined the trend in prescribing for these 2 classes of drugs among North Carolina children and adolescents who were covered by Medicaid between 1992 and 1998. During this time, the number of children receiving stimulants increased by 336% to nearly 30 000 annually, and the number receiving SSRIs increased by 1269% to 6984 annually. By 1998, 9.5% of school-aged children younger than 15 years were receiving stimulants and 1.5% SSRIs.

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State and Federal Compliance With the Synar Amendment
Federal Fiscal Year 1998
The Synar Ammendment was enacted in 1992 to require states to prohibit the sale of tobacco to minors and to enforce the law in a manner that would decrease the availability of tobacco to minors. DiFranza provides a surveillance report on how the states are doing in complying with the law. While all states and territories had laws complying with the Synar Amendment, only 22 had achieved measurable progress in reducing violation rates by youth; 16 states actually saw an increase in violation rates. The Department of Health and Human Services has allowed 19 states to negotiate weaker goals, and to continue to rely on educational efforts sponsored by industry as their only method to improve compliance with the law.

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Home Health Nurse Clinical Assessment of Neonatal Jaundice: A Comparison of 3 Methods
The American Academy of Pediatrics currently recommends that newborns be examined within 48 hours of discharge, in large part to examine the infant for jaundice. Home health nurses are commonly used for these early newborn assessments. In this study, home health nurses examined 164 infants with both clinical assessment and use of an icterometer. The nurses' clinical assessments strongly correlated with the actual serum bilirubin and they were able to identify all infants with bilirubin levels greater than or equal to 291 µmol/L (17 mg/dL).

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