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Now in its Second Edition, this text focuses exclusively on the management of hospitalized pediatric patients from admission to discharge. It is an excellent resource for residency programs, hospitalist fellowships, and continuing education for physicians whose practice includes the management of hospitalized newborns and children. Because pediatric hospital care is provided by a wide variety of healthcare professionals and in many different hospital settings, this text provides a framework for unified management and effective and efficient care. This edition includes new sections on emergency medicine and psychiatric hospitalization and expanded coverage of management of children with complex and chronic conditions.

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Purpose To describe: (1) development of ReadNPlay for a Bright Future with community stakeholders, (2) integration of a novel communicative tool, the ReadNPlay Baby Book, into infant-toddler well child visits, and (3) use of a quality improvement approach to monitor progress in promoting healthy active living in families with young children. Methods ReadNPlay for a Bright Future is funded by a grant from the American Academy of Pediatrics (AAP) and Metlife Foundation awarded to the East Tennessee State University Department of Pediatrics and Tennessee Chapter of the AAP. The setting for this project is in rural southern Appalachia, a U.S. region with a disproportionately high prevalence of obesity. During a community forum held in Northeast Tennessee in fall 2012, community stakeholders provided feedback to help finalize project materials and messages developed by the project team around four themes: Play More: Shut off the Screen, Play Together: Be Active as a Family, Fuel to Play: Eat Healthy, and Play Safely. A behavioral health consultant (BHC) assisted with provider training in brief motivational interviewing and behavioral counseling and project implementation in the clinic. An anonymous mothers' survey was designed to identify opportunities for improving behaviors and monitor progress in promoting healthy active living during well child visits. Process measures and feedback will be obtained from provider surveys and focus groups with parents and providers. Results As of February 2013, the ReadNPlay Baby Book is being provided to families starting at the newborn visit. The book contains age-appropriate guidance and areas for parents to record their baby's growth, milestones, eating habits, favorite books, and activities between birth and 18 months. Families are receiving small incentives for bringing it to each well child visit. A companion Healthy Active Living Tips booklet encourages healthy behaviors in the whole family. Use of social media, posters, and periodic community events provide reinforcement. A total of 80 mothers with infants 9-24 months of age are completing anonymous surveys during well child visits every 4-6 months (mostly Caucasian, 70% WIC recipients). Baseline surveys with mothers of younger infants (9-12 months of age) suggest: 60% of mothers are reading or looking at books with their infants on most days of the week; 80% of infants watch at least 30 minutes of television and 48.7% drink juice on a typical day; 82% of infants were ever-breastfed; 20% of mothers had sought care for their infants due to an injury; and 13.2% of infants routinely bed-share. Over 80% of all mothers wished that they themselves could get more exercise. Conclusion ReadNPlay for a Bright Future is using novel communication tools, community partnerships, and quality improvement methodology to encourage healthy active living during infant-toddler well child visits

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The obesity problem in the U.S. is of epidemic proportions and affects even the youngest members of society. For instance, 10% percent of U.S. infants have excess weight for length, and early onset of obesity incites later risk. The American Academy of Pediatrics (AAP) Council on Communications and Media has linked media exposure to obesity as well as sleep, behavior issues, inattention, and decreased parent-child interaction in young children. Further, the AAP concludes that no known health benefits exist for media exposure in children under 2 and discourage use in this age range. Reading has been shown to increase secure attachment in infants and to increase the quality of parent-child interaction in addition to positive gains in child literacy. Additionally, two existing studies found that reading reduces screen time, thus serving as a healthy alternative to media exposure. Despite these findings, and the importance of anticipatory guidance in pediatric primary care for discussing shared reading, only 15% of pediatricians talk to families about media exposure. ReadNPlay for a Bright Future is a multi-disciplinary, multicomponent pilot study and healthy weight promotion initiative for families with infants aged birth to 24 months to create health-promoting home environments, set goals, and monitor progress regarding reading and active play. The setting for this study is an academic pediatric primary care practice serving a primarily Caucasian, socio-economically disadvantaged population in Southern Appalachia, with involvement from pediatricians, nurses, and a behavioral health consultant. A novel communicative tool, the ReadNPlay Baby Book, along with provider training in brief motivational interviewing, posters, social media, and participation incentives (e.g., free children’s books) are being used to improve counseling on healthy active living behaviors during infant well child visits. The current research endeavor is focused on the Play More: Shut Off the Screens aspect of the ReadNPlay initiative and utilizes data from a baseline survey completed by 40 mothers with infants aged 9-12 months and 40 mothers with infants aged 13-24 months to assess trends in one form of media exposure, television watching, and reading in this population. While the AAP recommends that children under 2 years do not watch TV, mothers in this study reported that 80% of infants 9-12 months and 87% of infants 13-24 months watched at least 30 minutes on a typical day. Sixty percent of mothers of infants 9-12 months and 82.5% of mothers of infants 13-24 months reported reading 2013 Appalachian Student Research Forum Page 71 or looking at books with their child on most days of a typical week, perhaps as a result of an existing Reach Out and Read Initiative in the practice. The current study adds to the dearth of research regarding risk factors during infancy for future development of obesity. Future research may examine whether increases in reading time may decrease time spent in media exposure.