This mini course will set the stage for several discussions of particular issues of major importance and interest. What is "preparedness" and what are the real risks of continuing terrorism in the United States? What is the current status of preparedness in the U.S. hospital and public health systems? How do children differ from adults in terms of response to weapons of mass destruction (chemical, biological and radiological)? How do these differences matter in disaster planning? Are the needs of children being incorporated in local, state and federal disaster plans? Smallpox, anthrax and other biological threats: Where do we stand? What do we do? Nuclear power plants, nuclear weapons, dirty bombs and potassium iodide: What do we know? The mental health consequences of terrorism: What have we learned since 9/11, how do we prepare children for an increasingly vulnerable world, building resiliency and sustaining a positive vision. The new pediatric agenda: What do we have to teach students, residents and pediatricians about the pediatric aspects of terrorism planning. Children and exposure to weapons of mass destruction: science and the essential research agenda.

Introduction
Paul H. Saenger, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY

Welcome and Context
Irwin Redlener, National Center for Disaster Preparedness, Columbia University Mailman School of Public Health, New York, NY

Pediatric Preparedness for Terrorism and Disasters
David S. Markenson, Columbia University Mailman School of Public Health, New York, NY

Biological Weapons of Terror: What Pediatricians Need to Know
Theodore J. Cieslak, U.S. Army Research Institute of Infectious Diseases, Ft. Detrick, MD

Helping Children and Families Cope with Terrorism
David J. Schonfeld, Yale University School of Medicine, New Haven, CT

Radiologic Terrorism, Children and the Question of Potassium Iodide
Thomas P. Foley, University of Pittsburgh, Children's Hospital of Pittsburgh, Pittsburgh, PA

Potential conflicts of interest litter the halls of academic medical centers like unexploded ordnance. This symposium will discuss both non-financial and financial conflicts of interest and will demonstrate their power to erode trust. There is now overwhelming evidence for systematic bias due to conflicts of interest associated with financial links between researchers and their institutions to commercial entities. We will discuss managing and eliminating conflicts of interest and propose steps to regain public trust.

Overview
Ruth A. Etzel, George Washington University School of Public Health and Health Services, Washington, D.C.

The Importance of Conflicts of Interest to Clinical Researchers
Drummond Rennie, University of California, San Francisco, CA

Discussion
 

Children who are victims of violent behavior or merely observers of violence may learn destructive or self-destructive patterns of behavior. Violence is a major public health problem. This symposium will focus on breaking the cycle of violence and will showcase speakers who are working on violence prevention in the pediatric emergency department, school and community. The speakers will demonstrate what can be done by physicians who see the importance of this issue and the ways in which we can make a difference.

Violence Prevention in Primary Care: Moving from Public Health to Private Practice
Robert D. Sege, Tufts-New England Medical Center, Boston, MA

Beyond Treat and Street: Violence Prevention in the Emergency Department
Joel Fein, The Children’s Hospital of Philadelphia, PA

Efforts in the Community
Sheryl A. Ryan, University of Rochester School of Medicine, Rochester, NY

The National Children’s Study is a national prospective, longitudinal study of environmental effects, including physical, chemical, biological and psychosocial effects, on child health and development. The goal of the study is to improve the health and well-being of children. The study will examine these environmental effects on the health and development of more than 100,000 children across the United States, following them from before birth until age 21. The study is led by a consortium of federal agency partners: the U.S. Department of Health and Human Services, including the National Institute of Child Health and Human Development (NICHD); the National Institute of Environmental Health Sciences (NIEHS); the Centers for Disease Control and Prevention (CDC); and the U.S. Environmental Protection Agency (EPA). For additional information, visit the website at http://www.nationalchildrensstudy.gov/.

The National Children’s Study—An Overview
Duane Alexander, NICHD, National Institutes of Health, Bethesda, MD

The National Children’s Study—Methods
Peter C. Scheidt, National Institutes of Health, Bethesda, MD

Children’s Health and Environmental Exposures: The Most Important Unanswered but Answerable Questions
Michael Weitzman, The AAP Center for Child Health Research at the University of Rochester, Rochester, NY

The application of imaging technologies to solving questions in biology and medicine is revolutionizing medicine by accelerating analyses in situ and in vivo and providing new perspectives on biological processes as diverse as development, neoplasia and injury repair. In this plenary session, three internationally recognized speakers will focus on developmental processes and discuss how these new imaging technologies are providing dynamic insights into the genetic and epigenetic mechanisms that underpin hematopoiesis and vascular development.

Introduction
Lisa M. Guay-Woodford, University of Alabama at Birmingham, Birmingham, AL

Dynamic Imaging of Fluid Forces in Developing Mouse Vasculature
Mary Dickinson, Beckman Institute–Caltech, Pasadena, CA

Microscopic Imaging of Angiogenesis
Donald M. McDonald, University of California, San Francisco, CA

Watching Hematopoietic Stem Cell Engraftment and Hematopoiesis in Living Animals
Christopher H. Contag, Stanford University School of Medicine, Stanford, CA

Questions from the audience
 

Worldwide, more than 1,500 children per day become infected with HIV through mother-to-child transmission. Currently there are 2.7 million children living with HIV infection across the globe, >90% of whom reside in developing countries. While there have been enormous successes in the prevention and treatment of pediatric AIDS in the United States and Europe, it remains an open question as to how effectively these public health gains can be replicated in the poor countries of the world, which bear the greatest burden of disease. Efforts to develop an HIV vaccine appropriate for preventing infection among the world's children and adolescents are finally under way on a global scale. We will discuss these issues and accompanying controversies as they apply to the children of the developing world.

AIDS in Children—A Global Public Health Crisis
David L. Pugatch, Hasbro Children's Hospital and Brown Medical School, Providence, RI

Preventing Mother-to-Child Transmission of HIV in Developing Countries—Successes, Failures and Challenges
Catherine M. Wilfert, Elizabeth Glaser Pediatric AIDS Foundation, Santa Monica, CA and Washington, DC

HIV Treatment for Children—Can the Successes of Rich Countries Be Duplicated in Resource-Poor Settings?
Mark W. Kline, Baylor College of Medicine, Houston, TX

Finding an AIDS Vaccine That Works for the World's Children
Richard A. Koup, Vaccine Research Center, National Institutes of Health, Bethesda, MD

This session presents the field of developmental cognitive neuroscience from a clinical perspective. Typical and atypical language development in children serves as the focus of this session. The impact of recently available magnetic resonance imaging (MRI) techniques such as volumetric MRI and functional MRI (fMRI) will be illustrated. An overview of volumetric MRI and fMRI methods will be presented with developmental and clinically relevant examples. fMRI in typically developing children as compared to adults for a single word processing task will be presented and the possibility that differences represent maturational changes in functional neuroanatomy will be discussed. The application of volumetric imaging and fMRI to the study of a clinically relevant group of children at risk for cognitive deficits, i.e. children born as premature infants, will show how fMRI for non-invasive but quantitative assessment of language processing can be utilized. Finally, results from fMRI study of children with developmental dyslexia will be presented that show disruption in posterior brain neural circuits for reading.

Introduction: Overview of Volumetric and Functional MRI Techniques
Michael Rivkin, Boston Children's Hospital, Harvard Medical School, Boston, MA

Differences in fMRI Activation Between Adults and Children in Single Word Processing
Brad Schlaggar, Washington University School of Medicine, St. Louis, MO

Use of fMRI and Volumetric Imaging To Study Language Processing and Its Cognitive Correlates in Children Born as Premature Infants
Laura R. Ment, Yale University School of Medicine, New Haven, CT

New Insights into the Functional Neuroanatomy of Developmental Dyslexia
Bennett A. Shaywitz, Yale University Medical Center, New Haven, CT
 

The Injury Control SIG provides an opportunity for section members to review current topics in the area of pediatric injury control. A few of the presentations from last year focused on research related to the use of car seats, involvement in injury prevention legislation and the Violence Intervention and Prevention Program.

In 2004, we plan to have another exciting series of presentations. There will be an emphasis on injury prevention education and training; however, we are eager to hear about other research program developments. We encourage you to attend and to contact one of the Injury Control SIG co-chairs with topics that should be discussed.
 

Every day, nearly 5,000 children in the United States smoke their first cigarette. Approximately 60% of smokers start by the age of 13 and fully 90% before the age of 20. Publicly the tobacco companies have always maintained that they do not target youth, but internal documents reveal that they set out to aggressively advertise to kids.

This session will describe litigation as a public health strategy for fighting Big Tobacco in the United States and provide examples of the techniques used to attract children to smoking. Global trends and counter-advertising measures will be discussed.

Overview
Ruth A. Etzel, George Washington University School of Public Health and Health Services, Washington, D.C.

Fighting Big Tobacco in the United States: Litigation as a Public Health Strategy
Madelyn J. Chaber, Law Offices of Wartnick, Chaber, Harowitz & Tigerman, San Francisco, CA

Goliath Fleeing from David: The Global March of the Marlboro Man
Ronald M. Davis, Henry Ford Health System, Detroit, MI

Discussion
 

Hot Topics in General Pediatrics is a potpourri of topics of interest to all pediatricians. The topics include lead poisoning, West Nile Virus infection, sleep disorders and esophagitis. Each of these conditions has varied symptoms, signs and manifestations. For each topic there have been new findings that are in the "need to know" category for all pediatric generalists and subspecialists.

Kawasaki Disease
Jane C. Burns, University of California, San Diego, CA

West Nile Fever
Janak A. Patel, Children's Hospital, University of Texas Medical Branch, Galveston, TX

Lead Poisoning
Kevin Osterhoudt, The Children's Hospital of Philadelphia, Philadelphia, PA