Letter From the Editor

This issue, the fifth of the Journal of the Ambulatory Pediatric Association, covers the breadth of Association interests and investigation, from controlled clinical trials to educational research to child health policy. Pamela High and associates (Hasbro Children's Hospital and Brown University) describe an important randomized trial of a simple reading enhancement program in primary care practice, demonstrating significant effects on reading in low-income households. Sally Longstaffe and colleagues (Winnipeg) demonstrate improvements in self-concept and behavior with improvements in children's enuresis. Kathi Kemper and colleagues (Boston Children's Hospital and Harvard Medical School) provide results from a survey of pain patients' experience with acupuncture and indicate promising lines for future research. John Knight and associates (also Boston Children's Hospital) provide systematic evaluation of a short screening test for substance abuse in adolescents. Marion Sills and colleagues (Denver Children's Hospital and University of Colorado) find relatively limited knowledge of postcoital contraception methods among physicians working with sexually active adolescents. Jerry Rushton and colleagues (currently Children's Hospital of Michigan; work performed at the University of North Carolina) note important limitations in the knowledge and performance of primary care physicians in the management of childhood depression. Mark Wolraich (Children's Hospital at Vanderbilt) provides perspective regarding the importance of the work of Rushton and colleagues.Four articles describe interesting and important educational findings. Associate editors Ben Siegel and Larrie Greenberg provide commentary on the paper by Joseph Lopreiato and colleagues (National Naval Medical Center and Uniformed Services University of the Health Sciences), which offers clear evidence of behavior change associated with implementation of a new curriculum to address house officers' approaches to health maintenance. Lindsey Lane and Ruth Gottlieb's brief report (Jefferson Medical College) describes structured clinical observations as a teaching method, an area meriting further investigation. Judith Shaw and colleagues (Boston Children's Hospital, Harvard Medical School) demonstrate the effects of direct reminders on residents' performance of immunizations. Joel Alpert (a former APA president) and colleagues (Boston Medical Center) describe precursors of (academic) leadership in pediatrics, indicating the role of chief residency as preparation for leadership.Paul Newacheck and colleagues (University of California, San Francisco) analyze national data to characterize unmet health needs of America's children. Barbara Starfield and colleagues (Johns Hopkins University School of Public Health) provide documentation of a new measure of consumer experiences with primary care. In another article, Newacheck and colleagues describe recent efforts to expand public health insurance for children and provide guidance regarding issues in monitoring these expansions.In its issues so far, the Journal has described several important and successful educational interventions in pediatrics, providing more attention to this area of child health professional development than our colleague journals. Similarly, our attention to methodology in child health research will provide investigators with substantive guidance in variable choice and definition and strengthen consistency in general pediatric research. Other manuscripts published cover multiple areas of general pediatrics, including early childhood issues, reading, and adolescence, as well as key work in child health services research and child health policy. We look forward to your continuing support of the Association's Journal.

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