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New concussion laws result in big jump in concussion treatment

from MNTpaeds - 02 Jan 15

New laws regulating concussion treatment, bolstered by heightened public awareness, have resulted in a large increase in the treatment of concussion-related injuries for school-age athletes.



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Overweight teens lose weight for the right reasons, study shows

from MNTpaeds - 02 Jan 15

Most heavy teens' attempts to lose weight don't work, but a new study shows a big secret of those who do succeed.




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Advancing Children’s Rights and Ensuring the Well-being of Children

from ArchPedi - 01 Jan 15

On November 20, 2014, the global community will celebrate the 25th anniversary of the United Nations Convention on the Rights of the Child, the most comprehensive international legal instrument on children’s rights. The Convention is the most widely ratified human rights treaty in history, ratified by 194 countries. Only the United States, Somalia, and South Sudan have not ratified it. The United States signed the Convention in 1995 but, almost 20 years later, the United States has taken no furt



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Universal State Newborn Screening Programs Can Reduce Health Disparities

from ArchPedi - 01 Jan 15

Fifty years after the advent of state newborn screening (NBS) programs for a metabolic condition, there is evidence that the decision to mandate universal screening can reduce health disparities. When in-hospital screening for phenylketonuria began in the early 1960s, most hospitals simply added the procedure to the list of routine clinical practices for newborns, such as giving vitamin K. For a variety of reasons, including fear of missed cases, advocates managed to get state governments involv



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Ensuring Access to the Appropriate Health Care Professionals Regionalization and Centralization of Care in a New Era of Health Care Financing and Delivery

from ArchPedi - 01 Jan 15

Infants born prematurely continue to make up almost 11.5% of the more than 4 million deliveries in the United States, with 1.4% of these deliveries occurring at a gestational age of 28 weeks or less. The work of Kastenberg et al, published in this issue of JAMA Pediatrics, adds to the extensive literature showing that delivery at a high-volume/high-level neonatal intensive care unit is associated with lower mortality and morbidity linked with premature birth. Given the high cost of delivering ca



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Continued Promise of School Breakfast Programs for Improving Academic Outcomes Breakfast Is Still the Most Important Meal of the Day

from ArchPedi - 01 Jan 15

A groundbreaking study, published in this journal nearly 25 years ago, documented improved academic outcomes among low-income schoolchildren who received school breakfast via the School Breakfast Program (SBP) vs those who did not, including significantly decreased tardiness and absences and improved performance on standardized tests of academic achievement. Since that time, the empirical study of school breakfast initiatives has increased substantially, with several literature reviews documenti



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Considering the Potential Effect of Federal Policy on Childhood Obesity

from ArchPedi - 01 Jan 15

The study by Terry-McElrath et al in the current issue of JAMA Pediatrics seeks to answer important, timely questions related to how the new federal policy issued by the US Department of Agriculture (USDA) may affect the nutritional environment of US schools and childhood obesity rates. Beginning in the 2014-2015 school year, schools participating in federally reimbursable meal programs are required to implement nutritional standards for foods and beverages sold in competitive venues, including



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Is Lunch From Home Better Than the School Cafeteria? A Look at the New School Lunch Criteria

from ArchPedi - 01 Jan 15

In this issue of JAMA Pediatrics, Caruso and Cullen describe the nutritional quality and cost of lunch brought from home by elementary and intermediate school–aged children in Houston, Texas. As they remind us, this component of the school food environment is basically avoided by public health policy and rarely addressed by investigators. The authors conducted an observational study in 1 school district including 12 schools (8 elementary, 4 intermediate) in the fall of 2011. A total of 243 eleme



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Placental Transfusion at Birth Do We Have All of the Answers?

from ArchPedi - 01 Jan 15

Many questions remain about both delayed cord clamping (DCC) and umbilical cord milking (UCM). Al-Wassia and Shah report the first meta-analysis of UCM in infants. We review current recommendations and concerns impeding their translation into widespread practice. We next review new meta-analyses in the literature that address some of the remaining knowledge gaps for placental transfusion, including the aforementioned UCM meta-analysis. Finally, we highlight some remaining reasons clinicians shou



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Efficacy and Safety of Umbilical Cord Milking at Birth A Systematic Review and Meta-analysis

from ArchPedi - 01 Jan 15

ImportanceUmbilical cord milking (UCM) is suggested to improve neonatal outcomes.ObjectivesTo perform a systematic review and meta-analysis of the efficacy and safety of UCM in full-term and preterm neonates.Data SourcesA systematic search of MEDLINE, EMBASE, CINAHL, the Cochrane Database of Clinical Trials, the clinicaltrails.gov database, and the reference list of retrieved articles from 1940 to 2014.Study SelectionRandomized clinical trials comparing UCM with other strategies of handling the



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Effect of Deregionalized Care on Mortality in Very Low-Birth-Weight Infants With Necrotizing Enterocolitis

from ArchPedi - 01 Jan 15

ImportanceThere has been a significant expansion in the number of low-level and midlevel neonatal intensive care units (NICUs) in recent decades. Infants with necrotizing enterocolitis represent a high-risk subgroup of the very low-birth-weight (VLBW) (ObjectivesTo describe the current trend toward deregionalization and to test the hypothesis that infants with necrotizing enterocolitis represent a particularly high-risk subgroup of the VLBW population that would benefit from early identification



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Association of Early Caffeine Administration and Neonatal Outcomes in Very Preterm Neonates

from ArchPedi - 01 Jan 15

ImportanceAdvantages of caffeine for apnea of prematurity have prompted clinicians to use it prophylactically even before apnea.ObjectiveTo determine the effect of early initiation of caffeine therapy on neonatal outcomes in very preterm infants born in Canada.Design, Setting, and ParticipantsA retrospective cohort study was conducted. Patients included preterm neonates born at less than 31 weeks’ gestation admitted to 29 participating Canadian Neonatal Network neonatal intensive care units betw



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Good-Parent Beliefs of Parents of Seriously Ill Children

from ArchPedi - 01 Jan 15

ImportanceParents’ beliefs about what they need to do to be a good parent when their children are seriously ill influence their medical decisions, and better understanding of these beliefs may improve decision support.ObjectiveTo assess parents’ perceptions regarding the relative importance of 12 good-parent attributes.Design, Setting, and ParticipantsA cross-sectional, discrete-choice experiment was conducted at a children’s hospital. Participants included 200 parents of children with serious i



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Congenital Anomalies and In Utero Antiretroviral Exposure in Human Immunodeficiency Virus–Exposed Uninfected Infants

from ArchPedi - 01 Jan 15

ImportanceMost studies examining the association of prenatal antiretroviral (ARV) exposures with congenital anomalies (CAs) in children born to human immunodeficiency virus (HIV)–infected women have been reassuring, but some evidence suggests an increased risk with specific ARV agents.ObjectiveTo evaluate the association of in utero ARV exposures with CAs in HIV-exposed uninfected children.Design, Setting, and ParticipantsProspective cohort study design. The Pediatric HIV/AIDS Cohort Study’s Sur



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Explaining the Increase in the Prevalence of Autism Spectrum Disorders The Proportion Attributable to Changes in Reporting Practices

from ArchPedi - 01 Jan 15

ImportanceThe prevalence of autism spectrum disorders (ASDs) has increased markedly in recent decades, which researchers have suggested could be caused in part by nonetiologic factors such as changes in diagnosis reporting practices. To our knowledge, no study has quantified the degree to which changes in reporting practices might explain this increase. Danish national health registries have undergone a change in diagnostic criteria in 1994 and the inclusion of outpatient contacts to health regi



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Violent Reinjury and Mortality Among Youth Seeking Emergency Department Care for Assault-Related Injury A 2-Year Prospective Cohort Study

from ArchPedi - 01 Jan 15

ImportanceViolence is a leading cause of morbidity and mortality among youth, with more than 700?000 emergency department (ED) visits annually for assault-related injuries. The risk for violent reinjury among high-risk, assault-injured youth is poorly understood.ObjectiveTo compare recidivism for violent injury and mortality outcomes among drug-using, assault-injured youth (AI group) and drug-using, non–assault-injured control participants (non-AI group) presenting to an urban ED for care.Design



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Estimating Impacts of a Breakfast in the Classroom Program on School Outcomes

from ArchPedi - 01 Jan 15

ImportanceShort-term impacts of breakfast consumption on diet quality and cognitive functioning have been reported, but more evidence is needed to draw causal inferences about long-term impacts of school breakfast on indicators of school engagement and academic achievement.ObjectiveTo estimate the impact of a Breakfast in the Classroom (BIC) program on School Breakfast Program participation, school attendance, and academic achievement.Design, Setting, and ParticipantsThis quasi-experimental stud



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Potential Impact of National School Nutritional Environment Policies Cross-sectional Associations With US Secondary Student Overweight/Obesity, 2008-2012

from ArchPedi - 01 Jan 15

ImportanceThe latest US Department of Agriculture school meal and competitive venue standards (USDA standards) aim to improve student nutrition and health. However, significant opposition has been raised to their implementation.ObjectiveTo examine (1) the percentages of US middle and high school students who currently attend schools that have specific components of the USDA standards; (2) evidence that the identified USDA standard components may be associated with student overweight/obesity; and



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Quality and Cost of Student Lunches Brought From Home

from ArchPedi - 01 Jan 15

ImportanceThe nutritional quality and cost of lunches brought from home are overlooked and understudied aspects of the school food environment.ObjectivesTo examine the quality and cost of lunches brought from home by elementary and intermediate school students.Design, Setting, and ParticipantsAn observational study was conducted in 12 schools (8 elementary and 4 intermediate) in one Houston, Texas, area school district from October 6, 2011, to December 5, 2011. Participants included 242 elementa




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Problematic Consequences of Using Standard Errors Rather Than Standard Deviations Calculation of Effect Sizes

from ArchPedi - 01 Jan 15

To the Editor In the article recently published in JAMA Pediatrics on a cluster randomized trial of the Healthy Buddies program, Santos and colleagues reported effect sizes for the impact of intervention on the assessed outcomes, with waist circumference and body mass index z scores serving as primary outcomes. The formula given for calculating each effect size was the difference between treatment and control groups in baseline to follow-up differences on the outcome measure divided by the pool



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Problematic Consequences of Using Standard Errors Rather Than Standard Deviations—Reply

from ArchPedi - 01 Jan 15

In Reply On behalf of my coauthors, I thank Dr Dubois for highlighting the error of reporting treatment effect in the article that described the results of the cluster randomized clinical trial of the Healthy Buddies Curriculum, recently published in JAMA Pediatrics. Dr Dubois correctly highlighted the fact that the “the use of a measure’s standard error for calculating an effect size is problematic” because it would inflate the estimate of the effect size.



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Incorrect Grant Information

from ArchPedi - 01 Jan 15

In the article titled “Influence of Age at Virologic Control on Peripheral Blood Human Immunodeficiency Virus Reservoir Size and Serostatus in Perinatally Infected Adolescents,” published online October 6, 2014, and also in the December 2014 print issue of JAMA Pediatrics (2014;168[12]:1138-1146. doi:10.1001/jamapediatrics.2014.1560), 2 grant numbers in the Funding/Support section were incorrect and another grant was inadvertently omitted. On page 1145, the first sentence of the Funding/Support



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Minor Errors in Statistical Methods

from ArchPedi - 01 Jan 15

In the article titled “Effectiveness of Peer-Based Healthy Living Lesson Plans on Anthropometric Measures and Physical Activity in Elementary School Students: A Cluster Randomized Trial,” published online February 10, 2014, and also in the April 2014 print issue of JAMA Pediatrics (2014;168[4]:330-337. doi:10.1001/jamapediatrics.2013.3688), several minor errors existed in the statistical methods used in the study. Once recalculated, the treatment effects were modified slightly; however, these mo


 

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