JAMA pediatrics
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Multicenter Study
Potential impact of national school nutritional environment policies: cross-sectional associations with US secondary student overweight/obesity, 2008-2012.
The 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. ⋯ Because only 2% of middle school and less than 1% of high school students attended schools with all 5 identified USDA standard components in place, full implementation has the potential to substantially improve school nutritional environments. Some USDA standard components were associated with a lower risk for student overweight/obesity, especially for high school and nonwhite students.
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Randomized Controlled Trial Multicenter Study
Efficacy of a telephone-delivered sexually transmitted infection/human immunodeficiency virus prevention maintenance intervention for adolescents: a randomized clinical trial.
Behavioral change interventions have demonstrated short-term efficacy in reducing sexually transmitted infection (STI)/human immunodeficiency virus (HIV) risk behaviors; however, few have demonstrated long-term efficacy. ⋯ Sustaining the long-term impact of an STI/HIV intervention is achievable with brief, tailored telephone counseling.
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Multicenter Study Observational Study
Isolated loss of consciousness in children with minor blunt head trauma.
A history of loss of consciousness (LOC) is frequently a driving factor for computed tomography use in the emergency department evaluation of children with blunt head trauma. Computed tomography carries a nonnegligible risk for lethal radiation-induced malignancy. The Pediatric Emergency Care Applied Research Network (PECARN) derived 2 age-specific prediction rules with 6 variables for clinically important traumatic brain injury (ciTBI), which included LOC as one of the risk factors. ⋯ Children with minor blunt head trauma presenting to the emergency department with isolated LOC are at very low risk for ciTBI and do not routinely require computed tomographic evaluation.
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Multicenter Study Observational Study
Breastfeeding in children of women taking antiepileptic drugs: cognitive outcomes at age 6 years.
Breastfeeding is known to have beneficial effects, but concern exists that breastfeeding during maternal antiepileptic drug (AED) therapy may be harmful. We previously noted no adverse effects of breastfeeding associated with AED use on IQ at age 3 years, but IQ at age 6 years is more predictive of school performance and adult abilities. ⋯ No adverse effects of AED exposure via breast milk were observed at age 6 years, consistent with another recent study at age 3 years. In our study, breastfed children exhibited higher IQ and enhanced verbal abilities. Additional studies are needed to fully delineate the effects of all AEDs.
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Randomized Controlled Trial Multicenter Study
Nebulized hypertonic saline for bronchiolitis: a randomized clinical trial.
Bronchiolitis is one of the most common and costly respiratory diseases in infants and young children. Previous studies have shown a potential benefit of nebulized hypertonic saline; however, its effect in the emergency department (ED) setting is unclear. ⋯ Hypertonic saline given to children with bronchiolitis in the ED decreases hospital admissions. We can detect no significant difference in Respiratory Distress Assessment Instrument score or length of stay between the HS and NS groups.