JAMA pediatrics
-
Randomized Controlled Trial
Effect of early institutionalization and foster care on long-term white matter development: a randomized clinical trial.
Severe neglect in early life is associated with compromises in brain development and associated behavioral functioning. Although early intervention has been shown to support more normative trajectories of brain development, specific improvements in the white matter pathways that underlie emotional and cognitive development are unknown. ⋯ Results suggest that removal from conditions of neglect in early life and entry into a high-quality family environment can support more normative trajectories of white matter growth. Our findings have implications for public health and policy efforts designed to promote normative brain development among vulnerable children.
-
Recent national data suggest there were improvements in serum lipid concentrations among US children and adolescents between 1988 and 2010 but an increase in or stable blood pressure (BP) during a similar period. ⋯ In 2011-2012, approximately 1 in 5 children and adolescents aged 8 to 17 years had an adverse lipid concentration of TC, HDL-C, or non-HDL-C and slightly more than 1 in 10 had either borderline high or high BP. The prevalence of dyslipidemia modestly decreased between 1999-2000 and 2011-2012, but either high or borderline high BP remained stable. The reasons for these trends require further study.
-
In 2009, Washington State enacted legislation outlining the medical care of children and adolescents with concussion (ie, the Lystedt Law), with all other states and Washington, DC passing legislation by January 2014. ⋯ Increased health care utilization rates among children with concussion in the United States are both directly and indirectly related to concussion legislation. A portion of the increased rates (60%) in states without legislation is attributable to an ongoing upward trend demonstrated before enactment of the first state law in 2009. The remaining 40% increase in these states is thought to have resulted from elevated awareness brought about by heightened local and national media attention. Concussion legislation has had a seemingly positive effect on health care utilization, but the overall increase can also be attributed to increased injury awareness.
-
Multicenter Study
Risk and protective factors for falls from furniture in young children: multicenter case-control study.
Falls from furniture are common in young children but there is little evidence on protective factors for these falls. ⋯ If estimated associations are causal, some falls from furniture may be prevented by incorporating advice into child health contacts, personal child health records, and home safety assessments about use of safety gates; not leaving children, changing diapers, or putting children in car/bouncing seats on raised surfaces; allowing children to play or climb on furniture; and teaching children safety rules about climbing on objects.
-
Many adolescents and young adults use alternative tobacco products, such as water pipes and snus, instead of cigarettes. ⋯ Water pipe tobacco smoking and the use of snus independently predicted the onset of cigarette smoking and current cigarette smoking at follow-up. Comprehensive Food and Drug Administration regulation of these tobacco products may limit their appeal to youth and curb the onset of cigarette smoking.