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  • 更新日期:2017-09-21
  • Infantile-Onset Fever and Urticaria
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-18
    Sukesh Sukumaran, Vini Vijayan
    更新日期:2017-09-18
  • Association of an Asthma Improvement Collaborative With Health Care Utilization in Medicaid-Insured Pediatric Patients in an Urban Community
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-18
    Carolyn M. Kercsmar, Andrew F. Beck, Hadley Sauers-Ford, Jeffrey Simmons, Brandy Wiener, Lisa Crosby, Susan Wade-Murphy, Pamela J. Schoettker, Pavan K. Chundi, Zeina Samaan, Mona Mansour
    更新日期:2017-09-18
  • Association of Cigarette Price Differentials With Infant Mortality in 23 European Union Countries
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-18
    Filippos T. Filippidis, Anthony A. Laverty, Thomas Hone, Jasper V. Been, Christopher Millett
    更新日期:2017-09-18
  • Improving Asthma Care by Building Bridges Across Inpatient, Outpatient, and Community Settings
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-18
    Sean M. Frey, Jill S. Halterman

    Pediatric asthma continues to pose a significant challenge to population health. Despite more than 25 years of management guidelines1 from the National Heart, Lung, and Blood Institute and the wide availability of effective controller medications, asthma morbidity rates in the United States have stagnated.2 In this issue of JAMA Pediatrics, Kercsmar et al3 detail the influence of a triphasic quality improvement initiative on asthma outcomes in a population of Medicaid-insured children and adolescents (aged 2-17 years) in Hamilton County, Ohio. The 3 domains of bundled quality improvement (QI) interventions (inpatient, outpatient, and community) were sequentially implemented during a 5-year period and engaged a multidisciplinary team grounded in the chronic care model.

    更新日期:2017-09-18
  • BB Guns That Look Like Real GunsA Clinical Vignette and Policy Review
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-18
    Katherine E. M. Hoops, Stephen P. Teret
    更新日期:2017-09-18
  • Children’s Health Must Remain a Focus in the Recovery From Hurricane Harvey
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-15
    Aaron E. Carroll, Austin B. Frakt

    The United States has been consumed by the news about the flooding in Texas that accompanied and followed Hurricane Harvey. Many have been comforted by the relatively low levels of morbidity and mortality seen so far compared with disasters such as Hurricane Katrina. However, we should resist complacency. Unfortunately, most of the potential harm from the storm is yet to come, and much of it will fall on children. Although flooding is one of the most deadly types of natural disasters in the United States and worldwide, floods’ full physical and mental health effects, particularly in the long term, are still not well understood. However, some data do exist and have been summarized in a 2012 systematic review on floods and human health.1 Overall, mortality rates nearly double in the year after floods. Increases in disease outbreaks of hepatitis E and gastrointestinal infections are common, fueled by breakdowns in sanitation services and the contamination of potable water with sewage. The incidence of injuries is usually focused on the short term, driven by wounds from contact with debris. However, physical and mental effects of floods on children can be especially acute and worthy of dedicated, long-term attention.

    更新日期:2017-09-15
  • Nonoperative Treatment of Appendicitis—Reply
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-11
    Libin Huang, Yuan Li, Zongguang Zhou

    In Reply We appreciate the attention, comments, and questions on our article1 in JAMA Pediatrics. Regarding Bonadio’s first question, we would agree that criteria for adults are not always applicable for children. The references Bonadio cited, which showed nonappendicitis had a normal measured appendiceal diameter of greater than 6 mm, were adult-based studies. For children, 6 mm is a critical diagnostic criterion for acute appendicitis (AA).2 Meanwhile, diagnosis for AA is mainly based on clinical findings combined with imaging examination. The inclusion criteria of studies were comprehensive; appendiceal dilation as 6 to 11 mm is part of the criteria, which was defined to exclude either complicated appendicitis or normal appendix. But it could be possible that nearly normal or milder appendicitis be included in nonoperative treatment (NOT) group, so risk-stratified scoring system3,4 should be used for ultrasonography examination, providing more detailed information for the precision diagnosis of AA.

    更新日期:2017-09-11
  • Nonoperative Treatment of Appendicitis—Reply
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-11
    Monica E. Lopez, David E. Wesson

    In Reply We thank Minneci and Deans for their comment on our Editorial. We agree that the two 2017 meta-analyses of nonoperative treatment of pediatric appendicitis indeed have demonstrated the feasibility and initial success of this approach. While Huang et al1 did not report a pooled estimate for risk of treatment failure at 1 year, Georgiou et al2 found an overall nonoperative treatment efficacy of 82% at final reported follow-up, with both studies yielding similar histopathological appendicitis recurrence rates of 14% to 16%.1,2 In comparison, two 2017 meta-analyses of adult data, demonstrated an overall treatment effectiveness at 1 year of 64%3 and 73%,4 with Harnoss et al4 reporting a complication-free treatment success for nonoperative treatment at 1 year of 68% vs 90% for the operative treatment.4 The conclusions drawn from the pediatric meta-analyses published to date generate consensus that nonoperative treatment is “feasible and effective,” albeit a higher risk for treatment failure compared with appendectomy, especially in the setting of acute appendicitis with appendicolith,1 and that further evaluation by means of large randomized trials is needed with regard to longer-term clinical outcomes and cost-effectiveness.2 In fact, Georgiou et al2 recommend that nonoperative treatment of children with acute uncomplicated appendicitis “be reserved for those participating in carefully designed research studies.” We regret that Minneci and Deans have focused their contention on only 1 aspect of our conclusion in which we state that “nonoperative treatment remains an experimental proposition meriting ongoing consideration as a treatment strategy” for this condition and that “this therapeutic option should only be offered to pediatric patients under protocol in the setting of a clinical trial.”5 We stand by our recommendation that future studies should have attention “to longer follow-up and patient-centered outcomes, cost utility, and shared decision making.”5 This last area is essential as we attempt to understand how to align patients’ wishes, values, and their particular circumstances with their treatment plan. We commend Minneci and Deans on their ongoing work with preference-based trials and look forward to their long-term results. Their findings will provide critical information as we build a repository of evidence addressing all the previously mentioned categories so that we can provide patients’ families complete information to aid in their decision making. In spite of ongoing debates as to what the best study design is to establish superiority and to balance internal vs external validity, the current available evidence does not support routine nonoperative treatment of uncomplicated acute appendicitis in general practice.

    更新日期:2017-09-11
  • Nonoperative Treatment of Appendicitis
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-11
    Peter C. Minneci, Katherine J. Deans

    To the Editor We appreciate the meta-analysis1 and Editorial2 evaluating nonoperative treatment of uncomplicated appendicitis in children in this issue of JAMA Pediatrics. However, we propose an alternative interpretation of the evidence and future direction of this work.1,2

    更新日期:2017-09-11
  • Nonoperative Treatment of Appendicitis
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-11
    William A. Bonadio

    To the Editor I read with interest the meta-analysis by Huang et al1 combining results of 5 studies (n = 404 patients) with uncomplicated appendicitis (AUA) evaluating efficacy of nonoperative treatment (NOT). They found NOT was successful in 90% of cases and concluded that antibiotics as the initial treatment for pediatric patients with AUA may be feasible and effective without increasing the risk for complications.

    更新日期:2017-09-11
  • Accuracy of Complete Blood Cell Counts to Identify Febrile Infants 60 Days or Younger With Invasive Bacterial Infections
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-11
    Andrea T. Cruz, Prashant Mahajan, Bema K. Bonsu, Jonathan E. Bennett, Deborah A. Levine, Elizabeth R. Alpern, Lise E. Nigrovic, Shireen M. Atabaki, Daniel M. Cohen, John M. VanBuren, Octavio Ramilo, Nathan Kuppermann
    更新日期:2017-09-11
  • Association of Guideline-Adherent Antibiotic Treatment With Readmission of Children With Sickle Cell Disease Hospitalized With Acute Chest Syndrome
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-11
    David G. Bundy, Troy E. Richardson, Matthew Hall, Jean L. Raphael, David C. Brousseau, Staci D. Arnold, Ram V. Kalpatthi, Angela M. Ellison, Suzette O. Oyeku, Samir S. Shah
    更新日期:2017-09-11
  • White Blood Cell Count in the Evaluation of the Febrile InfantTime to Revisit the Dogma?
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-11
    Matthew Mischler, Francis McBee Orzulak, Jessica Hanks

    The diagnostic challenge of the infant younger than 60 days presenting to medical attention with fever has been the source of numerous publications, clinical scoring systems, and, more importantly, a high level of clinical uncertainty for caregivers evaluating this population.1- 3 The rate of serious bacterial infection is high enough in this age group to warrant evaluation, but it is unclear how much or how little evaluation is warranted.4 Clinical signs and symptoms have been shown to be unreliable at best, and as a result, there is a high level of clinical variability in emergency departments and clinical wards nationwide.5,6 The true impetus behind the evaluation of infants in this age group presenting with fever is the early recognition and diagnosis of invasive bacterial infections (IBI), thereby preventing the potential morbidity and mortality that comes with these infections.

    更新日期:2017-09-11
  • Deception in Schools—When Crisis Preparedness Efforts Go Too Far
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-11
    David J. Schonfeld, Eric Rossen, Diann Woodard

    Without warning, police burst into classrooms in a middle school, sparking panic among seventh graders as they point loaded weapons at students, aiming to protect them from an active shooter. The panic spreads to parents as students send text messages to them during the attack. Highway patrol officers go classroom to classroom in a high school notifying students that several classmates died in motor vehicle crashes over the weekend, sparking grief as peers first learn that students missing from the class that morning had died.

    更新日期:2017-09-11
  • New Approaches for Appendicitis in Children
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-05
    Megan A. Moreno
    更新日期:2017-09-07
  • Truth Telling in the Setting of Cultural Differences and Incurable Pediatric IllnessA Review
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-05
    Abby R. Rosenberg, Helene Starks, Yoram Unguru, Chris Feudtner, Douglas Diekema
    更新日期:2017-09-07
  • Association of Serum Soluble Urokinase Receptor Levels With Progression of Kidney Disease in Children
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-05
    Franz Schaefer, Howard Trachtman, Elke Wühl, Marietta Kirchner, Salim S. Hayek, Ali Anarat, Ali Duzova, Sevgi Mir, Dusan Paripovic, Alev Yilmaz, Francesca Lugani, Klaus Arbeiter, Mieczyslaw Litwin, Jun Oh, Maria Chiara Matteucci, Jutta Gellermann, Simone Wygoda, Augustina Jankauskiene, Günter Klaus, Jiri Dusek, Sara Testa, Aleksandra Zurowska, Alberto Caldas Afonso, Melissa Tracy, Changli Wei, Sanja Sever, William Smoyer, Jochen Reiser
    更新日期:2017-09-07
  • Safety and Feasibility of Antiretroviral Preexposure Prophylaxis for Adolescent Men Who Have Sex With Men Aged 15 to 17 Years in the United States
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-05
    Sybil G. Hosek, Raphael J. Landovitz, Bill Kapogiannis, George K. Siberry, Bret Rudy, Brandy Rutledge, Nancy Liu, D. Robert Harris, Kathleen Mulligan, Gregory Zimet, Kenneth H. Mayer, Peter Anderson, Jennifer J. Kiser, Michelle Lally, Jennifer Brothers, Kelly Bojan, Jim Rooney, Craig M. Wilson
    更新日期:2017-09-07
  • Navigating Nondisclosure Requests in PediatricsHonesty and Sensitivity Are Transcultural Practices
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-05
    Deena R. Levine, Liza-Marie Johnson, Justin N. Baker

    In a world rich with diversity, practicing culturally sensitive medicine is a unique challenge. Western medical ethical principles do not always translate well to other cultures. This is especially the case with regard to disclosure of prognosis in patients with terminal illness, particularly pediatric patients. In the review by Rosenberg and colleagues,1 the authors discuss the issue of request for nondisclosure of terminal prognosis using a hypothetical case example of Sara, a 15-year-old girl from the Middle East. A review of Western and Middle Eastern literature reveals great variability by country, medical specialty, and individual preference.2 The diversity of preferences underscores the importance of not making assumptions regarding patient and family values and beliefs and stresses the importance of individual assessments by the health care professional.

    更新日期:2017-09-07
  • Human Immunodeficiency Virus Preexposure Prophylaxis for Adolescent MenHow Do We Ensure Health Equity for At-Risk Young Men?
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-05
    Renata Arrington-Sanders

    Preexposure prophylaxis (PrEP), coformulated as tenofovir (TFV), disoproxil fumarate (TDF), and emtricitabine (FTC), is a biomedical intervention that has demonstrated a reduction of human immunodeficiency virus (HIV) transmission rates by as much as 75% in heterosexual serodiscordant partnerships and up to 99% among men having sex with men (MSM) and transgender women when taken daily.1,2 It was approved by the US Food and Drug Administration in 2012 for adults 18 years and older, but approval for adolescents younger than 18 years has stalled because of limited data on the efficacy, acceptability, and safety among adolescents younger than 18 years.

    更新日期:2017-09-07
  • Vision Screening in Very Young Children—Making Sense of an Inexorable Diagnostic Process
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-05
    William V. Good

    The current issue of JAMA includes guidelines for vision screening in young children.1,2 The guidelines are thorough and evidence-based. Simply condensed, vision screening is recommended for children older than 3 years; however, the evidence was insufficient to recommend for or against screening for children aged 6 months to 3 years. Screening offers detection of amblyopia (child has eyes with different refractive powers and/or strabismus), high refractive errors, and even anisocoria (unequal size pupils) in patients often unable to self-identify a problem. The proliferation of screening tools underscores the importance, both medical and financial, of screening.

    更新日期:2017-09-07
  • Medicine’s Firsts
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-05
    Lauren Rissman

    Practicing medicine is full of firsts: the first time someone calls you “doctor” and the first time a patient thanks you for saving their life. After those moments, you leave the hospital remembering why you went into medicine. You like to help people. Sometimes that means curing or easing someone’s suffering. Sometimes that means helping families cope with terminal conditions. You want to save the world 1 person at a time. And then, of course, there’s the first time you call time of death.

    更新日期:2017-09-07
  • Health Care Workforce Development to Enhance Mental and Behavioral Health of Children and Youths
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-05
    Thomas F. Boat, Marshall L. Land, Laurel K. Leslie

    Mental and behavioral disorder diagnoses in children and youths are increasing at a concerning rate and are antecedent to many lifetime physical and behavioral health disorders.1 The cost to individuals, families, communities, and the American public is enormous. Comprehensive attention to the risks of all children, starting early in life, through behavioral health promotion, risk prevention, early detection of concerning behaviors, and effective treatment of behavioral disorders is an unmet need.

    更新日期:2017-09-07
  • JAMA Pediatrics
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-01

    Vision: JAMA Pediatrics will be the most respected source of information for investigators, providers, and policy makers seeking the highest quality evidence to guide decision making. Mission Statement: JAMA Pediatrics seeks to provide state-of-the-art information to individuals and organizations working to advance the health and well-being of infants, children, and adolescents. The Journal also provides a forum for discussion of the most important issues and policies affecting child and adolescent health and health care. JAMA Pediatrics will use the most current technology to make timely information available to readers wherever and whenever it is needed.

    更新日期:2017-09-07
  • New Updates on Concussions in Girls and Menstrual Patterns
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-01
    Megan A. Moreno
    更新日期:2017-09-07
  • Error in Table
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-01

    In the Review titled “Early, Accurate Diagnosis and Early Intervention in Cerebral Palsy: Advances in Diagnosis and Treatment,”1 published online July 17, 2017, there was an error in Table 1. In the row 6.1, the HINE score value of “>73 (at 6, 9, or 12 mo)” should have been “<73.” This article was corrected online.

    更新日期:2017-09-07
  • The Benefit of Early Preventive Dental Care for Children
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-01
    Shulamite S. Huang, Ryan R. Ruff, Richard Niederman

    To the Editor The finding by Blackburn et al1 that “children with early preventive care visits from dentists were more likely to have…greater expenditures than children without preventive dental care” is stunning. This finding calls into question more than 25 years’ efficacy studies. What isn’t immediately obvious is that the findings and interpretation are likely to be spurious.

    更新日期:2017-09-07
  • The Benefit of Early Preventive Dental Care for Children—Reply
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-01
    Justin Blackburn, Michael A. Morrisey, Bisakha Sen

    In Reply Our recent analysis of early preventive dental care and restorative outcomes1 has prompted responses from many scientists and practitioners who clearly care deeply about children’s oral health. For this, we are grateful. However, it is necessary to respond to some of the points that they have raised. Our selection of outcomes was motivated by policy statements, such as the American Academy of Pediatric Dentists stating that “early dental visits should be expected to reduce the child’s future dental risk leading to improved oral health and reduced oral health costs.”2 We stated in the Limitations section that “claims data cannot capture any indirect benefits of preventive dental care, such as reductions in missed school days or an improved quality of life.”1 Thus, we agree with Webman and with Gerald that early preventive dental care may have other potentially important outcomes and that more research is warranted. However, it is unscientific to assert that such benefits exist (or do not exist) in the absence of this research.

    更新日期:2017-09-07
  • The Benefit of Early Preventive Dental Care for Children
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-01
    Oscar Arevalo, Rosie Roldan

    To the Editor We read with great interest the article by Blackburn et al, “Outcomes Associated With Early Preventive Dental Care Among Medicaid-Enrolled Children in Alabama,”1 in JAMA Pediatrics. Although Milgrom and Cunha-Cruz pointed at important shortcomings in their editorial,2 we challenge the article’s findings using relevant methodological, clinical, and epidemiologic data.

    更新日期:2017-09-07
  • The Benefit of Early Preventive Dental Care for Children
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-01
    Mark Webman

    To the Editor I read with great interest the article by Blackburn et al, “Outcomes Associated With Early Preventive Dental Care Among Medicaid-Enrolled Children in Alabama,”1 in JAMA Pediatrics. It is clear that the authors do not understand that these early visits are intended in part to identify children who may be susceptible to early childhood caries as well as those who have already been affected.

    更新日期:2017-09-07
  • The Benefit of Early Preventive Dental Care for Children
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-01
    Joe K. Gerald

    To the Editor The analysis by Blackburn et al1 of early preventive dental care, including the application of fluoride varnish, illustrates important limitations of claims-based analyses.1 The use of real-world data with long-term follow-up and the use of propensity matching to construct a comparison group were notable strengths. However, 2 limitations not addressed by Milgrom and Cunha-Cruz2 in the accompanying editorial warrant further consideration.

    更新日期:2017-09-07
  • Legalization of Same-Sex Marriage and Drop in Adolescent Suicide Rates: Association But Not Causation—Reply
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-01
    Julia Raifman, Ellen Moscoe, S. Bryn Austin

    In Reply We are grateful to Kamtchum-Tatuene et al for their comments on our article.1 We appreciate the opportunity to clarify that the sample size of 231 413 listed for our secondary analysis in Table 21 included all students in all states with data on sexual orientation and does not indicate that 30% of students identified as sexual minorities. We described in the analysis section that we interacted sexual minority identity and state same-sex marriage to assess associations with suicide attempts. We reported in the results section that 12.7% of students identified as sexual minorities in 2015.

    更新日期:2017-09-07
  • Legalization of Same-Sex Marriage and Drop in Adolescent Suicide Rates: Association but Not Causation
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-01
    Joseph Kamtchum-Tatuene, Jean Jacques Noubiap, Yannick F. Fogang

    To the Editor Raifman et al1 use robust statistical tools to demonstrate an association between the legalization of same-sex marriage (SSM) in the United States and a decrease in adolescent suicide rates, the absolute reduction being 0.6 percentage points for all students and 4 percentage points in sexual minorities. Nevertheless, we are concerned about the representativeness of their sample. Indeed, 30.2% of all students included in their sample belong to the “sexual minorities” group (Table 21). Consequently, the proportion of suicide attempts from this group (34.1% in 2015) and the net benefit potentially attributable to the legalization of SSM might be artificially inflated. Moreover, by concluding that “implementation of same-sex marriage policies reduced adolescent suicide attempts,”1 they jump over a few steps in the journey from association to causation.

    更新日期:2017-09-07
  • Ethical Considerations for Nutrition Counseling About Processed Food
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-01
    Stephanie R. Morain, Anne Barnhill

    To the Editor We read with great interest the article “Processed Food: An Experiment that Failed.”1 We applaud efforts to bring attention to the public health effects of processed food. However, we are concerned that it misses the mark on 2 important issues related to families’ efforts to eat more healthfully. First, we were troubled by the following sentence: “One-third of American mothers today don’t even know what real food is or how to cook,” a situation that renders them and their children “hostages to the processed food industry.”1 Such framing is concerning because it reinforces a problematic norm that mothers bear the primary responsibility for childhood obesity.2 Emphasizing the role of mothers in addressing childhood obesity makes sense from one perspective because US women are both more likely to shop for and prepare meals and to take children to the pediatrician than their male counterparts.3,4 Nevertheless, focusing solely on mothers represents a missed opportunity to enlist fathers and the broader society in promoting childhood nutrition and well-being.4 Relatedly, we must acknowledge the growing diversity of American families. In the 1960s, nearly three-quarters of American children lived in a family with 2 married parents in their first marriage. Today, less than half do so, one-quarter live with a single parent, and a growing number are in same-sex couple households. Recommendations and interventions for healthy eating should acknowledge and address changing household arrangements and their implications for children’s health.

    更新日期:2017-09-07
  • Ethical Considerations for Nutrition Counseling About Processed Food—Reply
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-01
    Robert H. Lustig

    In Reply In their letter, Morain and Barnhill appropriately point out that child caregivers come in many shapes, sizes, sexes, and situations and that focusing on mothers for cooking is inadequate for today’s pluralistic household.1 I agree wholeheartedly with the premise that men are as deficient as women in cooking skills; yet, there is plenty of evidence that the history and art of cooking is passed from mother (rather than from father) to children.2 Indeed, I believe that all children are now vulnerable owing to the lack of intergenerational transmission of food preparation and cooking education and that it is imperative that we as a society provide for all children to learn how to cook as an adult survival skill. To wit, I wrote a 2012 Huffington Post article titled “Bring Back ‘Home Ec,’ and This Time for Boys Too.”3

    更新日期:2017-09-07
  • Extending the Social Justice Call to Treatment Outcomes—Reply
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-01
    Andrew D. Racine

    In Reply Zito raises very interesting questions regarding the provision of health care services to vulnerable populations and the implications this has for social justice. In my initial article,1 the provision of health care was treated as a primary social good in that it is generally welfare-enhancing. Zito reminds us that this is not always the case.

    更新日期:2017-09-07
  • Extending the Social Justice Call to Treatment Outcomes
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-01
    Julie M. Zito

    To the Editor Kudos to Racine for calling the pediatric community to consider its role in a social justice framework.1 His call should extend to all of us in the pediatric research community as well. Further, I propose that it is even more critical where mental health treatment of the poor may result in overtreatment. Applying John Rawls’ ethical decision model to assure a just mental health treatment decision means forming a decision without knowing whether the child is poor and socially deprived or well off in a socially privileged environment or whether the caregiver is a foster parent or the pediatrician’s or researcher’s daughter. Most critically, a just decision may depend on the prescriber’s greater proportional responsibility for a continually evolving awareness of the strengths and limitations of the pediatric pharmacologic and treatment knowledge base as treatments are used over time.

    更新日期:2017-09-07
  • Trends in Differences in US Mortality Rates Between Black and White Infants
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-01
    Corinne A. Riddell, Sam Harper, Jay S. Kaufman
    更新日期:2017-09-07
  • Neonate With Cutaneous Vesicles and Respiratory Distress
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-01
    Kate E. Oberlin, Erin X. Wei, George W. Elgart
    更新日期:2017-09-07
  • Early, Accurate Diagnosis and Early Intervention in Cerebral PalsyAdvances in Diagnosis and Treatment
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-01
    Iona Novak, Cathy Morgan, Lars Adde, James Blackman, Roslyn N. Boyd, Janice Brunstrom-Hernandez, Giovanni Cioni, Diane Damiano, Johanna Darrah, Ann-Christin Eliasson, Linda S. de Vries, Christa Einspieler, Michael Fahey, Darcy Fehlings, Donna M. Ferriero, Linda Fetters, Simona Fiori, Hans Forssberg, Andrew M. Gordon, Susan Greaves, Andrea Guzzetta, Mijna Hadders-Algra, Regina Harbourne, Angelina Kakooza-Mwesige, Petra Karlsson, Lena Krumlinde-Sundholm, Beatrice Latal, Alison Loughran-Fowlds, Nathalie Maitre, Sarah McIntyre, Garey Noritz, Lindsay Pennington, Domenico M. Romeo, Roberta Shepherd, Alicia J. Spittle, Marelle Thornton, Jane Valentine, Karen Walker, Robert White, Nadia Badawi
    更新日期:2017-09-07
  • Achieving an Optimal Childhood Vaccine Policy
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-01
    Douglas J. Opel, Jason L. Schwartz, Saad B. Omer, Ross Silverman, Jeff Duchin, Eric Kodish, Douglas S. Diekema, Edgar K. Marcuse, Walt Orenstein

    Policies to remove parents’ ability to opt-out from school immunization requirements on the basis of religious or personal beliefs (ie, nonmedical exemptions) may be a useful strategy to increase immunization rates and prevent outbreaks of vaccine-preventable disease. However, there is uncertainty about the effectiveness of this strategy and the range of possible outcomes. We advocate for a more deliberative process through which a broad range of outcomes is scrutinized and the balance of values underlying the policy decision to eliminate nonmedical exemptions is clearly articulated. We identify 3 outcomes that require particular consideration before policies to eliminate nonmedical exemptions are implemented widely and outline a process for making the values underlying such policies more explicit.

    更新日期:2017-09-07
  • Association Between Linear Growth and Bone Accrual in a Diverse Cohort of Children and Adolescents
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-01
    Shana E. McCormack, Diana L. Cousminer, Alessandra Chesi, Jonathan A. Mitchell, Sani M. Roy, Heidi J. Kalkwarf, Joan M. Lappe, Vicente Gilsanz, Sharon E. Oberfield, John A. Shepherd, Karen K. Winer, Andrea Kelly, Struan F. A. Grant, Babette S. Zemel
    更新日期:2017-09-07
  • Availability of Definitive Hospital Care for Children
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-01
    Urbano L. França, Michael L. McManus
    更新日期:2017-09-07
  • Public Health and Economic Consequences of Vaccine Hesitancy for Measles in the United States
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-01
    Nathan C. Lo, Peter J. Hotez
    更新日期:2017-09-07
  • Association of Concussion With Abnormal Menstrual Patterns in Adolescent and Young Women
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-01
    Meredith L. Snook, Luke C. Henry, Joseph S. Sanfilippo, Anthony J. Zeleznik, Anthony P. Kontos
    更新日期:2017-09-07
  • Incidence, Risks, and Types of Infections in Pediatric Long-term Care Facilities
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-01
    Lisa Saiman, Philip Maykowski, Meghan Murray, Bevin Cohen, Natalie Neu, Haomioa Jia, Gordon Hutcheon, Edwin Simpser, Linda Mosiello, Luis Alba, Elaine Larson
    更新日期:2017-09-07
  • Early-Life Epilepsies and the Emerging Role of Genetic Testing
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-01
    Anne T. Berg, Jason Coryell, Russell P. Saneto, Zachary M. Grinspan, John J. Alexander, Mariana Kekis, Joseph E. Sullivan, Elaine C. Wirrell, Renée A. Shellhaas, John R. Mytinger, William D. Gaillard, Eric H. Kossoff, Ignacio Valencia, Kelly G. Knupp, Courtney Wusthoff, Cynthia Keator, William B. Dobyns, Nicole Ryan, Tobias Loddenkemper, Catherine J. Chu, Edward J. Novotny, Sookyong Koh
    更新日期:2017-09-07
  • Diagnostic Impact and Cost-effectiveness of Whole-Exome Sequencing for Ambulant Children With Suspected Monogenic Conditions
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-01
    Tiong Yang Tan, Oliver James Dillon, Zornitza Stark, Deborah Schofield, Khurshid Alam, Rupendra Shrestha, Belinda Chong, Dean Phelan, Gemma R. Brett, Emma Creed, Anna Jarmolowicz, Patrick Yap, Maie Walsh, Lilian Downie, David J. Amor, Ravi Savarirayan, George McGillivray, Alison Yeung, Heidi Peters, Susan J. Robertson, Aaron J. Robinson, Ivan Macciocca, Simon Sadedin, Katrina Bell, Alicia Oshlack, Peter Georgeson, Natalie Thorne, Clara Gaff, Susan M. White
    更新日期:2017-09-07
  • Screening Criteria for Ophthalmic Manifestations of Congenital Zika Virus Infection
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-01
    Andrea A. Zin, Irena Tsui, Julia Rossetto, Zilton Vasconcelos, Kristina Adachi, Stephanie Valderramos, Umme-Aiman Halai, Marcos Vinicius da Silva Pone, Sheila Moura Pone, Joel Carlos Barros Silveira Filho, Mitsue S. Aibe, Ana Carolina C. da Costa, Olivia A. Zin, Rubens Belfort, Patricia Brasil, Karin Nielsen-Saines, Maria Elisabeth Lopes Moreira
    更新日期:2017-09-07
  • Effect of a Baby-Led Approach to Complementary Feeding on Infant Growth and OverweightA Randomized Clinical Trial
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-01
    Rachael W. Taylor, Sheila M. Williams, Louise J. Fangupo, Benjamin J. Wheeler, Barry J. Taylor, Lisa Daniels, Elizabeth A. Fleming, Jenny McArthur, Brittany Morison, Liz Williams Erickson, Rhondda S. Davies, Sabina Bacchus, Sonya L. Cameron, Anne-Louise M. Heath
    更新日期:2017-09-07
  • Is Pediatric Long-term Care the Next Frontier in Infection Prevention and Control?
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-01
    Joanna Thomson, Samir S. Shah

    The prevalence of children with medical complexity has increased over the past several decades as a result of advances in medical care and improved survival of children with chronic, congenital, and critical illness.1,2 Most children with medical complexity receive care at home from families with or without the assistance of home health care and nursing; however, a small but growing proportion of sick children are served by skilled nursing facilities or pediatric long-term care facilities (pLTCFs).3,4 These children require assistance with activities of daily living and have complex medical care needs, including use of medical devices and technology (eg, enteral feeding tubes, tracheostomies, and ventilators). Pediatric LTCFs also provide developmentally appropriate therapies and socialization with other residents, staff, volunteers, and visitors.

    更新日期:2017-09-07
  • High-Throughput Sequencing as First-Tier Diagnostics in Congenital and Early-Onset Disorders
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-01
    Johannes R. Lemke

    The yield of genetic testing methods has dramatically improved within the past few years, enabling the identification of genetic causes in common as well as rare and unusual phenotypes in an increasing proportion of patients. Thus, genetic testing has become part of the routine diagnostic workup for many disorders. The studies by Tan et al1 and Berg et al2 in this issue of JAMA Pediatrics demonstrate the dramatic effect of the diagnostic yield of different genetic testing approaches on cost-effectiveness and the potential design of testing strategies in children with suspected monogenic conditions.

    更新日期:2017-09-07
  • Baby-Led Weaning—Safe and Effective but Not Preventive of Obesity
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-01
    Rajalakshmi Lakshman, Emma A. Clifton, Ken K. Ong

    Childhood obesity has important consequences for morbidity and mortality throughout life.1 In 2010, an estimated 43 million children younger than 5 years were obese or overweight worldwide, and the prevalence is expected to increase from 6.7% to 9.1% by 2020.2 Antenatal to early postnatal life is a period of rapid growth and developmental plasticity and therefore considered to be particularly sensitive for obesity prevention.3 Weaning, or the introduction of solid foods, is an important developmental milestone during this window of opportunity for obesity prevention and is a well-reasoned target for interventions. Baby-led weaning encourages infant self-feeding of all solid foods, rather than adult-led spoon-feeding, and is hypothesized to promote self-regulation of energy intake, a trait linked to the development of obesity in observational studies,4 and thereby lower obesity risk.5 However, concerns have been raised that baby-led weaning may increase the risks for infant undernutrition and choking, with most health care professionals reluctant to recommend it.6

    更新日期:2017-09-07
  • Tribalism in Medicine—Us vs Them
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-01
    Rebekah Mannix, Joshua Nagler

    Today, while having lunch in the cafeteria, it happened. Three men asked to join the far end of our table and their proximity, combined with their increasingly animated conversation, made eavesdropping inevitable. That, and the fact that “they” were unknowingly talking about “us.” “They can’t help it,” said the first man. “That’s how they practice medicine in the Emergency Department—fast, fast, fast.” His friend nodded, and with an odd mixture of annoyance and ennui moaned, “The other day they ordered a computed tomography before they had even completed a full physical examination.” “I can’t imagine having to practice medicine like them,” said the third. Their shared dismay seemed to bond them, until an incidental glance in our direction landed on our hospital identification badges, yielding the uncomfortable realization that the “them” they were discussing was, in fact, “us.”

    更新日期:2017-09-07
  • Preventing Human Immunodeficiency Virus Acquisition in Youth—Generations at Risk
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-01
    Lynne M. Mofenson

    Globally, there are approximately 1.8 billion youths aged 10 to 24 years, accounting for nearly 1 of every 4 people worldwide. Approximately 88% of the world’s youth live in low- and middle-income countries.1 Ensuring the health of these young people will have long-term benefits for their well-being as adults, the health of future generations, and society overall. Yet there remains a dearth of research on the health of young people, particularly in low- and middle-income countries. An estimated 1.3 million adolescents aged 10 to 19 years die annually, most of preventable or treatable causes. Prominent among these preventable causes is human immunodeficiency virus (HIV) infection. Human immunodeficiency virus is among the top causes of death for young people globally and the leading cause of death for African adolescents aged 10 to 19 years and for girls and young women aged 10 to 24 years worldwide.2

    更新日期:2017-09-07
  • Core Quality and Outcome Measures for Pediatric Health
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-01
    William Gardner, Kelly J. Kelleher
    更新日期:2017-09-07
  • Wellness for Families of Children With Chronic Health Disorders
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-01
    Thomas F. Boat, Stephanie Filigno, Raouf S. Amin

    Caring for children with a life-threatening or disabling chronic disorder is a challenge that affects, often adversely, the entire family. The prevalence of severe disabilities among children is increasing,1 with approximately 1 of 20 children having a severe disability.2 As this group has lived longer, filled more of the beds in children’s hospitals, and demanded increasing ambulatory medical attention, costs of care have increased. Costs to families have also escalated both economically and with regard to socioemotional development. Current child health systems have responded vigorously to the physical health challenges of chronic childhood disease but less consistently to the challenges of proactively supporting the wellness of patients and family members. Pediatric chronic care medicine must more effectively deliver interventions that promote family wellness and resilience.

    更新日期:2017-09-07
  • Highlights
    JAMA Pediatr. (IF 10.251) Pub Date : 2017-09-01

    In this issue we published 2 studies that examined genetic testing in diagnosing serious illnesses in children. In the first, Tan and colleagues examined 61 ambulatory children at a mean age of 28 months and provided 23 (52%) with diagnoses through singleton whole-exome sequencing. Eight diagnoses (35%) were unexpected and the sequencing was cost-saving.. The Editorial by Lemke discusses the use of high-throughput sequencing early in the diagnostic workup of children with early-onset disorders.

    更新日期:2017-09-07
Some contents have been Reproduced with permission of the American Chemical Society.
Some contents have been Reproduced by permission of The Royal Society of Chemistry.
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