JAMA pediatrics
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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.
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Parents' 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. ⋯ Parents endorse a broad range of beliefs that represent what they perceive they should do to be a good parent for their seriously ill child. Common patterns of how parents prioritize these attributes exist, suggesting future research to better understand the origins and development of good-parent beliefs among these parents. More important, engaging parents individually regarding what they perceive to be the core duties they must fulfill to be a good parent may enable more customized and effective decision support.
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Violence is a leading cause of morbidity and mortality among youth, with more than 700000 emergency department (ED) visits annually for assault-related injuries. The risk for violent reinjury among high-risk, assault-injured youth is poorly understood. ⋯ Violent injury is a reoccurring disease, with one-third of our AI group experiencing another violent injury requiring ED care within 2 years of the index visit, almost twice the rate of a non-AI comparison group. Secondary violence prevention measures addressing substance use and mental health needs are needed to decrease subsequent morbidity and mortality due to violence in the first 6 months after an assault injury.
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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.