Pediatrics
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We examined the association between state Medicaid and State Children's Health Insurance Program (SCHIP) income eligibility and the financial burden reported by low-income families raising children with special health care needs (CSHCN). ⋯ Beyond child and family characteristics, there is considerable state-level variability in low-income families' out-of-pocket expenditures for their CSHCN. A portion of this variability is associated with states' Medicaid and SCHIP income-eligibility thresholds. Families living in states with more generous programs report less absolute and relative financial burden than families living in states with less generous benefits.
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We hypothesized that pressure reactivity index (PRx) values indicating preserved cerebrovascular pressure autoregulation would be associated with survival in children with traumatic brain injury (TBI). This hypothesis was tested in a prospective, blinded, observational, pilot study. ⋯ Intact cerebrovascular pressure reactivity quantified with the PRx is associated with survival after severe head trauma in children. The PRx is CPP dependent in children. The PRx may be useful for defining age-specific and possibly patient-specific optimal targets for CPP after TBI.
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Randomized Controlled Trial Multicenter Study
HIV risk reduction among detained adolescents: a randomized, controlled trial.
Criminally involved adolescents engage in high levels of alcohol-related risky sex. A theory-based sexual and alcohol risk-reduction intervention was designed, implemented, and evaluated in juvenile detention facilities. ⋯ Findings support the feasibility of integrating alcohol-specific sexual risk content into a theory-based sexual risk-reduction intervention and provide additional evidence that theory-based interventions are effective at reducing risky sex in this population. There was limited evidence of intervention effects on alcohol-use outcomes. Future research should focus on strengthening the GPI + GMET to most effectively target risky sexual behavior among at-risk adolescents.
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In this study we examined geographic disparities in medical home access among US children with special health care needs (CSHCN) aged 0 to 17 years. ⋯ Although individual-level sociodemographic and state-level health policy variables are important predictors of access, substantial geographic disparities remain, with CSHCN in several western and northeastern states at high risk of not having a medical home.