Archives of pediatrics & adolescent medicine
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Arch Pediatr Adolesc Med · Jun 2012
Polygenic risk, rapid childhood growth, and the development of obesity: evidence from a 4-decade longitudinal study.
To test how genomic loci identified in genome-wide association studies influence the development of obesity. ⋯ Genetic variation linked with obesity risk operates, in part, through accelerating growth in the early childhood years after birth. Etiological research and prevention strategies should target early childhood to address the obesity epidemic.
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Arch Pediatr Adolesc Med · May 2012
Comparative StudyDifferences in nutrient intake associated with state laws regarding fat, sugar, and caloric content of competitive foods.
To determine whether nutrient intake is healthier among high school students in California, which regulates the nutrition content of competitive foods sold in high schools, than among students in states with no such standards. ⋯ California high school students consumed lower quantities of fat, sugar, and calories in school than students in states with no competitive food nutrition standards, but the nutrition composition of California students' in-school diet was similar. Policy initiatives should promote competitive foods that are consistent with the Dietary Guidelines for Americans.
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Arch Pediatr Adolesc Med · Apr 2012
Review Meta AnalysisNasal intermittent positive-pressure ventilation vs nasal continuous positive airway pressure for preterm infants with respiratory distress syndrome: a systematic review and meta-analysis.
To determine among preterm infants with respiratory distress syndrome whether the use of early nasal intermittent positive-pressure ventilation (NIPPV) vs nasal continuous positive airway pressure (NCPAP) decreases the need for invasive ventilation within the first 72 hours of life. ⋯ Among preterm infants with respiratory distress syndrome, NIPPV decreases the need for invasive ventilation within the first 72 hours of life compared with NCPAP. Trials are needed to assess whether NIPPV minimizes the occurrence of bronchopulmonary dysplasia and other comorbidities.
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Arch Pediatr Adolesc Med · Apr 2012
Multicenter Study Comparative StudyPrevalence of clinically important traumatic brain injuries in children with minor blunt head trauma and isolated severe injury mechanisms.
To determine the prevalence of clinically important traumatic brain injuries (TBIs) with severe injury mechanisms in children with minor blunt head trauma but with no other risk factors from the Pediatric Emergency Care Applied Research Network (PECARN) TBI prediction rules (defined as isolated severe injury mechanisms). ⋯ Children with isolated severe injury mechanisms are at low risk of clinically important TBI, and many do not require emergent neuroimaging.
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Arch Pediatr Adolesc Med · Apr 2012
Multicenter Study Comparative StudyAcademic medical centers and equity in specialty care access for children.
To test whether specialty clinics' academic medical center (AMC) affiliation was associated with equity in scheduling appointments for children with public vs private insurance. Academic medical centers are safety-net providers of specialty medical care and it is unknown whether equitable access is afforded by AMCs across insurance conditions. ⋯ Affiliation with an AMC was associated with fewer discriminatory denials of children with Medicaid-CHIP. However, children with Medicaid-CHIP had significantly longer wait times at AMC-affiliated clinics compared with privately insured children. Academic medical centers' propensity toward serving publicly insured patients makes them candidates for targeted resource allocation, perhaps with incentives contingent on equitable appointment acceptance and wait times.