JAMA Pediatrics最新文献

{"title":"What Parents Need to Know About Online Misinformation","authors":"Nusheen Ameenuddin, Lindsay A. Thompson","doi":"10.1001/jamapediatrics.2025.0290","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.0290","url":null,"abstract":"This <jats:italic>JAMA Pediatrics</jats:italic> Patient Page describes how parents can help their children build media literacy skills to recognize online misinformation.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"82 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143884342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal Trends in the Childhood Opportunity Index at Children’s Hospitals","authors":"Samantha A. House, Matthew Hall, Clemens Noelke, Yang Lu, Victor Ritter, Bren Botzheim, Alicia Lew, Alan R. Schroeder","doi":"10.1001/jamapediatrics.2025.1041","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.1041","url":null,"abstract":"This cohort study assessed annual changes in the Childhood Opportunity Index, a multidimensional measure of neighborhood conditions associated with health outcomes, for hospital-based encounters.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"130 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143880452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Type I Error Control-Avoiding an Upset.","authors":"John M VanBuren,Benjamin French","doi":"10.1001/jamapediatrics.2025.0528","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.0528","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"6 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143857201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"State-Level Policies and Antibiotic Use for Pediatric Conjunctivitis","authors":"Isdin Oke, Alexandra T. Geanacopoulos, S.V. Subramanian, Ann Chen Wu, Naomi S. Bardach, Daniel J. Shapiro","doi":"10.1001/jamapediatrics.2025.0478","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.0478","url":null,"abstract":"This cross-sectional study examines the patterns of topical antibiotics dispensation to commercially insured school-aged children with acute infectious conjunctivitis.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"28 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143853497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rates of Intraventricular Hemorrhage in Preterm Neonates During the First 6 Hours of Life-Reply.","authors":"Zsuzsanna Nagy,Tamás Kói,Miklós Szabó","doi":"10.1001/jamapediatrics.2025.0472","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.0472","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"138 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143857202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EEG-Guided Pediatric Anesthesia-A Quality Innovation?","authors":"C Dean Kurth, David A Gabrielsen, Ian Yuan","doi":"10.1001/jamapediatrics.2025.0514","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.0514","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Mental and Physical Health Among Youths.","authors":"Marie E Heffernan,Michelle L Macy","doi":"10.1001/jamapediatrics.2025.0556","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.0556","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"91 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143857203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rates of Intraventricular Hemorrhage in Preterm Neonates During the First 6 Hours of Life.","authors":"Sameer Yaseen Al-Abdi,Maryam Ali Al-Aamri","doi":"10.1001/jamapediatrics.2025.0475","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.0475","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"16 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143857200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EEG-Guided Titration of Sevoflurane and Pediatric Anesthesia Emergence Delirium","authors":"Kiyoyuki W. Miyasaka, Yasuyuki Suzuki, Emery N. Brown, Yasuko Nagasaka","doi":"10.1001/jamapediatrics.2025.0517","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.0517","url":null,"abstract":"ImportancePediatric anesthesia emergence delirium (PAED) is a common complication of general anesthesia and has unknown etiology. Exposure to volatile anesthetics may contribute to PAED, and excessive exposure may occur frequently during routine pediatric anesthesia.ObjectiveTo examine whether use of electroencephalography (EEG) monitoring can reduce PAED by minimizing exposure to sevoflurane while maintaining a state of unconsciousness under anesthesia.Design, Setting, and ParticipantsA single-center, parallel-group, 2-arm, superiority randomized clinical trial with a 1:1 allocation ratio was conducted from October 13, 2021, to March 18, 2023, at an academic tertiary pediatric hospital in Japan. The follow-up period was 24 ± 6 hours postoperatively or uneventful discharge to home, whichever came first. The observer for the primary outcome was blinded to patient assignment. The trial included a convenience sample of children aged 1 to younger than 6 years undergoing general anesthesia for procedures for which reliable antinociception can be provided. Data analysis was performed in March 2023.InterventionEEG-guided titration of anesthesia to minimize sevoflurane exposure (EEG-guided group) vs standard 1.0–minimum alveolar concentration (MAC) sevoflurane anesthesia (control group).Main Outcomes and MeasuresProportion of patients who developed PAED, defined by a maximum PAED score of 10 or higher.ResultsOf the 177 participants who completed follow-up, 125 (71%) were male and 52 (29%) were female. The EEG-guided group included 91 participants (mean [SD] age, 2.9 [1.5] years), and the control group included 86 participants (mean [SD] age, 2.8 [1.6] years). In the EEG-guided group, sevoflurane exposure was reduced by 1.4 MAC-hours (96.65% CI, 1.1 to 1.6 MAC-hours). A total of 30 (35%) in the control group and 19 (21%) in the EEG-guided group developed PAED (difference, 14%; 96.65% CI, −0.0019% to 28%; 95% CI, 0.92% to 27%; <jats:italic>P</jats:italic> = .04). Children in the EEG-guided group emerged a mean of 21.4 minutes (96.65% CI, 15.4 to 27.4 minutes) earlier from general anesthesia and spent a mean of 16.5 minutes less (96.65% CI, 10.8 to 22.3 minutes less) in the postanesthesia care unit.Conclusions and RelevanceEEG-guided management of general anesthesia reduced sevoflurane exposure and pediatric anesthesia emergence delirium in children, with faster emergence and shorter postanesthesia care unit stays. The findings suggest that high concentrations of sevoflurane for induction followed by routine use of 1.0-MAC sevoflurane for maintenance may be excessive.Trial RegistrationJapan Registry of Clinical Trials Identifier: <jats:ext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" ext-link-type=\"uri\" xlink:href=\"https://jrct.mhlw.go.jp/en-latest-detail/jRCTs032210248\">jRCTs032210248</jats:ext-link>","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"24 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143853496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Removable Boot vs Casting of Toddler’s Fractures","authors":"Ariane Boutin, Keith Colaco, Jennifer Stimec, Mark Camp, Unni Narayanan, Maala Bhatt, Naveen Poonai, Andrew R. Willan, Ramona Cook, Marie-Lyne Nault, Sasha Carsen, Kathy Boutis","doi":"10.1001/jamapediatrics.2025.0560","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.0560","url":null,"abstract":"ImportanceToddler’s fractures (TF) of the tibia are commonly treated with casts and fracture clinic follow-up. However, a prefabricated removable boot might be sufficient and reduce unnecessary follow-up.ObjectivesTo determine whether pain in children with TF treated with a removable boot is not worse than those managed with a circumferential cast at 4 weeks postinjury.Design, Setting, and ParticipantsThis pragmatic, multicenter, assessor-blinded, noninferiority randomized clinical trial was conducted between October 2019 and February 2024 at 4 urban, tertiary care, pediatric Canadian emergency departments. Children aged between 9 months and 4 years with a radiograph-visible TF were eligible for inclusion.InterventionsPrefabricated walking boot for up to 3 weeks (removable at caregivers’ discretion) vs circumferential cast immobilization (site standard of care) for 3 weeks.Main Outcomes and MeasureThe primary outcome was pain score, measured with the Evaluation Enfant Douleur (EVENDOL) scale (maximum score: 15). Additional outcomes included return to baseline activities, complications, parental satisfaction and care burden.ResultsIn 129 enrolled children, the mean (SD) age was 2.2 (0.8) years, and 56 children (43%) were female. Of these, 118 children (92%) completed the 4-week follow-up, and the boot (n = 64) vs cast (n = 54) groups demonstrated mean (SD) EVENDOL pain scores of 1.21 (1.54) and 1.76 (2.13), respectively (difference, −0.55; 95% CI, −1.23 to 0.13). The percentage of participants who returned to baseline activities “almost all of the time” was 49 of 64 children (77%) in the boot group and 22 of 54 (41%) in the cast group (difference, 36%; 95% CI, 9%-63%). Skin complications occurred in both groups (boot: 46 total complications [72%], with 5 stage 1 pressure sores; cast: 27 total complications (50%), with 1 pressure sore]; difference, 22%; 95% CI, −6% to 50%). There was no statistically significant difference in the percentage of caregivers who were satisfied or very satisfied with the treatment (difference, 9%; 95% CI, −24% to 43%). Fewer caregivers reported bathing care burden (difference, −32%; 95% CI, −47% to −18%) and challenges with carrying the child (difference, −21%; 95% CI, −27% to −15%) in the boot vs cast group.Conclusions and RelevanceIn this multicenter randomized clinical trial examining the management of children with TF, a removable boot without physician follow-up was noninferior to circumferential casting with respect to pain recovery. While there was a clinically relevant but not statistically significant trend toward more skin complications in the boot group, there was no difference in caregiver satisfaction, and the boot strategy demonstrated reduced childcare-related challenges.Trial RegistrationClinicalTrials.gov Identifier: &lt;jats:ext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" ext-link-type=\"uri\" xlink:href=\"https://www.clinicaltrials.gov/study/NCT03971448?cond=NCT03971448&amp;amp;amp;rank=1\"&gt;NCT03971448&lt;/","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"23 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143853498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}