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Mask Versus Nasal Tube for Stabilization of Preterm Infants at Birth: A Randomized Controlled Trial

Effective ventilation is fundamental to successful resuscitation of newborns, but face mask leak and airway obstruction are common during manual positive-pressure ventilation in the delivery room, which may compromise resuscitation.

Compared with a soft, round silicone face mask, using a nasal tube to provide respiratory support in the delivery room does not reduce the rate of intubation but may be a suitable alternative with equivocal efficacy. (Read the full article)




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A Randomized Trial of Nasal Prong or Face Mask for Respiratory Support for Preterm Newborns

Respiratory support is commonly given to newborn infants via a face mask in the delivery room. Respiratory support given to preterm infants via a single nasal prong may be more effective.

Compared with a face mask, using a single nasal prong to deliver respiratory support to preterm newborns did not result in less intubation and ventilation in the delivery room. (Read the full article)




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Assessing Functional Impairment in Siblings Living With Children With Disability

Previous research on potential deleterious effects of typically developing children growing up in households with children with disability has produced mixed results. Research methods have been cited as a problem in many studies.

This is the largest known empirical study comparing functional impairment in siblings living with a child with disability and siblings residing with children who are typically developing. This study also follows the trajectory of functional impairment across 2 measurement periods. (Read the full article)




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Visual Processing in Adolescents Born Extremely Low Birth Weight and/or Extremely Preterm

Data available before the 1990s in addition to small studies with clinical populations have shown that ocular growth and development differ between extremely preterm and term-born children.

Contemporary data on long-term visual outcomes indicate that adolescents born extremely low birth weight and/or extremely preterm exhibit more visual sensory and perceptual morbidity than adolescents born at term. (Read the full article)




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Rotavirus Vaccination of Very Low Birth Weight Infants at Discharge From the NICU

Preterm and low birth weight infants are at increased risk of hospitalization due to rotavirus gastroenteritis, and rotavirus vaccine is immunogenic and well tolerated among these infants when provided at or after discharge from the NICU.

Many preterm infants with a birth weight of ≤1500 g are not eligible to receive rotavirus vaccination because they remain in the NICU beyond the upper age limit recommended for immunization. New strategies are needed. (Read the full article)




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ADHD and Learning Disabilities in Former Late Preterm Infants: A Population-Based Birth Cohort

Previous studies have reported that former late preterm infants are at increased risk for future learning and behavioral problems; thus it has been suggested that their development be closely monitored.

This population-based study indicates that the risk for attention deficit/hyperactivity disorder and learning disabilities may not be higher in former late preterm infants, and therefore intensive neurodevelopmental follow-up may not be required for all late preterm infants. (Read the full article)




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Late-Preterm Birth and Lifetime Socioeconomic Attainments: The Helsinki Birth Cohort Study

More than 70% of all preterm deliveries are late-preterm (34–36 weeks of gestation). Compared with those born at term, those born late-preterm have higher risk for medical and neurodevelopmental disabilities and suffer more often from mental and behavioral problems.

Late-preterm birth is associated with considerable lifetime socioeconomic disadvantages across the adult years. These disadvantages are not explained by childhood parental socioeconomic position. (Read the full article)




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Maternal Influence on Child HPA Axis: A Prospective Study of Cortisol Levels in Hair

Stress affects health of children, potentially persisting as a trajectory into adulthood. Earlier biological markers assess only momentary stress, making it difficult to investigate stress over longer periods of time. Cortisol in hair is a new biomarker of prolonged stress.

Mother and child hair cortisol association suggests a heritable part or maternal calibration. Cortisol output gradually stabilizes, has a stable trait, and is positively correlated to birth weight. Hair cortisol is a promising noninvasive biomarker of prolonged stress, especially applicable for children. (Read the full article)




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Approval and Perceived Impact of Duty Hour Regulations: Survey of Pediatric Program Directors

Several studies have been published evaluating the impact of 2011 Accreditation Council for Graduate Medical Education duty hour regulations. Although resident quality of life may be improved, it appears that resident education and patient care may be worse.

This is the first study to evaluate pediatric program director approval of 2011 Accreditation Council for Graduate Medical Education Common Program Requirements and the perceived impact of the regulations on patient care, resident education, and quality of life. (Read the full article)




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Early Feeding and Risk of Celiac Disease in a Prospective Birth Cohort

Lower risk of early celiac disease (CD) has been observed with breastfeeding and low dose of gluten at introduction. Gluten introduction before 4 or after 6 months has been associated with increased risk. For CD diagnosed after 2 years, the association is unclear.

Gluten introduction delayed to >6 months as well as breastfeeding >12 months was associated with a modest increase in CD in this first population-based birth cohort study, and gluten introduction under continued breastfeeding was not protective. (Read the full article)




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Clinical Utility of the Colorado Learning Difficulties Questionnaire

Caregiver behavioral symptom ratings are frequently used to assist in diagnosing childhood behavioral disorders. Although behavioral disorders are highly comorbid with learning disabilities (LDs), little work has examined the utility of caregiver ratings of learning concerns for screening of comorbid LD.

The validity of a time- and cost-efficient caregiver rating of academic concerns (Colorado Learning Difficulties Questionnaire) was examined. The screening measure accurately predicted children without LD, suggesting that the absence of parent-reported difficulties may be adequate to rule out overt LD. (Read the full article)




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Prenatal Exposure to Air Pollution, Maternal Psychological Distress, and Child Behavior

Prenatal exposures to diverse pollutants and psychosocial stressors have been shown independently to adversely affect child development. Less is known about the potential interactions between these factors, although they commonly co-occur, especially in disadvantaged populations.

The combination of high prenatal exposure to environmental polycyclic aromatic hydrocarbons and maternal demoralization adversely affects child behavior, and maternal demoralization has a greater effect among children with high prenatal polycyclic aromatic hydrocarbon exposure for a majority of behavioral symptoms. (Read the full article)




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Spanking and Child Development Across the First Decade of Life

A large and growing literature has demonstrated significant associations between the use of spanking and later child aggression, but we know less about paternal spanking, effects of spanking on cognitive development, and longer-term effects.

Accounting for a broad array of risk factors, spanking predicts both aggression and receptive vocabulary across the first decade of life. Importantly, we include paternal spanking, cognitive outcomes, and a longitudinal span longer than that of much of the literature. (Read the full article)




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Serum Tocopherol Levels in Very Preterm Infants After a Single Dose of Vitamin E at Birth

Preterm infants are born with low serum levels and low body stores of tocopherol. Serum levels ≥0.5 mg/dL are required for protection against lipid peroxidation. Previous studies have shown good intestinal absorption of vitamin E given intragastrically to preterm infants.

Serum α-tocopherol increases after a single 50-IU/kg dose of vitamin E as dl-α-tocopheryl acetate given intragastrically to very preterm infants soon after birth; however, 30% of infants still have serum α-tocopherol level <0.5 mg/dL 24 hours after dosing. (Read the full article)




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Age at Menarche and Age at First Sexual Intercourse: A Prospective Cohort Study

Young age at first sexual intercourse (FSI) is related to risk-taking behaviors and negative outcomes. Previous studies using a cohort or cross-sectional design have concluded that younger age at menarche (AAM) is related to younger age at FSI.

This large birth cohort study is the first to address the temporal relationship between AAM and FSI. We found that younger AAM does not confer higher risk of early FSI, whether in terms of calendar age or time since menarche. (Read the full article)




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Acetylcholinesterase Activity and Neurodevelopment in Boys and Girls

Prenatal and postnatal organophosphate (cholinesterase inhibitor) pesticide exposure has been associated with delays in attention, memory, intelligence, and inhibitory control. Two recent studies reported decreased attention and working memory with greater exposure to organophosphates in boys but not in girls.

This is the first study to report associations between decreased acetylcholinesterase activity, a stable marker of cholinesterase inhibitor pesticide exposure, and lower overall neurodevelopment, attention, inhibitory control, and memory. These associations were present in boys but not in girls. (Read the full article)




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Gestational Age, Birth Weight, and Risk of Respiratory Hospital Admission in Childhood

Preterm birth is associated with increased morbidity during childhood. Many studies have focused on outcomes for preterm births before 32 weeks’ gestation, but there are few follow-up data for late preterm infants (34–36 weeks’ gestation).

The risk of respiratory admission during childhood decreased with each successive week in gestation up to 40 to 42 weeks. The increased risk is small for late preterm infants, but the number affected is large and has an impact on health care services. (Read the full article)




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Psychosocial Outcomes of Young Adults Born Very Low Birth Weight

Several studies have suggested that very low birth weight young adults have increased risks of physical and health problems, educational underachievement, and poorer social functioning than their peers, but there are limited population-based and longitudinal data.

Former VLBW young adults in this national cohort scored as well as term controls on many measures of health and social functioning, including quality-of-life scores, with some differences largely confined to those with disability at age 7 to 8 years. (Read the full article)




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Bidirectional Associations Between Mothers' and Fathers' Parenting Consistency and Child BMI

Parents influence their child’s overweight development through lifestyle-related parenting practices. Although broader parenting dimensions may also affect children’s BMI, reverse causality is possible and there have been calls to examine the possible impacts of fathers.

More consistent parenting prospectively predicted lower child BMI with effects equally strong for fathers and mothers. There was little evidence of child BMI influencing parenting. Improved child BMI could be among the benefits of promoting parenting consistency of both parents. (Read the full article)




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Environmental Risk Factors by Gender Associated With Attention-Deficit/Hyperactivity Disorder

Attention-deficit/hyperactivity disorder (ADHD) is the most common mental health condition diagnosed in childhood, is highly heritable, and more common in boys. Although studies have identified perinatal risk factors, no one has investigated perinatal risk factors separately in boys and girls.

Contrary to other studies, low birth weight, postterm pregnancy, low Apgar scores, and fetal distress were not risk factors for ADHD irrespective of gender. Early term deliveries increased the risk of ADHD, and oxytocin augmentation in girls may be protective. (Read the full article)




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Identifying Potential Kidney Donors Among Newborns Undergoing Circulatory Determination of Death

The demand for donor kidneys for transplantation exceeds supply. En bloc kidney transplantation and donation after determination of circulatory death from pediatric donors increases the potential donor pool.

Newborn infants undergoing elective withdrawal of life support in the NICU are a previously unrecognized source of potential kidney donors. (Read the full article)




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Early Puberty, Negative Peer Influence, and Problem Behaviors in Adolescent Girls

Early timing of puberty and affiliation with deviant friends are associated with higher levels of delinquent and aggressive behavior. Early-maturing adolescents tend to affiliate with more-deviant peers and appear more susceptible to negative peer influences.

Young early-maturing girls do not yet associate with deviant friends but are more susceptible to negative peer influences. Early puberty effects are stable over time for delinquency but dissipate for aggression. Most of these relationships are invariant across race/ethnicity. (Read the full article)




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Comparative Effectiveness of Empiric Antibiotics for Community-Acquired Pneumonia

Broad-spectrum antibiotics are frequently used to empirically treat children hospitalized with community-acquired pneumonia despite recent national recommendations to use narrow-spectrum antibiotics.

Narrow-spectrum antibiotics are similar to broad-spectrum antibiotics for the treatment of children hospitalized with community-acquired pneumonia in terms of clinical outcomes and resource utilization. This study provides scientific evidence to support national consensus guidelines. (Read the full article)




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Acute Lower Respiratory Infection Among Bacille Calmette-Guerin (BCG)-Vaccinated Children

Bacille Calmette-Guerin (BCG) vaccination may provide benefits beyond protecting against pediatric tuberculosis. Evidence suggests links between cell-mediated immunity from tuberculosis and bacterial/viral-related pneumonia but the impact of BCG on acute lower respiratory infection is not fully known.

BCG-vaccinated children had a lower risk of suspected acute lower respiratory infection. Protection was amplified when children were vaccinated against diphtheria-tetanus-pertussis (DTP). Number of DTP doses did not modify this effect, but order in which vaccines were received did. (Read the full article)




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Human Rhinovirus and Disease Severity in Children

Human rhinovirus has been known as the common cold agent. Recently, studies have reported that this virus is responsible for severe infections of the lower respiratory tract in children. Reports of factors that increase disease severity have been contradictory.

This study identifies some of the factors involved in disease severity in HRV infections in children. We expect that children at risk for developing severe disease could be identified sooner and appropriate measures could be taken. (Read the full article)




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Patient Health Questionnaire for School-Based Depression Screening Among Chinese Adolescents

Major depression is common among adolescents. The PHQ-9 has good sensitivity and specificity for detecting depression among adolescents in primary care settings. However, no study has examined the psychometric properties of the PHQ-9 among Chinese adolescents in school settings.

This is the first study to validate the use of the PHQ-9, Patient Health Questionnaire–2 item, and Patient Health Questionnaire–1 item among Chinese adolescents in Taiwan. The PHQ-9 and its 2 subscales have good sensitivity and specificity for detecting depression among school adolescents. (Read the full article)




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Hospitalizations Due to Firearm Injuries in Children and Adolescents

Firearm injuries are the second leading cause of death among American children. Previous estimates of nonfatal injuries have relied on small samples of emergency department visits and do not allow a detailed understanding of these injuries among children and adolescents.

In 2009, there were 7391 hospitalizations for firearm-related injuries in US children and adolescents; 89% of hospitalizations occurred in males. Hospitalization rates were highest for 15- to 19-year-olds and for black males. Deaths in the hospital occurred in 6.1% of children and adolescents. (Read the full article)




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Incidence and Impact of CMV Infection in Very Low Birth Weight Infants

Congenital cytomegalovirus (CMV) infection is a leading cause of sensorineural hearing loss and neurodevelopmental impairment in full-term infants. The incidence of congenital CMV infection in preterm infants and the possible associations with developmental outcomes are unknown.

This study defines the incidence of congenital CMV infection in very low birth weight infants and identifies strong associations of congenital CMV infection with hearing loss and adverse neurodevelopmental outcomes in this population. (Read the full article)




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Fertility Rate Trends Among Adolescent Girls With Major Mental Illness: A Population-Based Study

Although fertility rates among adolescents have declined in recent years, certain groups of adolescent girls remain at risk. Whereas adolescents with major mental illness have many risk factors for teenage pregnancy, their fertility rates have not been yet to be examined.

Fertility rates among adolescent girls with major mental illness are almost 3 times higher than among unaffected adolescents and are not decreasing to the same extent. Mental health considerations are highly important for pregnancy prevention and for perinatal interventions targeting adolescents. (Read the full article)




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Duration of Protection After First Dose of Acellular Pertussis Vaccine in Infants

Waning effectiveness of 5 doses of acellular pertussis vaccines is well documented after 6 years of age, but data are lacking for fewer doses in younger children.

In 2- to 3-month-old infants, 1 dose of the diphtheria–tetanus–acellular pertussis vaccine gave significant protection against hospitalized pertussis. The effectiveness of 3 doses decreased from 84% between 6 and 11 months to 59% after 3 years. (Read the full article)




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Local Food Prices and Their Associations With Children's Weight and Food Security

A growing body of research suggests that the food environment affects children’s weight. Specifically, living in areas with higher-priced fast foods and soda is associated with lower weight and BMI, whereas higher fruit and vegetable prices demonstrate the opposite association.

Using longitudinal data on lower-income young children, this study finds that higher-priced fruits and vegetables are associated with higher child BMI, but not food insecurity, and that this relationship is driven by the prices of fresh fruits and vegetables. (Read the full article)




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Effectiveness of Nebulized Beclomethasone in Preventing Viral Wheezing: An RCT

Viral wheezing is common in preschool-aged children. The efficacy of inhaled steroids in preventing viral wheezing is debated. Despite this debate, nebulized beclomethasone is widely prescribed (particularly in a few countries) to children with upper respiratory tract infections.

Findings from this study confirm that inhaled steroids are not effective in preventing viral wheezing. Moreover, no differences were found in the persistence of symptoms (eg, runny nose, sore throat) or in the parental perception of asthma-like symptom severity. (Read the full article)




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Clinical Utility of PCR for Common Viruses in Acute Respiratory Illness

Quantitative real-time polymerase chain reaction allows sensitive detection of respiratory viruses. The clinical significance of detection of specific viruses is not fully understood, however, and several viruses have been detected in the respiratory tract of asymptomatic children.

Our results indicate that quantitative real-time polymerase chain reaction is limited at distinguishing acute infection from detection in asymptomatic children for rhinovirus, bocavirus, adenovirus, enterovirus, and coronavirus. (Read the full article)




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Thirdhand Smoke Beliefs of Parents

Little is known about how thirdhand smoke beliefs are related to smoking and quitting behaviors, and how parental smokers’ thirdhand smoke beliefs influence behaviors to protect children. A previous study suggests thirdhand smoke beliefs are associated with home smoking bans.

This is the first study to show that parents’ beliefs about thirdhand smoke are associated with multiple smoking-related attitudes and behaviors that affect the health of children. (Read the full article)




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Association Between Riding With an Impaired Driver and Driving While Impaired

Motor vehicle crashes, heavy drinking, and drug use are serious, interactive health concerns for the teenage population. Teenage alcohol-impaired driving behaviors are associated with heavy drinking, parenting practices, and exposure to drinking and driving.

Earliness of exposure to alcohol/drug impaired driving (DWI) and early licensure were independent risk factors for teenage DWI. A strong, positive dose-response existed between DWI and amount of prior exposure to DWI in the form of riding with an impaired driver. (Read the full article)




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Activity Levels in Mothers and Their Preschool Children

Physical activity is beneficial to health. Parents are crucial in shaping children’s behaviors, with active mothers appearing to have active children. Little is known about this association in preschool-aged children, or about factors influencing activity in mothers of young children.

Mother-child physical activity levels were positively associated and influenced by temporal and demographic factors. Maternal activity levels were low, and influences differ by activity intensity. Health promotion efforts to increase activity in mothers may also benefit their young children. (Read the full article)




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Free Thyroxine Levels After Very Preterm Birth and Neurodevelopmental Outcomes at Age 7 Years

Preterm infants have transiently lowered thyroid hormone levels during the early postnatal period. Past research suggests that low thyroid hormone levels are related to cognitive and developmental deficits in children born preterm.

Contrary to expectations, in this study of children born <30 weeks’ gestation, higher concentrations of free thyroxine over the first 6 weeks of life were associated with poorer cognitive function at 7 years of age. (Read the full article)




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Motor Vehicle-Pedestrian Collisions and Walking to School: The Role of the Built Environment

Many studies have demonstrated that the built environment is related to both collision risk and walking to school. However, little research examines the influence of the built environment on the relationship between walking to school and pedestrian collision risk.

Increased walking was not associated with increased pedestrian collision once the effects of the built environment and socioeconomic status were modeled. Safety was related primarily to the built environment and specifically features related to road crossing. (Read the full article)




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Genome-Wide Expression Profiles in Very Low Birth Weight Infants With Neonatal Sepsis

Rapid and reliable tools for the diagnosis of neonatal sepsis are still unavailable. No single biomarker studied has yielded conclusive results. Genome-wide expression profiles (GWEPs) have been successfully determined for the diagnosis of sepsis in pediatric and adult populations.

GWEPs are described for the first time in very low birth weight infants with proven bacterial sepsis. Our results suggest that GWEPs could be used for early discrimination of septic newborn versus nonseptic infants. (Read the full article)




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Empiric Combination Therapy for Gram-Negative Bacteremia

Existing data do not demonstrate a need for combination therapy after antimicrobial susceptibility data indicate adequate in vitro activity with β-lactam monotherapy. However, the role of empirical combination therapy for the treatment of Gram-negative bacteremia in children remains unsettled.

We conducted a retrospective, propensity-score matched study demonstrating no improvement in 10-day mortality of children who have Gram-negative bacteremia receiving empirical β-lactam and aminoglycoside combination therapy compared with β-lactam monotherapy, unless the bacteremic episode was attributable to a multidrug-resistant organism. (Read the full article)




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Rape Prevention Through Empowerment of Adolescent Girls

In parts of sub-Saharan Africa, sexual assault incidence among adolescents is as high as 24%, resulting in serious physical and mental health problems. In the United States, empowerment and self-defense training have been shown to decrease incidence of sexual assault.

This study evaluated an empowerment and self-defense training intervention for adolescent girls in the African context. This intervention proved highly effective at preventing sexual assault and should be replicable in other countries in sub-Saharan Africa and around the world. (Read the full article)




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United States Birth Weight Reference Corrected For Implausible Gestational Age Estimates

Population-based references of birth weight for gestational age are useful indices of birth size in clinical and research settings.

This article uses 2009–2010 US natality data and corrects for likely errors in gestational age dating to yield an up-to-date birth weight for gestational age reference. (Read the full article)




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Child Passenger Deaths Involving Alcohol-Impaired Drivers

Approximately 20% of US child passenger deaths involve an alcohol-impaired driver, typically in the child’s own vehicle. The higher the blood alcohol concentration of a driver, the more likely his or her child passenger was unrestrained in the fatal crash.

The risk of a child passenger dying while being transported with an alcohol-impaired driver varies meaningfully across states. These state-specific rates may help to inform renewed prevention efforts. (Read the full article)




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Respiratory Syncytial Virus Prophylaxis in Down Syndrome: A Prospective Cohort Study

Down syndrome is an independent risk factor for severe respiratory syncytial virus infection and subsequent hospitalization.

This observational study suggests that immunoprophylaxis may reduce respiratory syncytial virus-related hospitalization by 3.6-fold (95% confidence interval, 1.5–8.7) in children with Down syndrome overall. (Read the full article)




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Peer Mentoring for Type 2 Diabetes Prevention in First Nations Children

Type 2 diabetes mellitus is one of the fastest growing pediatric chronic illnesses worldwide and disproportionately affects indigenous people from all continents.

These data support the growing body of evidence that peer mentoring is an attractive strategy for teaching health behaviors and improving health outcomes in children. (Read the full article)




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Common Genetic Variants and Risk of Brain Injury After Preterm Birth

Preterm birth is strongly associated with alterations in brain development and long-term neurocognitive impairment that are not fully explained by environmental factors.

Common genetic variation in genes associated with schizophrenia and lipid metabolism modulates the risk for preterm brain injury; known susceptibilities to neurologic disease in later life may be exposed by the stress of preterm birth. (Read the full article)




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Safety of Rotavirus Vaccine in the NICU

Rotavirus vaccination is discouraged during hospitalization, given concerns regarding live-attenuated virus transmission; vaccination is recommended upon NICU discharge for eligible infants, however. Vaccination must be initiated before 104 days of age or infants become age-ineligible.

RotaTeq vaccine administered with routine 2-month vaccinations within the NICU was tolerated in recipients, with no suggestion of symptomatic nosocomial transmission to neighboring unvaccinated infants. (Read the full article)




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Follow-up Formula Consumption in 3- to 4-Year-Olds and Respiratory Infections: An RCT

Inadequate nutrient intake can compromise a child’s nutritional status, which may affect immune function. Improving dietary intake via a follow-up formula may support appropriate immune responses and improve a child’s ability to resist infection.

Children who consumed an experimental follow-up formula had fewer episodes and shorter duration of acute respiratory infections, as well as less antibiotic treatment, and fewer days missed of day care due to illness. (Read the full article)




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Validity of a Single Item Food Security Questionnaire in Arctic Canada

Food insecurity is best measured by comprehensive assessments. However, rapid assessments can be useful in certain circumstances, but their validity is not characterized.

Rapid assessment of food insecurity is feasible among Inuit adults and children. (Read the full article)




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Rotavirus Vaccines and Health Care Utilization for Diarrhea in the United States (2007-2011)

Since the introduction of rotavirus vaccines, diarrhea-associated health care utilization among US children has decreased substantially. Moreover, indirect benefits from rotavirus vaccination have been observed in unvaccinated children and in adults.

With increasing rotavirus vaccine coverage during 2009–2011, we observed continued reductions in diarrhea-associated health care utilization and cost. Both rotavirus vaccines conferred high protection against rotavirus hospitalizations; pentavalent rotavirus vaccine provided durable protection through the fourth year of life. (Read the full article)