Pub Date : 2026-01-20DOI: 10.1001/jamapediatrics.2025.5708
Chungsoo Kim,Mona Sharifi,Joseph S Ross,Yong Chen,Hua Xu,Harlan M Krumholz,Yuan Lu
{"title":"GLP-1 Receptor Agonist Prescriptions for Adolescents With Obesity and Associated Disparities.","authors":"Chungsoo Kim,Mona Sharifi,Joseph S Ross,Yong Chen,Hua Xu,Harlan M Krumholz,Yuan Lu","doi":"10.1001/jamapediatrics.2025.5708","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.5708","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"6 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146005033","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}
Pub Date : 2026-01-20DOI: 10.1001/jamapediatrics.2025.5717
Gillian M Nixon,Deborah Anderson,Alice Baker,Andrew Davidson,Amanda Griffiths,Anneke C Grobler,Gideon Pinczower,Joanne Rimmer,Elizabeth Rose,Chris J Selman,Catherine M Simpson,Moya Vandeleur,Kirsten P Perrett
ImportanceSymptoms of obstructive sleep apnea are common in childhood and associated with significant comorbidity. Surgical treatment with adenotonsillectomy is first-line treatment but medical treatments show potential to improve symptoms and reduce the need for surgery.ObjectiveTo determine the efficacy of 6 weeks of intranasal steroid (INS) compared with saline in children with obstructive sleep-disordered breathing (OSDB) with persistent symptoms after a 6-week intranasal saline run-in.Design, Setting, and ParticipantsThis was a double-blind, placebo-controlled, randomized clinical trial involving specialist clinic waitlists at 2 sites in Australia. Included were children aged 3 to 12 years. Study data were analyzed from January to June 2025.InterventionsAll children received once-daily intranasal saline for 6 weeks (run-in). Those with persisting symptoms (SDB score ≥-1) were randomized to either once-daily intranasal mometasone furoate, 50 µg, (INS) or continued saline for a further 6 weeks.Main Outcomes and MeasuresThe primary outcome was symptom resolution (SDB score <-1). Secondary outcomes included behavior, quality of life, and parental perception of need for surgery. Analyses were adjusted for site and baseline measures.ResultsA total of 150 children (mean [SD] age, 6.2 [2.3] years; 93 male [62%]) were recruited. Of 139 children who completed the run-in phase, 41 (29.5%) had symptom resolution after saline run-in. Among 93 children randomized to intervention groups (47 INS; 46 saline), symptom resolution occurred in 35.6% (95% CI, 22.9%-50.6%) and 36.4% (95% CI, 23.5%-51.6%) of the INS and saline group, respectively, with no evidence for a clinically significant difference between groups (risk difference, -0.9%; 95% CI, -20.7% to 19.0%; P = .93). No group differences were found in secondary outcomes. Subgroup analysis did not reveal a group more or less likely to respond to medical treatment.Conclusions and RelevanceResults of this randomized clinical trial show that 6 weeks of intranasal saline resolved OSDB symptoms in nearly one-third of children. An additional 6-week course of INS or saline led to resolution in another one-third (total resolution around 50%), with no added benefit from INS. Intranasal saline is an effective short-term first-line treatment for OSDB before consideration of polysomnography or surgical intervention. Results suggest that saline should be recommended for 3 months before assessing the need for specialist referral.Trial RegistrationClinicalTrials.gov Identifier: NCT05382494.
{"title":"Intranasal Treatments for Children With Sleep-Disordered Breathing: The MIST+ Randomized Clinical Trial.","authors":"Gillian M Nixon,Deborah Anderson,Alice Baker,Andrew Davidson,Amanda Griffiths,Anneke C Grobler,Gideon Pinczower,Joanne Rimmer,Elizabeth Rose,Chris J Selman,Catherine M Simpson,Moya Vandeleur,Kirsten P Perrett","doi":"10.1001/jamapediatrics.2025.5717","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.5717","url":null,"abstract":"ImportanceSymptoms of obstructive sleep apnea are common in childhood and associated with significant comorbidity. Surgical treatment with adenotonsillectomy is first-line treatment but medical treatments show potential to improve symptoms and reduce the need for surgery.ObjectiveTo determine the efficacy of 6 weeks of intranasal steroid (INS) compared with saline in children with obstructive sleep-disordered breathing (OSDB) with persistent symptoms after a 6-week intranasal saline run-in.Design, Setting, and ParticipantsThis was a double-blind, placebo-controlled, randomized clinical trial involving specialist clinic waitlists at 2 sites in Australia. Included were children aged 3 to 12 years. Study data were analyzed from January to June 2025.InterventionsAll children received once-daily intranasal saline for 6 weeks (run-in). Those with persisting symptoms (SDB score ≥-1) were randomized to either once-daily intranasal mometasone furoate, 50 µg, (INS) or continued saline for a further 6 weeks.Main Outcomes and MeasuresThe primary outcome was symptom resolution (SDB score <-1). Secondary outcomes included behavior, quality of life, and parental perception of need for surgery. Analyses were adjusted for site and baseline measures.ResultsA total of 150 children (mean [SD] age, 6.2 [2.3] years; 93 male [62%]) were recruited. Of 139 children who completed the run-in phase, 41 (29.5%) had symptom resolution after saline run-in. Among 93 children randomized to intervention groups (47 INS; 46 saline), symptom resolution occurred in 35.6% (95% CI, 22.9%-50.6%) and 36.4% (95% CI, 23.5%-51.6%) of the INS and saline group, respectively, with no evidence for a clinically significant difference between groups (risk difference, -0.9%; 95% CI, -20.7% to 19.0%; P = .93). No group differences were found in secondary outcomes. Subgroup analysis did not reveal a group more or less likely to respond to medical treatment.Conclusions and RelevanceResults of this randomized clinical trial show that 6 weeks of intranasal saline resolved OSDB symptoms in nearly one-third of children. An additional 6-week course of INS or saline led to resolution in another one-third (total resolution around 50%), with no added benefit from INS. Intranasal saline is an effective short-term first-line treatment for OSDB before consideration of polysomnography or surgical intervention. Results suggest that saline should be recommended for 3 months before assessing the need for specialist referral.Trial RegistrationClinicalTrials.gov Identifier: NCT05382494.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"44 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146005238","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}
Pub Date : 2026-01-12DOI: 10.1001/jamapediatrics.2025.5619
Ben Singh,Mason Zhou,Rachel Curtis,Carol Maher,Dorothea Dumuid
ImportanceSocial media's association with adolescent well-being remains debated. Heavy use has been associated with distress, while abstinence may cause missed connections.ObjectiveTo investigate 3-year longitudinal associations between after-school social media use and adolescent well-being using a large longitudinal cohort dataset modeled within a repeated cross-sectional framework.Design, Setting, and ParticipantsThis cohort study included Australian students in grades 4 through 12 (2019-2022). After-school social media use was self-reported and grouped as none, moderate, or highest. Well-being was assessed using 8 validated indicators (eg, happiness, life satisfaction, emotional regulation), dichotomized as high vs low. Well-being was assessed concurrently with social media use during the annual school-based survey in each year of data collection. Data analysis was conducted from June to July 2025.ExposuresSelf-reported after-school social media use between 3 pm and 6 pm (weekdays), classified into 3 categories: none (0 h/wk), moderate (>0 to <12.5 h/wk), and highest (≥12.5 h/wk).Main Outcomes and MeasuresThe primary outcome was overall well-being, measured as the mean score across 8 validated domains (happiness, optimism, life satisfaction, worry, sadness, perseverance, emotional regulation, and cognitive engagement), dichotomized as high vs low (<3 on a scale of 1-5). Secondary outcomes were each individual well-being indicator, similarly dichotomized. Mixed-effects logistic models were used for analyses, stratified by sex and adjusted for demographic covariates.ResultsThe analytic sample included 100 991 adolescents, contributing 173 533 observations (86 582 [49.9%] observations from female participants; mean [SD] age, 13.5 [2.2] years). A U-shaped association was observed between after-school social media use and well-being. Compared with moderate users, adolescents with the highest use had greater odds of low well-being (grades 7-9, girls: odds ratio [OR], 3.13 [95% CI, 2.88-3.39]; boys: OR, 2.25 [95% CI, 1.86-2.72]), while nonusers also had higher odds of low well-being in later adolescence (grades 10-12, girls: OR, 1.79 [95% CI, 1.41-2.27]; boys: OR, 3.00 [95% CI, 2.01-4.46]). These patterns were consistent across survey years and robust to sensitivity analyses.Conclusions and RelevanceIn this cohort study of students in grades 4 through 12, social media's association with adolescent well-being was complex and nonlinear, varying by age and sex. While heavy use was associated with poorer well-being and abstinence sometimes coincided with less favorable outcomes, these findings are observational and should be interpreted cautiously.
{"title":"Social Media Use and Well-Being Across Adolescent Development.","authors":"Ben Singh,Mason Zhou,Rachel Curtis,Carol Maher,Dorothea Dumuid","doi":"10.1001/jamapediatrics.2025.5619","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.5619","url":null,"abstract":"ImportanceSocial media's association with adolescent well-being remains debated. Heavy use has been associated with distress, while abstinence may cause missed connections.ObjectiveTo investigate 3-year longitudinal associations between after-school social media use and adolescent well-being using a large longitudinal cohort dataset modeled within a repeated cross-sectional framework.Design, Setting, and ParticipantsThis cohort study included Australian students in grades 4 through 12 (2019-2022). After-school social media use was self-reported and grouped as none, moderate, or highest. Well-being was assessed using 8 validated indicators (eg, happiness, life satisfaction, emotional regulation), dichotomized as high vs low. Well-being was assessed concurrently with social media use during the annual school-based survey in each year of data collection. Data analysis was conducted from June to July 2025.ExposuresSelf-reported after-school social media use between 3 pm and 6 pm (weekdays), classified into 3 categories: none (0 h/wk), moderate (>0 to <12.5 h/wk), and highest (≥12.5 h/wk).Main Outcomes and MeasuresThe primary outcome was overall well-being, measured as the mean score across 8 validated domains (happiness, optimism, life satisfaction, worry, sadness, perseverance, emotional regulation, and cognitive engagement), dichotomized as high vs low (<3 on a scale of 1-5). Secondary outcomes were each individual well-being indicator, similarly dichotomized. Mixed-effects logistic models were used for analyses, stratified by sex and adjusted for demographic covariates.ResultsThe analytic sample included 100 991 adolescents, contributing 173 533 observations (86 582 [49.9%] observations from female participants; mean [SD] age, 13.5 [2.2] years). A U-shaped association was observed between after-school social media use and well-being. Compared with moderate users, adolescents with the highest use had greater odds of low well-being (grades 7-9, girls: odds ratio [OR], 3.13 [95% CI, 2.88-3.39]; boys: OR, 2.25 [95% CI, 1.86-2.72]), while nonusers also had higher odds of low well-being in later adolescence (grades 10-12, girls: OR, 1.79 [95% CI, 1.41-2.27]; boys: OR, 3.00 [95% CI, 2.01-4.46]). These patterns were consistent across survey years and robust to sensitivity analyses.Conclusions and RelevanceIn this cohort study of students in grades 4 through 12, social media's association with adolescent well-being was complex and nonlinear, varying by age and sex. While heavy use was associated with poorer well-being and abstinence sometimes coincided with less favorable outcomes, these findings are observational and should be interpreted cautiously.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"39 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949778","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}
Pub Date : 2026-01-12DOI: 10.1001/jamapediatrics.2025.5627
Yael Cannon,Julie M Linton,Del Ivey,Shaquita Bell
{"title":"The Politics and Policies Against US Children.","authors":"Yael Cannon,Julie M Linton,Del Ivey,Shaquita Bell","doi":"10.1001/jamapediatrics.2025.5627","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.5627","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"6 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949781","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}
Pub Date : 2026-01-12DOI: 10.1001/jamapediatrics.2025.5980
{"title":"Error in Table, Text, and Figure.","authors":"","doi":"10.1001/jamapediatrics.2025.5980","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.5980","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"3 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949780","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}
Pub Date : 2026-01-12DOI: 10.1001/jamapediatrics.2025.5630
Haris Majeed,Carmen H Logie,Daniyal Zuberi
{"title":"Child Poverty Trends by Race and Ethnicity in the US From 2022 to 2025.","authors":"Haris Majeed,Carmen H Logie,Daniyal Zuberi","doi":"10.1001/jamapediatrics.2025.5630","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.5630","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"48 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949777","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}
Pub Date : 2026-01-05DOI: 10.1001/jamapediatrics.2025.5450
Avihu Z. Gazit, Steven M. Schwartz, Joshua W. Salvin, Peter C. Laussen
This Viewpoint examines the gap between the development of artificial intelligence (AI) models in pediatric intensive care and their use in clinical practice and proposes deployment of AI models during specific phases of care.
{"title":"AI in Critical Care—Use for De-Escalation Rather Than Escalation of Care","authors":"Avihu Z. Gazit, Steven M. Schwartz, Joshua W. Salvin, Peter C. Laussen","doi":"10.1001/jamapediatrics.2025.5450","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.5450","url":null,"abstract":"This Viewpoint examines the gap between the development of artificial intelligence (AI) models in pediatric intensive care and their use in clinical practice and proposes deployment of AI models during specific phases of care.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"79 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145897753","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}
Pub Date : 2026-01-05DOI: 10.1001/jamapediatrics.2025.5485
Kyung E Rhee,Tanayott Thaweethai,Deepti B Pant,Cheryl R Stein,Amy L Salisbury,Patricia A Kinser,Lawrence C Kleinman,Richard Gallagher,David Warburton,Sindhu Mohandas,Jessica N Snowden,Melissa S Stockwell,Kelan G Tantisira,Valerie J Flaherman,Ronald J Teufel,Leah Castro,Alicia Chung,Jocelyn Espinoza Esparza,Christine W Hockett,Maria Isidoro-Chino,Anita Krishnan,Lacey A McCormack,Aleisha M Nabower,Erica R Nahin,Johana M Rosas,Sarwat Siddiqui,Jacqueline R Szmuszkovicz,Nita Vangeepuram,Emily Zimmerman,Heather-Elizabeth Brown,Megan Carmilani,K Coombs,Liza Fisher,Margot Gage Witvliet,John C Wood,Joshua D Milner,Erika B Rosenzweig,Katherine Irby,Elizabeth W Karlson,Zihan Qian,Michelle F Lamendola-Essel,Denise C Hasson,Stuart D Katz,H Shonna Yin,Andrea S Foulkes,Rachel S Gross, ,Judy L Aschner,Andrew M Atz,Dithi Banerjee,Amanda Bogie,Hulya Bukulmez,Katharine Clouser,Lesley A Cottrell,Kelly Cowan,Viren A D'Sa,Allen J Dozor,Amy J Elliott,E Vince S Faustino,Alexander G Fiks,Sunanda Gaur,Maria L Gennaro,Stewart T Gordon,Uzma N Hasan,Christina M Hester,Alexander H Hogan,Daniel S Hsia,David C Kaelber,Jessica S Kosut,Sankaran Krishnan,Russell J McCulloh,Ian C Michelow,Sheila M Nolan,Carlos R Oliveira,Wilson D Pace,Paul Palumbo,Hengameh Raissy,Andy Reyes,Judith L Ross,Juan C Salazar,Rangaraj Selvarangan,Michelle D Stevenson,Alan Werzberger,John M Westfall,Kathleen Zani,William T Zempsky,James Chan,Torri D Metz,Jane W Newburger,Dongngan T Truong,Candace H Feldman,Robin Aupperle,Fiona C Baker,Marie T Banich,Deanna M Barch,Arielle Baskin-Sommers,James M Bjork,Mirella Dapretto,Sandra A Brown,B J Casey,Linda Chang,Duncan B Clark,Anders M Dale,Thomas M Ernst,Damien A Fair,Sarah W Feldstein Ewing,John J Foxe,Edward G Freedman,Naomi P Friedman,Hugh Garavan,Dylan G Gee,Raul Gonzalez,Kevin M Gray,Mary M Heitzeg,Megan M Herting,Joanna Jacobus,Angela R Laird,Christine L Larson,Krista M Lisdahl,Monica Luciana,Beatriz Luna,Pamela A F Madden,Erin C McGlade,Eva M Müller-Oehring,Bonnie J Nagel,Michael C Neale,Martin P Paulus,Alexandra S Potter,Perry F Renshaw,Elizabeth R Sowell,Lindsay M Squeglia,Lucina Q Uddin,Sylia Wilson,Deborah A Yurgelun-Todd
ImportanceMillions of children worldwide are experiencing prolonged symptoms after SARS-CoV-2 infection, yet social risk factors for developing long COVID are largely unknown. As child health is influenced by the environment in which they live and interact, adverse social determinants of health (SDOH) may contribute to the development of pediatric long COVID.ObjectiveTo identify whether adverse SDOH are associated with increased odds of long COVID in school-aged children and adolescents in the US.Design, Setting, and ParticipantsThis cross-sectional analysis of a multicenter, longitudinal, meta-cohort study encompassed 52 sites (health care and community settings) across the US. School-aged children (6-11 years; n = 903) and adolescents (12-17 years; n = 3681) with SARS-CoV-2 infection history were included. Those with an unknown date of first infection, history of multisystem inflammatory syndrome in children, or symptom surveys with less than 50% of questions completed were excluded. Participants were recruited via health care systems, long COVID clinics, fliers, websites, social media campaigns, radio, health fairs, community-based organizations, community health workers, and existing research cohorts from March 2022 to August 2024, and surveys were completed by caregivers between March 2022 and August 2024.ExposureTwenty-four individual social determinant of health factors were grouped into 5 Healthy People 2030 domains: economic stability, social and community context, caregiver education access and quality, neighborhood and built environment, and health care access and quality. Latent classes were created within each domain and used in regression models.Main Outcomes and MeasuresPresence of long COVID using caregiver-reported, symptom-based, age-specific research indices.ResultsThe mean (SD) age among 4584 individuals included in this study was 14 (3) years, and 2330 (51%) of participants were male. The number of latent classes varied by domain; the reference group was the class with the least adversity. In unadjusted analyses, most classes in each domain were associated with higher odds of long COVID. After adjusting for many factors, including age group, sex, timing of infection, referral source, and other social determinant of health domains, economic instability characterized by difficulty covering expenses, poverty, receipt of government assistance, and food insecurity were associated with an increased risk of having long COVID (class 2 adjusted odds ratio [aOR], 1.57; 95% CI, 1.18-2.09; class 4 aOR, 2.39; 95% CI, 1.73-3.30); economic instability without food insecurity (class 3) was not (aOR, 0.93; 95% CI, 0.70-1.23). Poorer social and community context (eg, high levels of discrimination and low social support) was also associated with long COVID (aOR, 2.17; 95% CI, 1.77-2.66). Sensitivity analyses stratified by age group and adjusted for race and ethnicity did not alter or attenuate these results.Conclusions and RelevanceIn this stud
{"title":"Social Determinants of Health and Pediatric Long COVID in the US.","authors":"Kyung E Rhee,Tanayott Thaweethai,Deepti B Pant,Cheryl R Stein,Amy L Salisbury,Patricia A Kinser,Lawrence C Kleinman,Richard Gallagher,David Warburton,Sindhu Mohandas,Jessica N Snowden,Melissa S Stockwell,Kelan G Tantisira,Valerie J Flaherman,Ronald J Teufel,Leah Castro,Alicia Chung,Jocelyn Espinoza Esparza,Christine W Hockett,Maria Isidoro-Chino,Anita Krishnan,Lacey A McCormack,Aleisha M Nabower,Erica R Nahin,Johana M Rosas,Sarwat Siddiqui,Jacqueline R Szmuszkovicz,Nita Vangeepuram,Emily Zimmerman,Heather-Elizabeth Brown,Megan Carmilani,K Coombs,Liza Fisher,Margot Gage Witvliet,John C Wood,Joshua D Milner,Erika B Rosenzweig,Katherine Irby,Elizabeth W Karlson,Zihan Qian,Michelle F Lamendola-Essel,Denise C Hasson,Stuart D Katz,H Shonna Yin,Andrea S Foulkes,Rachel S Gross, ,Judy L Aschner,Andrew M Atz,Dithi Banerjee,Amanda Bogie,Hulya Bukulmez,Katharine Clouser,Lesley A Cottrell,Kelly Cowan,Viren A D'Sa,Allen J Dozor,Amy J Elliott,E Vince S Faustino,Alexander G Fiks,Sunanda Gaur,Maria L Gennaro,Stewart T Gordon,Uzma N Hasan,Christina M Hester,Alexander H Hogan,Daniel S Hsia,David C Kaelber,Jessica S Kosut,Sankaran Krishnan,Russell J McCulloh,Ian C Michelow,Sheila M Nolan,Carlos R Oliveira,Wilson D Pace,Paul Palumbo,Hengameh Raissy,Andy Reyes,Judith L Ross,Juan C Salazar,Rangaraj Selvarangan,Michelle D Stevenson,Alan Werzberger,John M Westfall,Kathleen Zani,William T Zempsky,James Chan,Torri D Metz,Jane W Newburger,Dongngan T Truong,Candace H Feldman,Robin Aupperle,Fiona C Baker,Marie T Banich,Deanna M Barch,Arielle Baskin-Sommers,James M Bjork,Mirella Dapretto,Sandra A Brown,B J Casey,Linda Chang,Duncan B Clark,Anders M Dale,Thomas M Ernst,Damien A Fair,Sarah W Feldstein Ewing,John J Foxe,Edward G Freedman,Naomi P Friedman,Hugh Garavan,Dylan G Gee,Raul Gonzalez,Kevin M Gray,Mary M Heitzeg,Megan M Herting,Joanna Jacobus,Angela R Laird,Christine L Larson,Krista M Lisdahl,Monica Luciana,Beatriz Luna,Pamela A F Madden,Erin C McGlade,Eva M Müller-Oehring,Bonnie J Nagel,Michael C Neale,Martin P Paulus,Alexandra S Potter,Perry F Renshaw,Elizabeth R Sowell,Lindsay M Squeglia,Lucina Q Uddin,Sylia Wilson,Deborah A Yurgelun-Todd","doi":"10.1001/jamapediatrics.2025.5485","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.5485","url":null,"abstract":"ImportanceMillions of children worldwide are experiencing prolonged symptoms after SARS-CoV-2 infection, yet social risk factors for developing long COVID are largely unknown. As child health is influenced by the environment in which they live and interact, adverse social determinants of health (SDOH) may contribute to the development of pediatric long COVID.ObjectiveTo identify whether adverse SDOH are associated with increased odds of long COVID in school-aged children and adolescents in the US.Design, Setting, and ParticipantsThis cross-sectional analysis of a multicenter, longitudinal, meta-cohort study encompassed 52 sites (health care and community settings) across the US. School-aged children (6-11 years; n = 903) and adolescents (12-17 years; n = 3681) with SARS-CoV-2 infection history were included. Those with an unknown date of first infection, history of multisystem inflammatory syndrome in children, or symptom surveys with less than 50% of questions completed were excluded. Participants were recruited via health care systems, long COVID clinics, fliers, websites, social media campaigns, radio, health fairs, community-based organizations, community health workers, and existing research cohorts from March 2022 to August 2024, and surveys were completed by caregivers between March 2022 and August 2024.ExposureTwenty-four individual social determinant of health factors were grouped into 5 Healthy People 2030 domains: economic stability, social and community context, caregiver education access and quality, neighborhood and built environment, and health care access and quality. Latent classes were created within each domain and used in regression models.Main Outcomes and MeasuresPresence of long COVID using caregiver-reported, symptom-based, age-specific research indices.ResultsThe mean (SD) age among 4584 individuals included in this study was 14 (3) years, and 2330 (51%) of participants were male. The number of latent classes varied by domain; the reference group was the class with the least adversity. In unadjusted analyses, most classes in each domain were associated with higher odds of long COVID. After adjusting for many factors, including age group, sex, timing of infection, referral source, and other social determinant of health domains, economic instability characterized by difficulty covering expenses, poverty, receipt of government assistance, and food insecurity were associated with an increased risk of having long COVID (class 2 adjusted odds ratio [aOR], 1.57; 95% CI, 1.18-2.09; class 4 aOR, 2.39; 95% CI, 1.73-3.30); economic instability without food insecurity (class 3) was not (aOR, 0.93; 95% CI, 0.70-1.23). Poorer social and community context (eg, high levels of discrimination and low social support) was also associated with long COVID (aOR, 2.17; 95% CI, 1.77-2.66). Sensitivity analyses stratified by age group and adjusted for race and ethnicity did not alter or attenuate these results.Conclusions and RelevanceIn this stud","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"84 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145903552","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}
Pub Date : 2026-01-05DOI: 10.1001/jamapediatrics.2025.5443
Daniel R. Arnold, Megha Reddy, Jonathan Cantor, Ryan K. McBain, Hao Yu, Christopher M. Whaley, Yashaswini Singh
This economic evaluation reports the number of therapeutic services for autism spectrum disorder that were acquired by private equity companies between 2015 and 2024.
这份经济评估报告了2015年至2024年间私募股权公司收购的自闭症谱系障碍治疗服务的数量。
{"title":"Private Equity in Autism Services","authors":"Daniel R. Arnold, Megha Reddy, Jonathan Cantor, Ryan K. McBain, Hao Yu, Christopher M. Whaley, Yashaswini Singh","doi":"10.1001/jamapediatrics.2025.5443","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.5443","url":null,"abstract":"This economic evaluation reports the number of therapeutic services for autism spectrum disorder that were acquired by private equity companies between 2015 and 2024.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"94 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145897819","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：