Pub Date : 2025-01-13DOI: 10.1001/jamapediatrics.2024.5326
Antonio Piolanti, Iason E. Schmid, Fabian J. Fiderer, Catherine L. Ward, Heidi Stöckl, Heather M. Foran
ImportanceSexual violence against children is a global concern, yet worldwide figures of its prevalence are scant.ObjectiveTo estimate the global prevalence of sexual violence against children using national-level population-based studies.Data SourcesWe searched the PubMed, Embase, CINAHL, Web of Science, PsycINFO, ERIC, and APA PsycArticles databases from their respective inceptions to March 2022. Searches were updated through April 2024.Study SelectionReports were included if (1) they were national-level population-based studies, (2) they reported lifetime or past-year prevalence data on any form of sexual violence against children (mean age ≤19 years), and (3) the data were based on children’s self-reports of sexual violence perpetrated by anyone.Data Extraction and SynthesisData extraction included study and participant characteristics, prevalence rates, and types of sexual violence. Outcomes were pooled using a random-effects model. Exploratory subgroup analyses were performed with categorical moderators.Main Outcomes and MeasuresPrimary outcomes included lifetime and past-year prevalence of forced sexual intercourse, contact sexual violence, and sexual harassment.ResultsWe identified 165 studies that included 958 182 children from 80 countries, with the majority of data focusing on girls (58.2%). The sample sizes of the studies ranged from 330 to 132 948; the mean age ranged from 10.5 to 19.4 years. Lifetime sexual harassment was the most prevalent outcome, with a pooled rate of 11.4% (95% CI, 8.5%-15.1%), followed by any contact sexual violence, with a rate of 8.7% (95% CI, 4.7%-15.5%). Furthermore, 6.1% (95% CI, 5.1%-7.3%) of children reported experiencing completed forced sexual intercourse in their lifetime, and 1.3% (95% CI, 1.0%-1.7%) reported experiencing it in the preceding year. Rates of lifetime completed forced sexual intercourse were higher among girls (6.8% [95% CI, 6.1%-7.6%]) compared with boys (3.3% [95% CI, 2.5%-4.3%]), similar to past-year violence (2.3% [95% CI 1.9%-2.7%] for girls and 0.6% [95% CI 0.4%-0.9%] for boys). We found considerable variation across regions and countries in the reported prevalence of sexual violence. Older age of children, lower national income levels, and the use of school-based surveys were associated with higher rates of sexual violence reporting in some exploratory analyses.Conclusions and RelevanceThe findings of this systematic review and meta-analysis highlight the burden of sexual violence against children worldwide based on current available evidence. There is a pressing need to enhance data collection efforts globally, especially in underresearched regions and for boys.Study RegistrationPROSPERO CRD42022327090
针对儿童的性暴力是一个全球关注的问题，但全球范围内关于其普遍程度的数据很少。目的通过国家级人口研究，估计全球儿童性暴力发生率。我们检索了PubMed， Embase， CINAHL, Web of Science, PsycINFO， ERIC和APA的PsycArticles数据库，从它们各自的创建到2022年3月。搜索更新到2024年4月。研究选择纳入以下报告：(1)它们是国家级的基于人群的研究，(2)它们报告了针对儿童的任何形式的性暴力的终生或过去一年的流行数据（平均年龄≤19岁），以及(3)数据基于儿童对任何人实施的性暴力的自我报告。数据提取和综合数据提取包括研究和参与者特征、患病率和性暴力类型。使用随机效应模型汇总结果。探索性亚组分析采用分类调节因子。主要结局和测量方法主要结局包括终生和过去一年强迫性交、接触性暴力和性骚扰的发生率。我们确定了165项研究，包括来自80个国家的958182名儿童，其中大多数数据集中在女孩身上（58.2%）。这些研究的样本量从330到133248不等；平均年龄为10.5 ~ 19.4岁。终身性骚扰是最普遍的结果，总发生率为11.4% (95% CI, 8.5%-15.1%)，其次是任何接触性暴力，发生率为8.7% （95% CI, 4.7%-15.5%）。此外，6.1% （95% CI, 5.1%-7.3%）的儿童报告在其一生中经历过完全的强迫性交，1.3% （95% CI, 1.0%-1.7%）的儿童报告在前一年经历过。终生强迫性交的发生率在女孩中（6.8% [95% CI, 6.1%-7.6%]）高于男孩（3.3% [95% CI, 2.5%-4.3%]），与过去一年的暴力发生率相似（女孩为2.3% [95% CI 1.9%-2.7%]，男孩为0.6% [95% CI 0.4%-0.9%]）。我们发现，不同地区和国家报告的性暴力发生率存在很大差异。在一些探索性分析中，儿童年龄较大、国民收入水平较低以及使用基于学校的调查与较高的性暴力报告率有关。结论和相关性这项系统回顾和荟萃分析的结果强调了基于现有证据的世界范围内针对儿童的性暴力负担。迫切需要在全球范围内加强数据收集工作，特别是在研究不足的地区和男孩。研究注册号prospero CRD42022327090
{"title":"Global Prevalence of Sexual Violence Against Children","authors":"Antonio Piolanti, Iason E. Schmid, Fabian J. Fiderer, Catherine L. Ward, Heidi Stöckl, Heather M. Foran","doi":"10.1001/jamapediatrics.2024.5326","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2024.5326","url":null,"abstract":"ImportanceSexual violence against children is a global concern, yet worldwide figures of its prevalence are scant.ObjectiveTo estimate the global prevalence of sexual violence against children using national-level population-based studies.Data SourcesWe searched the PubMed, Embase, CINAHL, Web of Science, PsycINFO, ERIC, and APA PsycArticles databases from their respective inceptions to March 2022. Searches were updated through April 2024.Study SelectionReports were included if (1) they were national-level population-based studies, (2) they reported lifetime or past-year prevalence data on any form of sexual violence against children (mean age ≤19 years), and (3) the data were based on children’s self-reports of sexual violence perpetrated by anyone.Data Extraction and SynthesisData extraction included study and participant characteristics, prevalence rates, and types of sexual violence. Outcomes were pooled using a random-effects model. Exploratory subgroup analyses were performed with categorical moderators.Main Outcomes and MeasuresPrimary outcomes included lifetime and past-year prevalence of forced sexual intercourse, contact sexual violence, and sexual harassment.ResultsWe identified 165 studies that included 958 182 children from 80 countries, with the majority of data focusing on girls (58.2%). The sample sizes of the studies ranged from 330 to 132 948; the mean age ranged from 10.5 to 19.4 years. Lifetime sexual harassment was the most prevalent outcome, with a pooled rate of 11.4% (95% CI, 8.5%-15.1%), followed by any contact sexual violence, with a rate of 8.7% (95% CI, 4.7%-15.5%). Furthermore, 6.1% (95% CI, 5.1%-7.3%) of children reported experiencing completed forced sexual intercourse in their lifetime, and 1.3% (95% CI, 1.0%-1.7%) reported experiencing it in the preceding year. Rates of lifetime completed forced sexual intercourse were higher among girls (6.8% [95% CI, 6.1%-7.6%]) compared with boys (3.3% [95% CI, 2.5%-4.3%]), similar to past-year violence (2.3% [95% CI 1.9%-2.7%] for girls and 0.6% [95% CI 0.4%-0.9%] for boys). We found considerable variation across regions and countries in the reported prevalence of sexual violence. Older age of children, lower national income levels, and the use of school-based surveys were associated with higher rates of sexual violence reporting in some exploratory analyses.Conclusions and RelevanceThe findings of this systematic review and meta-analysis highlight the burden of sexual violence against children worldwide based on current available evidence. There is a pressing need to enhance data collection efforts globally, especially in underresearched regions and for boys.Study RegistrationPROSPERO <jats:ext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" ext-link-type=\"uri\" xlink:href=\"https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022327090\">CRD42022327090</jats:ext-link>","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"50 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967927","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 : 2025-01-13DOI: 10.1001/jamapediatrics.2024.5474
David J Goldberg, Anna Costello, Bryan H Goldstein
{"title":"Is It Safe to Exhale?","authors":"David J Goldberg, Anna Costello, Bryan H Goldstein","doi":"10.1001/jamapediatrics.2024.5474","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2024.5474","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970897","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 : 2025-01-13DOI: 10.1001/jamapediatrics.2024.5100
Sophie Cain Miller, Mohammad H. Dar, S. Maria E. Finnell, Douglas G. Fish, Christopher R. Cogle
ImportanceCell and gene therapies are revolutionizing the treatment landscape for children and adults with rare diseases and can be life-changing for patients and their families. Successful implementation of these new therapies into clinical practice depends on their accessibility and affordability, particularly through publicly funded Medicaid agencies, which cover many children and adults with rare diseases.ObjectiveTo provide a framework to broadly assess cell and gene therapies, evaluate payment options, and ensure equitable access through the lens of publicly funded Medicaid programs.Evidence ReviewThis review draws on peer-reviewed articles, federal reports, and other relevant publications as well as the expertise of chief medical officers and medical directors of state Medicaid agencies across 5 diverse states.FindingsTwenty-nine articles and other references provide the foundation for this review. The recommendations presented focus on thoughtful implementation of cell and gene therapies, including policy recommendations in the domains of safety, effectiveness, population health, access, and budget.Conclusions and RelevanceProposed health care policy changes are intended to balance innovation, affordability, and equitable access for children and adults with rare diseases.
{"title":"Medicaid and the Promise for Cure","authors":"Sophie Cain Miller, Mohammad H. Dar, S. Maria E. Finnell, Douglas G. Fish, Christopher R. Cogle","doi":"10.1001/jamapediatrics.2024.5100","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2024.5100","url":null,"abstract":"ImportanceCell and gene therapies are revolutionizing the treatment landscape for children and adults with rare diseases and can be life-changing for patients and their families. Successful implementation of these new therapies into clinical practice depends on their accessibility and affordability, particularly through publicly funded Medicaid agencies, which cover many children and adults with rare diseases.ObjectiveTo provide a framework to broadly assess cell and gene therapies, evaluate payment options, and ensure equitable access through the lens of publicly funded Medicaid programs.Evidence ReviewThis review draws on peer-reviewed articles, federal reports, and other relevant publications as well as the expertise of chief medical officers and medical directors of state Medicaid agencies across 5 diverse states.FindingsTwenty-nine articles and other references provide the foundation for this review. The recommendations presented focus on thoughtful implementation of cell and gene therapies, including policy recommendations in the domains of safety, effectiveness, population health, access, and budget.Conclusions and RelevanceProposed health care policy changes are intended to balance innovation, affordability, and equitable access for children and adults with rare diseases.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"15 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967910","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 : 2025-01-13DOI: 10.1001/jamapediatrics.2024.5466
Dongngan T Truong, Felicia L Trachtenberg, Chenwei Hu, Gail D Pearson, Kevin Friedman, Arash A Sabati, Audrey Dionne, Matthew E Oster, Brett R Anderson, Joseph Block, Tamara T Bradford, M Jay Campbell, Laura D'Addese, Kirsten B Dummer, Matthew D Elias, Daniel Forsha, Olukayode D Garuba, Keren Hasbani, Kerri Hayes, Camden Hebson, Pei-Ni Jone, Anita Krishnan, Sean Lang, Brian W McCrindle, Kimberly E McHugh, Elizabeth C Mitchell, Tonia Morrison, Juan Carlos Muniz, R Mark Payne, Michael A Portman, Mark W Russell, Yamuna Sanil, Divya Shakti, Kavita Sharma, J Ryan Shea, Michelle Sykes, Lara S Shekerdemian, Jacqueline Szmuszkovicz, Deepika Thacker, Jane W Newburger
<p><strong>Importance: </strong>Multisystem inflammatory syndrome in children (MIS-C) is a life-threatening complication of COVID-19 infection. Data on midterm outcomes are limited.</p><p><strong>Objective: </strong>To characterize the frequency and time course of cardiac dysfunction (left ventricular ejection fraction [LVEF] <55%), coronary artery aneurysms (z score ≥2.5), and noncardiac involvement through 6 months after MIS-C.</p><p><strong>Design, setting, and participants: </strong>This cohort study enrolled participants between March 2020 and January 2022 with a follow-up period of 2 years. Participants were recruited from 32 North American pediatric hospitals, and all participants met the 2020 Centers for Disease Control and Prevention case definition of MIS-C.</p><p><strong>Exposure: </strong>MIS-C after COVID-19 infection.</p><p><strong>Main outcomes and measures: </strong>Outcomes included echocardiography core laboratory (ECL) assessments of LVEF and maximum coronary artery z scores (zMax); data collection on cardiac and noncardiac sequelae during hospitalization and at 2 weeks, 6 weeks, and 6 months after discharge; and age-appropriate Patient-Reported Outcomes Measurement Information Systems (PROMIS) Global Health Instruments at follow-up. Descriptive statistics, linear regression models, and Kaplan-Meier analysis were used.</p><p><strong>Results: </strong>Of 1204 participants (median [IQR] age, 9.1 [5.6-12.7] years; 724 male [60.1%]), 325 self-identified with non-Hispanic Black race (27.0%) and 324 with Hispanic ethnicity (26.9%). A total of 548 of 1195 participants (45.9%) required vasoactive support, 17 of 1195 (1.4%) required extracorporeal membrane oxygenation, and 3 (0.3%) died during hospitalization. Of participants with echocardiograms reviewed by the ECL (n = 349 due to budget constraints), 131 of 322 (42.3%) had LVEF less than 55% during hospitalization; of those with follow-up, all but 1 normalized by 6 months. Black race (vs other/unknown race), higher C-reactive protein level, and abnormal troponin level were associated with lowest LVEF (estimate [SE], -3.09 [0.98]; R2 = 0.14; P =.002). Fifteen participants had coronary artery z scores of 2.5 or greater at any time point; 1 participant had a large/giant aneurysm. Of the 13 participants with z scores of 2.5 or greater during hospitalization, 12 (92.3%) had normalized by 6 months. Return to greater than 90% of pre-MIS-C health status (energy, sleep, appetite, cognition, and mood) was reported by 711 of 824 participants (86.3%) at 2 weeks, increasing to 548 of 576 (95.1%) at 6 months. Fatigue was the most common symptom reported at 2 weeks (141 of 889 [15.9%]), falling to 3.4% (22 of 638) by 6 months. PROMIS Global Health parent/guardian proxy median T scores for fatigue, global health, and pain interference improved significantly from 2 weeks to 6 months (fatigue, 56.1 vs 48.9; global health, 48.8 vs 51.3; pain interference, 53.0 vs 43.3; P < .001) and by the 6-week visit
重要性：儿童多系统炎症综合征（MIS-C）是COVID-19感染的危及生命的并发症。中期结果的数据有限。目的：表征心功能障碍（左室射血分数[LVEF]）的频率和时间过程。设计、环境和参与者：该队列研究于2020年3月至2022年1月招募参与者，随访期为2年。参与者从32家北美儿科医院招募，所有参与者都符合2020年疾病控制和预防中心对MIS-C的病例定义。暴露：COVID-19感染后的MIS-C。主要观察指标：包括超声心动图核心实验室（ECL） LVEF评估和最大冠状动脉z评分（zMax）；住院期间、出院后2周、6周和6个月心脏和非心脏后遗症的数据收集；和与年龄相适应的患者报告结果测量信息系统（PROMIS）全球卫生工具的随访。采用描述性统计、线性回归模型和Kaplan-Meier分析。结果：1204名参与者(中位[IQR]年龄为9.1[5.6-12.7]岁；724名男性[60.1%])，325名自我认同为非西班牙裔黑人（27.0%），324名西班牙裔（26.9%）。1195名参与者中共有548名（45.9%）需要血管活性支持，17名（1.4%）需要体外膜氧合，3名（0.3%）在住院期间死亡。在ECL复查超声心动图的参与者中（由于预算限制，n = 349）， 322名参与者中有131名（42.3%）住院期间LVEF小于55%；在接受随访的患者中，除1例外，其余均在6个月后恢复正常。黑人（相对于其他/未知种族）、较高的c反应蛋白水平和异常的肌钙蛋白水平与最低的LVEF相关(估计[SE]， -3.09 [0.98]；r2 = 0.14；P = .002)。15名参与者的冠状动脉z评分在任何时间点都在2.5或更高；1例患者有大/巨型动脉瘤。在住院期间z得分为2.5或更高的13名参与者中，12名（92.3%）在6个月后恢复正常。824名参与者中有711人（86.3%）报告在2周时恢复到大于90%的mis - c前健康状态（能量、睡眠、食欲、认知和情绪），在6个月时增加到576人中的548人（95.1%）。疲劳是治疗2周时最常见的症状（889例中有141例[15.9%]），到6个月时下降到3.4%（638例中有22例）。从2周到6个月，PROMIS Global Health家长/监护人代理疲劳、整体健康和疼痛干扰的中位T评分显著提高(疲劳，56.1 vs 48.9；全球卫生，48.8比51.3；疼痛干扰，53.0 vs 43.3；结论和相关性：这项队列研究的结果表明，尽管患有MIS-C的儿童和年轻人在急性期可能有严重的疾病，但大多数人恢复得很快，中期预后令人放心。
{"title":"Six-Month Outcomes in the Long-Term Outcomes After the Multisystem Inflammatory Syndrome in Children Study.","authors":"Dongngan T Truong, Felicia L Trachtenberg, Chenwei Hu, Gail D Pearson, Kevin Friedman, Arash A Sabati, Audrey Dionne, Matthew E Oster, Brett R Anderson, Joseph Block, Tamara T Bradford, M Jay Campbell, Laura D'Addese, Kirsten B Dummer, Matthew D Elias, Daniel Forsha, Olukayode D Garuba, Keren Hasbani, Kerri Hayes, Camden Hebson, Pei-Ni Jone, Anita Krishnan, Sean Lang, Brian W McCrindle, Kimberly E McHugh, Elizabeth C Mitchell, Tonia Morrison, Juan Carlos Muniz, R Mark Payne, Michael A Portman, Mark W Russell, Yamuna Sanil, Divya Shakti, Kavita Sharma, J Ryan Shea, Michelle Sykes, Lara S Shekerdemian, Jacqueline Szmuszkovicz, Deepika Thacker, Jane W Newburger","doi":"10.1001/jamapediatrics.2024.5466","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2024.5466","url":null,"abstract":"<p><strong>Importance: </strong>Multisystem inflammatory syndrome in children (MIS-C) is a life-threatening complication of COVID-19 infection. Data on midterm outcomes are limited.</p><p><strong>Objective: </strong>To characterize the frequency and time course of cardiac dysfunction (left ventricular ejection fraction [LVEF] <55%), coronary artery aneurysms (z score ≥2.5), and noncardiac involvement through 6 months after MIS-C.</p><p><strong>Design, setting, and participants: </strong>This cohort study enrolled participants between March 2020 and January 2022 with a follow-up period of 2 years. Participants were recruited from 32 North American pediatric hospitals, and all participants met the 2020 Centers for Disease Control and Prevention case definition of MIS-C.</p><p><strong>Exposure: </strong>MIS-C after COVID-19 infection.</p><p><strong>Main outcomes and measures: </strong>Outcomes included echocardiography core laboratory (ECL) assessments of LVEF and maximum coronary artery z scores (zMax); data collection on cardiac and noncardiac sequelae during hospitalization and at 2 weeks, 6 weeks, and 6 months after discharge; and age-appropriate Patient-Reported Outcomes Measurement Information Systems (PROMIS) Global Health Instruments at follow-up. Descriptive statistics, linear regression models, and Kaplan-Meier analysis were used.</p><p><strong>Results: </strong>Of 1204 participants (median [IQR] age, 9.1 [5.6-12.7] years; 724 male [60.1%]), 325 self-identified with non-Hispanic Black race (27.0%) and 324 with Hispanic ethnicity (26.9%). A total of 548 of 1195 participants (45.9%) required vasoactive support, 17 of 1195 (1.4%) required extracorporeal membrane oxygenation, and 3 (0.3%) died during hospitalization. Of participants with echocardiograms reviewed by the ECL (n = 349 due to budget constraints), 131 of 322 (42.3%) had LVEF less than 55% during hospitalization; of those with follow-up, all but 1 normalized by 6 months. Black race (vs other/unknown race), higher C-reactive protein level, and abnormal troponin level were associated with lowest LVEF (estimate [SE], -3.09 [0.98]; R2 = 0.14; P =.002). Fifteen participants had coronary artery z scores of 2.5 or greater at any time point; 1 participant had a large/giant aneurysm. Of the 13 participants with z scores of 2.5 or greater during hospitalization, 12 (92.3%) had normalized by 6 months. Return to greater than 90% of pre-MIS-C health status (energy, sleep, appetite, cognition, and mood) was reported by 711 of 824 participants (86.3%) at 2 weeks, increasing to 548 of 576 (95.1%) at 6 months. Fatigue was the most common symptom reported at 2 weeks (141 of 889 [15.9%]), falling to 3.4% (22 of 638) by 6 months. PROMIS Global Health parent/guardian proxy median T scores for fatigue, global health, and pain interference improved significantly from 2 weeks to 6 months (fatigue, 56.1 vs 48.9; global health, 48.8 vs 51.3; pain interference, 53.0 vs 43.3; P < .001) and by the 6-week visit ","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970852","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 : 2025-01-13DOI: 10.1001/jamapediatrics.2024.6172
Roy Wade, Kenneth R Ginsburg
{"title":"Talking to Families of Color About Police Encounters.","authors":"Roy Wade, Kenneth R Ginsburg","doi":"10.1001/jamapediatrics.2024.6172","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2024.6172","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970856","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 : 2025-01-13DOI: 10.1001/jamapediatrics.2024.5333
David Finkelhor
{"title":"Meta-Analysis and Crossnational Comparisons of Sexual Violence Against Children.","authors":"David Finkelhor","doi":"10.1001/jamapediatrics.2024.5333","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2024.5333","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970899","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 : 2025-01-06DOI: 10.1001/jamapediatrics.2024.5539
Steven M Levy
{"title":"Caution Needed in Interpreting the Evidence Base on Fluoride and IQ.","authors":"Steven M Levy","doi":"10.1001/jamapediatrics.2024.5539","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2024.5539","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931814","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 : 2025-01-06DOI: 10.1001/jamapediatrics.2024.5311
Rachel G Greenberg, Wes Rountree, Mary Allen Staat, Elizabeth P Schlaudecker, Brenda Poindexter, Andrea Trembath, Matthew Laughon, Marek S Poniewierski, Rachel L Spreng, Karen R Broder, A Patricia Wodi, Oidda Museru, E Gloria Anyalechi, Paige L Marquez, Emily A Randolph, Samia Aleem, Ryan Kilpatrick, Emmanuel B Walter
<p><strong>Importance: </strong>Preterm infants are recommended to receive most vaccinations at the same postnatal age as term infants. Studies have inconsistently observed an increased risk for postvaccination apnea in preterm infants.</p><p><strong>Objective: </strong>To compare the proportions of hospitalized preterm infants with apnea and other adverse events in the 48 hours after 2-month vaccinations vs after no vaccinations.</p><p><strong>Design, setting, and participants: </strong>This randomized, open-label clinical trial took place at 3 US neonatal intensive care units between August 2018 and October 2021. Infants between 6 and 12 weeks' postnatal age who were born at less than 33 weeks' gestational age and were eligible to receive 2-month vaccines were included.</p><p><strong>Intervention: </strong>Infants were randomized 1:1 to vaccinated (received vaccines within 12 hours of randomization) or unvaccinated (no vaccines received during the study period) groups. Cardiorespiratory data were collected during the 48 hours after vaccination or randomization (unvaccinated group).</p><p><strong>Main outcomes and measures: </strong>The primary outcome was apnea, defined as a respiration pause greater than 20 seconds or a respiration pause greater than 15 seconds with associated bradycardia less than 80 beats per minute. Other outcomes included the number and duration of apnea episodes, serious adverse events, respiratory support escalation, and receipt of positive pressure ventilation.</p><p><strong>Results: </strong>Of 223 randomized infants (117 female; median [range] gestational age, 27.6 [23.0-32.9] weeks), 107 (48%) were vaccinated, and 116 (52%) were unvaccinated. For 2 infants in the vaccinated group, the primary outcome was unable to be assessed. The proportion of infants with 1 or more apnea event was 25 of 105 (24%) in the vaccinated group vs 12 of 116 (10%) in the unvaccinated group (adjusted odds ratio, 2.70; 95% CI, 1.27 to 5.73; P = .01). The mean number of apneic episodes did not significantly differ (model point estimate of difference, 0.54; 95% CI, -0.12 to 1.21) between the vaccinated (2.72) and unvaccinated (2.00) groups. The mean duration of apneic episodes did not significantly differ (model point estimate of difference, 4.6; 95% CI, -5.4 to 14.7) between the vaccinated (27.7) and unvaccinated (32.3) groups. No serious adverse events occurred during the 48-hour monitoring period. Other outcomes were not significantly different between groups.</p><p><strong>Conclusions and relevance: </strong>In hospitalized preterm infants, the odds of apnea within 48 hours were higher after 2-month vaccinations vs after no vaccinations. The similar number and duration of apneic events and lack of serious adverse events suggest that current vaccination recommendations for hospitalized preterm infants are appropriate. Neonatal clinicians should continue providing evidence-based anticipatory guidance about postvaccination apnea risk.</p><p><s
{"title":"Apnea After 2-Month Vaccinations in Hospitalized Preterm Infants: A Randomized Clinical Trial.","authors":"Rachel G Greenberg, Wes Rountree, Mary Allen Staat, Elizabeth P Schlaudecker, Brenda Poindexter, Andrea Trembath, Matthew Laughon, Marek S Poniewierski, Rachel L Spreng, Karen R Broder, A Patricia Wodi, Oidda Museru, E Gloria Anyalechi, Paige L Marquez, Emily A Randolph, Samia Aleem, Ryan Kilpatrick, Emmanuel B Walter","doi":"10.1001/jamapediatrics.2024.5311","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2024.5311","url":null,"abstract":"<p><strong>Importance: </strong>Preterm infants are recommended to receive most vaccinations at the same postnatal age as term infants. Studies have inconsistently observed an increased risk for postvaccination apnea in preterm infants.</p><p><strong>Objective: </strong>To compare the proportions of hospitalized preterm infants with apnea and other adverse events in the 48 hours after 2-month vaccinations vs after no vaccinations.</p><p><strong>Design, setting, and participants: </strong>This randomized, open-label clinical trial took place at 3 US neonatal intensive care units between August 2018 and October 2021. Infants between 6 and 12 weeks' postnatal age who were born at less than 33 weeks' gestational age and were eligible to receive 2-month vaccines were included.</p><p><strong>Intervention: </strong>Infants were randomized 1:1 to vaccinated (received vaccines within 12 hours of randomization) or unvaccinated (no vaccines received during the study period) groups. Cardiorespiratory data were collected during the 48 hours after vaccination or randomization (unvaccinated group).</p><p><strong>Main outcomes and measures: </strong>The primary outcome was apnea, defined as a respiration pause greater than 20 seconds or a respiration pause greater than 15 seconds with associated bradycardia less than 80 beats per minute. Other outcomes included the number and duration of apnea episodes, serious adverse events, respiratory support escalation, and receipt of positive pressure ventilation.</p><p><strong>Results: </strong>Of 223 randomized infants (117 female; median [range] gestational age, 27.6 [23.0-32.9] weeks), 107 (48%) were vaccinated, and 116 (52%) were unvaccinated. For 2 infants in the vaccinated group, the primary outcome was unable to be assessed. The proportion of infants with 1 or more apnea event was 25 of 105 (24%) in the vaccinated group vs 12 of 116 (10%) in the unvaccinated group (adjusted odds ratio, 2.70; 95% CI, 1.27 to 5.73; P = .01). The mean number of apneic episodes did not significantly differ (model point estimate of difference, 0.54; 95% CI, -0.12 to 1.21) between the vaccinated (2.72) and unvaccinated (2.00) groups. The mean duration of apneic episodes did not significantly differ (model point estimate of difference, 4.6; 95% CI, -5.4 to 14.7) between the vaccinated (27.7) and unvaccinated (32.3) groups. No serious adverse events occurred during the 48-hour monitoring period. Other outcomes were not significantly different between groups.</p><p><strong>Conclusions and relevance: </strong>In hospitalized preterm infants, the odds of apnea within 48 hours were higher after 2-month vaccinations vs after no vaccinations. The similar number and duration of apneic events and lack of serious adverse events suggest that current vaccination recommendations for hospitalized preterm infants are appropriate. Neonatal clinicians should continue providing evidence-based anticipatory guidance about postvaccination apnea risk.</p><p><s","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931810","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 : 2025-01-06DOI: 10.1001/jamapediatrics.2024.6081
Landon D Hughes, Brittany M Charlton, Isa Berzansky, Jae D Corman
{"title":"Gender-Affirming Medications Among Transgender Adolescents in the US, 2018-2022.","authors":"Landon D Hughes, Brittany M Charlton, Isa Berzansky, Jae D Corman","doi":"10.1001/jamapediatrics.2024.6081","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2024.6081","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":24.7,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931824","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}
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