A Teacher in the Living Room? Educational Media for Babies, Toddlers, and Preschoolers

Examines available research, and arguments by proponents and critics, of electronic educational media use by young children. Examines educational claims in marketing and provides recommendations for developing research and product standards

Afraid in the hospital: Parental concern for errors during a child's hospitalization

OBJECTIVE: (1) To determine the proportion of parents concerned about medical errors during a child's hospitalization; and (2) the association between this concern and parental self-efficacy with physician interactions. STUDY DESIGN: Cross-sectional survey. SETTING: Tertiary care children's hospital. PARTICIPANTS: Parents of children admitted to the general medical service. OUTCOME MEASURE: Parental concern about medical errors. METHODS: Parents were asked their agreement with the statement “When my child is in the hospital I feel that I have to watch over the care that he/she is receiving to make sure that mistakes aren't made.” We used multivariate logistic regression to examine the association between parents' self-efficacy with physician interactions and the need “to watch over a child's care,” adjusting for parent and child demographics, English proficiency, past hospitalization, and social desirability bias. RESULTS: Of 278 eligible parents, 130 completed surveys and 63% reported the need to watch over their child's care to ensure that mistakes were not made. Parents with greater self-efficacy with physician interactions were less likely to report this need (odds ratio [OR], 0.83; 95% confidence interval [CI], 0.72-0.92). All parents who were “very uncomfortable” communicating with doctors in English reported the need to watch over their child's care to prevent mistakes. CONCLUSIONS: Nearly two-thirds of surveyed parents felt the need to watch over their child's hospital care to prevent mistakes. Parents with greater self-efficacy with physician interactions were less likely to report the need to watch over their child's care while parents with lower English proficiency were more likely to report this need. Journal of Hospital Medicine 2009;4:521–527. © 2009 Society of Hospital Medicine.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/64556/1/508_ftp.pd

Television viewing, computer use, obesity, and adiposity in US preschool children

Professor.Background: There is limited evidence in preschool children linking media use, such as television/video viewing and computer use, to obesity and adiposity. We tested three hypotheses in preschool children: 1) that watching > 2 hours of TV/videos daily is associated with obesity and adiposity, 2) that computer use is associated with obesity and adiposity, and 3) that > 2 hours of media use daily is associated with obesity and adiposity. Methods: We conducted a cross-sectional study using nationally representative data on children, aged 2�5 years from the National Health and Nutrition Examination Survey, 1999-2002. Our main outcome measures were 1) weight status: normal versus overweight or at risk for overweight, and 2) adiposity: the sum of subscapular and triceps skinfolds (mm). Our main exposures were TV/video viewing (= 2 or > 2 hours/day), computer use (users versus non-users), and media use (= 2 or > 2 hours/day). We used multivariate Poisson and linear regression analyses, adjusting for demographic covariates, to test the independent association between TV/video viewing, computer use, or overall media use and a child's weight status or adiposity. Results: Watching > 2 hours/day of TV/videos was associated with being overweight or at risk for overweight (Prevalence ratio = 1.34, 95% CI [1.07, 1.66]; n =1340) and with higher skinfold thicknesses ([Beta] = 1.08, 95% CI [0.19, 1.96]; n = 1337). Computer use > 0 hours/day was associated with higher skinfold thicknesses ([Beta] = 0.56, 95% CI [0.04, 1.07]; n = 1339). Media use had borderline significance with higher skinfold thicknesses ([Beta] = 0.85, 95% CI [-0.04, 1.75], P=0.06; n = 1334) Conclusion: Watching > 2 hours/day of TV/videos in US preschool-age children was associated with a higher risk of being overweight or at risk for overweight and higher adiposity-findings in support of national guidelines to limit preschool children's media use. Computer use was also related to higher adiposity in preschool children, but not weight status. Intervention studies to limit preschool children's media use are warranted.USDA/ARS under Cooperative Agreement No. 58-6250-6001

Gender and Sexuality: LGBTQ+ Youth Experiences

Internet-enabled information and communication technologies (ICTs) pose simultaneous risks and opportunities for contemporary lesbian, gay, bisexual, transgender, queer, or otherwise sexual and/or gender diverse (LGBTQ+) adolescents and young adults—a population who may be particularly active users of ICTs. This chapter provides a brief overview of LGBTQ+ youths’ lived experiences and barriers to care, followed by a review of extant knowledge regarding the ICT experiences of this population with a particular focus on the context of the United States. Significant gaps in knowledge regarding LGBTQ+ youths’ engagement with ICTs persist and proposed areas of inquiry for future research are provided. As ICTs continue to advance, sustained examination must be undertaken. Specifically, how current and emerging technologies impact LGBTQ+ youths’ lives, emphasizing heretofore under-researched subpopulations (e.g., transgender youth, ethnic and racial minorities). Knowledge translated informs multiple areas, including education, service provision, policy development, and expansion of technologies that consider LGBTQ+ youths’ unique needs. Specific recommendations for various stakeholder communities (e.g., educators, service providers, policy makers) are offered

Equity and the JAMA Network

The key objective of JAMA is “To promote the science and art of medicine and the betterment of the public health”; similar objectives and mission statements are supported by all 12 JAMA Network Journals. Together this family of journals is committed to publishing the best research, reviews, and opinion articles to advance medical science, promote public health, and improve patient care. The ultimate goal is to promulgate truth in science and medicine

Internet addiction: a 21st century epidemic?

Internet addiction, while not yet officially codified within a psychopathological framework, is growing both in prevalence and within the public consciousness as a potentially problematic condition with many parallels to existing recognized disorders. The rapid and unfettered increase in the number of people accessing a relatively unrestricted internet substantially increases the possibility that those suffering with an underlying psychological comorbidity may be at serious risk of developing an addiction to the internet, lending further credence to this hitherto understudied condition. In this commentary, I outline my recommendations for improved diagnosis, study and prevention of internet addiction

A Cluster Randomized Clinical Trial to Improve Prescribing Patterns in Ambulatory Pediatrics

Having shown previously that an electronic prescription writer and decision support system improved pediatric prescribing behavior for otitis media in an academic clinic setting, we assessed whether point-of-care delivery of evidence could demonstrate similar effects for a wide range of other common pediatric conditions.Cluster randomized controlled trial.A teaching clinic/clinical practice site and a primary care pediatric clinic serving a rural and semi-urban patient mix.A total of 36 providers at the teaching clinic/practice site and eight providers at the private primary pediatric clinic.An evidence-based message system that presented real-time evidence to providers based on prescribing practices for acute otitis media, allergic rhinitis, sinusitis, constipation, pharyngitis, croup, urticaria, and bronchiolitis.The proportion of prescriptions dispensed in accordance with evidence.The proportion of prescriptions dispensed in accordance with evidence improved four percentage points, from 38% at baseline to 42% following the intervention. The control group improved by one percentage point, from 39% at baseline to 40% at trial's conclusion. The adjusted difference between the intervention and control groups was 8% (95% confidence interval 1%, 15%). Intervention effectiveness did not decrease with time.For common pediatric outpatient conditions, a point-of-care evidence-based prescription writer and decision support system was associated with significant improvements in prescribing practices

Ethnic and racial differences in children and young people with respiratory and neurological post-acute sequelae of SARS-CoV-2: an electronic health record-based cohort study from the RECOVER Initiative

BackgroundChildren from racial and ethnic minority groups are at greater risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, but it is unclear whether they have increased risk for post-acute sequelae of SARS-CoV-2 (PASC). Our objectives were to assess whether the risk of respiratory and neurologic PASC differs by race/ethnicity and social drivers of health.MethodsWe conducted a retrospective cohort study of individuals <21 years seeking care at 24 health systems across the U.S, using electronic health record (EHR) data. Our cohort included those with a positive SARS-CoV-2 molecular, serology or antigen test, or with a COVID-19, multisystem inflammatory disease in children, or PASC diagnosis from February 29, 2020 to August 1, 2022. We identified children/youth with at least 2 codes associated with respiratory and neurologic PASC. We measured associations between sociodemographic and clinical characteristics and respiratory and neurologic PASC using odds ratios and 95% confidence intervals estimated from multivariable logistic regression models adjusted for other sociodemographic characteristics, social vulnerability index or area deprivation index, time period of cohort entry, presence and complexity of chronic respiratory (respectively, neurologic) condition and healthcare utilization.FindingsAmong 771,725 children in the cohort, 203,365 (26.3%) had SARS-CoV-2 infection. Among children with documented infection, 3217 children had respiratory PASC and 2009 children/youth had neurologic PASC. In logistic regression models, children <5 years (Odds Ratio [OR] 1.78, 95% CI 1.62-1.97), and of Hispanic White descent (OR 1.19, 95% CI 1.05-1.35) had higher odds of having respiratory PASC. Children/youth living in regions with higher area deprivation indices (OR 1.25, 95% CI 1.10-1.420 for 60-79th percentile) and with chronic complex respiratory conditions (OR 3.28, 95% CI 2.91-3.70) also had higher odds of respiratory PASC. In contrast, older (OR 1.57, 95% CI 1.40-1.77 for those aged 12-17 years), non-Hispanic White individuals and those with chronic pre-existing neurologic conditions (OR 2.04, 95% CI 1.78-2.35) were more likely to have a neurologic PASC diagnosis.InterpretationRacial and ethnic differences in healthcare utilization for neurologic and respiratory PASC may reflect social drivers of health and inequities in access to care.FundingNational Institutes of Health