Association of Picky Eating and Food Neophobia with Weight: A Systematic Review

Background: Picky eating and food neophobia are common during childhood. Childhood eating behaviors are often predictive of adult eating behaviors

Vision Screening in Children Aged 6 Months to 5 Years: Evidence Report and Systematic Review for the US Preventive Services Task Force

Importance: Preschool vision screening could allow detection and treatment of vision abnormalities during a critical developmental stage, preserving function and quality of life. Objective: To review the evidence on screening for and treatment of amblyopia, its risk factors, and refractive error in children aged 6 months to 5 years to inform the US Preventive Services Task Force. Data Sources: MEDLINE, Cochrane Library, CINAHL, and trial registries through June 2016; references; and experts, with surveillance of the literature through June 7, 2017. Study Selection: English-language randomized clinical trials (RCTs) or prospective cohort studies that evaluated screening, studies evaluating test accuracy, RCTs of treatment vs inactive controls, and cohort studies or case-control studies assessing harms. Data Extraction and Synthesis: Dual review of abstracts, full-text articles, and study quality; qualitative synthesis of findings. Studies were not quantitatively pooled because of clinical and methodological heterogeneity. Main Outcomes and Measures: Visual acuity, amblyopia, school performance, functioning, quality of life, test accuracy, testability, and harms. Results: Forty studies were included (N = 34 709); 34 evaluated test accuracy. No RCTs compared screening with no screening, and no studies evaluated school performance, function, or quality of life. Studies directly assessing earlier or more intensive screening were limited by high attrition. Positive likelihood ratios were between 5 and 10 for amblyopia risk factors or nonamblyogenic refractive error in most studies of test accuracy and were greater than 10 in most studies evaluating combinations of clinical tests. Inability to cooperate may limit use of some tests in children younger than 3 years. Studies with low prevalence (75%). Among children with amblyopia risk factors (eg, strabismus or anisometropia), patching improved visual acuity of the amblyopic eye by a mean of less than 1 line on a standard chart after 5 to 12 weeks for children pretreated with glasses (2 RCTs, 240 participants); more children treated with patching than with no patching experienced improvement of at least 2 lines (45% vs 21%; P = .003; 1 RCT, 180 participants). Patching plus glasses improved visual acuity by about 1 line after 1 year (0.11 logMAR [95% CI, 0.05-0.17]) for children not pretreated with glasses (1 RCT, 177 participants). Glasses alone improved visual acuity by less than 1 line after 1 year (0.08 logMAR [95% CI, 0.02-0.15], 1 RCT, 177 participants). Conclusions and Relevance: Studies directly evaluating the effectiveness of screening were limited and do not establish whether vision screening in preschool children is better than no screening. Indirect evidence supports the utility of multiple screening tests for identifying preschool children at higher risk for vision problems and the effectiveness of some treatments for improving visual acuity outcomes

Addressing Childhood Obesity

The overweight and obesity epidemic among children and adolescents in the United States continues to worsen, with notable racial, ethnic, and socioeconomic disparities. Risk factors for pediatric obesity include genetics; environmental and neighborhood factors; increased intake of sugar-sweetened beverages (SSBs), fast-food, and processed snacks; decreased physical activity; shorter sleep duration; and increased personal, prenatal, or family stress. Pediatricians can help prevent obesity by measuring body mass index at least yearly and providing age- and development-appropriate anticipatory guidance to families. Public policies and environmental interventions aim to make it easier for children to make healthy nutrition and physical activity choices. Interventions focused on family habits and parenting strategies have also been successful at preventing or treating childhood obesity

Maternal Concern for Child Undereating

To describe features of maternal concern for her child undereating; examine maternal and child correlates of maternal concern for undereating; and determine whether maternal concern for undereating is associated with feeding practices

Impact of COVID-19 on Pediatric Primary Care Visits at Four Academic Institutions in the Carolinas

We aimed to determine how COVID-19 affected the number and type of pediatric primary care visits in April 2020, compared to April 2019, and which characteristics were associated with obtaining care in 2020. We performed a retrospective chart review of patients receiving care in April 2019 and April 2020 from four large, academic institutions across two states. The subjects were included if they were aged 0–18 years and were seen in a pediatric clinic in April 2019 or April 2020. We extracted the number of visits, visit type, and visit diagnosis; and the patient characteristics, including age, race/ethnicity, and insurance status. Logistic regression analysis identified characteristics associated with obtaining care in April 2020. We included 120,230 visits. Participants were 50% white and half had Medicaid. In 2020 there were significantly fewer visits for both well and acute visits with 42,670 visits in 2020 compared to 77,560 in 2019; 6616 were telehealth visits in 2020. Visits for chronic conditions were significantly decreased in 2020. Attending a visit in 2020 was more likely if the participant was black or Hispanic, younger, attending an acute visit, or had private insurance. During the COVID-19 pandemic, pediatric primary care decreased substantially for both well visits and follow-up of chronic conditions

Parental Perceptions of Weight During the First Year of Life

More than half of parents underestimate their overweight child’s weight; however, prior research focuses on children greater than 2 years of age. The objective of this study was to assess whether parents of 2–12month-old infants are able to accurately perceive their children’s weight status

Alpha band prefrontal asymmetry does not underlie pain approach-avoidance: Results from two EEG studies

Pain research is often focused on escape from pain or approach of relief, yet individuals with chronic pain make complex choices to face their pain to satiate other drives (approach-avoidance conflicts). An abundance of research has indicated that prefrontal alpha band asymmetry (PFA) underlies approach-avoidance in general, but there is limited information about whether PFA underlies pain approach-avoidance conflicts. Electroencephalogram activity was recorded while 70 participants with chronic pain (n=33) and without chronic pain (n=37) approached/avoided stimuli containing simultaneous pain (low-high) and monetary reward (low-high). Findings from both studies revealed that approach-avoidance for pain stimuli is not accompanied by prefrontal asymmetry, irrespective of the presence of chronic pain

First Sagittarius A* Event Horizon Telescope results. II. EHT and multiwavelength observations, data processing, and calibration

We present Event Horizon Telescope (EHT) 1.3 mm measurements of the radio source located at the position of the supermassive black hole Sagittarius A* (Sgr A*), collected during the 2017 April 5–11 campaign. The observations were carried out with eight facilities at six locations across the globe. Novel calibration methods are employed to account for Sgr A*'s flux variability. The majority of the 1.3 mm emission arises from horizon scales, where intrinsic structural source variability is detected on timescales of minutes to hours. The effects of interstellar scattering on the image and its variability are found to be subdominant to intrinsic source structure. The calibrated visibility amplitudes, particularly the locations of the visibility minima, are broadly consistent with a blurred ring with a diameter of ∼50 μas, as determined in later works in this series. Contemporaneous multiwavelength monitoring of Sgr A* was performed at 22, 43, and 86 GHz and at near-infrared and X-ray wavelengths. Several X-ray flares from Sgr A* are detected by Chandra, one at low significance jointly with Swift on 2017 April 7 and the other at higher significance jointly with NuSTAR on 2017 April 11. The brighter April 11 flare is not observed simultaneously by the EHT but is followed by a significant increase in millimeter flux variability immediately after the X-ray outburst, indicating a likely connection in the emission physics near the event horizon. We compare Sgr A*'s broadband flux during the EHT campaign to its historical spectral energy distribution and find that both the quiescent emission and flare emission are consistent with its long-term behavior.http://iopscience.iop.org/2041-8205Physic

First Sagittarius A* Event Horizon Telescope Results. II. EHT and Multiwavelength Observations, Data Processing, and Calibration

We present Event Horizon Telescope (EHT) 1.3 mm measurements of the radio source located at the position of the supermassive black hole Sagittarius A* (Sgr A*), collected during the 2017 April 5–11 campaign. The observations were carried out with eight facilities at six locations across the globe. Novel calibration methods are employed to account for Sgr A*'s flux variability. The majority of the 1.3 mm emission arises from horizon scales, where intrinsic structural source variability is detected on timescales of minutes to hours. The effects of interstellar scattering on the image and its variability are found to be subdominant to intrinsic source structure. The calibrated visibility amplitudes, particularly the locations of the visibility minima, are broadly consistent with a blurred ring with a diameter of ∼50 μas, as determined in later works in this series. Contemporaneous multiwavelength monitoring of Sgr A* was performed at 22, 43, and 86 GHz and at near-infrared and X-ray wavelengths. Several X-ray flares from Sgr A* are detected by Chandra, one at low significance jointly with Swift on 2017 April 7 and the other at higher significance jointly with NuSTAR on 2017 April 11. The brighter April 11 flare is not observed simultaneously by the EHT but is followed by a significant increase in millimeter flux variability immediately after the X-ray outburst, indicating a likely connection in the emission physics near the event horizon. We compare Sgr A*’s broadband flux during the EHT campaign to its historical spectral energy distribution and find that both the quiescent emission and flare emission are consistent with its long-term behavior

Trends in food insecurity rates at an academic primary care clinic: a retrospective cohort study

BACKGROUND: Healthcare organizations are increasingly screening and addressing food insecurity (FI); yet, limited data exists from clinic-based settings on how FI rates change over time. The objective of this study was to evaluate household FI trends over a two-year period at a clinic that implemented a FI screening and referral program. METHODS: In this retrospective cohort study, data were extracted for all visits at one academic primary care clinic for all children aged 0-18 years whose parents/guardians had been screened for FI at least once between February 1, 2018 to February 28, 2019 (Year 1) and screened at least once between March 1, 2019 to February 28, 2020 (Year 2). Bivariate analyses tested for differences in FI and demographics using chi-square tests. Mixed effects logistic regression was used to assess change in FI between Years 1 and 2 with random intercept for participants controlling for covariates. The interaction between year and all covariates was evaluated to determine differences in FI change by demographics. RESULTS: Of 6182 patients seen in Year 1, 3691 (59.7%) were seen at least once in Year 2 and included in this study. In Year 1, 19.6% of participants reported household FI, compared to 14.1% in Year 2. Of those with FI in Year 1, 40% had FI in Year 2. Of those with food security in Year 1, 92.3% continued with food security in Year 2. Compared to Hispanic/Latinx participants, African American/Black (OR: 3.53, 95% CI: 2.33, 5.34; p \u3c 0.001) and White (OR: 1.88, 95% CI: 1.06, 3.36; p = 0.03) participants had higher odds of reporting FI. African American/Black participants had the largest decrease in FI between Years 1 and 2 (- 7.9, 95% CI: - 11.7, - 4.1%; p \u3c 0.0001). CONCLUSIONS: Because FI is transitional, particularly for racial/ethnic minorities, screening repeatedly can identify families situationally experiencing FI