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In This Issue of JAMA Pediatrics |

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JAMA Pediatr. 2015;169(6):515. doi:10.1001/jamapediatrics.2014.2130.
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Day-to-day readiness of emergency departments (EDs) affects disaster planning and response and patient safety. Gausche-Hill and colleagues examine the compliance with national guidelines for pediatric readiness of all EDs in the United States. Of the 4149 EDs responding, readiness was better in higher-volume sites and those with physician and nurse pediatric emergency care coordinators. In their accompanying editorial, Alessandrini and Wright discuss the importance of performance measures for ED care.

Continuing Medical Education and Journal Club

To date, interventions in pediatric primary care to improve weight control have not been successful. Taveras and colleagues examine the effectiveness of an intervention in 14 practices using clinical decision support at the point of care of obese children, with or without individualized family coaching, on improved children’s body mass index. The greatest improvements in body mass index were among participants in the decision support plus coaching arm, with the highest fidelity to the intervention protocol. Both interventions substantially improved the quality of care for childhood obesity.

Current national recommendations for treatment of lipid levels in adolescents differ from those for adults. Gooding and colleagues compare the potential implications of these guidelines among a cohort of young people aged 17 to 21 years using data on 6338 individuals from the National Health and Nutrition Examination Survey. They found that 2.5% of this group would qualify for treatment with statins under the pediatric guidelines compared with only 0.4% under the adult guidelines. These differences translate into statin treatment for more than 400 000 additional adolescents and young adults nationally under the pediatric than the adult guidelines.

Childhood sleep problems are common but there is limited knowledge about their association with subsequent emotional and behavior problems. In this prospective cohort study of more than 32 000 children, Sivertsen and colleagues find that short sleep duration and frequent night awakenings at age 18 months significantly predict concurrent and later incidence of emotional and behavioral problems at age 5 years. Targeting sleep patterns during early life could constitute a pathway to reduce or prevent current and later mental health problems. Garrison’s editorial discusses the potential mediating role that sleep problems may play in many social determinants of health.





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