Genes may work by modulating the way individuals respond to environment variation. Silveira and colleagues found that girls carrying the 7-repeat allele of the DRD4 gene and living under adverse economic conditions had higher fat intake than those who were not carriers, while those with the 7-repeat allele living in a more healthy environment had lower fat intake than noncarriers. Alleles previously thought to be obesity risk alleles may in fact function as plasticity alleles, determining openness to environmental modification. Belsky’s editorial discusses the implications of these findings for prioritizing interventions to those most likely to be helped.
While survival of very preterm infants has improved, many have subsequent disability from bronchopulmonary dysplasia. Hascoët and colleagues conduct a randomized clinical trial of surfactant in very preterm infants who still needed ventilation at 14 days of life. While there was no difference in ventilation duration, there was a significant reduction in the risk for rehospitalization for respiratory problems in the first year of life. Jobe’s accompanying editorial discusses this trial and other interventions to decrease the risk for bronchopulmonary dysplasia in surviving very preterm infants.
Timely initiation of effective treatment for adolescent depression is crucial because failure to achieve remission is associated with higher likelihood of relapse and more impaired long-term functioning. O’Connor and colleagues examine the electronic health records for 4612 adolescents with depression treated in 3 large health care systems. While treatment was initiated for nearly two-thirds, 68% did not have follow-up symptom assessment and 19% did not receive any follow-up care. Differences in rates of follow-up care were evident across sites, suggesting differences within health systems may affect care.
While fish is the major dietary source of long-chain polyunsaturated fatty acids, it is also a common source of human exposure to persistent organic pollutants. In a population-based birth cohort of more than 26 000 women, Stratakis and colleagues examine the association of fish intake during pregnancy and rapid growth in infancy and childhood obesity. Fish intake of more than 3 times per week during pregnancy was associated with higher offspring body mass index and greater risk for rapid infant growth and childhood overweight/obesity, especially in girls. These findings support the fish intake limit for pregnancy proposed by the Environmental Protection Agency and US Food and Drug Administration.
Parent-reported errors may be a fruitful source of errors and adverse event surveillance. Khan and colleagues survey parents of hospitalized children on general pediatric, short-stay, and subspecialty teams. Parent-reported medical errors were found for 62% of admissions, of which 43% had not been documented in the medical record.
Highlights. JAMA Pediatr. 2016;170(4):307. doi:10.1001/jamapediatrics.2015.2515