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Introduction: The emergency department (ED) is a safety net, caring for families who lack adequate access to food and other basic needs. The COVID-19 pandemic caused a dramatic rise in food insecurity (FI) nationally; however, little is known about the prevalence of FI among families seen in pediatric EDs (PED). In this study we aimed to determine the prevalence of FI, as well as awareness and utilization of supplemental food services, among families seen in an urban PED during the COVID-19 pandemic using an electronic screening survey.Methods: This was a cross-sectional survey of families screened for FI in an urban PED. An electronic survey was advertised to all families via posters placed in patient rooms and other locations in the PED between February–October 2022. Surveys in English and Spanish were accessed on personal electronic devices via QR codes. Six validated US Department of Agriculture household food security questions and sociodemographic questions were included. We calculated respondents’ food security and performed descriptive and bivariate analyses of patient sociodemographics and responses to FI questions.Results: Of 42,697 PED visits, 612 surveys were completed and analyzed (1.4%). Nearly 50% of respondents identified as White and non-Hispanic, with approximately 80% female. Thirty percent had a household income of

OBJECTIVES: In the United States, pediatric emergency department (ED) visits for behavioral health (BH) are increasing. We sought to determine ED-level characteristics associated with having recommended BH-related policies. METHODS: We conducted a retrospective serial cross-sectional study of National Pediatric Readiness Project assessments administered to US EDs in 2013 and 2021. Changes in responses related to BH items over time were examined. Multivariable logistic regression models examined ED characteristics associated with the presence of specific BH-related policies in 2021. RESULTS: Of 3554 EDs that completed assessments in 2021, 73.0% had BH-related policies, 66.5% had transfer guidelines for children with BH issues, and 38.6% had access to BH resources in a disaster. Of 2570 EDs that completed assessments in both 2013 and 2021, presence of specific BH-related policies increased from 48.6% to 72.0% and presence of appropriate transfer guidelines increased from 56.2% to 64.9%. The adjusted odd ratios (aORs) of having specific BH-related policies were lower in rural (aOR 0.73; 95% confidence interval [CI] 0.57, 0.92) and remote EDs (aOR 0.65; 95% CI 0.48, 0.88) compared to urban EDs; lower among EDs with versus without trauma center designation (aOR 0.80; 95% CI 0.67, 0.95); and higher among EDs with a nurse and physician pediatric emergency care coordinator (PECC) (aOR 1.89; 95% CI 1.54, 2.33) versus those without a PECC. CONCLUSION: Although pediatric readiness for BH conditions increased from 2013 to 2021, gaps remain, particularly among rural EDs and designated trauma centers. Having nurse and physician PECCs is a modifiable strategy to increase ED pediatric readiness pertaining to BH.

BACKGROUND AND OBJECTIVE: Pediatric firearm injuries increased during the coronavirus disease 2019 pandemic, but recent trends in firearm injury emergency department (ED) visits are not well described. We aimed to assess how pediatric firearm injury ED visits during the pandemic differed from expected prepandemic trends. METHODS: We retrospectively studied firearm injury ED visits by children

Background: The COVID‐19 pandemic adversely affected children's mental health (MH) and changed patterns of MH emergency department (ED) utilization. Our objective was to assess how pediatric MH ED visits during the COVID‐19 pandemic differed from expected prepandemic trends. Methods: We retrospectively studied MH ED visits by children 5 to <18 years old at nine U.S. hospitals participating in the Pediatric Emergency Care Applied Research Network Registry from 2017 to 2022. We described visit length by time period: prepandemic (January 2017–February 2020), early pandemic (March 2020–December 2020), midpandemic (2021), and late pandemic (2022). We estimated expected visit rates from prepandemic data using multivariable Poisson regression models. We calculated rate ratios (RRs) of observed to expected visits per 30 days during each pandemic time period, overall and by sociodemographic and clinical characteristics. Results: We identified 175,979 pediatric MH ED visits. Visit length exceeded 12 h for 7.3% prepandemic, 8.4% early pandemic, 15.0% midpandemic, and 19.2% late pandemic visits. During the early pandemic, observed visits per 30 days decreased relative to expected rates (RR 0.80, 95% confidence interval [CI] 0.78–0.84), were similar to expected rates during the midpandemic (RR 1.01, 95% CI 0.96–1.07), and then decreased below expected rates during the late pandemic (RR 0.92, 95% CI 0.86–0.98). During the late pandemic, visit rates were higher than expected for females (RR 1.10, 95% CI 1.02–1.20) and for bipolar disorders (RR 1.83, 95% CI 1.38–2.75), schizophrenia spectrum disorders (RR 1.55, 95% CI 1.10–2.59), and substance‐related and addictive disorders (RR 1.50, 95% CI 1.18–2.05). Conclusions: During the late pandemic, pediatric MH ED visits decreased below expected rates; however, visits by females and for specific conditions remained elevated, indicating a need for increased attention to these groups. Prolonged ED visit lengths may reflect inadequate availability of MH services. [ABSTRACT FROM AUTHOR]

The article offers information on preventing sleep-related deaths in infants through the promotion of safe sleep practices. Topics discussed include the identification of risk factors associated with unsafe sleep environments; disparities in sleep-related infant deaths; and also mentions about the critical role of healthcare providers in educating and supporting families to adhere to safety guidelines.

Background Multiplex molecular diagnostic panels have greatly enhanced detection of gastrointestinal pathogens. However, data on the impact of these tests on clinical and patient-centered outcomes are limited. Methods We conducted a prospective, multicenter, stepped-wedge trial to determine the impact of multiplex molecular testing at 5 academic children's hospitals on children presenting to the emergency department with acute gastroenteritis. Caregivers were interviewed on enrollment and 7–10 days after enrollment to determine symptoms, risk factors, subsequent medical visits, and impact on family members. During the pre-intervention period, diagnostic testing was performed at the clinician's discretion. During the intervention period, multiplex molecular testing was performed on all children, with results available to clinicians. The primary outcome was return visits to a healthcare provider within 10 days of enrollment. Results Potential pathogens were identified by clinician-ordered tests in 19 of 571 (3.3%) in the pre-intervention period compared with 434 of 586 (74%) in the intervention period; clinically relevant pathogens were detected in 2.1% and 15%, respectively. In the multivariate model, the intervention was associated with a 21% reduction in the odds of any return visit (odds ratio, 0.79; 95% confidence interval,.70–.90) after adjusting for potential confounders. Appropriate treatment was prescribed in 11.3% compared with 19.6% during the intervention period (P =.22). Conclusions Routine molecular multiplex testing for all children who presented to the ED with acute gastroenteritis detected more clinically relevant pathogens and led to a 21% decrease in return visits. Additional research is needed to define patients most likely to benefit from testing. Clinical Trials Registration. NCT02248285. [ABSTRACT FROM AUTHOR]

INTRODUCTION A significant amount of effort has been put into developing models of automobile drivers' route choice for both theoretical and practical purposes (for reviews, see Ben-Akiva & Lerman, 1997; […], Automobile drivers were recently found to be risk averse when choosing among routes that had an average travel time shorter than the certain travel time of a route considered as a reference. Conversely, drivers were found to be risk seeking when choosing among routes that had an average travel time longer than the certain travel time of the reference route. In a driving simulation study in which the reference route had a range of travel times, this pattern was replicated when the reference range was smaller than the ranges of the available routes. However, the pattern was reversed when the reference range was larger than the ranges of the available routes. We recently proposed a simple heuristic model that fit the relatively complex data quite well. Actual or potential applications of this research include the design of variable message signs and of route choice support systems.

INTRODUCTION Historically, 16-year-olds have been overinvolved in fatal crashes. Surprisingly, this overinvolvement has almost doubled in the last 20 years. For every 100 000 licensed 16-year-old drivers, there were 19 […], Driver education classes were once seen as a remedy for young drivers' overinvolvement in crashes, but research results from the early 1970s were disappointing. Few changes in the content or methods of instruction occurred until recently, but this could change rapidly. Personal computers (PCs) can now present videos or photorealistic simulations of risky, cognitively demanding traffic scenarios that require quick responses without putting the participant at risk. As such programs proliferate, evaluating their effectiveness poses a major challenge. We report the use of a fixed-base driving simulator to study the effects of both experience on the road and PC-based risk awareness training on younger drivers' part-task simulator driving performance in risky traffic scenarios. We ran three groups of drivers on the simulator: one group first trained on the PC (younger, inexperienced drivers) and two groups who received no PC training (younger, inexperienced and experienced drivers). Overall, the younger inexperienc ed drivers who were trained on a PC operated their vehicles in risky scenarios in ways that differed measurably from those of the untrained younger, inexperienced drivers and, more important, in ways that we believe would decrease their exposure to risk considering that, on average, their behavior was more similar to the behavior of the untrained, experienced drivers. More research is needed to demonstrate whet her these findings apply on the open road to the larger population of younger drivers. However, at least initially. the research suggests that PC-based risk awareness training programs have the potential to reduce the high crash rate among younger, inexperienced drivers.

Issues concerning the manner in which lexical and syntactical ambiguities are processed when comprehending sentences are examined. Topics include the role of noun-verb combinations, discourse bias, and thematic fit in such phrases as 'the defendant examined' when it is initially unclear whether 'examined' is a verb or a modifier.

An experiment has been conducted to examine how clause wrap-up affects eye movements during reading, with a focus on whether decisions on when to move the eyes are independent of decisions on where to move the eyes. Topics discussed include initial fixation times, probability of skipping, landing position, regressions, typicality effect, clause wrap-up effect, regressions and clause boundaries, saccade length and landing positions.

Two experiments that measured the effects of strongly biased context on the processing time of ambiguous homonyms were critiqued. Problems with the experimental methodology and materials are cited as reasons to dispute the previous findings.