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To the Editor In a recent article, Dudovitz et al prospectively investigated the association of adolescent substance use with exposure to high-performing schools. This article explores education as a key social determinant of health and attempts to expound on how school environments can influence health. The authors explain that previous studies suggest exposure to better educational environments can improve health behaviors, but these studies do not examine the transition to high-performing schools or provide data about other factors in adolescent health.
In Reply In a Letter to the Editor, Odom insightfully notes that school mobility is an understudied factor that may influence adolescent health by disrupting adolescent social networks and reducing their social capital. Alternatively, mobility may be a marker for risky behaviors, as students often change schools because of academic or behavioral difficulties. In the Reducing Inequities Through Social and Educational Change Follow-up (RISE Up) Study, we found that students who won the admissions lottery and were offered a spot in a high-performing charter school were less likely than lottery losers to engage in substance use and also less likely to change schools during the study period. Odom is correct that we looked only at whether student.
This has been another extraordinary year for. JAMA Pediatrics. . We continue to pursue our mission to vet and disseminate the best science and perspectives regarding child health. According to the data presented in the Table , 2018 was another successful year for the journal. We received 2335 manuscripts (a 5% increase from 2017) and our acceptance rate for research articles was 5% (down from 6% in 2017). Our impact factor increased again to 10.8 and remains the highest of any pediatric journal in the world.
To the Editor I wish to respond to the Clinical Guideline Synopsis on the Baby-Friendly Hospital Initiative (BFHI) by Bass et al, with an alternative approach leading to differing recommendations and conclusions. The use of the GRADE method and systematic reviews in this synopsis may not necessarily represent the best framework for evaluating interventions for an essentially normal process. Breastfeeding is not a medical problem. The Oxford Center for Evidence-Based Medicine Criteria could be used because other lower levels of evidence may also be suitable for guiding care.
In Reply I am pleased to respond to Walker’s comments on our Baby-Friendly Hospital Initiative (BFHI) Guideline Synopsis. Her statement that the synopsis used the GRADE method is inaccurate because that evidence assessment method was actually used by the World Health Organization (WHO) and is widely used and respected because of its rigorous approach to evidence rating. Suggesting that a lower level of evidence was warranted because breastfeeding is not a medical problem reflects confusion concerning the purpose of the BFHI guideline: to analyze the best manner to support breastfeeding, not to judge the value of breastfeeding.
In Reply We are pleased our research has inspired more thinking about pedestrian safety and appreciate the opportunity to clarify our findings. We found that Halloween was associated with a 43% increase in the relative risk of fatality among pedestrians of any age (odds ratio, 1.43; 95% CI, 1.29-1.59;. P. < .001) and a 360% increase in the relative risk of fatality for children 17 years or younger (odds ratio, 3.60; 95% CI, 2.81-4.63;. P. < .001). The average Halloween was associated with about 4 additional deaths for pedestrians of any age, and about 3 of these additional deaths occurred among pedestrians 17 years or younger. This means that Yiannakoulias is off by an order of magnitude in claiming “roughly 1 death per 3 years” in exposure att.
To the Editor A Research Letter published in. JAMA Pediatrics. , “Pedestrian Fatalities Associated With Halloween in the United States,” quantifies the association of Halloween with child pedestrian fatality risk in the United States. The authors found that Halloween is associated with a 1.43 times increased risk of child pedestrian fatality. Using this number, along with a few other readily available numbers, it is trivial to estimate the effect of Halloween on the risk of child pedestrian fatality in terms of exposure attributable risk. I did so for Canada and found that Halloween is responsible for roughly 1 extra fatality every 30 years. In the United States, it would probably be roughly 1 death per 3 years.

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