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This Month in Archives of Pediatrics & Adolescent Medicine
Arch Pediatr Adolesc Med. 2001;155:10.
Effects of Reducing Children's Television and Video Game Use on Aggressive
Behavior: A Randomized Controlled Trial
By the age of 18 years, US children witness 200 000 acts of violence
on television. This randomized controlled trial among third- and fourth-grade
students reduced the time they spent watching TV and playing video games.
Reduction in use resulted in significant decreases in aggressive behavior
among these children. In addition to showing that TV and video use can be
reduced by intervention, this study presents further evidence that TV violence
does affect children's aggressive behavior.
(SEE ARTICLE)
Counseling Smoking Parents of Young Children
Second-hand smoke is a major cause of morbidity in young children, and
exposure to smoking parents is the principal source. Family physicians are
much more likely than pediatricians to counsel parents about smoking cessation
and give them specific advice about how to do so. Pediatricians often believe
that parents will ignore their advice about smoking cessation, most likely
because many feel that they lack appropriate counseling skills. Given the
importance of the problem and the availability of effective counseling techniques,
pediatricians should work to improve their counseling skills.
(SEE ARTICLE)
Comparison of Auscultatory and Oscillometric Blood Pressures
The Dinamap Monitor has become widely used in pediatric practice to
measure the blood pressure of children and adolescents. Until now, little
information has been available on how readings with this device compare with
standard auscultatory methods. This large study of more than 7200 children
and adolescents found that the Dinamap readings were 10 mm Hg higher for systolic
pressures and 5 mm Hg higher for diastolic pressures compared with auscultatory
methods. The 2 techniques of blood pressure measurement are not interchangeable,
and the diagnosis of hypertension should be made cautiously when this device
is used.
(SEE ARTICLE)
Are Overreferrals on Developmental Screening Tests Really a Problem?
Approximately 15% to 30% of children examined with developmental screening
tests have failing scores. Most of these children do not meet the standard
criteria for developmental disability, raising questions about the usefulness
of screening tests. However, these children are much more likely than those
with normal screens to fall into the lower 25th percentile on diagnostic tests
of language skills, intelligence, and academic achievement. Overall, 70% of
these children scored below the 25th percentile on at least 1 measure. Thus,
screening tests may be useful in identifying a group of children who would
benefit from early interventions to improve their language and academic skills.
(SEE ARTICLE)
Reliability of the Urinalysis for Predicting Urinary Tract Infections
in Young Febrile Children
Urinary tract infections are the most common source of serious bacterial
infections in young children. Most physicians obtain a urinalysis to screen
for infection before obtaining a culture. In this study of nearly 9000 patients,
the sensitivity of the urinalysis for urinary tract infections was 82%, and
the specificity was 92%. With children younger than 2 years, sensitivity and
specificity do not vary by age. If the prevalence of urinary tract infections
is 2%, 1 infection would be missed for every 250 patients screened with a
urinalysis.
(SEE ARTICLE)
Randomized Controlled Trial of a Safer Sex Intervention for High-Risk
Adolescent Girls
A safer sex intervention for adolescents must capture their attention,
impart information, and promote change of attitude and behavior. This randomized
controlled trial of adolescent girls with sexually transmitted diseases used
motivational interviews and a short video to promote safer sex. One year later,
the women in the intervention group had a lower rate of recurrent sexually
transmitted disease, although there were no differences in condom use. Continued
development of effective interventions is needed to decrease the risk of sexually
transmitted disease in adolescents.
(SEE ARTICLE)
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