A JAMA THEME ISSUE
Edited by Catherine D. DeAngelis, MD, MPH, and Jody W. Zylke, MD
In a randomized trial of pediatric weight management, Savoye and colleagues compared an intensive family-based program involving supervised exercise, nutrition education, and behavioral modification with traditional semiannual clinical weight management counseling. The authors report that children in the family-based program had lower body mass index, less body fat, and greater improvements in insulin sensitivity than children who received traditional weight management counseling through 12 months of follow-up.
Geenen and colleaguesArticle assessed treatment-specific adverse health outcomes in a retrospective cohort study of patients who had survived 5 or more years after a primary childhood malignancy. The authors found that 74.5% had 1 or more adverse outcomes, 24.6% had 5 or more. These outcomes were much more common after radiotherapy than chemotherapy or surgery. In an editorial, Oeffinger and RobisonArticle discuss risk-based health care of childhood cancer survivors.
The population-based SEARCH for Diabetes in Youth Study assessed the incidence of newly diagnosed diabetes mellitus (DM) in youth 20 years and younger in 2002-2003. The SEARCH investigatorsArticle report that the incidence of DM (per 100 000 person-years) was 24.3 (95% confidence interval, 23.3-25.3), with the highest rates of type 1 DM in non-Hispanic white youth and the highest rates of type 2 DM among adolescent minority populations. In an editorial, LiptonArticle discusses the importance of monitoring trends in childhood diabetes.
In a retrospective review of national data on place of death among children and adolescents with complex chronic conditions, Feudtner and colleagues found that between 1989 and 2003, the proportion of children who died at home (vs hospital) increased significantly from 10.1% to 18.2%. However, compared with whites, black and Hispanic children and adolescents had a reduced likelihood of dying at home.
Robertson and colleagues assessed the prevalence of cerebral palsy (CP) among very premature infants (20 to 27 weeks' gestational age) whose birth weights ranged from 500 to 1249 g and who were born from 1974 through 2003 in Northern Alberta, Canada. The authors found that CP prevalence rates increased through 1994 and have declined significantly in the last decade.
Prevalence estimates of chronic health conditions in children vary widely. The lack of a clear definition of chronic health conditions in childhood may contribute to this variability. In a systematic review of the literature, van der Lee and colleagues found little consistency in the definition of chronic health conditions of childhood and diversity in the source of information, method of information retrieval, and populations investigated to derive estimates of chronic disease prevalence.
“It will never be easy to care for a child with special health care needs. But it can be easier with reinforcement from an extended family.” From “Extended Family.”
Sleep-disordered breathing may spur hyperactivity and learning problems in children, but early treatment may reverse these symptoms.
Effects of multiple, long-term hospitalizations on child development.
Common etiologies may account for increases in childhood chronic health conditions.
The issue editors discuss the burden of chronic disease on children, families, and society.
Childhood lead poisoning and legal action to protect child health.
For your patients: Information about chronic diseases of children.
This Week in JAMA . JAMA. 2007;297(24):2671. doi:10.1001/jama.297.24.2671