Copyright 2001 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2001
There has been a dramatic decline in the rate of firearm homicides involving adolescents and young adults in the United States from the peak in 1992. Reasons for this decline are hotly debated by experts around the country. This ethnographic study of 45 incarcerated adolescents indicated that fear of arrest or incarceration were the most important demand-side factors discouraging gun acquisition or carrying. High price and lack of availability were cited as frequent supply-side deterrents. This study indicates that actions by the criminal justice and regulatory community have had an affect on gun acquisition and gun carrying by youth.
While rectal temperatures remain the gold standard for the assessment of fever in infants, newer noninvasive thermometers have been developed. This study compares these noninvasive methods with rectal temperatures in infants younger than 1 year. While temporal artery thermometers correlated better with the rectal temperatures than did tympanic devices, and were somewhat more sensitive in identifying febrile infants, neither had adequate sensitivity to detect fever in these children.
Achievement of a 90% up-to-date vaccination rate by 2 years of age remains a national goal that has been difficult to achieve. Missed opportunities are a major reason for our lack of success. This study found that simple, inexpensive reminders attached to charts at the time of acute care visits significantly improved vaccination delivery rates, particularly among children continuously enrolled in a health plan.
More adults are overweight now than 20 years ago, and the prevalence of overweight among American children and adolescents is increasing. Data on more than 4000 children in the Third National Health and Nutrition Examination Survey study indicated that obesity was 2.6-fold greater among children watching 4 or more hours of television per day, compared with those watching 1 hour or less. The caloric intake was nearly 400 kcal higher in girls who watched this much television. This study clearly indicates the need to reduce sedentary behaviors such as television watching and to promote a more active lifestyle.
A strikingly large portion of young children, especially in the inner city, witness violence in their lives. Schuler and Nair found that children of non–substance-abusing mothers witness as much violence as children with substance-abusing mothers. Almost half of 6 year olds had witnessed a beating, and 1 in 14 had seen someone shot or stabbed. Not surprisingly, these children had more problems with aggression, attention, and stress than children not exposed to violence. The long-term effects on children must be examined, and appropriate interventions implemented.
While standard pediatric texts list grunting as a sign of respiratory distress in newborns, the significance and course of grunting have not been examined. This study of 466 newborns found an incidence of grunting in the first 4 hours of life for 17.4%. Grunting stopped in 93% of infants by 2 hours. These infants were more likely to have received bag mask ventilation in the delivery room, and their mothers were more likely to have received intrapartum antibiotics. Since grunting resolved quickly in the vast majority of infants, laboratory evaluation can be postponed for 1 to 2 hours.
This Month in Archives of Pediatrics & Adolescent Medicine. Arch Pediatr Adolesc Med. 2001;155(3):329. doi:10-1001/pubs.Pediatr Adolesc Med.-ISSN-1072-4710-155-3-ptm0301