In the United States, one of the great concerns in the obesity epidemic is the disparity among racial and ethnic groups in the prevalence of obesity. Data from the Fragile Families and Child Well-being Study represent a birth cohort from 75 hospitals across 20 large cities in 15 states. At 3 years of age, 26% of Hispanic children were obese compared with 16% of black children and 15% of white children. This higher prevalence of obesity in Hispanic children was not explained by maternal education, household income, or children's food security status. Other yet unidentified factors must be explored to explain these differences, particularly since they occur so early in life.
A basic component of quality health care is that it be current, which requires continued lifelong learning by physicians. Unfortunately, most continuing medical education has been found to be ineffective in either changing behavior or improving care. Few studies have examined the efficacy of Web-based learning compared with traditional styles of continuing medical education. Gerard and colleagues conducted a randomized controlled trial to compare a traditional pediatric advanced life support course with a Web-based version. Students taking the Web-based pediatric advanced life support course performed very similarly to those taking the traditional course on follow-up evaluation, and all indicated that they would recommend it to a colleague. The findings in this study support the continued development and promotion of the Web-based pediatric advanced life support course.
Unwanted sex is a common element of the sexual experiences of many young women and is associated with harm to both physical and mental health. In this study of 279 females with a mean age of 16 years, 41% reported unwanted sex at least once. The most common type was owing to fear that the partner would get angry if denied sex; 10% reported being forced to have sex. Risk factors for unwanted sex were the woman having a baby with the partner, lack of sexual control with a partner, lower condom use, and partner's use of marijuana. These same behaviors can put women at risk of sexually transmitted infections and unwanted pregnancies.
The effect of physical activity training on glycemic control of children with diabetes remains controversial. In this large cohort of 18 392 children with type 1 diabetes from 179 sites in Germany and Austria, regular physical activity was assessed. Glycemic control (as measured by hemoglobin A1c) was better at all ages in patients with more regular physical activity; in girls, this was also accompanied by a lower body mass index (calculated as weight in kilograms divided by the square of height in meters). Physical activity did not increase the chance of symptomatic hypoglycemia. Regular physical activity should be recommended in all patients with diabetes.
Glycosylated hemoglobin A1c (HbA1c) level in age groups stratified by frequency of regular physical activity (RPA) per week. RPA0 indicates none; RPA1, 1 or 2 times per week; and RPA2, 3 or more times per week.
Despite the availability of effective medication, many children with asthma have inadequate control of their symptoms, which results in frequent emergency department visits and hospital admissions. The objective of this randomized trial was to examine the effectiveness of a home-based educational intervention targeting symptom recognition and nebulizer use in young children with persistent asthma. Although most children in the study received appropriate nonurgent asthma care, the nebulizer education intervention had no impact on home nebulizer practice, asthma morbidity, or health care use. This study found a high rate of undertreatment and asthma mortality in young inner-city children.
This Month in Archives of Pediatrics & Adolescent Medicine. Arch Pediatr Adolesc Med. 2006;160(6):567. doi:10.1001/archpedi.160.6.567