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This Month in Archives of Pediatrics and Adolescent Medicine
September 2010

This Month in Archives of Pediatrics & Adolescent Medicine

Arch Pediatr Adolesc Med. 2010;164(9):793. doi:10.1001/archpediatrics.2010.162
Trends in Exposure to Television Food Advertisements Among Children and Adolescents in the United States

On average, children watch more than 3 hours of television each day. This study sought to examine changes in the extent and content of food advertising that children and adolescents saw during the 2003-2007 period. Between 2003 and 2007, daily average exposure to food ads fell by 13.7% and 3.7% among children aged 2 to 5 years and 6 to 11 years, respectively, but increased by 3.7% among adolescents aged 12 to 17 years. Exposure to sweets and beverage ads fell across all age groups, with substantial decreases in exposure to ads for the most heavily advertised sugar-sweetened beverages—fruit drinks and regular soft drinks. In contrast, exposure to fast food ads for children and adolescents increased, and there was a marked increase in diet soft drink advertising. Continued monitoring of children's television food ad exposure along with nutritional assessments of advertised products will improve understanding of the extent to which self-regulation can translate into a reduction in the promotion of unhealthy food products.

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Parental Hopeful Patterns of Thinking, Emotions, and Pediatric Palliative Care Decision Making

Parents of children with advanced life-threatening conditions confront daunting medical decisions. One of the major decisions is whether to institute a limit of intervention (LOI) order for their child. This prospective study tested the hypothesis that hopeful patterns of thoughts and emotions of parents of 33 pediatric patients receiving palliative care consultative services are related to subsequent decisions, specifically regarding LOI orders. During 6 months of cohort follow-up, children with life-threatening conditions were more likely to have an LOI order enacted if their parents had higher hope scores at baseline, after adjustment for the parents' baseline measures of affect and perceptions of the child's health trajectory. At the time of entry into this cohort, the parents reported high levels of both positive and negative affect during the preceding week and had scores regarding hopeful patterns of thinking comparable with reference groups. The findings of this study underscore the importance of affect and patterns of hopeful thinking in the processes of decision making when confronting serious illness and strongly suggest the need for clinicians to be aware of and respond to these influences.

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Associations Between Perfluorooctanoic Acid and Perfluorooctanesulfonate and Serum Lipids in Children

Perfluorooctanoic acid (PFOA) and perfluorooctanesulfonate (PFOS) are used as emulsifiers during the manufacture of fluoropolymers, chemicals that give nonstick heat resistance to cookware and breathable and waterproof properties to fabrics and upholstery. The liver is a primary target organ for perfluoroalkyl acid physiologic activity. The C8 Health Project resulted from a pretrial settlement of the class action lawsuit Leach v E.I. du Pont de Nemours & Co. Serum PFOA concentration for 12- to 19-year-old adolescents in the project population was substantially above the reported concentration for those in the 2003-2004 National Health and Nutrition Examination Survey study. Total cholesterol and low-density lipoprotein cholesterol were linearly and positively associated with both PFOA and PFOS. This study reports the first known assessment of associations between PFOA/PFOS and serum lipids in children from the largest community-based study of the effects of PFOA exposure to date. The large sample size of the current study and findings consistent with results from adult occupational and larger community studies support a strong need to prioritize studying the effects of perfluoroalkyl acids in children to assess whether the clear associations reported here are etiologic.

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Postinfectious Fatigue in Adolescents: The Role of Physical Activity

Chronic fatigue syndrome (CFS) represents a significant public health concern, possibly affecting as many as 800 000 individuals (primarily adolescents and adults) within the United States. Research suggests that infectious mononucleosis may be 1 disease process that leads to symptom complexes involving severe fatigue and associated physical and cognitive symptoms. Little is known about the role of physical activity in the development of CFS in adolescents. In this prospective study of 301 adolescents with infectious mononucleosis, 39 met criteria for CFS 6 months after acute infection. Compared with their matched controls, adolescents with CFS reported significantly higher levels of fatigue at all points and spent significantly more time sleeping during the day 6 and 12 months following infection. Adolescents with CFS did not differ significantly from controls in terms of physical activity levels before, during, or after infection. Adolescents with CFS appear to be pushing themselves in an attempt to maintain similar activity levels as their peers but paying for it in terms of fatigue severity and an increased need for sleep, particularly during the day.

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