Television viewing is associated with an increased risk of obesity as well as increased levels of aggressive behavior in children. Although prior interventions have focused on school-aged children, young children are also widely exposed to television and videos. This randomized controlled trial of preschool and day care centers examined the effects of a health promotion curriculum designed to reduce television viewing. The intervention resulted in a reduction in television watching by 3.1 hours per week, whereas the control group increased their television watching by 1.6 hours per week during the course of the study. This study demonstrates that means are available to reduce television and video watching among preschool children and thereby to decrease their negative consequences.
Resources at state health departments have been stretched thin by the decline in fiscal health of nearly all states and by the increased demand for preparedness against bioterrorism. However, these agencies must continue to carry on their traditional public health activities such as investigation of and response to infectious disease outbreaks. Wheeler and colleagues show how vulnerabilities in the public health infrastructure affected the state health department's response to a pertussis outbreak during the 2001-2002 respiratory infection season. The lessons learned from this pertussis outbreak can serve as important reminders to recognize and correct barriers to public health management that might also be relevant for the public health response to potential bioterrorism.
Treatment of children with bronchiolitis is a common problem confronting pediatricians during the winter months. King and colleagues conducted a systematic review of the literature to examine the effectiveness of commonly used treatments for this disorder, including epinephrine, β-2-agonists, corticosteroids, and ribavirin. Studies were generally underpowered and did not collect data on the most important outcomes. Overall, there is still little evidence to support the routine use of these drugs in treating infants with bronchiolitis.
The diagnosis of bronchiolitis is primarily clinical, and the role of laboratory and radiological testing is unclear. Bordley and colleagues conducted a systematic review of the literature to examine the utility of diagnostic tests in bronchiolitis. Of the 80 studies examined, no data supported improved outcomes through the use of respiratory syncytial virus tests, chest radiographs, blood counts, or blood cultures. The use of chest x-ray films was associated with an increased use of antibiotics without a change in outcome. There are no clear indications for the routine use of any of these tests in the treatment of children with bronchiolitis.
This Month in Archives of Pediatrics & Adolescent Medicine. Arch Pediatr Adolesc Med. 2004;158(2):105. doi:10.1001/archpedi.158.2.105