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While depression is one of the greatest causes of disability around the world, limited attention has been paid to mental health problems of youth in low- and middle-income countries. This study reports on depressive symptoms in 539 youth in Rwanda who were orphaned and consequently the heads of their households caring for younger siblings. More than half of the youth screened positive for depression, with the greatest risks of depression among those with few household assets, those eating less than 1 meal per day, those with high levels of grief, and those who lost at least one parent in the genocide. The potential effect of depression in these youth on the development of their younger siblings will jeopardize the next generation and indicates the need for large-scale, community-wide interventions.
See page 836
Growing concern about the global obesity epidemic has fostered interest in new ways of increasing physical activity among children. In this study of 6- to 12-year-old children, energy expenditure was measured while they were engaged in video games that require active movement. The 2 games tested significantly increased energy expenditure and heart rate during play compared with basal statuses. The study indicates that manipulating the gaming environment can provide children with potentially appealing activity alternatives. It holds the promise of an activity that is attractive to children while at the same time increases energy expenditure.
See page 886
Vomiting due to acute gastroenteritis is a commonly encountered problem in pediatric offices and emergency departments. Newer medications for the treatment of vomiting have warranted a systematic review to examine their effectiveness. This meta-analysis of 6 randomized controlled trials of ondansetron found that the medication reduced the risk of subsequent vomiting, need for intravenous fluids, and hospital admission by half. Future guidelines should consider incorporating ondansetron into the treatment protocols for acute gastroenteritis.
The relative risk (RR) of persistent emesis in the emergency department (ED) in ondansetron-treated patients. The size of each box is proportional to the sample size of the trial. Horizontal bars indicate 95% confidence intervals (CIs); white diamond, the pooled estimate; the peak of the diamond, the point estimate; and the width of the diamond, 95% CI.
See page 858
Despite the demonstrated benefits of breastfeeding, only 1 in 7 infants in the United States is exclusively breastfed at 6 months of age. One known deterrent to breastfeeding is new mothers receiving formula packs on discharge from the hospital. Merewood and colleagues contacted all 1295 maternity hospitals in 21 eastern states and the District of Columbia to determine hospital policies on distribution of infant formula sample packs. The study found that 94% of hospitals distributed formula sample packs, ranging from a low of 70% of New Hampshire hospitals to 100% of hospitals in 5 other states. Fortunately, increasing numbers of hospitals are not distributing the packs.
Percentage of hospitals distributing formula sample packs by state.
See page 823
This Month in Archives of Pediatrics & Adolescent Medicine. Arch Pediatr Adolesc Med. 2008;162(9):811. doi:10.1001/archpedi.162.9.811
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