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This Month in Archives of Pediatrics and Adolescent Medicine
January 5, 2009

This Month in Archives of Pediatrics & Adolescent Medicine

Arch Pediatr Adolesc Med. 2009;163(1):5. doi:10.1001/archpediatrics.2008.538

Adolescents' Display of Health Risk Behaviors on MySpace

Social networking sites are increasingly popular among teenagers, with 25% of 200 million MySpace users estimated to be minors. Adolescents' Web profiles can place them at risk of a number of adverse consequences because of the health risk information displayed, such as sexual activity and substance use. In this study, Moreno and colleagues examined 500 profiles of self-reported 18-year-olds in the United States. More than half of the profiles referenced 1 or more high-risk behaviors: 24% sexual behaviors, 41% substance use, and 14% violence. Male adolescents were more likely to display references to violent behavior, while female adolescents were more likely to display references to sexual behaviors. Involvement with church or sports decreased the likelihood of references to health risk behaviors. It is important for both parents and pediatricians to be aware of these sites and to counsel adolescents on the dangers of displaying personal and inappropriate material on them. These sites may also serve as a venue for interventions in high-risk youth.

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Cerebral Palsy, Autism Spectrum Disorders, and Developmental Delay in Children Born After Assisted Conception

An increasing number of births in the United States and Europe are a result of assisted conception, either in vitro fertilization or ovulation induction. This meta-analysis examined the neurodevelopmental outcomes of children born after assisted conception in 41 articles. Among 19 000 children born after in vitro fertilization, the odds of cerebral palsy was 2.18; part of this increased risk appears to be because of preterm deliveries. In contrast, the data on risks of autism spectrum disorder and delayed motor, behavioral, and cognitive development were inconsistent. There is an urgent need for more longitudinal follow-up studies in these children, given the frequency of assisted conception.

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Diagnosis of Neonatal Sepsis by Universal Primer Polymerase Chain Reaction

The ideal test for the diagnosis of neonatal sepsis continues to be an elusive entity. This study examined the diagnostic utility and accuracy of universal primer polymerase chain reaction (PCR) in a level III neonatal intensive care unit. Of 242 infants undergoing evaluation for sepsis in the sample obtained at the time of initial evaluation, 52 had positive blood cultures (21.5%), of which 50 were PCR-positive. The PCR had a sensitivity and specificity of 96%, a positive predictive value of 87.7%, and a negative predictive value of 98.9%. In the 7 subjects with negative blood cultures and positive PCRs, all appeared to be septic. The PCR rapidly turned negative after the institution of antibiotics. The PCR appeared to be unaffected by maternal antibiotic exposure. These results should be repeated in larger studies to guide clinical decision-making.

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Respite Care for Children With Special Health Care Needs

There is increasing evidence that caring for children with special needs exacts a formidable toll on many parents, both physically and psychologically. Respite care seeks to decrease the burden on caregivers by giving them a break and has been shown to improve caregiver well-being. Access to respite care was examined in this large, national survey conducted in 2001 of caregivers of children with special health care needs. Nearly 9% of caregivers reported a need for respite care in the prior 12 months. This need was greater for caregivers of more disabled children as well as for caregivers with limited education and income. One-quarter of those who needed respite care reported that their needs were unmet. Unmet respite needs were greater for uninsured children, children with more disability, and for mothers with lower educational achievement. It will be important to determine whether the Life Span Respite Care Act passed by Congress in 2006 has decreased the unmet respite care needs of these families.

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