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Copyright 2007 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2007
The medical profession has increasingly recognized the magnitude and impact of intimate partner violence. Intimate partner violence also occurs in teenagers in the form of dating violence. Olshen and colleagues surveyed more than 8000 high school students and found that approximately 10% of both female and male teenagers reported dating violence in the last year. Suicide attempts in the last year were reported by 11% of adolescent girls and 7% of adolescent boys. Dating violence was associated with a 60% greater chance of suicide attempts in adolescent girls; whereas for adolescent boys, sexual assault at any point in their lives increased the risk of suicide attempt nearly 4-fold. This study indicates the need to address intimate partner violence among teenagers and to intervene with all children and adolescents who are victims of violence to prevent long-term adverse effects.
Relieving pain during procedures in the emergency department (ED) is challenging but is an important and necessary element of providing quality care. Children in the ED is a somewhat unique situation because the caregivers, while attempting to comfort their children, are exposed to the psychological trauma of the painful procedure as well. This study examined the physiological and anxiety responses of caregivers while watching their child undergo intravenous cannulation. Caregivers were found to have a significant increase in heart rate, blood pressure, and anxiety while watching. The caregivers' distress and anxiety were found to account for a substantial portion of the variability in the child's distress and anxiety. Thus, comforting of the child must also include measures to reduce stress and anxiety in the caregivers, as well.
Necrotizing enterocolitis (NEC) is the most common neonatal gastrointestinal emergency, with an incidence of 5% to 10% in very low-birth-weight infants. This systematic review and meta-analysis were undertaken to determine whether infants with NEC were at risk for later development of neurodevelopmental impairment. The meta-analysis of 8 studies found a nearly 2-fold increased risk of neurodevelopmental impairment in infants with stage II or worse NEC compared with infants without NEC. Those infants who required surgical intervention were at higher risk of later neurodevelopmental impairment compared with those who required medical management only. The risk of impairment associated with NEC was higher in patients with cerebral palsy, cognitive impairment, or severe visual impairment.
Because of the obesity epidemic in children, increasing attention is being paid to the longer-term effect of intervention programs aimed at weight reduction and increasing physical activity. In this study, Carrel and colleagues followed a cohort of children who had lost weight with a lifestyle-focused physical education class to determine if this weight loss and other accompanying physiologic improvements were maintained during the 3-month summer vacation. Unfortunately, body fat and fasting insulin increased during the summer break, and cardiovascular physical fitness decreased. This study indicates that efforts to address obesity and its concurrent problems in children need to be continued throughout the year.
This Month in Archives of Pediatrics & Adolescent Medicine. Arch Pediatr Adolesc Med. 2007;161(6):535. doi:10.1001/archpedi.161.6.535