Showing posts with label behavior. Show all posts
Showing posts with label behavior. Show all posts

Thursday, October 16, 2014

Obesity and Interpersonal Dynamics at Family Meals

By: Lewis First, MD, MS; Editor-in-Chief 

Photo by Phyllis Buchanan via Flickr
We certainly run a lot of studies on the role of proper nutrition and exercise in preventing a child from becoming overweight or obese, but what about the dynamics of a family meal itself? Could certain characteristics regarding a family eating together be protective against obesity and other characteristics that contribute to excess weight gain?

Berge et al. (doi:10.1542/peds.2014-1936) performed a cross-sectional observational study in which family meals were videoed in the homes of 120 low-income and minority communities. Communication among family members and other aspects of parent-child and child-sibling dynamics were studied and compared to a child’s weight status. The results are fascinating and indicate the more positive the family dynamic around the table, the less risk of a child being overweight.

While this study cannot prove causality, it is certainly food for thought in regard to our promoting the importance not just having healthy food on the table, but the whole family being gathered together to share and support each other through conversation and other positive dynamics practiced at the family table. Read this study and learn more that you, in turn, can share with your patients’ families.

Related Reading:

Monday, June 30, 2014

Sexting in Middle School Students: Here & Happening More Than You Think

By: Lewis First, MD, MS

Photo by zoe via Flickr
We are well aware via journal studies and the public media that sexting, the sending or receiving of sexually explicit texts or photographs on smart phones and other computerized devices, is prevalent among older teens in high school—but what about students in middle school?

Winetrobe et al. (doi: 10.1542/peds. 2013-2991) opted to study almost 1300 middle school students who submitted data in the 2012 Youth Risk Behavior Survey for Los Angeles. These students answered questions about their sexting behavior and their sexual risk-taking behaviors in real life. Looking at the study results, the percentage of middle school students who sent or received sexual texts and were also sexually active is concerning. What’s even worse were the number of students more likely to sext and have unprotected sex.

Do you talk with your teen patients about sexting? Would texting your teen patients with advice on how to better use social media and the dangers of sexting be something you might consider?

We would love to know whether you address this problem with your patients by responding to this blog, or sharing your thoughts on this study or what you do in your practice to try to address sexting via Facebook, Twitter or perhaps via an eLetter to the journal.

Related Reading:

Tuesday, June 17, 2014

Firearm Homicide & Other Causes of Death in Delinquent Youth

Pediatrics Editorial Board Member Joann Schulte, DO, MPH, shares her expert perspective on a new article from our July issue. To learn more about Dr. Schulte and her work in general pediatrics and preventive medicine, check out her bio on our Contributors page.

By: Joann Schulte, DO, MPH

Photo by  AnjaPetrol via Pixabay (modified)
Fairy tales have happy endings, but the real life of delinquent adolescents often end at young ages and by homicide. That stark story is highlighted in researched published this month from Pediatrics’ July issue (doi: 10.1542/ peds.2013-3966).

The Northwestern Juvenile Project examines the health needs and outcomes of delinquents in custody in a prospective, longitudinal study. Linda Telpin and other researchers interviewed 1,829 adolescents in Chicago (Cook County, Illinois) who were in custody between 1995 and 1998 and then tracked the participants during a 16-year period.

They examined vital statistics records to assess deaths and found 111 had died, seven percent of the males and almost four percent of the females. Of those 111 who died, more than two-thirds (75 and 68 percent, for males and females, respectively) had been murdered, most often with firearms (68 and 91 percent, for males and females, respectively). In the study, female delinquents died at almost 5 times higher rates than the general population. Among Hispanic males and females, the death rates were 5 and 9 times greater than the general population.

This study is considered important because it includes ethnic and racial minorities and calculated death rates and compares them to the general population.

Researchers involved in the project are from Northwestern University, Edward Hines, Jr. Veterans Administration Hospital and the University of Illinois – Chicago Institute for Juvenile Research. They have also published related research on psychiatric disorders among the adolescents and published an earlier assessment in Pediatrics. The 2005 study in Pediatrics also found homicide to be most common cause of death in the study population.

Monday, April 14, 2014

Two Studies on Media Exposure in Young Children Provide Concerning Results

Photo by normanack via Flickr
The AAP has made media awareness a priority issue for pediatricians and patients and policies to limit media exposure in infants, children and teens have come forth over the past few years in our journal (doi: 10.1542/ peds.2013-2656).

Despite the policies, children seem to be spending more and more time engaged in media usage so this week we are releasing two studies you can share with your patients that might make more of a dent in reducing the amount of television or other media children are often routinely exposed to at home.

The first study by Cespedes et al. (doi: 10.1542/peds.2013-3998) looked at sleep duration differences between infancy and mid-childhood when there was a television in the bedroom as the child got older, as well as whether sleep duration was influenced negatively by the amount of television watched overall. Given the studies we have published on the association of inadequate sleep with general mental and physical health, having sleep duration potentially influenced, or at least associated with, prolonged television exposure and/or television in the bedroom is a message that is well-worth sharing with your patients.

Similarly, a second study by Radesky et al. (doi: 10.1542/peds.2013-2367) looked at parental report of infant behavioral self-regulation and its association with early childhood media exposure. The authors’ study hypothesis was that poor-self regulation would result in parents placing their child in front of television and videos more than those parents who did not perceive their children having self-regulation problems. Again—alerting families that there are better solutions to perceived behavioral issues with their children than simply putting them in front of a television or video screen is also some guidance we might provide to parents in our quest to reduce media exposure in our youngest patients.

Channel your energy into reading these two studies so you can in turn channel your media-reduction messages even more to your patients.

Related Reading:

Thursday, January 9, 2014

Does Early Preterm Crying Mean Behavioral Issues Up the Road?

Photo by Bonoz via Pixabay
Pediatrics and other journals have published a myriad of articles on preterm infants and the complications with which they may present. Yet we have not seen much on the preterm infant who cries “excessively” according to parents and whether that higher amount of crying is a harbinger of behavioral problems as the child gets older.

Korja et al. (doi: 10.1542/peds.2013-1204) decided to investigate this interesting issue by tracking 202 infants who weighed less than 1500 grams at birth using a parental diary to note preterm infant crying behavior at term, 6 weeks, and 5 months of corrected age. The duration and frequency of crying was then compared to the child’s behavior using the Child Behavioral Check List tool at ages 3 and 4 years, and the Parental Stress Index tool at ages 2 and 4 years.

You may shed a tear when you see the results—or at least opt to ask parents of preterms about their infants’ crying behaviors as they move through infancy so that appropriate behavioral guidance or reduction of parenting stress can be suggested so as to abate the behavioral issues that are more likely to occur based on this interesting association.

Have you seen a similar association in your own preterm patients as they move into toddlerhood, or have you not thought to review the crying history relative to the behavioral history? Read this study and you will be more likely to want to associate the two than ever before.

Related Readings:

Wednesday, December 11, 2013

Early Puberty: Does It Increase the Risk of Problem Behaviors in Young Adolescent Girls?

We have published several articles recently noting the earlier and earlier onset of puberty (e.g. doi: 10.1542/peds.2012-3773) and suggested reasons for this phenomenon. But what about the behaviors of those who develop earlier? Does it make teens more apt to become aggressive and/or delinquent?

Photo by  PublicDomainPictures via Pixabay

Mrug et al. (doi:10.1542/peds.2013-0628) try to answer these questions in a fascinating and troubling longitudinal study of more than 2,300 girls from three urban areas, as well as their parents, who were interviewed at three time points over 6 years from ages 11 to 16. The influence of a best friend’s behavior on the early versus non-early pubertal female adolescent was also studied.

The results show some initial behavioral findings that are well-worth knowing about. After reading this study, you will want to immediately apply the findings to younger teens in your own practice who experience early menarche to determine if their behavioral patterns are as concerning as those in this study.

Do you agree with the findings? Whether or not you do, we’d love to hear your comments by responding to this blog entry below or sharing your thoughts on Facebook, Twitter, or an eLetter that we can post on our website.

Related Readings:

Monday, October 21, 2013

The Longitudinal Effects of Spanking

We are certainly aware of prior studies that suggest discipline and limit-setting should not be achieved through corporal punishment such as spanking. Yet despite our educating families to use different strategies such as time-outs, in this country and around the world, parents continue spanking. Is there anything new to further convince parents that their hand striking a child’s bottom is not the way to make their point?

Photo by Captain Ted via Flickr
Fortunately, a new study we are releasing this week might help our educational efforts with families. MacKenzie et al. (doi: 10.1542/peds.2013-1227) report on a longitudinal birth cohort of almost 2,000 children in 20 cities whose parents self-reported spanking at ages 3 and 5 and who were then followed to age 9 and evaluated for their behavior and cognitive development. The study indicates that both fathers and mothers still spank their children at a much higher percentage than I expected, and perhaps you as well.

More concerning is the association between spanking and behavioral and cognitive development as shown in this study—but rather than tell you about the findings, read them for yourself and then take some time out with families to make sure they understand the potential negative effects spanking may have on their child’s future behavioral and cognitive development.

Related Reading: