Recurrent otitis media is an extremely common problem that pediatricians manage daily. No current treatment options are impressively effective or without complications. Mills and colleagues conducted a randomized controlled trial to test another intervention: the use of osteopathic manipulation as adjuvant therapy for recurrent otitis media. Osteopathic manipulation resulted in fewer episodes of otitis media, fewer surgical procedures, and more surgery-free months compared with children who received usual care. These children were more likely to have normal tympanogram results. Osteopathic manipulation is an intriguing potential addition to the care of this common chronic problem.
Elimination of racial and ethnic disparities is an important goal and the subject of many local and national initiatives. This systematic review of the literature provides important information on disparities in care for adolescents. In general, black and Hispanic youths received less primary and mental health care than white youths. Too few studies have been conducted to allow us to judge the presence of disparities in reproductive health care. The findings suggest that greater attention must be directed at better understanding the reasons for disparities in adolescent health care.
Prior observational and intervention studies have demonstrated that television watching is related to both obesity and violent behavior. In this survey of mothers of 3- and 4-year-old children, Burdette and colleagues found that one quarter of preschool children watched more than 3 hours of television per day. Children were more likely to be in this high television-viewing group if their mothers had clinically significant depressive symptoms or were obese. Nearly half of children with obese and depressed mothers watched more than 3 hours of television per day, placing these children at great risk for adverse health consequences from their environment.
Intimate partner violence has finally been recognized as a major public health problem in the United States and has been shown to have multiple health and psychological effects in adults. Using the National Longitudinal Study of Adolescent Health, Roberts and colleagues demonstrated that similar consequences occur in adolescents involved with intimate partner violence. Adolescent females who had been abused had increased depressive symptoms, substance use, antisocial behavior, and suicidal behavior. These findings should provide an even stronger impetus to address intimate partner violence at all ages.
The epidemic of obesity in the United States is well recognized, and attention must now be focused on changeable risk factors, especially during childhood. Giammattei and colleagues studied 319 sixth- and seventh-grade children, 17.4% of whom had a body mass index greater than the 95th percentile. Watching 2 or more hours of television per night was associated with a 24% increased likelihood of being overweight, and drinking 3 or more soft drinks per day was associated with a 46% increase in the chance of being overweight. This study indicates that limiting television watching and decreasing soft drink consumption are important interventions to prevent obesity.
This Month in Archives of Pediatrics & Adolescent Medicine. Arch Pediatr Adolesc Med. 2003;157(9):843. doi:10.1001/archpedi.157.9.843