
Maternal and Child Health Library
This and past issues of the MCH Alert are available at http://www.mchlibrary.info/alert/archives.html.
April 11, 2008
1. Presentation Released to Support Sharing of
Information About the Importance of Systems of Services
2. Journal Supplement Addresses Inflicted Traumatic Brain
Injury in Young Children
3. Journal Supplement Recognizes Significance of Underage
Alcohol Use in Child and Adolescent Health and Development
4. Article Compares Characteristics of Adolescents with
and Without Bedroom TVs
5. Study Quantifies the Increased Use of Health Care
Services Associated with Obesity During Pregnancy
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1. PRESENTATION RELEASED TO SUPPORT SHARING OF INFORMATION ABOUT THE
IMPORTANCE OF SYSTEMS OF SERVICES
Defining a Community-Based System of Services for Children and Youth
with Special Health Care Needs explains the importance of organizing
community services so that children and adolescents with special health
care needs and their families can use these services more easily. The
Flash presentation, created by Champions for Inclusive Communities
(ChampionsInC), explains the importance of community-based systems of
services and illustrates the six outcomes that communities are
currently working toward. A redistributable version of the presentation
and a transcript are available for use by communities or organizations
that would like to share this information with others. A Spanish
version of the presentation will be available in the future. The
presentation is
available for viewing online or as a download at
http://www.championsinc.org/about/intro/download_form.cfm.
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2. JOURNAL SUPPLEMENT ADDRESSES INFLICTED TRAUMATIC BRAIN INJURY IN
YOUNG CHILDREN
The April 2008 supplement to the American Journal of Preventive
Medicine focuses on efforts to monitor inflicted childhood traumatic
brain injury (TBI) and on the programs in place to prevent inflicted
TBI from occurring. The supplement, produced with support from the
Division of Violence Prevention, National Center for Injury Prevention
and Control at the Centers for Disease Control and Prevention, examines
public health approaches to measuring inflicted TBI and the value of
epidemiology in understanding and preventing violence against children.
The content is drawn from an October 2006 meeting sponsored by the
National Center on shaken baby syndrome to bring together a
multidisciplinary group of professionals with scientific and clinical
expertise to address the challenges of implementing valid and reliable
shaken baby syndrome and abusive head trauma surveillance systems in
the United State and other countries. Supplement topics include
measuring incidence and findings from current measurement systems,
evaluating the effectiveness of preventive initiatives, and defining
the ideal system. The supplement is available at http://www.sciencedirect.com/science?_ob=PublicationURL&_tockey=%23TOC%236075%232008%23999659995.8998%23683859%23FLA%23&_cdi=6075&_pubType=J&_auth=y&_acct=C000035538&_version=1&_urlVersion=0&_userid=655954&md5=86b2979882908e95bded44a9c5933e3c.
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3. JOURNAL SUPPLEMENT RECOGNIZES SIGNIFICANCE OF UNDERAGE ALCOHOL USE
IN CHILD AND ADOLESCENT HEALTH AND DEVELOPMENT
The April 2008 supplement to Pediatrics addresses the complex
relationship between development and underage drinking. The supplement,
sponsored by the National Institute on Alcohol Abuse and Alcoholism
(NIAAA), draws from discussions among members of the NIAAA Team on
Underage Drinking and its group of outside experts about the nature and
extent of underage drinking in the United States and efforts to
integrate research in child and adolescent development with alcohol
research. The first article provides a developmental framework for
understanding and addressing underage drinking. The next three articles
present information on underage drinking divided into three age
groupings: children under age 10, younger adolescents (ages 10-15), and
older adolescents (ages 16-20). Certain topics necessarily appear in
multiple articles because they are not confined in the course of
natural development to a single age group. The final three articles
review the state of the science on prevention and treatment
interventions for underage drinking. Abstracts of supplement articles
are available at http://pediatrics.aappublications.org/content/vol121/Supplement_4/index.shtml.
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4. ARTICLE COMPARES CHARACTERISTICS OF ADOLESCENTS WITH AND WITHOUT
BEDROOM TVS
"These exploratory analyses are important and pertinent to the health
of adolescents and have implications for parents considering whether
they should allow their children to have a TV in their bedrooms," state
the authors of an article published in the April 2008 issue of
Pediatrics. It has been well documented that adolescents spend a great
deal of time watching TV. Heavy TV use is of concern because more use
is associated with negative behavioral and physical outcomes, such as
poor school performance, poor dietary habits, and a higher body mass
index. A related factor that may contribute to increased TV viewing and
that is associated with negative outcomes is the presence of a TV in
adolescents' bedrooms. The study described in this article examines the
prevalence of having a bedroom TV among a large, population-based
sample of adolescents ages 15-18 and compares sociodemographic,
personal, and behavioral characteristics of adolescents with and
without a bedroom TV.
The data analyzed for the study were from Project Eat Among Teens
(EAT)-II, the follow-up portion of a study that examined
socioenvironmental, personal, and behavioral determinants of dietary
intake and weight status in adolescents. The final sample included in
the analysis was an ethnically and socioeconomically diverse group of
781 adolescents. Measures included presence of a bedroom TV, physical
activity, sedentary behaviors, eating behaviors, and personal factors
(demographic features, weight status, grade point average, family
connectedness, depression).
The authors found that
- Sixty-two percent of adolescents reported having a bedroom TV.
- Gender, race and ethnicity, and socioeconomic status were
associated with the presence of a bedroom TV.
- Girls with a bedroom TV reported less time engaging in vigorous
physical activity, more time watching TV, lower vegetable intake,
higher sweetened beverage consumption, and fewer family meals, compared
to girls without a bedroom TV.
- Boys with a bedroom TV reported more time watching TV, lower
fruit intake, and fewer family meals, compared to boys without a
bedroom TV.
- The prevalence of snacking while watching TV did not differ
according to the presence of a bedroom TV.
- Twice as many adolescents with a bedroom TV reported heavy TV use
(at least 5 hours per day) compared to adolescents without a bedroom TV.
The authors conclude that "refraining from placing a TV in adolescents'
bedrooms may be a first step in helping to decrease screen time and
subsequent behaviors associated with increased TV watching."
Barr-Anderson DJ, van den Berg P, Neumark-Sztainer D, et al. 2008.
Characteristics associated with older adolescents who have a TV in
their bedrooms. Pediatrics 121(4):718-724. Abstract available at http://pediatrics.aappublications.org/cgi/content/abstract/121/4/718.
Readers: More information is available from the following MCH Library
resources:
- Knowledge Path: Healthy Social and Emotional Development in Children
and Adolescents at
http://www.mchlibrary.info/KnowledgePaths/kp_Mental_Healthy.html
- Knowledge Path: Overweight and Obesity in Children and Adolescents at
http://www.mchlibrary.info/KnowledgePaths/kp_overweight.html
- Knowledge Path: Physical Activity and Children and Adolescents at
http://www.mchlibrary.info/KnowledgePaths/kp_phys_activity.html
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5. STUDY QUANTIFIES THE INCREASED USE OF HEALTH CARE SERVICES
ASSOCIATED WITH OBESITY DURING PREGNANCY
"We found that obesity was associated with greater use of inpatient and
outpatient health care services," state the authors of an article
published in the April 2, 2008, issue of the New England Journal of
Medicine. Although it is recognized that pregnant women who are obese
use more health care services than those who are not, published
estimates of the magnitude of the increase are limited. The article
presents findings from a study to estimate the increase in use of
maternal health care services associated with obesity during pregnancy.
Data for the study were drawn from multiple Kaiser Permanente Northwest
automated data systems. The final study sample included 13,442 women
ages 18 and older with pregnancy episodes (defined as beginning 2 weeks
before conception and ending 8 weeks after delivery) that began on or
after January 1, 2000, and ended on or before December 31, 2004, and
that resulted in a live birth or a stillbirth (fetal death at 20 weeks
of gestation or later). The analyses assessed associations between
measures of use of health care services and maternal body mass index
(BMI), with length of hospital stay for delivery as the primary measure
of use of health care services.
The authors found that
- The mean total length of hospital stay and the mean postpartum
length of stay were significantly higher for pregnancies of overweight
(BMI 25.0 to 29.9) and obese (BMI 30.0 to 34.9) women than for
pregnancies of women of normal weight (BMI 18.5 to 24.9).
- The frequencies of fetal tests, obstetrical ultrasonographic
examinations, prenatal visits with physicians, outpatient medications
dispensed, and telephone calls to the department of obstetrics and
gynecology were significantly greater for pregnancies of obese, very
obese, and extremely obese women (BMI equal to or greater than 30.0)
than for pregnancies of women of normal weight.
- The relation between BMI and frequency of prenatal visits varied
according to the type of heath professional seen: the frequency of
prenatal visits with physicians increased significantly with increasing
BMI, but the frequency of visits with nurse practitioners and physician
assistants decreased significantly with increasing BMI.
- When controlling for either the mode of delivery or the presence
or absence of a high-risk condition, the length of stay remained
significantly higher for pregnancies of obese, very obese, and
extremely obese women than for pregnancies of women of normal weight.
- The presence of a high-risk condition during pregnancy increased
overall use of health care services, but it also modified the
association between BMI and use of health care services for all
procedures and encounters.
"Maternal BMI higher than normal is associated with greater use of
health care services," state the authors. "Of the 4 million births each
year in the United States, approximately 1 million involve obese women.
Thus, even a small increase in the cost of health care associated with
obesity will have substantial economic implications."
Chu SY, Bachman DJ, Callaghan WM, et al. 2008. Association between
obesity during pregnancy and increased use of health care. New England
Journal of Medicine 358(14):1444-1453. Abstract available at
http://content.nejm.org/cgi/content/short/358/14/1444?query=TOC.
Readers: More information is available from the following MCH Library
resources:
- Knowledge Path: Preconception and Pregnancy at
http://www.mchlibrary.info/KnowledgePaths/kp_pregnancy.html
- Nutrition During Pregnancy (organizations resource list) at
http://www.mchlibrary.info/action.lasso?-database=Biblio&-layout=Web&-response=/databases/BibLists/bib_pregnutr.html&-MaxRecords=all&-DoScript=auto_search_pregnutr&-search
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MCH Alert © 1998-2008 by National Center for Education in Maternal
and
Child Health and Georgetown University. MCH Alert is produced by
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