Media and technology use predicts ill-being among children, preteens and teenagers independent of the negative health impacts of exercise and eating habits.

The American Academy of Pediatrics recommends no screen time for children under the age of 2 and limited screen time for all children. However, no such guidelines have been proposed for preteens and teenagers. Further, research shows that children, preteens, and teenagers are using massive amounts of media and those with more screen time have been shown to have increased obesity, reduced physical activity, and decreased health. This study examined the impact of technology on four areas of ill-being-psychological issues, behavior problems, attention problems and physical health-among children (aged 4-8), preteens (9-12), and teenagers (13-18) by having 1030 parents complete an online, anonymous survey about their own and their child's behaviors. Measures included daily technology use, daily food consumption, daily exercise, and health. Hypothesis 1, which posited that unhealthy eating would predict impaired ill-being, was partially supported, particularly for children and preteens. Hypothesis 2, which posited that reduced physical activity would predict diminished health levels, was partially supported for preteens and supported for teenagers. Hypothesis 3, that increased daily technology use would predict ill-being after factoring out eating habits and physical activity, was supported. For children and preteens, total media consumption predicted illbeing while for preteens specific technology uses, including video gaming and electronic communication, predicted ill-being. For teenagers, nearly every type of technological activity predicted poor health. Practical implications were discussed in terms of setting limits and boundaries on technology use and encouraging healthy eating and physical activity at home and at school.

Making a plan. Helping patients in end-of-life decision making.

Few medical legal issues are more complex or confusing than end-of-life decision-making. Many people form definite views about what they would or would not want based on the case of a friend or relative, only to discover when their turn comes that the medical facts are very different, and their preconceived views are inapplicable. Others simply change their minds.

Does endotoxin tolerance prevent the release of inflammatory monokines (interleukin 1, interleukin 6, or tumor necrosis factor) during sepsis?

Mice were subjected to sepsis by cecal ligation and puncture to determine whether macrophages from endotoxin-tolerant C3H/HeJ mice are also activated systemically to release inflammatory monokines associated with septic mortality. Blood levels of both tumor necrosis factor and interleukin 6 were significantly elevated during the first 1 to 4 hours of sepsis as compared with sham controls. Peritoneal macrophages from septic mice exhibited a marked spontaneous release of interleukin 1, interleukin 6, and tumor necrosis factor at 1 hour. However, the addition of endotoxin to macrophage cultures taken from septic mice had no further stimulatory effect. Sham controls alternatively showed no significant innate monokine release, but their macrophages did release increased monokine numbers in response to endotoxin. These results indicate that the spontaneous macrophage release of these monokines is comparable with that previously observed in endotoxin-sensitive mice, suggesting a common mechanism by which macrophages are primed by traumatic injury by an agent other than endotoxin to release monokines during sepsis. Thus, the administration of agents that decrease or prevent the deleterious effects of systemic inflammatory mediators during sepsis could be useful adjuvants in those clinical situations where the bacterial origin is unknown.

Studying the Pan Asian community.

The author examines the population size, dynamics, natural increase, and income of what is described as the Pan Asian population of the United States. "This population is extremely diverse, giving rise to the term 'Pan Asian,' which encompasses immigrants from Asian and Pacific Island countries and native-born citizens descended from those ethnic groups." Data are from official U.S. sources, including the census and current population surveys.

High fertility of Old Colony Mennonites in Mexico.

Old Colony Mennonites in Mexico appear to demonstrate natural fertility, using no form of artificial birth control and apparently not attempting to limit family size. The resulting fertility is nearly as high as that of the Hutterites, although the Mennonites lack the communal economic system of the latter. Most Mennonites in Mexico migrated from Canada in the 1920s, and the largest single settlement, called the Manitoba Colony, is one of four in the state of Chihuahua. A 1967 partial census obtained data from 38% of the Mennonite households. Family size in the sample was close to that in a local survey taken in the same year. Available church records matched with census forms permitted verification of and corrections to 560 female reproductive histories. The median number of live births to women over age 45 years was 9.5, compared with 10.4 in the Hutterites. Age-specific marital fertility rates and birth intervals closely resembled those of the Hutterites.

PIP: Old Colony Mennonites in Mexico appear to demonstrate natural fertility, use no form of artificial birth control, and are apparently not attempting to limit family size. The resulting fertility is nearly as high as that of the Hutterites, although the Mennonites lack the communal economic system of the latter group. Most Mennonites in Mexico migrated from Canada in the 1920s and the largest single settlement, called the Manitoba Colony, is 1 of 4 in the state of Chihuahua. A partial census in 1967 obtained data from 38% of the Mennonite households. Family size in the sample was close to that of a local survey taken in the same year. Available church records matched with census forms permitted verification of and corrections to 560 female reproductive histories. The median number of livebirths to women over age 45 was 9.5 compared with 10.4 in the Hutterite community. Age- specific marital fertility rates and birth intervals closely resembled those of the Hutterites.

Spotlight: Afghanistan.

PIP: Afghanistan is a landlocked country approximately the size of Texas with an estimated population of 14.5 million. The fertility level (6.7 children per women) is estimated to be very high, as is the mortality rate (183 infant deaths/1,000 live births). Demographic data sources are scarce, and current estimates are based on a 1972-1974 series of surveys and a 1979 census which enumerated only 55-60% of the population. The government of Afghanistan, a Marxist state, has asked for international aid to improve data collection and analysis. Compounding the problems of accurate data collection is the state of civil war that has existed in Afghanistan since the Marxist coup in in 1978 and Soviet occupation in 1979. The war impelled the emigration of 5 million refugees, who live in camps in neighboring Pakistan and Iran. Although the population decline that resulted from this emigration is significant, the repatriation of the refugees will play a role in determining the population dynamics for the next decade, as will the withdrawal of Soviet troops -- expected in 1990. Because of Afghanistan's central-Asia location, there is a unique ethnic and linguistic mixture of tribes. The largest group is the Pushtus, who make up 40% of the population. Afghan Persian and Pushtu are the dominant languages, and 98% of all Afghans are Moslem. The economy is largely agricultural and half the cultivated land must be irrigated. 85% of the population live in rural areas and another 2.5 million are nomads. The low status of women and female children, low levels of health care, and high fertility contribute to the lower life expectancy of females over males. Although the government supports contraceptive services, such services are inadequate, and sterilization is illegal. The withdrawal of Soviet troops and the possible end to civil war between the Kabul government and the rebel factions, and the effects of repatriation of refugees will determine the direction of Afghanistan's future development.^ieng

Peritoneal clearance of creatinine and inulin during dialysis in dogs: effect of splanchnic vasodilators.

The peritoneal clearance of creatinine and inulin during isotonic peritoneal dialysis was studied in dogs before and after the administration of two vasodilators: isoproterenol and glucagon. One-liter exchanges with 15-min dwell times were used. Blood flow in the superior mesenteric artery was recorded with an electromagnetic flow probe and used as an index for total splanchnic flow. Intravenous isoproterenol (2.4 microgram/min) increased blood flow by 88%, but did not alter peritoneal clearance. When isoproterenol was given i.p. (0.5 microgram/ml dialysis fluid), blood flow increased by 81%, and inulin clearance rose by 26.8% (2.06 +/- 0.18 to 2.61 +/- 0.23 ml/min; P less than 0.05). Creatinine clearance increased by 17.5%, from 10.94 +/- 0.32 to 12.85 +/- 0.34 ml/min (P less than 0.05). When blood flow was returned to control levels with a clamp, clearances also returned to control levels. Glucagon given i.p. (1.0 microgram/ml) had no effect on any measured variable. Glucagon given i.v. at 10 microgram/min caused blood flow to rise by 81% and inulin clearance to rise by 25% from 1.88 +/- 0.16 to 2.35 +/- 0.19 ml/min (P less than 0.05). Cp, inulin clearance remained at control levels. Vasodilators seem to exercise two effects in augmenting clearance of small and middle-sized molecules: a direct permeability effect and a blood-flow related effect, possibly in increasing the surface area available for exchange and/or increasing permeability of the capillary endothelium.