White Coat Notes

Study links toddlers’ TV habits and later problems in classroom

(Photos By Istockphoto.Com)
May 10, 2010

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Children who watched more television than their peers when they were toddlers and preschoolers were more likely to have trouble when they reached fourth grade, with poorer academic achievement, psychosocial behavior, and physical well-being, a Canadian study reports.

For each hour of television above the average that the more than 1,300 children had watched as toddlers, their classroom engagement fell by 7 percent and their math achievement by 6 percent, the researchers found. Reading did not differ. Each additional hour of TV above the average was associated with a 10 percent higher likelihood of being victimized by classmates, according to a social behavior questionnaire completed by teachers. Time spent being physically active fell 13 percent with each additional hour of TV watching as toddlers. Body mass index was 5 percent higher, and consumption of soft drinks and snacks was 9 percent and 10 percent higher, respectively. The results were similar for the 4-year-old preschoolers.

“For the 2 1/2-year-olds, the aftereffects did not fade out after eight years,’’ lead author Linda Pagani of the University of Montreal said in an interview. “Families should understand that the television is not just a piece of innocuous furniture in the family room.’’

Dr. Michael Rich, director of the Center on Media and Child Health at Children’s Hospital Boston, called the findings important. “Because of the size of the sample, I think that these are pretty hefty changes,’’ he said in an interview. He was not involved in the study, which appears in the Archives of Pediatric and Adolescent Medicine. “We can’t draw causal connections but we can certainly feel pretty confident about contributory connections.’’

Watching television may be one factor among others, he said, or it could be a key player influencing how well a child does later in life. Parents who just park their children in front of the television for more than two hours a day may behave in other ways that affect later skills, he said. They may also read to their children less or spend less time with their children pursuing open-ended, creative activities, for example. The Canadian researchers did take into account the mother’s education, the child’s temperament, and whether the child came from a single-parent family, factors that previous research has found to be related to TV viewing. When all of those things were equal, children who watched more television were still at higher risk of later problems.

Bar-coding improves patient safety

You see them at the checkout counter: black bars on stickers that cashiers scan before ringing up a sale. Bar-coding systems are becoming almost as ubiquitous in health care, enlisted as tools to improve patient safety.

A new study conducted at Brigham and Women’s Hospital found that after bar-code technology was added to electronic medication records, errors in transcribing medication orders were eliminated and errors in administering drugs with potentially serious consequences were cut in half. Transcription errors included the wrong directions for how to give and the wrong dose. Administration errors involved giving the drug by mouth rather than through a nasogastric tube or giving the wrong drug.

“The hospital gives about 6 million doses a year, so there are a lot of opportunities to make sure the right patient gets the right drug at the right time,’’ Dr. Eric Poon, lead author of the New England Journal of Medicine article, said in an interview. “We found that with the new system, we are preventing more than 90,000 serious errors that would otherwise occur on an annual basis.’’

Boston shines in sun exposure study

Boston ranks fifth out of 26 American cities based on knowledge, attitudes, and behavior related to sun exposure and skin cancer, according to a survey by the American Academy of Dermatologists, which warns that there is no such thing as a safe or healthy tan.

We stacked up pretty well when asked if it’s smarter to tan indoors using a tanning bed instead of outdoors. Three-quarters correctly answered no, above the national average of 63 percent. A little more than a quarter of Bostonians know SPF 30 doesn’t provide twice the protection of SPF 15, compared with a little under a quarter of the 7,000 adults polled nationally. Seven in 10 Bostonians examine their own skin for suspicious moles annually, equal to the rest of the country.

The biggest boost to Boston’s ranking comes from how many of us get our skin checked by a health-care provider at least every year. One-third of the Boston respondents said they did, compared with 19 percent nationally.

Hartford came in first and Pittsburgh came in last.