Effects of Mass Media Exposure in Children

The Committee on Public Education of the American Academy of Pediatrics (AAP) has issued a statement on the effects of the mass media on children and adolescents. The paper appears in the August 1999 issue of Pediatrics.

The statement discusses the amount of time the average American child spends watching television, the impact media violence has on aggressive behavior, the frequency of sexual content and the use of products such as tobacco and alcohol in the media, and how the media affects obesity rates and school performance. The paper also examines the value of media education (the study and analysis of the mass media) as a means of reducing the harmful effects of the media.

The AAP committee makes the following recommendations:

• Physicians should become educated about the public health risks of media exposure.

• Physicians should incorporate questions about media use into their patients' routine visits.

• Physicians should urge parents to avoid television viewing for children under two years of age, as direct interaction is vital for healthy brain growth and the development of appropriate social, emotional and cognitive skills.

• Physicians should serve as role models by limiting the use of television and videos in waiting rooms and patient rooms.

• Physicians should alert and educate parents, children, teachers and other professionals about health risks associated with the media.

• Physicians should collaborate with other professionals to promote media education.

• Physicians should continue to monitor media and advocate for more educational and prosocial programming and messages.

• Physicians should encourage government funding of media education programs for schools and media education research.

Copies of the policy statement can be obtained by accessing the AAP Web site at http://www.aap.org.

Caution with Use of Penicillin G Alternatives

Because of severe shortages of penicillin G sodium and penicillin G potassium, the Centers for Disease Control and Prevention (CDC) recently recommended that penicillin G procaine and penicillin G benzathine be used as alternatives in certain circumstances. However, the Institute for Safe Medication Practices (ISMP) warns that caution is needed when using these alternatives because the use of procaine and benzathine has been associated with repeated medication errors and because the use of these alternatives will likely increase as a result of the CDC recommendations.

Procaine and benzathine are long-acting forms of penicillin G that only should be administrated intramuscularly. According to the ISMP, error reports show that these drugs are often confused with other forms of penicillin G and mistakenly administered intravenously. Errors are typically caused by name confusion, lack of familiarity with these specific medications, reference texts that are ambiguous or misleading (especially older outdated texts) and a widely held but mistaken belief that procaine and benzathine may be administered intravenously.

To prevent medication errors when administering these drugs, the ISMP has made the following recommendations:

• Specific reminder warnings should be placed in all medication administration records. A similar computerized order input warning also should be implemented.

• Distinctive auxilliary warning labels should be applied to these products.

• Reference texts currently used in health care facilities should be examined to assure that information about the proper administration of these medications is clearly communicated.

• Outdated or unclear reference texts should be discarded, and up-to-date, clearly written texts should be provided to patient care areas annually.

• Ongoing staff education activities should include the topic of proper procaine and benzathine administration.

For more information, contact the ISMP at 301-497-2375 or write to the following address: P.O. Box 328, Fulton, MD 20759-0328.

Pneumococcal Conjugate Vaccine for Children

The Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) has recommended Prevenar, the first pneumococcal conjugate vaccine, for routine use in all children up to five years of age and for priority use in specific populations. The recommendation is contingent on licensure from the U.S. Food and Drug Administration (FDA) and an additional review if new safety or efficacy data become available.

ACIP states that in the event of resource or logistic constraints, immunizations should be provided according to the following priorities:

PRIORITY 1

• All children up to 24 months of age

• Children 24 to 59 months of age with sickle cell disease, functional or anatomic asplenia or human immunodeficiency virus infection

• Children 24 to 59 months of age who are immunocompromised, have chronic illness or are Alaskan Natives or American Indians

PRIORITY 2

• All healthy children 24 to 35 months of age

• Children 36 to 59 months who are at increased risk for pneumococcal infection, including children who have had frequent or complicated episodes of acute otitis media during the previous year; children who are socially or economically disadvantaged; or children who attend group child care

PRIORITY 3

• Children 36 to 59 months of age who are not mentioned in the above groups

In infants, the vaccine should be given in four doses at two, four, six and 12 to 15 months of age. In children who are seven to 11 months of age, three doses are needed. In children who are 12 to 23 months of age, two doses are required, and in children two years of age or older, only one dose is needed.

FDA Approval of Urinary Incontinence Device

The U.S. Food and Drug Administration (FDA) recently approved the FemSoft Insert for use in the treatment of stress urinary incontinence or the involuntary loss of urine. Approximately 6.6 million women in the United States have stress incontinence, which is caused by pressure on the bladder from everyday activities such as coughing, sneezing, lifting, rising from a seated position or exercising.

The FemSoft Insert is a small, single-use device made of liquid and silicone that can be inserted easily into the urethra. The insert is latex-free and consists of a narrow silicone tube that is completely encapsulated by a soft, conformable, fluid-filled sleeve. As the device is inserted, the sleeve slides into and conforms to the urethra, creating a seal at the neck of the bladder to prevent accidental urine leakage. During routine bathroom visits, the insert is removed, discarded and replaced with a fresh insert. The FemSoft Insert is available by prescription with each insert costing less than $2.

After clinical trials of the FemSoft Insert were conducted at eight medical institutions throughout the United States, the manufacturer received FDA approval to move ahead with plans for a phased introduction of the FemSoft Insert. According to Dr. Larry Sirls, a urologist at William Beaumont Hospital in Royal Oak, Mich., “. . .90 percent of the study participants were satisfied with dryness when using the FemSoft Insert.” Study participants also reported “. . . an overall improved quality of life. Nearly 80 percent of women indicated a desire to continue using the product, and over 95 percent said they would recommend the insert to a friend.”

For more information on the FemSoft Insert, access the Rochester Medical Web site at http://www.rocm.com.