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This Month in Archives of Pediatrics & Adolescent Medicine
Feb 2012

This Month in Archives of Pediatrics & Adolescent Medicine

Arch Pediatr Adolesc Med. 2012;166(2):110-111. doi:10.1001/archpediatrics.2011.514

In this population-based study by Coulm et alArticle, the positive predictive value of screening for 21-hydroxylase deficiency was 2.3% with a sensitivity of 93.5% and a specificity of 99.7%. The false-positive rate was particularly high in preterm infants, for which the positive predictive value was 0.4%, and screening should perhaps be reconsidered in this group.

Carmichael et alArticle found a strong association between anencephaly and maternal dietary quality, with the risk of anencephaly 51% lower for those with the highest-quality diets compared with the lowest-quality diets. High-quality diets were associated with a 34% lower risk of cleft lip with or without cleft palate and 26% lower risk of cleft palate.

Prado et alArticle show that a family-based intervention was efficacious in reducing human immunodeficiency virus (HIV) risk behaviors, including unprotected sexual behavior, engaging in sex while under the influence of alcohol and/or drugs, and number of sexual partners, among Hispanic delinquent youth. Working primarily with parents may be an especially effective strategy for preventing or reducing HIV risk behaviors among Hispanic delinquent youth.

Cavazos-Rehg et alArticle found that while there was a 3-fold variation among states in adolescent birthrates, more teaching of sexuality education was not associated with lower adolescent birthrates when accounting for state characteristics (ie, higher religiosity, stricter abortion policies, and sociodemographic characteristics). The strong influence of state characteristics on adolescent birthrates above and beyond sexuality education must be considered when evaluating the efficacy of sexuality education programs.

In a study by Hawkins et alArticle, community-wide beneficial effects of the Communities That Care prevention system on the incidence of adolescent delinquency and tobacco and alcohol use and the prevalence of delinquent behavior, violence, and tobacco use were observed 1 year beyond supported implementation of the program.

This randomized controlled trial by Waasdorp et alArticle in 37 Maryland public elementary schools found that a whole-school, universal prevention program that aims to improve the school environment decreased bullying and peer rejection, especially among those who were exposed to the program at younger ages.

Many students display references to alcohol on Facebook. Moreno et alArticle found that students who displayed intoxication or problem drinking were 4-fold more likely to score in the problem drinking category of the Alcohol Use Disorders Identification Test, had 64% higher Alcohol Use Disorders Identification Test scores overall, and were more likely to report an alcohol-related injury in the past year. Clinical criteria for problem drinking can be applied to Facebook alcohol references.

Turner and ChaloupkaArticle found that approximately half of all public and private elementary school students in the United States could purchase foods from vending machines, school stores, snack bars, or à la carte lines on campus. Sugary foods were available to almost all students with access to these sources. Public elementary school students in the South had greater availability of salty and sweet products in those venues compared with students in other parts of the country.

Nguyen et alArticle show that the Loozit community-based group lifestyle intervention for overweight and obese adolescents provided significant but modest improvements in primary weight outcomes (body mass index z score and waist to height ratio) and several psychosocial outcomes at 12 months. Supplementary telephone and electronic contact did not provide further benefits as an adjunct to the Loozit group program.

In a study by Kugelman et al (10.1001/archpediatrics.2011.891), the combined poor outcomes of death or severe morbidity at discharge of infants born at 24 to 26 weeks' gestation were significantly influenced by 3 parameters available at birth in addition to gestational age: sex, sex-specific birth weight percentile, and prenatal steroid therapy. Gestational age alone should not be used to estimate the likelihood of survival without major neonatal morbidity among extremely preterm infants.

In this systematic review by Guillén et alArticle of articles describing 34 185 infants, neurodevelopmental impairment rates ranged from 12.4% to 57.5%. Higher losses to follow-up are associated with higher rates of impairment at 18 to 24 months, suggesting strong ascertainment bias.