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This Month in Archives of Pediatrics and Adolescent Medicine
September 2006

This Month in Archives of Pediatrics & Adolescent Medicine

Arch Pediatr Adolesc Med. 2006;160(9):874. doi:10.1001/archpedi.160.9.874
Long-term Effects of Universal Preventive Interventions on Methamphetamine Use Among Adolescents

Methamphetamine use among adolescents increased dramatically during the 1990s with those in rural areas and small towns particularly vulnerable. Spoth and colleagues conducted 2 randomized controlled trials of the longitudinal effects on methamphetamine use of partnership-based universal preventive interventions. The studies involved sixth and seventh grade students and their families in a Midwestern state. The interventions focused on both the adolescents and their families; more than 1200 families participated in the study. At grades 11 and 12, the intervention students had almost no methamphetamine use compared with 3% to 5% among control students. These results indicate that large-scale trials of such universal preventive interventions should be conducted to protect future adolescents against drug abuse and its attendant consequences.

Figure.
Lifetime and past-year methamphetamine use 4½ to 6½ years past baseline. No lifetime use data were available from study 1; in study 2 at 11th grade, lifetime use is equal to past-year use for both intervention conditions. For study 2, the 12th-grade sample size differs from 11th grade because of sample attrition. ISFP indicates Iowa Strengthening Families Program; LST, Life Skills Training; PDFY, Preparing for the Drug Free Years; and SFP 10-14 + LST, Strengthening Families Program: For Parents and Youth 10-14 plus Life Skills Training. *, P≤.05. †, P≤.01.

Lifetime and past-year methamphetamine use 4½ to 6½ years past baseline. No lifetime use data were available from study 1; in study 2 at 11th grade, lifetime use is equal to past-year use for both intervention conditions. For study 2, the 12th-grade sample size differs from 11th grade because of sample attrition. ISFP indicates Iowa Strengthening Families Program; LST, Life Skills Training; PDFY, Preparing for the Drug Free Years; and SFP 10-14 + LST, Strengthening Families Program: For Parents and Youth 10-14 plus Life Skills Training. *, P≤.05. †, P≤.01.

Article
Measuring Effectiveness of Dietetic Interventions in Child Obesity: A Systematic Review of Randomized Trials

The response to the obesity epidemic will require primary prevention as well as weight reduction programs. This systematic review was conducted to evaluate the best available evidence on the effectiveness of dietetic treatment and management for overweight children or adolescents. Of the 1310 original articles identified, 37 studies met inclusion criteria, involving a total of 2262 participants. Among the 8 studies suitable for meta-analysis, dietetic intervention by itself or in conjunction with increased physical activity was successful in reducing weight by as much as 8%. However, the effect of the interventions appeared to wane over time.

Figure.
Meta-analysis of 3 randomized controlled trials of interventions for child obesity where a “true” control arm was used and results were reported after a period of follow-up.

Meta-analysis of 3 randomized controlled trials of interventions for child obesity where a “true” control arm was used and results were reported after a period of follow-up.

Article
Effect of Open Access Scheduling on Missed Appointments, Immunizations, and Continuity of Care for Infant Well-Child Visits

Open access scheduling attempts to provide access to care at the point it is needed. Under open access, when a parent calls to schedule a well-child visit, the patient would be seen within 1 or 2 days in contrast to usual systems of 4- to 6-week delays. In this randomized controlled trial involving 10 providers and 878 infants, providers were randomized to either open access for future visits or open access for current visits. In both groups, missed appointment rates dropped dramatically, although more so among the same-day open access group. Immunization rates increased in both groups; provider continuity was higher in the group with open access for future visits.

Article
Children Treated at an Expeditionary Military Hospital in Iraq

Coppola and colleagues report on their experiences caring for children at a level III expeditionary hospital in Iraq. Over a 17-month period, 85 children were treated, representing 5% of all patients treated at the hospital. Approximately half were treated for trauma, most commonly due to injuries from explosions. Overall, 6% of the children died.

Figure.
Mechanism of injury in 48 children treated at an expeditionary military hospital. GSW/SW indicates gunshot wound and stab wound.

Mechanism of injury in 48 children treated at an expeditionary military hospital. GSW/SW indicates gunshot wound and stab wound.

Article
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