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This Month in Archives of Pediatrics and Adolescent Medicine
March 02, 2009

This Month in Archives of Pediatrics & Adolescent Medicine

Arch Pediatr Adolesc Med. 2009;163(3):199. doi:10.1001/archpediatrics.2008.574
Association Between Swimming Lessons and Childhood Drowning

Drowning is a common cause of injury death for children. Medical care for drowning victims does little to increase the chance of survival with good neurological recovery. Prevention efforts to date have included pool fencing, use of personal flotation devices, and promotion of swimming lessons for older children. This case-control study sought to examine the association of swimming lessons and risk of drowning in children aged 1 to 19 years. Of the 61 drowning cases in 1- to 4-year-olds, only 3% had participated in formal swimming lessons compared with 26% of matched controls. Swimming lessons for these younger children were associated with an 88% lower risk of drowning. Among those aged 5 to 19 years, swimming lessons were associated with a 64% lower risk of drowning, though this difference was not statistically significant. Formal swimming lessons may have the potential to make dramatic reductions in the risk of drowning in preschool-aged children.

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Alcohol-Branded Merchandise and Its Association With Drinking Attitudes and Outcomes in US Adolescents

Alcohol-branded merchandise consists of clothing and other personal items that bear an alcohol brand; these are produced by alcohol companies and are widely distributed through retail and other outlets. This study sought to examine the association between ownership of such items and measures of alcohol susceptibility and use. In a large sample of more than 6500 adolescents, 11% to 20% of teenagers were found to own alcohol-branded merchandise, which was most commonly clothing and headwear and usually obtained as a gift from a family member or friend. Nearly half of the items bore the Budweiser brand. Ownership of this merchandise was associated with both direct and indirect effects on drinking initiation and on binge drinking. This study suggests that policies to restrict this marketing practice should be considered.

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Parental Attitudes About Cigarette Smoking and Alcohol Use in the Motion Picture Association of America Rating System

High exposure to smoking and alcohol use in movies may influence adolescents' use of these substances. Tobacco use appears in 40% to 80% of popular contemporary youth-rated movies and alcohol use appears in 50% to 95%. This study was designed to examine parental attitudes toward including smoking and drinking in Motion Picture Association of America film-rating criteria and whether R ratings should be assigned to movies with these behaviors. In a survey of 2279 parents of children aged 9 to 15 years, 52% believed that cigarette use should be used in movie ratings criteria and 66% thought that alcohol use should be considered in the criteria. Parents were more likely to support adding cigarette and alcohol use as rating criteria if they believed that current ratings were not useful and if they restricted their children from watching R-rated movies. Only 29% of parents supported an R rating for movies that depicted smoking. Many parents appeared to underestimate the effect of movie smoking and drinking on their children.

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A Randomized Controlled Evaluation of the Effect of Community Health Workers on Hospitalization for Asthma: The Asthma Coach

Asthma continues to be a common cause of hospitalization, despite the availability of effective treatment for the disease. The risk of hospitalization is highest for poor children in urban settings. This study examined the effectiveness of high school–educated community health workers on the risk of rehospitalization for poor children with asthma living in an inner city area. Community health workers had an average of 21 contracts with the family during the 24-month study period. The relative risk of rehospitalization was 0.61 in the intervention group compared with controls, though there was no effect on emergency department visits. Overall, the study supports the use of peer interventions for reaching and benefiting low-income groups.

Percentages of cases with at least 1 hospitalization in first and second years following randomization for all participants disaggregated by treatment group, usual care or asthma coach, and also for those with or without hospitalization in the year prior to admission.

Percentages of cases with at least 1 hospitalization in first and second years following randomization for all participants disaggregated by treatment group, usual care or asthma coach, and also for those with or without hospitalization in the year prior to admission.

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