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This Month in Archives of Pediatrics and Adolescent Medicine
January 03, 2011

This Month in Archives of Pediatrics & Adolescent Medicine

Author Affiliations

Copyright 2011 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2011

Arch Pediatr Adolesc Med. 2011;165(1):5. doi:10.1001/archpediatrics.2010.262
Community Treatment of Posttraumatic Stress Disorder for Children Exposed to Intimate Partner Violence

This study tested whether trauma-focused cognitive behavior therapy would improve children's posttraumatic stress disorder (PTSD) symptoms related to witnessing intimate partner violence at home significantly more than would child-centered therapy. This randomized controlled trial of 124 children aged 7 to 14 years demonstrated significantly greater improvement of PTSD symptoms with the trauma-focused cognitive behavior therapy intervention. There was a 75% remission rate in children meeting criteria for PTSD diagnosis in this group compared with a 44% remission rate in the group receiving child-centered therapy. The project documented the success of implementing trauma-focused cognitive behavior therapy for multiply traumatized children in a usual community setting. More research is needed to address optimal treatment for children traumatized by the ongoing threat or reality of intimate partner violence.

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Randomized Controlled Trial of Primary Care Pediatric Parenting Programs

Media exposure is increasingly recognized as a public health concern. One factor related to harm may be reduced parent-child interactions in association with media. This study assessed whether interventions to enhance parent-child interactions and early child development resulted in reduced media exposure and whether enhanced parenting mediated effects on media exposure. Mother-newborn dyads were enrolled after childbirth and were assessed at the children's mean age of 6.9 months; at this age, the median media exposure was 146.5 min/d. A pediatric primary care parenting intervention, the Video Interaction Project, resulted in a small reduction in media exposure for 6-month-old infants compared with the Building Blocks intervention. Pediatric primary care may represent an important venue for addressing the public health problem of media exposure in young children at a population level.

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Adverse Adolescent Reproductive Health Outcomes After Pelvic Inflammatory Disease

The best management for adolescents with pelvic inflammatory disease (PID) is unclear. This study compared longitudinal behavioral correlates and reproductive health outcomes between adolescents and adults with PID. In this analysis of data from the PID Evaluation and Clinical Health study, adolescents were significantly more likely than adults to have evidence of endometritis and sexually transmitted infection (Neisseria gonorrhoeae /Chlamydia trachomatis) at baseline and 30 days. During the study, 42.7% of patients experienced chronic abdominal pain, 18.6% experienced infertility, and 21.3% had recurrent PID. Adolescents had a shorter time to both recurrent PID and pregnancy compared with adult women.

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Survival curves depicting time to pregnancy by age group status.

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Factors Affecting the Stability of Blood Lipid and Lipoprotein Levels From Youth to Adulthood

This study examined the effect of lifestyle changes on the stability of blood lipid and lipoprotein levels from youth to adulthood in 8498 Australian school children aged 7 to 15 years first undergoing assessment in 1985 and aged 26 to 36 years at follow-up. Among males and females with high triglyceride levels in youth, most had normal levels in adulthood. Approximately 40% to 70% with high-risk total cholesterol and low-density lipoprotein cholesterol levels as adults also had high-risk levels in youth. The group that did not improve any lifestyle factor between youth and adulthood had more than double the prevalence of low high-density lipoprotein cholesterol levels in adulthood compared with the study sample mean. The prevalence of low high-density lipoprotein cholesterol levels in those who had improved 2 or 3 or more lifestyle factors was less than one-quarter of the study population prevalence. Unhealthy lifestyle changes between youth and adulthood affect whether an individual maintains, loses, or develops high-risk blood lipid and lipoprotein levels in adulthood.

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Proportions of participants (least squared means) with high-risk (ie, low) levels of high-density lipoprotein cholesterol (HDL-C) in adulthood according to the number of positive lifestyle changes from youth.

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