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This Month in Archives of Pediatrics and Adolescent Medicine
July 2004

This Month in Archives of Pediatrics & Adolescent Medicine

Arch Pediatr Adolesc Med. 2004;158(7):613. doi:10.1001/archpedi.158.7.613
Does Parental Involvement Predict New Sexually Transmitted Diseases in Female Adolescents?

The highest rates of new gonorrhea and chlamydia infections are seen in adolescent girls aged 15 to 19 years. Understanding the effect of family context on acquiring sexually transmitted diseases (STDs) in adolescents is important because modifying family factors may influence new infection rates. In this prospective study of 14- to 19-year-old girls attending urban health clinics, Bettinger et al examined the effect of parental involvement as perceived by adolescents on their risk of acquiring a new STD. High levels of perceived parental supervision were associated with a 94% lower risk of new infection compared with those with lower levels. Interventions designed to increase parental involvement with youth may affect both adolescents' behavior and their development of STDs.

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Neighborhood Predictors of Concealed Firearm Carrying Among Children and Adolescents

Studies have indicated that a substantial proportion of youth have carried a concealed weapon. Neighborhood characteristics of social cohesion and informal social control have been shown to affect the amount of neighborhood juvenile violence. The Project on Human Development in Chicago Neighborhoods examined individual, family, and neighborhood characteristics' effects on youths' carrying of concealed guns. Youth were more likely to carry firearms in neighborhoods rated by community members as unsafe for children and in those characterized by social and physical disorder. Neighborhood collective efficacy was associated with a decreased likelihood that youth would carry concealed guns. Each of these neighborhood characteristics is potentially modifiable and important when considering primary and secondary prevention of youth violence.

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Sex Differences in Adolescent Exposure to Alcohol Advertising in Magazines

Underage drinking is a serious US public health problem. Low-alcohol refreshers (eg, alcoholic lemonades and other flavored alcoholic beverages) account for much of the increase in teenage alcohol consumption in recent years. Jernigan et al examined over 6000 advertisements in 103 national magazines during 2001 and 2002 to determine the media exposure of underage youth to alcohol advertising. Alcohol companies spent nearly $600 million on magazine advertisements during these 2 years. In 2002, underage youth saw more alcohol advertisements for beer, wine, distilled spirits, and low-alcohol refreshers than people 21 and older. Underage girls' exposure to low-alcohol refresher advertisements increased by 216% between 2001 and 2002. This study points to the failure of industry self-regulation and the need for action to decrease drinking in youth.

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Pediatricians' Self-reported Clinical Practices and Adherence to National Immunization Guidelines After the Introduction of Pneumococcal Conjugate Vaccine

Pneumococcal conjugate vaccine has become a routine part of care for children younger than 2 years in the United States. However, it is not known how the use of this vaccine has altered the well-child care schedule or how it has affected the usual evaluation of febrile infants. This large survey of Massachusetts pediatricians found that after the introduction of this new vaccine, 39% of pediatricians moved other routine infant vaccinations to different visits, and another 15% added additional visits to the infant well-child care schedule. More than one third of pediatricians reported nonadherence to the national immunization guidelines for at least 1 vaccine, likely secondary to the addition of another vaccination to the schedule. Also, the incorporation of the pneumoccocal vaccine into routine care may have adverse effects on the appropriate evaluation of febrile infants.

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Glycemic Patterns Detected by Continuous Subcutaneous Glucose Sensing in Children and Adolescents With Type 1 Diabetes Mellitus Treated by Multiple Daily Injections vs Continuous Subcutaneous Insulin Infusion

Strict metabolic control of type 1 diabetes leads to better long-term outcomes but is associated with an increased risk of hypoglycemic events. Continuous subcutaneous insulin infusion offers the most physiologic mode of insulin delivery. In this open randomized crossover study, 23 children and adolescents with diabetes compared multiple insulin injections with continuous subcutaneous insulin infusion. The continuous infusion was associated with better glucose profiles throughout the day and a smaller risk of hypoglycemia, indicating some advantages of the infusion compared with multiple daily insulin injections.

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