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This Month in Archives of Pediatrics and Adolescent Medicine
January 2007

This Month in Archives of Pediatrics & Adolescent Medicine

Arch Pediatr Adolesc Med. 2007;161(1):10. doi:10.1001/archpedi.161.1.10
A Systematic Review of School-Based Interventions to Prevent Bullying

Recent studies indicate that bullying and being victimized by bullies is common among children in elementary and high schools, and can have a multitude of adverse effects ranging from poor school performance to suicide and homicide. This systematic review examined 26 studies evaluating the effectiveness of school-based interventions to prevent bullying; all 26 studies included elementary school students, and 6 included older students, as well. Interventions that consisted of classroom-level curricula seldom improved bullying prevalence. Likewise, social skills training was not very effective. In contrast, whole-school interventions addressing bullying as a systemic problem were effective. This study emphasizes that schools and communities should choose intervention programs wisely to reduce the victimization of children from bullying.

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Multimicronutrient Supplementation for Undernourished Pregnant Women and the Birth Size of Their Offspring: A Double-blind, Randomized, Placebo-Controlled Trial

Prepregnancy and maternal undernutrition are important predictors of reduced birth weight in low-income countries. Recent evidence indicates that both macronutrients and micronutrients may be deficient in these mothers. This study of poor women in India randomized 200 pregnant mothers to receive either a micronutrient supplement containing 29 vitamins and minerals or a daily placebo beginning 24 to 32 weeks into gestation until delivery. Adjusted birth weight was a mean of 98 g higher in the supplemented group, and the risk of low birth weight was 70% lower. The incidence of neonatal morbidity was nearly double in the control group compared with the placebo group. This study has potential implications for reducing infant mortality in low-income countries.

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Effect of Multisource Feedback on Resident Communication Skills and Professionalism: A Randomized Controlled Trial

Communication and professionalism form the foundation of the patient-physician relationship and are essential to quality health care. In this randomized controlled trial, residents were assigned to complete self-assessment and multisource feedback from parents and nurses or were assigned to standard feedback from the supervisory attending and senior resident. The intervention was found to be more effective than standard feedback alone in improving selected areas of resident communication and professionalism as perceived by nurses but not by parents. This study indicates that better methods of feedback for residents can improve performance and professionalism and justify further rigorous studies to test new interventions.

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Externalizing and Attentional Behaviors in Children of Depressed Mothers Treated With a Selective Serotonin Reuptake Inhibitor Antidepressant During Pregnancy

Selective serotonin reuptake inhibitor (SSRI) antidepressants are frequently used to treat maternal anxiety and depression during pregnancy. Recent concerns about altered neonatal behaviors following prenatal exposure have raised questions about possible long-term neurodevelopmental effects. This study examined children at age 4 years, after prolonged exposure to SSRIs in utero. Maternal depressed mood, stress, and anxiety when mothers' children were 4 years of age were more important predictors of child behavior problems than prenatal exposure to SSRIs. Prenatal SSRI dose and duration of treatment were not independently associated with child behavior problems at age 4 years. Other strategies are needed to reduce or eliminate the effect of maternal mood disorders on children.

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