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This Week in JAMA
June 3, 2009

This Week in JAMA

JAMA. 2009;301(21):2185. doi:10.1001/jama.2009.797


Edited by Catherine D. DeAngelis, MD, MPH, and Jody W. Zylke, MD

Parental depression is a risk factor for depression in adolescents. Garber and colleagues report results of a randomized trial that compared the effects of a group cognitive behavioral intervention with usual care in preventing the onset of depression among adolescents with a history of depression or current depressive symptoms and a parent with a current or prior depressive disorder. During a 9-month follow-up, the authors found that compared with usual care, the cognitive behavioral intervention was associated with fewer clinical diagnoses of depression and fewer self-reported depressive symptoms among adolescents whose parent was not currently depressed.

Current data on infant survival after extremely preterm birth are important to inform perinatal care guidelines and parental counseling. In the Extremely Preterm Infants in Sweden Study, which evaluated short-term and long-term outcomes of infants born before 27 gestational weeks, the investigators found that overall perinatal mortality was 45% and that overall survival of live-born infants was 70% at a year, ranging from 10% among infants born at 22 weeks to 85% among infants born at 26 weeks. Forty-seven percent of surviving infants had no major neonatal morbidity.

Patterns of growth in infancy and early childhood may be associated with risks of cardiovascular disease and diabetes in later life. In an analysis of observational data from young adults in the Netherlands, Leunissen and colleagues examined the relationships between periods of first-year growth and tempo of weight gain and determinants of cardiovascular disease and type 2 diabetes. The authors report that rapid weight gain relative to height growth in the first 3 months of life was associated with an unfavorable cardiovascular and metabolic profile in early adulthood, including a higher percentage of body fat, more central adiposity, and reduced insulin sensitivity compared with slow weight gain during the entire first year.

An oral pentavalent rotavirus vaccine (RV5) has shown high efficacy against severe rotavirus disease in developed countries. To assess the efficacy of RV5 in a developing nation, Patel and colleagues conducted a case-control study in Nicaragua, where RV5 was introduced to the childhood immunization schedule in 2006. The authors found that RV5 vaccination was associated with a lower risk of rotavirus diarrhea requiring overnight admission or intravenous hydration in the emergency department for children younger than 2 years. However, the risk reduction was less than that observed in clinical trials conducted in industrialized countries.

Shonkoff and colleagues discuss the evidence that adverse experiences and exposures in early childhood are linked to poor health and illness in adulthood and review the implications of understanding the biology of early adversity for disease prevention and health promotion.

Strasburger discusses negative and positive aspects of easy media access on child health and well-being.

“As a physician-parent, I struggle at times to understand what is expected of me.” From “Is There a Doctor in the House?”

Clinicians can play a role in mitigating the influence of climate change on children, who may be especially vulnerable to its potential health effects.

Accelerated infant vaccination during a pertussis outbreak improved overall vaccination rates.

Creating a healthier future through early interventions for children

The relation of blood platelets to hemorrhagic disease

DeAngelis and Zylke discuss early intervention to promote health and prevent disease in children.

For your patients: Information about premature infants