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In This Issue of JAMA Pediatrics
May 2016


JAMA Pediatr. 2016;170(5):407. doi:10.1001/jamapediatrics.2015.2522


Long-acting reversible contraception (LARC) offers an unprecedented opportunity to reduce unintended pregnancies among adolescents. Steiner and colleagues use the 2013 national Youth Risk Behavior Survey to examine concomitant condom use among sexually active female LARC users. Users of LARC were 60% less likely to use condoms compared with oral contraceptive users, increasing their risk for sexually transmitted infections. The accompanying editorial by Potter and Soren discusses the need to craft a clear message for adolescents about both pregnancy prevention and sexually transmitted infection prevention.


Many children and youth in the world find themselves spending a portion or most of their time on the streets. Embleton and colleagues compile data from 49 studies to determine the reasons why children and youth become street-involved. Poverty, family conflict, and abuse were the most commonly reported reasons for street involvement. In their editorial, Auerswald and Goldblatt discuss this study in light of the stigmatizing beliefs about street-connected children.


Transgender people who have a sex assigned at birth that differs from their current gender identity represent approximately 0.5% of the US population. Reisner and colleagues study the prevalence of mental health, substance dependence, and comorbid psychiatric disorders among 298 sexually active, transgender women aged 16 through 29 years. Two of every 5 had 1 or more mental health or substance dependence diagnoses; 20% had 2 or more comorbid psychiatric diagnoses. Olson-Kennedy’s editorial discusses the lack of accessible and trained mental health professionals for the transgender population regardless of age.


Continuing Medical Education and Journal Club

Low working memory is associated with reading and math difficulties and risk for school failure. In a randomized clinical trial, Roberts and colleagues test the effect of 20 or more working memory training sessions in young school children with low working memory. There was no benefit to academic outcomes at 12 or 24 months, as well as no effect on parent and teacher ratings of attention and social-emotional difficulties.

Clinical Review & Education

Polycystic ovary syndrome is the most common endocrine disorder among women of reproductive age, affecting 6% to 8% of all women. In this review, Fields and Trent examine the literature on treatment for polycystic ovary syndrome and its effects on metabolic and/or cardiovascular outcomes. Most studies found significant benefit of metformin as a monotherapy or dual therapy supplement in cardiovascular risk factors and, in several studies, on androgen excess and associated cutaneous and menstrual symptoms.