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Indian Pediatr 2018;55: 714 |
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Clippings
Theme: Adolescent Pediatrics
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Preeti M Galagali
Email:
[email protected]
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Tdap vaccination strategies for preventing pertussis
in adolescents (J Adolesc Health. 2018;62:661-6)
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In recent times, there has been a global resurgence of pertussis. High
Tdap vaccine coverage in adolescents protects against pertussis and
decreases the reservoir for transmission to vulnerable population. This
retrospective cohort study among 165,541 adolescents (age 11-18 y)
enrolled in heath care systems from 2005-12 was conducted in USA to
determine the vaccine effectiveness (VE) of Tdap in those who had
received only acellular vaccine, and in those who had received at least
one dose of whole cell vaccine by primary series. Overall VE was 57%
(95% CI 42%, 68%). VE was 65% (95% CI 54%, 79%) in mixed vaccine cohort
and 52% (95% CI 30%, 68%) in those who received only acellular vaccine;
the difference was not statistically significant. In both the groups, VE
waned similarly and significantly (P< 0.01) after 2 years;
overall VE was 69% (95% CI 54%, 79%) during first two years
post-vaccination and 34% (95% CI 1%, 55%) beyond two years of receiving
vaccine.
There is a need to develop new pertussis vaccines and strategies for
prolonged immunity against pertussis.
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‘Sexting’ behavior among youth (JAMA Pediatr.
2018;172:327-35)
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Current easy access to smartphones has provided adolescents the
opportunity to explore their emerging sexuality in novel ways. Sexting
is sharing of sexually explicit video, images or messages through
electronic means, and may be associated with emotional problems such as
cyberbullying and revenge porn, and other high-risk behaviors. This
systematic review of 39 international research studies conducted from
2008 to 2016, with 110,380 adolescent participants, estimated the mean
prevalence for sending and receiving ‘sexts’ as 14.8% (95% CI 12.8%,
16.8%) and 27.4% (95% CI 23.1%, 31.7%) respectively. The prevalence was
equal in both sexes and increased with age, time and with the device
being used (more by smartphones compared to computers). The prevalence
of forwarding a ‘sext’ without consent was 12.0% (95% CI 8.4%, 5.6%) and
of having a ‘sext’ forwarded without consent was 8.4% (95% CI 4.7%,
12.0%). Pediatricians, parents, teachers, lawyers and policy makers
should be aware about the prevalence of ‘sexting’ and its behavioral
ramifications to deal with the issue in a developmentally appropriate
manner. In India, currently, ‘sexting’ is a crime under POCSO Act.
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Online game shutdown policy and its impact on adolescents
(J Adolesc Health. 2018;62:548-55)
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Gaming disorder is included as an addictive disorder in the recently
released draft revision of International Classification of Diseases-11
(ICD-11). Its prevalence is increasing worldwide, especially among
adolescents. In 2011, the South Korean government banned online gaming
from 12 AM to 6 AM for those aged <15 years in order to reduce internet
addiction. This study analyzed data of 243,957 adolescents using
stratified multistage cluster sampling design from the Korean Youth Risk
Behaviour Web based Survey from 2011-15 to evaluate the effect of this
shutdown. It did not show substantial decrease in daily internet usage
or internet addiction rates, and did not result in increase in sleeping
hours. Female adolescents, those with poor academic performance, and
those with low exercise levels showed longer lasting initial declines in
internet usage time. This study suggests that a simple shutdown policy
fails to deal with the menace of internet addiction in the population,
other effective clinical and public health measures should be devised.
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Strategies forself-regulation in children and adolescents
(JAMA Pediatr. 2018;172:566-75)
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Self-regulation is the ability to control emotions and impulses, develop
healthy interpersonal relations and to promote self-directed learning.
This review, the first of its kind, evaluated 49 randomized clinical
trials conducted between 1977 and 2017 with 23,098 participants, aged 2
to 17 years. Consistent improvement in self-regulationwas reported in
76% curriculum-based interventions, 50% mindfulness and yoga
interventions (especially effective in adolescents), 56% family-based
programs, 67% exercise-based programs, and 67% social and personal
skills interventions. Associations of interventions withself-regulation
task performance scores showed a positive effect with pooled effect size
of 0.42 (95% CI 0.32, 0.53). Positive associations were also reported on
academic achievement, substance abuse, conduct disorders, social skills,
depression, behavioral problems, and on reducing school suspension.
Pediatricians should partner with parents and take the lead in advocacy
for school-based curriculum programs promoting life skills, physical
activity, yoga and meditation to enhance biopsychosocial well-being in
children and adolescents.
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