JAMA news releases are made available to the public after 3 pm US Central time on the first 4 Tuesdays of each month. The Archives Journals news releases are made available to the public after 3 pm Central time on Mondays. We also provide a list of previous news releases.
THIS WEEK'S CONTENTS
ARCHIVES OF GENERAL PSYCHIATRY NEWS RELEASES
Embargoed Until: 3 P.M. (CT), Monday, September 4, 2006
OLDER FATHERS MORE LIKELY TO HAVE AUTISTIC CHILDREN
DRINKING DURING PREGNANCY LINKED TO OFFSPRING'S RISK OF ALCOHOL DISORDERS IN EARLY ADULTHOOD
ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE NEWS RELEASES
Embargoed Until: 3 P.M. (CT), Monday, September 4, 2006
SHORT-TERM INTERVENTION PROGRAMS HAVE POTENTIAL TO REDUCE TEEN METHAMPHETAMINE USE
TELEVISED MOVIE TRAILERS EXPOSE YOUTH TO IMAGES OF TOBACCO USE
INJURED, ILL CHILDREN TREATED AT U.S. MILITARY HOSPITAL IN IRAQ
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, September 4, 2006
Media Advisory: To contact Abraham Reichenberg, Ph.D., call the Mount Sinai press office at 212-241-9200.
OLDER FATHERS MORE LIKELY TO HAVE AUTISTIC CHILDREN
CHICAGO—Children of men age 40 and older have a significantly increased risk of having autism spectrum disorders compared with those whose fathers are younger than 30 years, according to an article in the September issue of the Archives of General Psychiatry, one of the JAMA/Archives journals.
Autism is characterized by social and language abnormalities and repetitive patterns of behavior, according to background information in the article. Autism and related conditions, known collectively as autism spectrum disorders, have become increasingly common, affecting 50 in every 10,000 children as compared with five in 10,000 two decades ago. This increase is partially due to higher levels of awareness and changes in diagnosis processes, but could also reflect an increase in incidence of autism, according to the authors. Older parental age has previously been linked to abnormalities in the brain development of children; however, few studies have effectively examined the effect of mothers' and especially fathers' ages on autism.
Abraham Reichenberg, Ph.D., of the Mount Sinai School of Medicine, New York, and Institute of Psychiatry, King's College, London, and colleagues evaluated this association in children born during the 1980s in Israel. All men and three-fourths of the women born in these years were assessed by the draft board at age 17, during which time any psychiatric disorders were recorded. Dr. Reichenberg and colleagues obtained draft board information and the age of the father for 318,506 individuals; age of the mother was available for 132,271 of those.
Two hundred and eight individuals in the larger group (a rate of 6.5 per 10,000) and 110 in the group with both maternal and paternal ages (8.3 per 10,000) had a diagnosis of autism spectrum disorder, according to the information in the draft board registry. Among the paternal age groups of 15 to 29 years, 30 to 39 years, 40 to 49 years and older than 50 years, there were 34 cases, 62 cases, 13 cases and one case, respectively, of autism spectrum disorders. Advancing age among fathers was associated with increased risk of autism. This association persisted after the researchers controlled for year of birth, socioeconomic status and the mother's age, such that the odds of autism spectrum disorder were nearly six times greater among children of men age 40 and older than those of men 29 years and younger. Older age among mothers was not associated with autism after researchers factored in the effect of the father's age.
The authors discuss several possible genetic mechanisms for the paternal age effect, including spontaneous mutations in sperm-producing cells or alterations in genetic "imprinting," which affects gene expression. "It is important to keep in mind, however, that age at paternity is influenced by the sociocultural environment and varies across societies and over time," they continue. "In a given population, a change in the sociocultural environment could produce a change in paternal age at birth. In theory, it could thereby lead to a change in the incidence of genetic causes of autism."
"Although further work is necessary to confirm this interpretation, we believe that our study provides the first convincing evidence that advanced paternal age is a risk factor for autism spectrum disorder," they conclude.
(Arch Gen Psychiatry.
2006;63:1026-1032. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, September 4, 2006
Media Advisory: To contact Rosa Alati, Ph.D., e-mail: r.alati{at}sph.uq.edu.au.
DRINKING DURING PREGNANCY LINKED TO OFFSPRING'S RISK OF ALCOHOL DISORDERS IN EARLY ADULTHOOD
CHICAGO—Individuals whose mothers drink three or more glasses of alcohol at any one occasion in early pregnancy have an increased risk of developing alcohol disorders by 21 years of age, according to a report in the September issue of the Archives of General Psychiatry, one of the JAMA/Archives journals.
Exposure to maternal drinking during early childhood has been associated with difficulties in thinking, learning and memory, as well as mental and behavioral problems. However, few studies have examined the link between drinking during pregnancy and a child's later risk for alcohol dependence and other disorders, according to background information in the article. Animal studies have provided extensive evidence of a link between exposure to alcohol before birth and early acceptance of alcohol. "Similar results replicated in human studies would carry considerable implications for public health intervention," the authors write. "First, such studies would suggest that even small quantities of alcohol exposure, if consumed in a single session, may cause in utero neurodevelopmental changes that in turn may lead to the early onset of alcohol disorder in youth. Second, they would provide support for the role of a biological origin of alcohol disorders."
Rosa Alati, Ph.D., from The University of Queensland, Herston, Australia, and colleagues explored whether maternal exposure to alcohol during pregnancy increased a child's risk of developing alcohol disorders in 2,138 participants who were followed from birth to age 21. A group of 7,223 mothers was originally interviewed at their first prenatal physician visit, between 1981 and 1984 in Brisbane, Australia. The mothers and children were assessed at birth and again 6 months and 5, 14, and 21 years later. Before pregnancy, in early (first 18 weeks) and late (last three months) pregnancy, and when their children were age 5 and 14, the mothers were asked how often they drank alcohol and the number of drinks consumed on any one occasion. Children were evaluated for alcohol disorders at age 21.
Of the 2,555 children who completed an assessment at 21 years, 640 (25 percent) met criteria for a diagnosis of alcohol disorder; 333 (13 percent) of those reported developing the disorder before age 18 and 307 (12 percent) between age 18 and 21. In the final analysis, which included 2,138 individuals, those whose mothers drank more than three glasses of alcohol on any one occasion during early pregnancy were 2.47 times as likely to develop an early-onset (before age 18) alcohol disorder and 2.04 times as likely to develop a late-onset (between ages 18 and 21) alcohol disorder. Drinking during other stages of pregnancy, including late pregnancy, also increased risk. These associations remained strong after the researchers considered other biological and environmental factors that may contribute to the risk of developing alcohol disorders.
Interactions between genetic factors and exposure to alcohol before birth may affect the development of the nervous system in ways that predispose children and adults to alcohol problems, the authors write. "Our findings support a biological contribution to the origin of alcohol disorders and suggest that greater attention should be given to the role of the programming effect of in utero alcohol exposure to the development of alcohol disorders in adulthood," they conclude.
(Arch Gen Psychiatry.
2006;63:1009-1016. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: This study was supported in part by the National Health and Medical Research Council (NHMRC), Queensland Health, Queensland Treasury, the Centre for Accident Research and Road Safety-Queensland, the Australian Institute of Criminology, the Telstra Foundation, a NHMRC Public Health Fellowship grant and a NHMRC Capacity Building grant. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, September 4, 2006
Media Advisory: To contact Richard L. Spoth, Ph.D., call Mike Ferlazzo at 515-294-8986.
SHORT-TERM INTERVENTION PROGRAMS HAVE POTENTIAL TO REDUCE TEEN METHAMPHETAMINE USE
CHICAGO—Brief school- and family-based intervention programs may reduce methamphetamine use among adolescents, according to a report in the September issue of the Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
Methamphetamine use reached epidemic proportions in the United States by the mid-1990s, and use among adolescents has decreased but remained prevalent since then, according to background information in the article. The drug can impair social functioning and cause a wide variety of health problems. Teens in small towns and rural areas, including those in the Midwest, have been shown to be at higher risk for methamphetamine use. Because of the devastating consequences, prevention is key, the authors write; however, few studies have assessed the effect of preventive programs on the methamphetamine problem.
Richard L. Spoth, Ph.D., and colleagues at Iowa State University, Ames, conducted two studies of preventive programs involving rural public school students in the Midwest from 1993 to 2004. One program, Preparing for the Drug-Free Years, is a five-session course designed to enhance parent-child interaction and reduce the risk for early drug use. The seven-session Iowa Strengthening Families Program aims to promote healthy interactions among family members.
In the first study, 667 sixth-graders were assigned to a control group (208) or to one of the two programs (238 to Iowa Strengthening Families Program and 221 to Preparing for the Drug-Free Years). Of those, 457 families participated in a follow-up when the children were in 12th grade. In the second study, 679 seventh-graders were also divided into three groups: 226 completed a revised version of the Iowa Strengthening Families Program plus a separate program called Life Skills Training; 231 did Life Skills Training only; and 222 served as controls. In this study, 588 families were followed up in 11th grade and 597 in 12th grade.
Methamphetamine use rates among the control groups were similar to rates found in national surveys-in study one, five students (3.2 percent) of the 156 in the control group had used methamphetamines in the past year at the 12th-grade follow-up. In study two, 10 (5.2 percent) of the 193 control students reported ever having used methamphetamines by 11th grade, including eight (4.2 percent) who had used them in the past year; nine (4.6 percent) reported past-year use at the 12th-grade follow-up.
Preparing for the Drug-Free Years did not significantly reduce methamphetamine use; the Iowa Strengthening Families Program, with or without the Life Skills Training course, produced a statistically significant decrease in both short-term use and lifetime use; and Life Skills Training by itself was effective in addressing lifetime use. At the 12th-grade follow-up for study one, none of the students who had participated in the Iowa Strengthening Families Program and five (3.6 percent) of those participating in Preparing for the Drug-Free Years had used methamphetamines in the past year. In study two, among the students in the 11th grade completing the revised Iowa Strengthening Families Program plus Life Skills Training, one (.5 percent) reported using methamphetamines in the past year or ever using them and four (2.1 percent) reported past-year use in 12th grade; of those who completed Life Skills Training only, 5 (2.5 percent) reported using in the past year when asked in 11th grade and three (1.4 percent) reported using in the past year when asked in 12th grade.
"Given the lack of previous preventive intervention outcome research on methamphetamine use, the results of the current study are welcome, indicating the effectiveness of three of four universal interventions on lifetime or annual methamphetamine use across two randomized studies," the authors write. "It is noteworthy in this context that none of the interventions had content specific to the prevention of methamphetamine use; the observed intervention effects were obtained by addressing general risk and protective factors for drug use associated with family and school environments."
(Arch Pediatr Adolesc Med.
2006;160:876-882. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: This study was supported by a research grant from the National Institute on Drug Abuse, by a grant from the National Institute of Mental Health and by a grant from the National Institute on Alcohol Abuse and Alcoholism. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, September 4, 2006
Media Advisory: To contact corresponding author Jane Appleyard Allen, M.A., call Julia Cartwright at 202-454-5596.
TELEVISED MOVIE TRAILERS EXPOSE YOUTH TO IMAGES OF TOBACCO USE
CHICAGO—Despite a ban on tobacco advertising on television, nearly all U.S. children age 12 to 17 years may have been exposed to tobacco use through movie advertisements televised in 2001 to 2002, according to an article in the September issue of the Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
Tobacco advertising was banned from television in 1971, but tobacco use is still portrayed in a variety of forms on television, including movie advertisements or trailers. "Trailers pair tobacco use with popular movie stars and edgy action shots," the authors write. "These images translate into positive images of tobacco that are conveyed to a broad audience, including a large population younger than 18 years." Studies have shown that most movies released in the United States contain images of smoking, including about half of those with PG or G ratings, according to background information in the article. Surveys of children and adolescents indicate that they are more likely to smoke if their favorite movie stars do, and that watching movies in which characters smoke can have an immediate effect on their attitudes toward smoking.
Cheryl G. Healton, Dr.P.H., American Legacy Foundation, Washington, D.C., and colleagues studied all 216 movie trailers that aired in the United States from August 2001 through July 2002. They first analyzed the full-length versions of all the trailers to determine whether they included images of tobacco use. They then obtained viewer information from Nielson Media Research, the primary source of U.S. television ratings, to determine the population exposed to each trailer.
Of the 216 trailers, 31 (14.4 percent) depicted tobacco use, including 23 (24 percent) of trailers for R-rated movies and eight (7.5 percent) of those for PG- and PG-13-rated movies. The Nielson data estimage that 95 percent of all young people age 12 to 17 years saw at least one movie trailer with images of tobacco use during this one-year period, with 89 percent seeing at least one of the trailers three or more times. Over the course of a year, these trailers were seen 270 million times among youth age 12 to 17 years-or about 111 times per youth, on average.
The authors suggest that public health officials call on the movie industry to eliminate depictions of tobacco use in movie trailers, as well as pressure television networks to refuse to air trailers that contain such imagery. Future research should also address other avenues by which young people are exposed to tobacco use on television, the authors conclude.
(Arch Pediatr Adolesc Med. 2006;160:885-888. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: This study was supported by the American Legacy Foundation and a grant from the National Cancer Institute. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, September 4, 2006
Media Advisory: To contact Lt. Col. Christopher P. Coppola, U.S.A.F., M.C., call the Wilford Hall Medical Center public affairs office at 210-292-7688.
INJURED, ILL CHILDREN TREATED AT U.S. MILITARY HOSPITAL IN IRAQ
CHICAGO—Based on the experience of Air Force personnel at an expeditionary military hospital in Iraq, military hospitals should be prepared with the proper staff, training and equipment to treat injured and noninjured children who require medical care, according to a report in the September issue of the Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.
Military hospitals are likely to encounter injured children as wars move away from the battlefield and into civilian territories, according to background information in the article. Children sometimes serve as soldiers or are used as human shields. In addition, because war disrupts medical facilities in the affected area, children with other injuries or illnesses may seek medical care at U.S. military hospitals as well. When U.S. and coalition forces entered Iraq in 2003, Iraqi civilian hospitals were already understaffed and lacked the supplies and infrastructure needed to effectively care for citizens. From early in the conflict, medical care was offered to injured civilians in cases of severe injury, and hospital commanders could approve care for children with medical needs that could not be handled by the Iraqi system.
Lt. Col. Christopher P. Coppola, U.S.A.F., M.C., and colleagues at the Lackland Air Force Base, Texas, reported on the children treated at one level III (medical facility in a combat area) hospital in Balad, Iraq, from January 2004 to May 2005. The 332nd Air Force Theater Hospital is approximately 40 miles north of Baghdad and consists of a series of tents with concrete floors, linked by a corridor. The facility has a staff of 420 and can accommodate up to 24 intensive care unit beds and 80 additional beds; up to six surgeries can be performed at once.
"Our primary mission as a level III hospital was to provide evaluation, resuscitation and surgical care to combat-injured troops," the authors write. "However, our facility experienced 'mission creep' because of the presence of injured civilians, including children. Children additionally had dehydration and malnutrition, which contribute to increased mortality. After Jan. 1, 2005, a pediatric surgeon was available and a broader range of non-traumatic conditions were treated in children."
During the time period studied, 85 children with an average age of 8 years (age range one day to 17 years) were evaluated and treated at the hospital, accounting for 5.2 percent of all patients and 18 percent of treated Iraqi civilians. Forty-eight (56 percent) of the children were treated for traumatic injury, including 25 (52 percent) with a fragmentation wound, such as that inflicted by improvised explosive devices, mines or blasts. Of the children with injuries, 18 (38 percent) had wounds in the leg, 11 (23 percent) in the head, eight (17 percent) in the arm, eight in the abdomen and three (6 percent) in the chest. A total of 134 operations were performed on 63 children (74 percent of the total); each of the children had an average of 2.1 procedures. Five children died-two from burns, two from infection and one from complications following a traumatic head injury and transfer to a civilian facility.
The experience illuminates several key points regarding caring for children in a war zone, the authors conclude. Hospitals near battlefields should expect to treat civilians, including children. These children are likely to have fragmentation injuries, which are generally contaminated and likely to become infected, requiring multiple procedures. "Local health resources may be so disrupted that children cannot be safely discharged until they are well enough to survive under the care of their families," they continue. "To provide adequate care for children during war, expeditionary medical hospitals must prepare for them by providing the proper personnel, training and equipment."
(Arch Pediatr Adolesc Med. 2006;160:972-976. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.
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