Context-Identifying and evaluating efficacious treatments for pediatric weight loss is of critical importance.Objective-This quantitative review represents the first meta-analysis of the efficacy of randomized controlled trials comparing lifestyle interventions to control conditions. Data Sources-MEDLINE, PsychINFO, and Cochrane Controlled Trials Register were searched up to August 2005.Study Selection-Eligible studies were randomized controlled trials involving lifestyle interventions for pediatric overweight that had as a comparison either a no-treatment or information/ education-only control. The primary outcome of interest was change in weight status. Fourteen trials were eligible, resulting in 19 effect sizes.Data Extraction-Information on study design, participant characteristics, interventions, and results were extracted using a standardized coding protocol.Data Synthesis-For trials with no-treatment controls, the mean effect size was 0.75 (k=9, 95% CI 0.52 to 0.98) at end of treatment and 0.60 (k=4, CI 0.27 to 0.94) at follow-up. For trials with information/education only controls, the mean effect size was 0.48 (k = 4, CI 0.13 to 0.82) at end of treatment and 0.91 (k = 2, CI 0.32 to 1.50) at follow-up. No significant moderator effects were identified.Conclusions-Lifestyle interventions for the treatment of pediatric overweight are efficacious in the short-term with some evidence for persistence of effects. Future research is required to identify moderators and mediators of outcome and to determine the optimal length and intensity of treatment required to produce enduring changes in weight status.

The objective of this review is to summarize the literature on diabetes and smoking related to epidemiological risks, efficacy and cost-effectiveness of different cessation approaches, and implications for clinical practice. Over 200 studies were reviewed, with special emphasis placed on publications within the past 10 years. Intervention studies that included patients with diabetes but did not report results separately by disease are included. Diabetes-specific studies are highlighted. There are consistent results from both cross-sectional and prospective studies showing enhanced risk for micro- and macrovascular disease, as well as premature mortality from the combination of smoking and diabetes. The general cessation literature is extensive, generally well-designed, and encouraging regarding the impact of cost-effective practical office-based interventions. In particular, system-based approaches that make smoking a routine part of office contacts and provide multiple prompts, advice, assistance, and follow-up support are effective. Although there is minimal information on the effectiveness of cessation interventions specifically for people with diabetes, there is no reason to assume that cessation intervention would be more or less effective in this population. There is a clear need to increase the frequency of smoking cessation advice and counseling for patients with diabetes given the strong and consistent data on smoking prevalence; combined risks of smoking and diabetes for morbidity, mortality, and several complications; and the proven efficacy and cost-effectiveness of cessation strategies.

Depression is a significant problem for some breast cancer survivors after the end of treatment. This study assessed depression using the CES-D for 84 breast cancer patients at the conclusion of radiation treatment, and at 3 and 6 months post-treatment. Based on the pattern of CES-D scores, patients were divided into five groups: (1) Stay Depressed (scores above clinical cutoff for depression at all timepoints); (2) Recover (above threshold at baseline, but below at follow-up); (3) Become Depressed (below threshold at baseline, but above at follow-up); (4) Never Depressed (below threshold at all times); and (5) Vacillate (none of the above patterns). This study examined the relationships between depression groups and a variety of medical, demographic, and psychological measures, including anxiety and quality of life (QOL). Number of children at home significantly distinguished the groups, with the Become Depressed group having more children and the Vacillate group having fewer children. Anxiety levels were different among the groups, with Recover and Never Depressed groups having consistently lower anxiety scores. QOL scores also distinguished the groups in that Never Depressed patients demonstrated better QOL than all other groups. The findings have implications for understanding resilience in cancer patients.

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Lower estimated insulin sensitivity was associated with risk for hyperfiltration over time, whereas increased albumin excretion was associated with hyperglycemia in youth-onset T2DM.