Youth gambling is an increasing concern. As a response, the “Don’t Gamble Away our Future (DGAOF)” program has been implemented among children in central Illinois. We aim to assess the long-term effectiveness of this school-based youth gambling prevention program in Illinois using the data from 2005 to 2009. The intervention included interactive PowerPoint presentations and prevention materials in parent packets. Students aged 8 to 18 years were eligible to participate in the intervention and the questionnaire pre-post knowledge tests (total score 0–9). Students in 5th grade and above also received a gambling behavior screen test using the Modified South Oaks Gambling Screening for Teens (MSOGST) for identifying probable gamblers. Multivariable generalized mixed models were conducted to detect the effects of a 5-year youth gambling prevention program as controlling potential confounders. A total of 16,262 and 16,421 students completed pre-post tests and MSOGST tests, respectively. Of 16,262, half were female, the majority (76.1%) were from senior high school, and 21.3% received the intervention at least twice. The median gap between interventions was 368 days. Students receiving multiple interventions had higher scores on the pre-test as compared to those receiving a single intervention (P<0.001 for all comparisons among groups), and they demonstrated an increasing trend of awareness about gambling over time (P<0.001 for multiple interventions; P = 0.538 for single intervention). The prevalence of problem gambling had decreased among students receiving the intervention twice as compared to receiving the intervention once (7.9% versus 9.4%; OR = 0.89, 95% CL: 0.82–0.97). However, this effect was not confirmed among students receiving the intervention three or more times. In conclusion, the DGAOF program has demonstrated a positive long-term impact on increasing gambling knowledge and partially reducing pathological gamblers through direct training. It suggests that multiple repeated interventions are important for youth gambling prevention.
Objectives: To assess the efficacy and safety of atosiban in pregnant women under threat of preterm birth. MethOds: A systematic review was carried out, inclusion criteria were adult pregnant women diagnosed with preterm labor threat with the following characteristics: regular uterine contractions lasting at least 30 seconds, contraction frequency greater than 4 every 30 minutes, cervix dilatation from 1 to 3 cm, gestational age from 24 to 33 weeks and normal fetal heart rate (110 -160 bpm). Atosiban was set as intervention and the comparators were nifedipin, indomethacin, terbutaline, fenoterol and placebo. Assessed outcomes were: Gestational age at birth, delay in the timing of birth, neonatal mortality, neonatal respiratory distress syndrome, intraventricular hemorrhage, periventricular leukomalacia, rate of maternal adverse events, rate of neonatal complications. Quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool. The comparison measurements found on studies were extracted in order to perform a network meta-analysis. Results were expressed through forest plots. Results: 11 studies were included in network meta-analysis, all of them were randomized controlled clinical trials. The results showed that atosiban has the greater probability of being the most effective alternative on the following outcomes: delay in the timing of birth (0.81), neonatal mortality (0.85) and rate of maternal adverse events (0.99). cOnclusiOns: Atosiban showed similar efficacy for delaying labor in women with preterm labor threat with comparators. However, it showed a greater safety profile with respect to maternal adverse events and a similar level compared to nifedipine for neonatal complications.
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