Objective: Attempts have been made to reduce childhood obesity through school-based programs. Systematic reviews of studies until 2006 reported a lack of consistency about effectiveness of such programs. Presented is an updated systematic review and meta-analysis. Design and Methods: Replication of methodology used in previous comprehensive systematic review and meta-analysis of randomized controlled trials of school-based obesity prevention programs covering studies until 2006 to review studies thru January 2012. Results: Based on 32 studies (n 5 52,109), programs were mildly effective in reducing BMI relative to controls not receiving intervention. Studies of children had significant intervention effects, those of teenagers did not, though the difference between the two groups was not statistically significant. Metaregression showed a significant linear hierarchy of studies with the largest effects for comprehensive programs more than 1 year long that aimed to provide information on nutrition and physical activity, change attitudes, monitor behavior, modify environment, involve parents, increase physical activity and improve diet, particularly among children. Conclusions: Unlike earlier studies, more recent studies showed convincing evidence that school-based prevention interventions are at least mildly effective in reducing BMI in children, possibly because these newer studies tended to be longer, more comprehensive and included parental support.

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ObjectiveThis study explored the perceptions, lived experiences, and coping approaches of women who live with spouses who have alcohol use disorder (AUD) in response to implicit and explicit messages from professionals and others in their environment.BackgroundWomen who live with a spouse with AUD are affected by their spouses' behavior and experience high levels of mental stress. These women are viewed as problem‐solvers and rescuers, on the one hand, or as enablers and “codependents” on the other. These attitudes may reflect society's ideas of women's gender‐related caretaking role.MethodSemistructured interviews were conducted with 12 women whose spouses had a diagnosis of lifetime AUD.ResultsContent analysis yielded three themes regarding the kinds of messages the women received: responsible and guilty, distanced and silenced, and reinforced and supported. The women indicated internalization of these messages and expressed they felt guilty, ashamed, and excluded, but in some cases, strengthened.ConclusionSociety and the people around these women bear responsibility for the negative images they internalize.ImplicationsAwareness of the implicit and explicit messages conveyed to these women is needed. Specific interventions should be designed to validate their difficulties and support them.

Introduction: Substance use is common among military personnel and war veterans, especially combat veterans. Despite substantially high prevalence of cannabis use and Cannabis Use Disorder (CUD) consistently reported among veterans, little is known about psychological factors which may underlie CUD among this population.Methods: In this study, we used narrative analysis in order to interpret retrospective in-depth interviews of combat veterans (N = 12) who were released from mandatory military duty during the past 5 years and currently qualified for a diagnosis of CUD. Participants were recruited from a larger quantitative study were eligible for participation if they screened positive for a diagnosis of CUD according to the Cannabis Use Disorder Identification Test- Revised (CUDIT-R) questionnaire. CUD diagnosis was validated in-person using the cannabis section of the Alcohol Use Disorder and Associated Disabilities Interview Schedule-5 (AUDADIS-5) interview protocol. All interviews were transcribed and coded using the content analysis procedure.Findings: Five main themes were extracted: (a) Traumatic events (b) Attitudes toward cannabis use (c) Combatant identity (d) The role of authority/father figures, and (e) Moral crisis. A meta-theme has been identified, “from enchantment to disillusion,” representing a gradual psychological shift from a hopeful, highly motivated stance into the current state of mental rupture and moral injury, which are unsuccessfully compensated by excessive use of cannabis.Conclusions: This study shed light on the etiology of CUD among young combat veterans, highlighting the role of supposed self-medication for trauma and sense of betrayal.