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Adolescents and young adults continue to use e-cigarettes, and communication campaigns are needed to decrease use among these populations. We developed and tested a point-of-sale communication campaign focused on e-cigarette chemical exposure. We developed messages based on formative research and tested them (versus text-only messages) in a nationally-representative online survey among adolescents and young adults (16–25) (Phase 1). Based on survey findings, we selected a message focused on nicotine and brain development for the point-of-sale trial (Phase 2). We then conducted a cluster-randomized trial at six gas stations with convenience stores, randomly assigned to the intervention (messages displayed) or no message control condition. We conducted intercept surveys with repeated cross-sectional samples of 50 participants (ages 16–25) per store, at baseline and a four-week follow-up. Phase 1 included 1,636 participants in the online study. Intervention messages were rated as more attention grabbing than plain text messages (p <.05), though were rated similarly on other outcomes. Exposure to intervention messages resulted in larger changes from pre- to posttest for beliefs about addiction and relative harms versus cigarettes (p <.05). Phase 2 included 586 participants in the point-of-sale study. Real-world campaign exposure was low (31.8%), and no differences were found between conditions. E-cigarette prevention messages focused on nicotine's impact on brain development show promise. However, garnering attention for communication campaigns in saturated point-of-sale environments, often dominated by tobacco advertising, is challenging. Future efforts should utilize additional communication channels to directly target adolescents and young adults. [ABSTRACT FROM AUTHOR]

Many adolescents and young adults hold erroneous beliefs that cigarillos and waterpipe tobacco (WT) are safer than cigarettes, contributing to use. Communication campaigns can correct misperceptions and increase risk beliefs. We tested point-of-sale (POS) communication campaigns focused on chemical exposure for cigarillos and WT. We conducted two cluster randomized trials at 20 gas stations with convenience stores (10 stores for cigarillos, 10 for WT) in North Carolina between June and November 2017. Within each trial, stores were randomly assigned to either the intervention (campaign messages displayed) or a no message control condition. We conducted intercept surveys with repeated cross-sectional samples of 50 adolescents and young adults (ages 16–25) per store, at baseline and follow-up. There were 978 participants (mean age = 20.9 years) in the cigarillo trial, and 998 participants (mean age = 21.0 years) in the WT trial. Rates of campaign exposure were low (26% for cigarillos; 24.3% for WT). The cigarillo campaign increased knowledge that ammonia is in cigarillo smoke (p <.01). There were also significant increases in knowledge about ammonia and cyanide in cigarillo smoke and arsenic in WT smoke (p <.05) in the sub-sample who reported exposure to the campaign. No differences were found in outcome expectancies, product attitudes, worry about chemical exposure, or behavioral intentions in either campaign. Garnering attention for communication campaigns in saturated POS environments, often dominated by tobacco advertising, is challenging. Our study demonstrates the feasibility of anti-tobacco campaigns at the POS and points to several lessons learned for future POS campaigns. [ABSTRACT FROM AUTHOR]

Objective: To establish the prevalence of mood and wellness behaviors in college students across a school year. Methods: 1,554 college students (69.4% female; average age 18.8 years) were followed with daily surveys on wellness behaviors for the school year. 1,207 participants completed at least 50% of daily surveys on mood, exercise, sleep, nutrition, mindfulness practice and singing/playing musical instrument. Results: Over 88.7% of college students reported at least one wellness behavior each day with 17.7% reporting 4 or more. Each of the wellness behaviors, however, displayed distinct prevalence patterns, varied significantly across the school year, and often across a given school week. Almost every individual wellness behavior was associated with a positive mood, and the cumulative number of daily wellness behaviors was a strongly associated with mood state. Conclusions: Daily wellness behaviors are collectively common, vary significantly within individuals, and are strongly associated with positive mood, both individual and cumulatively. [ABSTRACT FROM AUTHOR]

We examined whether waterpipe café, vape shop, and traditional tobacco retailer (e.g. stores selling cigarettes, cigars, smokeless tobacco) locations were associated with census tract composition and tobacco use among young adults in North Carolina and Virginia. Methods: We identified waterpipe cafés, vape shops, and traditional tobacco retailers in North Carolina and Virginia and conducted multivariable analyses between community characteristics (gender, race, ethnicity, education, college enrollment, and poverty) and density per 1000 population. Using fall 2017 data from 1099 young adults residing in North Carolina and Virginia, we conducted logistic regression analyses to determine whether tobacco retailer density and proximity were associated with tobacco use. Results: Waterpipe café, vape shop, and traditional retailer density were higher in communities with more people who were Hispanic, college-educated, and college-enrolled (each p <.05). Waterpipe café and traditional retailer density were higher in communities with more people living below the poverty level (each p <.05). Waterpipe café density was higher in communities with more people who were male (p <.05), while traditional retailer density was lower (p <.05). Waterpipe café and vape shop proximity were associated with increased likelihood of waterpipe tobacco use in the past 6 months (each p <.05; unadjusted). Traditional retailer proximity and waterpipe café, vape shop, and traditional retailer density were not associated with tobacco use. Conclusions: Waterpipe cafés and vape shops are located in both impoverished and college-educated communities in North Carolina and Virginia, similar to where traditional tobacco retailers are located. Further research is needed to examine associations with tobacco use. [ABSTRACT FROM AUTHOR]

Pinterest, a widely used social media platform, has shaped how people seek and share health information. Cannabidiol (CBD), a non-psychoactive component of cannabis is marketed as a treatment for many conditions and sales rose to more than 820 million in 2017. Yet CBD is mostly unregulated, legality is murky, and many of the health claims are not scientifically proven. Purpose: This content analysis examined how CBD products were portrayed on Pinterest. Methods: In 2018, using the search terms cannabidiol and CBD, researchers sampled every fifth pin to collect 226 relevant pins. A codebook was developed, pilot tested, and used to code pins. Results: The majority (91.6%) of pins positively portrayed CBD with many claiming a physical or mental benefit including anxiety, depression, pain, and inflammation relief. Most pins did not (98.2%) address potential side effects or recommend dosage. In this sample, user engagement was high with 85.2% of pins being saved and links to commercial sites selling CBD products, personal blogs, and social media accounts. Conclusions: Social media has become a powerful source of health information. This study revealed widespread acceptance of the use of CBD products with minimal information from reliable public health sources represented. [ABSTRACT FROM AUTHOR]

Pinterest has changed the way we seek and share health information with more than 300 million active users. Nearly 40% of Americans are obese and seek fast, easy weight loss solutions online despite evidence that diet and physical activity are the only effective ways to manage weight. Purpose: This study used content analysis to examine how exercises to reduce belly fat were portrayed on Pinterest, a social media website used to bookmark online content. Methods: Using search terms belly fat exercises and belly fat workouts, researchers sampled Pinterest pins to collect 234 relevant pins. A codebook was developed, tested, and used to code pins. Results: Of the 234 pins, the majority of pins highlighted being thinner (73.1%) rather than overall health (9.4%). Pins were primarily geared toward women (70%) with nearly half of the pins depicting women in sports bras (52.9%) with swimsuit model figures (48.7%); and 18% of the pins showed signs of photo edits. Discussion: Social media is a powerful source of health information. However, there is evidence of misleading weight loss, specifically belly fat loss strategies being promoted. Translation to Health Education Practice: Health educators need to develop social media campaigns to promote positive body image with realistic weight loss strategies. [ABSTRACT FROM AUTHOR]

Social media, specifically Pinterest with more than 175 million users, has changed the way people seek and share health information. Recent consumer interest in natural products has led to an increase of shared recipes for homemade products including sunscreen. Homemade sunscreen products are risky because they are not regulated or tested for efficacy like commercial sunscreens. With rising skin cancer rates, the use of effective broadband sunscreen is critical to reduce incidence of skin cancer. This study used directed content analysis to examine how homemade sunscreens were portrayed on Pinterest. Using the search terms, homemade sunscreen and natural sunscreen, researchers sampled every fifth pin to collect 189 relevant pins. A codebook was developed, pilot tested, and used to code pins. Two researchers coded pins and interrater reliability was established at 90%. Of the 189 pins, the majority of pins (95.2%) positively portrayed the effectiveness of homemade sunscreens and 68.3% recommended recipes for homemade sunscreens that offered insufficient UV radiation protection. Sun Protection Factor (SPF) claims were made in 33.3% of pins with a range of SPF 2 to SPF 50. In this sample of pins, 41.8% of pins had been saved by other users ranging from one to more than 21,000 times. Social media is a powerful source of health information. However, this study revealed widespread interest and acceptance of insufficient sun protection information. Pinterest and the interest in homemade recipes for sunscreen present an opportunity for public health professionals to proactively engage on social media. Abbreviations: US: United States; SPF: sun protection factor; USFDA: United states food and drug administration; UV: ultraviolet [ABSTRACT FROM AUTHOR]

Despite recent evidence that 5-hydroxymethylcytosine (5hmC) possesses roles in gene regulation distinct from 5-methylcytosine (5mC), relatively little is known regarding the functions of 5hmC in mammalian tissues. To address this issue, we utilized an approach combining both paired bisulfite (BS) and oxidative bisulfite (oxBS) DNA treatment, to resolve genome-wide patterns of 5hmC and 5mC in normal breast tissue from disease-free women. Although less abundant than 5mC, 5hmC was differentially distributed, and consistently enriched among breast-specific enhancers and transcriptionally active chromatin. In contrast, regulatory regions associated with transcriptional inactivity, such as heterochromatin and repressed Polycomb regions, were relatively depleted of 5hmC. Gene regions containing abundant 5hmC were significantly associated with lactate oxidation, immune cell function, and prolactin signaling pathways. Furthermore, genes containing abundant 5hmC were enriched among those actively transcribed in normal breast tissue. Finally, in independent data sets, normal breast tissue 5hmC was significantly enriched among CpG loci demonstrated to have altered methylation in pre-invasive breast cancer and invasive breast tumors. Primarily, our findings identify genomic loci containing abundant 5hmC in breast tissues and provide a genome-wide map of nucleotide-level 5hmC in normal breast tissue. Additionally, these data suggest 5hmC may participate in gene regulatory programs that are dysregulated during breast-related carcinogenesis. [ABSTRACT FROM AUTHOR]

Number system knowledge (NSK) is broadly defined as the understanding of number relationships and is an essential mathematics skill for young elementary school-aged students. NSK instruction that emphasizes connections between number sense and spatial reasoning could be a critical anchor for second-grade students to stay rooted in their conceptual understanding of numbers while learning to operate with abstract symbols. In this mixed-methods study, we examined the variations and shifts in second-grade students' NSK outcomes after participating in an instructional treatment focused on building their NSK through visual representations. After receiving professional development in the instructional treatment, five classroom teachers implemented a systematically planned series of 27 visual number activities across 9 weeks. Analysis using a general linear model indicates that, based on 75 students' pretest and posttest achievement data, students made significant improvements in NSK that are most likely attributable to the instructional treatment. Additional analyses indicate that students with the lowest pretest scores made the greatest gains and the most substantial shifts in their thinking following the instructional treatment. [ABSTRACT FROM AUTHOR]

We report an effort to replicate and extend Levelt and Kelter’s (1982) Experiment 3. In their study, experimenters phoned businesses and asked, At what time does your shop close? or What time does your shop close? Participants were more likely to produce prepositional responses (At 7 o’clock) to questions containing a preposition than to questions that did not. Across three experiments, we replicated Levelt and Kelter’s method, and included a number of other communicative contexts (asking questions by phone, in person, or by text message, and asking people both known and unknown to the experimenter). Our efforts produced mixed results. Across experiments, and within each communicative context, we found the predicted pattern of results (more prepositional responses following prepositional questions). Although this pattern was not statistically reliable in our individual experiments, it was significant in an analysis conducted across all of our experiments. Overall, our results suggest that the structural repetition effect observed by Levelt and Kelter is replicable, but is weaker than the effect reported in the original paper. [ABSTRACT FROM AUTHOR]

Background: Adolescents with brain injury (BI) often experience impairment in participation, which is an important predictor of outcomes. Objective: Describe the Social Participation and Navigation (SPAN) program, and report participant feedback and preliminary outcomes. Method: Four adolescents and four coaches participated. SPAN included a mobile app, online didactic information, and peer coaching. Adolescents met weekly with coaches via video-conference, developed participation goals, and plans to achieve goals. Social and behavioral functioning before and after was assessed, and feedback about SPAN was collected. Results: SPAN was well received. Participants used the app to define and achieve goals. Medium to large effect sizes were found on adolescent self-reported measures, with negligible effects on parent-report measures. Positive and critical feedback is described. Conclusions: Findings support the usability of SPAN, which has the potential to improve social participation of adolescents with a history of TBI through an innovative use of technology and peer coaching. [ABSTRACT FROM AUTHOR]

To explore the factors influencing parents’ choice of communication mode during early education of their child with hearing loss. Qualitative descriptive analysis of semi-structured interviews with parents of children with hearing loss. Fourteen parents of children who participated in the Longitudinal Outcomes of Children with Hearing Impairment study. Four themes emerged from thematic analysis of the interview data: (1) parents draw on a variety of experiences and information to make decisions; (2) parents’ preferred outcomes for their children drive their choices; (3) child’s preference and proficiency drive parental choice; and (4) parents’ fears and worries influence decisions. The results reinforced the importance of parents receiving unbiased, descriptive information as well as evaluative information from professionals, so that they could consider all options in making a decision that met their needs. Parents also require continual support for implementation of their choices as they adjust to their children’s changing communication needs. Parent decisions around communication mode are rarely made in isolation, but occur within a larger decision-making matrix that include device choices, early intervention agency choices, and ‘future-proofing’ the child’s ongoing communication needs. [ABSTRACT FROM AUTHOR]

Objective: Colleges have implemented policies to limit tobacco use on-campus; however, the off-campus environment is often overlooked in tobacco control efforts. We assessed availability, marketing, and promotion of cigarettes, snus, and traditional smokeless tobacco (SLT) in a sample of communities surrounding 11 college campuses in North Carolina and Virginia. Participants: Between January-March of 2011, 2012 and 2013, 481 tobacco-selling retailers, including convenience stores, pharmacies and supermarkets, located near campuses were assessed. Methods: Trained observers completed annual point-of-sale assessments. Results: The percentage of stores selling (81.4% to 58.6%; p <.0001) and advertising snus (80.1% to 53.11%; p <.0001) significantly decreased over time. Convenience stores increased promotions of cigarettes (65.4% to 72.8%; p = 0.04) and SLT (3.1% to 23.3%; p = 0.02). Conclusions: Off-campus environments have abundant tobacco availability and marketing. Colleges should collaborate with state and local tobacco control advocates to address tobacco promotion near campuses to potentially decrease product appeal and access among young adults. [ABSTRACT FROM AUTHOR]

The objective of this study was to test the Interpersonal Psychological Theory of Suicide (IPTS) proposal that the association of nonsuicidal self-injury (NSSI) with suicide attempt is mediated by acquired capability. Inpatient adolescents (n = 134) reported on suicide ideation and attempts, NSSI frequency and methods, depressive symptoms, and acquired capability for suicide. Consistent with the IPTS, both measures of NSSI were positively associated with acquired capability after accounting for depressive symptoms and past history of attempts. However, both NSSI measures explained independent variance in number of suicide attempts after controlling for suicide ideation and acquired capability. These findings contradict the IPTS and suggest that the role of NSSI in suicide attempt is mediated by variables external to the IPTS. [ABSTRACT FROM PUBLISHER]

Objective: To examine perspectives of multiple stakeholders to inform the design of an app-based coaching intervention to promote social participation in teenagers with traumatic brain injury (TBI).Methods: Teenagers and college students with and without TBI and parents of teenagers with TBI were recruited from two children’s hospitals and two universities in the USA (n= 39). Data were collected via interviews, focus groups, and surveys and examined using descriptive statistics and content analyses.Results: Teenagers with TBI reported more social participation barriers and fewer strategies for addressing these barriers than teenagers without TBI. There was consensus across groups about the value of college student coaches and use of smartphones and apps. Participants expressed mixed views on the use of chat rooms and degree of parent involvement.Conclusion: Results provided insights about the possible benefits of the intervention, and informed its initial design (e.g., desired coach qualities, and type of coach training and supervision). [ABSTRACT FROM PUBLISHER]

This study examined the relationship between frequency of exposure to non-suicidal self-injury (NSSI) and engagement in NSSI among adolescents. Ninety inpatient adolescents with a history of NSSI, ages 12 to 17, completed a structured interview. The majority of participants had learned about NSSI prior to initiating the behavior themselves. More frequent exposure to specific methods of NSSI was associated with greater frequency of using those same methods. Greater exposure to NSSI in the media and seeking out NSSI content were related to greater frequency of engagement in NSSI. Clinicians may help those who self-injure to become more knowledgeable and educated consumers of media to prevent NSSI behavior and contagion. [ABSTRACT FROM PUBLISHER]

Semantic knowledge can be extended in a variety of ways, including self-generation of new facts through integration of separate yet related episodes. We sought to promote integration and self-generation by providing “hints” to help 6-year-olds (Experiment 1) and 4-year-olds (Experiment 2) see the relevance of separate episodes to one another. Varying the timing of presentation of the hints—whether provided between episodes or before test—afforded insights into the processes responsible for self-generation of new semantic knowledge through integration. In both experiments, hints provided immediately before testing facilitated performance relative to a control condition. In contrast, hints provided between episodes did not. The findings imply that integration of distinct experiences is not an automatic process set into motion based on shared elements. Even when integration is primed through a hint that a prior episode is relevant to a forthcoming experience, shared elements apparently are not sufficient to promote self-generation of new semantic knowledge. Instead, the process seems to occur upon demand, such as in response to a question. These findings can be used to guide interventions designed to promote enrichment of semantic memory and also further our understanding of the basic cognitive processes involved in extension of knowledge. [ABSTRACT FROM AUTHOR]

Objective: To examine parents' recollections of and their experiences with bringing up a child diagnosed with hearing loss at a very young age. Design: Based on the analysis of informal parent discussion groups, four open-ended questions were formulated to solicit information about parents' expectations following diagnosis, as well as experiences and challenges when raising a child with a hearing loss. Study sample: Forty parents of children, aged between three to five years, who were diagnosed with hearing loss before the age of three years. Results: Parents' responses revealed strong support for early intervention, high expectations for their child's development, and desire for information tailored to individual needs. Parents also reported anxiety relating to their perceptions of the significance of consistent device usage on their child's development. Further concerns arose from their observations of the difficulties experienced by their child in real-world environments despite consistent device usage, and their perception of their child's language delay despite early intervention. Conclusions: The findings point to a need to support parents to form realistic expectations based on current knowledge. Implications for clinicians to provide improved management of children with hearing loss are discussed. [ABSTRACT FROM AUTHOR]