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This paper investigates the impact of job control and work‐related loneliness on employee work behaviors and well‐being during the massive and abrupt move to remote work amid the COVID‐19 pandemic. We draw on job‐demands control and social baseline theory to link employee perceived job control and work‐related loneliness to emotional exhaustion and work‐life balance and posit direct and indirect effects on employee minor counterproductive work behaviors, depression, and insomnia. Using a two‐wave data collection with a sample of U.S. working adults to test our predictions, we find that high job control was beneficially related to emotional exhaustion and work‐life balance, while high work‐related loneliness showed detrimental relationships with our variables of interest. Moreover, we find that the beneficial impact of high perceived job control was conditional on individual segmentation preferences such that the effects were stronger when segmentation preference was low. Our research extends the literature on remote work, job control, and workplace loneliness. It also provides insights for human resource professionals to manage widespread remote work that is likely to persist long after the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

Purpose: To identify how speech‐language pathologists (SLPs) in the United States are screening for and identifying dysphagia. To do this, we examined the approaches most often used to screen for dysphagia and the influence of contextual factors such as setting, continuing education and means of staying up to date with the most current literature on screening approaches. Method: A web‐based survey composed of 32 questions was developed and field tested for content, relevance and workflow. The survey was distributed online, via social media, online SLP forums and through the American Speech‐Language‐Hearing Association's Special Interest Group 13 (swallowing disorders). One hundred and thirty‐seven clinicians from the United States completed the survey and were included for analysis using descriptive statistics and linear regression modelling to assess associations of continuing education and years practicing with screening protocols and consumption of evidence. Results: Respondents worked in a variety of settings, including acute care, skilled nursing facilities, and inpatient rehabilitation. Most respondents worked with adult populations (88%). The most common screening protocols reported were a volume‐dependent water swallow test (74%), subjective patient report (66%), and trials of solids/liquids (49%). Twenty‐four percent (24%) reported using a questionnaire, the Eating Assessment Tool (80%) being most common. How clinicians consume their evidence was significantly associated with the types of screening approaches used. Continuing education hours were significantly associated with dysphagia screening protocol choice (p < 0.001) and how clinicians stayed up to date with evidence (p < 0.001). Conclusions: Results from this study provide an in‐depth look at the choices clinicians are making in the field regarding how to effectively screen patients for the presence of dysphagia. Contextual factors such as evidence base consumption patterns should serve researchers to continue seeking alternative ways to share evidence with clinicians, accessibly. Associations between continuing education and protocol choice show the need for continued evidence‐based and high‐quality continuing education opportunities. WHAT THIS PAPER ADDS: This study provides an in‐depth look at the choices clinicians are making in the field regarding effective dysphagia screening practices. Clinician screening choices are examined with contextual factors such as evidence base consumption patterns and continuing education. This paper increases knowledge of the most used dysphagia screening practices and context for clinicians and researchers to improve use, evidence and dissemination of best practices. [ABSTRACT FROM AUTHOR]

Background/aim The successful development and maintenance of professional identity is associated with professional development and retention in the health workforce. This paper explores students' perspectives on the ways pre-entry experiences and curricula content shape professional identity. Methods An online cross-sectional survey was sent to students enrolled in the final year of entry-level programmes in five countries. Descriptive statistical analyses of data were completed. Results The results reflect the perceptions of 319 respondents from five countries. Respondents identified professional education (98%) and professional socialisation during placement (92%) as curricula components with the greatest influence on professional identity formation. Discipline-specific knowledge such as, occupation-focussed models and occupational science were ranked lower than these aspects of practice. The students' length of programme and level of entry-level programme did not impact on these results. Conclusion When designing curricula educators need to be mindful that students perceive practice education and professional socialisation have the greatest affect on professional identity formation. The findings reinforce the need for curricula to provide students with a range of practice experiences, which allow the observation and application of occupation-based practices. It highlights a need for educators to provide university-based curricula activities, which better prepare students for a potential dissonance between explicit occupation-based curricula and observed practice education experiences. The study indicates the need for further research into the role curricula content, and in particular practice education, plays in the multidimensional formation of professional development within entry-level programmes. [ABSTRACT FROM AUTHOR]

Background Alcohol-related blackouts are periods of amnesia that reflect the failure of the brain to record memories of what transpires while drinking. This paper examined the incidence, predictors, and behavioral correlates of blackouts among emerging adults and examined whether questions about blackouts could serve as better markers of risk for other alcohol related harms than questions about levels of consumption. Methods In 2012 to 2013, 1,463 (68%) of 2,140 respondents 1-year past high school reported having consumed alcohol. They were asked whether, in the past 6 months because of drinking, they forgot where they were or what they did. The survey also explored demographics, substance use behaviors, and other alcohol-related problems in the past 6 months. Chi-square and logistic regression analyses explored bivariate and multivariate predictors of blackouts and other alcohol-related problems. Results Twenty percent of respondents who ever drank alcohol reported a blackout in the past 6 months. Blackouts were more prevalent among females and those who, in the past 30 days, used multiple drugs, more frequently binged, were drunk, smoked, had lower body weight, and lived in college dorms. After controlling for drinking levels, having a blackout was the strongest independent predictor of most other alcohol problems examined, including in the past 6 months because of drinking, missing class or work, getting behind in work or school, doing something respondents later regretted, arguing with friends, experiencing an overdose, and total number of alcohol problems reported. It was also an independent predictor of hangovers, damaging property, getting hurt, and trouble with police. Conclusions Because blackouts indicate drinking at levels that result in significant cognitive and behavioral impairment, questions about blackouts could serve as important, simple screeners for the risk of experiencing other alcohol related harms. Additional work on this subject is warranted. [ABSTRACT FROM AUTHOR]

Background This paper examines the prevalence, the symptom profile, and the drinking and sociodemographic predictors of current (past 12 months) DSM- IV alcohol abuse and dependence among Mexican Americans living along the U. S.- Mexico border and those living in metropolitan areas away from the border. Methods Respondents in the non-border areas (primarily Houston and Los Angeles) constitute a multistage probability sample ( N = 1,288) of these areas, interviewed as part of the 2006 Hispanic Americans Baseline Alcohol Survey ( HABLAS). Respondents in the border area ( N = 1,307) constitute a household probability sample of Mexican Americans living on the border. In both surveys, data were collected during computer-assisted interviews conducted in respondents' homes. The HABLAS and the border sample response rates were 76 and 67%, respectively. Results Although bivariate analyses revealed no overall differences between border and non-border locations, (negative) age trends were more pronounced on the border for male abuse and for dependence among both genders. Among females aged 18 to 29, border residence was linked to significantly higher rates of dependence. In multivariable analyses, the prevalence of male abuse declined more rapidly with age on the border than off the border. Other unique predictors of male abuse were Jewish/other religion and weekly volume of alcohol consumption. Being married or out of the workforce, attaining a higher education, having no religious preference, and weekly volume uniquely predicted female dependence. Age and weekly volume uniquely predicted male dependence. Conclusions The prevalence of alcohol use disorders among Mexican Americans on and off the U. S.- Mexico border largely mirrors previously documented patterns of alcohol consumption in these areas. For young Mexican American women in particular, border residence is linked to heightened vulnerability to alcohol dependence. [ABSTRACT FROM AUTHOR]

Background: The objective of this paper is to examine 10-year trends (1992 to 2002) in the number and type of indicators of DSM-IV abuse and dependence among whites, blacks, and Hispanics in the United States. Methods: Data are from the 1991 to 1992 National Longitudinal Alcohol Epidemiologic Survey (NLAES; n = 42,862) and the 2001 to 2002 National Epidemiologic Study on Alcohol and Related Conditions (NESARC; n = 43,093). Both surveys used multistage cluster sample procedures to select respondents 18 years of age and older from the U.S. household population. Results: Increases in the prevalence of alcohol abuse between 1992 and 2002 seem associated with a rise in the prevalence of the indicator for 'hazardous use.' which usually means reports of driving after drinking. The decrease in dependence was not associated with changes in a particular indicator. In addition, both in 1992 and 2002, 12.3 to 15.4% of the men and 5.2 to 7.9% of the women were diagnostic 'orphans.' These respondents reported 1 or 2 indicators of alcohol dependence as present. Conclusions: The observed trends in number and types of indicators of DSM-IV alcohol abuse and dependence were probably triggered by a complex interplay between individuals' volume and pattern of drinking and reactions from the drinkers' social environment. The close association between hazardous use of alcohol and the prevalence of abuse deserves further discussion. A medical diagnostic category should not be so dependent on a criterion that may be influenced by social situations. It is necessary to understand more about diagnostic 'orphans' to better design interventions to address their problems. [ABSTRACT FROM AUTHOR]

Background: There have been limited trend studies examining variations on the patterns of alcohol consumption among Whites, Blacks, and Hispanics in the United States. The current paper reports national trends in drinking patterns, volume of drinking (number of drinks per month), binge drinking, and drinking to intoxication among Blacks, Whites, and Hispanics over a period of 10 years and identifies sociodemographic predictors of these behaviors across the 3 ethnic groups. Methods: Data are from the 1991 to 1992 National Longitudinal Alcohol Epidemiologic Survey (NLAES; n = 42,862) and the 2001 to 2002 National Epidemiologic Study on Alcohol and Related Conditions (NESARC; n = 43,093). Both surveys used multistage cluster sample procedures to select respondents 18 years of age and older from the U.S. household population. Results: Trends varied across different dimensions of drinking and ethnic groups. There were no statistically significant differences in the mean number of drinks consumed per month among men and women in any of the 3 ethnic groups between 1992 and 2002, but there was a significant rise in the proportion of current drinkers in both genders and in all 3 ethnic groups. Multivariate analysis indicated that, compared to Whites in 1992, Blacks and Hispanics did not increase their volume of drinking, but Whites did. Drinking 5 or more drinks in day at all did not increase between 1992 and 2002, but drinking 5 or more drinks at least once a month was more likely for all groups in 2002 compared to Whites in 1992. Drinking to intoxication at all was more likely among Whites in 2002 than 1992, but drinking to intoxication at least once a month was more likely among Whites and Blacks in 2002 than 1992. Conclusion: The only common trend between 1992 and 2002 across both genders and 3 ethnic groups was a rise in the proportion of drinkers. There was also a rise in drinking 5 or more drinks in a day (Whites, Blacks, and Hispanics) and drinking to intoxication (Whites and Blacks), but this was limited to those reporting such drinking at least once a month. The reasons for these changes are many and may involve complex sociodemographic changes in the population. It is important for the field to closely monitor these cross-ethnic trends in alcohol consumption. [ABSTRACT FROM AUTHOR]

The status‐legitimacy hypothesis proposes that those who are most disadvantaged by unequal social systems are even more likely than members of more advantaged groups to provide ideological support for the very social system that is responsible for their disadvantages. Li, Yang, Wu, and Kou (2020, Personality and Social Psychology Bulletin) sought to expand the generalizability of this hypothesis by testing it in China, addressing inconsistencies surrounding the empirical support for this hypothesis by postulating that the construct of status should be separated into an objective and subjective status marker. They reported that objective socioeconomic status (SES; income and education) negatively predicted system justification, while subjective SES positively predicted system justification. In the present study we attempt to replicate and extend the work of Li et al. in a cross‐cultural comparison of demographic stratified quota online samples in China and the United States. We test the status‐legitimacy hypothesis using objective and subjective SES to predict system justification using cross‐sectional and cross‐lagged regression analyses. We received partial support for Li et al.'s findings. Specifically, subjective SES positively predicted system justification for both societies during cross‐sectional and cross‐lagged longitudinal analyses. However, we failed to replicate Li et al.'s findings surrounding objective SES in China during cross‐sectional and cross‐lagged analyses. [ABSTRACT FROM AUTHOR]

Introduction: Risky sexual behavior has been explored in women living with HIV (WLHIV) internationally but is not well studied in WLHIV in the United States (U.S.). This merits further investigation due to the negative reproductive and HIV health outcomes associated with risky sexual behavior, such as the increased risk for HIV transmission and infertility from sexually transmitted infections (STIs). The aims of this study are to (1) describe sexual behaviors in a cohort of WLHIV in Florida, (2) determine whether demographic characteristics, substance use, and mental health symptoms are associated with risky sexual behavior in a cohort of WLHIV in Florida, and (3) explore whether the relationship between substance use and mental health symptoms and risky sexual behavior differs in reproductive‐age (age 18–49), compared to non‐reproductive‐age WLHIV (age 50+). Design: This was a cross‐sectional analysis of data from a multisite cohort study done in Florida. Methods: Data were collected from a sample of 304 participants who were recruited into the Florida Cohort Study from 9 clinical and community sites in Florida between 2014 to 2017. The predictor variables of interest were mental health symptoms, substance use, and demographic variables. The outcome variable of interest was risky sexual behavior which was defined as reporting ≥1 of the following: (1) at least one STI diagnosis in the past 12 months, (2) two or more sexual partners in the past 12 months, or (3) any inconsistent condom use in the past 12 months. Descriptive statistics, bivariate analysis, and logistic regression (p < 0.1) were conducted on the variables of interest. Results: The mean age of the sample was 47.8 years, and approximately half (51.6%) of the sample was of reproductive‐age. Reporting ≥1 risky sexual behavior was reported in over half (51.6%) of the reproductive‐age WLHIV in the sample and 32% of the non‐reproductive‐age WLHIV in the sample. Binge drinking, alcohol‐related problems, marijuana use, and age were all significantly associated with self‐reporting ≥1 risky sexual behaviors in all WLHIV. Self‐reporting binge drinking, marijuana use, and a high alcohol‐related problems score respectively were associated with increased odds of self‐reporting ≥1 risky sexual behavior in all WLHIV. Neither mental health symptoms nor race/ethnicity or education were significantly associated with self‐reporting ≥1 risky sexual behavior in all WLHIV. Self‐reporting severe anxiety symptoms and high alcohol‐related problems scores respectively were associated with increased odds of self‐reporting ≥1 risky sexual behavior only in reproductive‐age WLHIV from the sample. Conclusion: Marijuana use, binge drinking, and alcohol‐related problems appear to have a relationship with risky sexual behavior in WLHIV regardless of age. Reproductive‐age also appears to influence risky sexual behavior in WLHIV, and specific reporting severe anxiety symptoms and high alcohol‐related problems in reproductive‐age WLHIV increases the odds of engaging in risky sexual behavior. Clinical Significance: This study holds clinical significance for nurses and other clinicians working in reproductive health settings and clinics with WLHIV. Results indicate that it could be beneficial to do more screening for mental health symptoms (particularly anxiety) and alcohol use in younger reproductive‐age WLHIV. [ABSTRACT FROM AUTHOR]

The article focuses on the variation in firearm screening and access based on LGBT status among Veterans with the risk of firearm-related suicide in both LGBT individuals and Veterans. It mentions that the study aims to fill this gap by examining LGBTQI+ status, emergency department visits, and firearm screening and access using natural language processing and machine learning algorithms applied to clinical notes in the Veterans Affairs (VA) electronic health records.

Background: The majority of the US population have poor knowledge of cancers related to human papillomavirus (HPV). Identifying best sources for communicating this information can guide strategies to promote HPV vaccination. Objectives: To assess the relationship between sources of health information and individuals' knowledge of HPV‐related cervical and oropharyngeal cancer. Methods: This study conducts logistic regression on the most recent wave (2019) of the Health Information National Trends Survey. Dependent variables are indicators for self‐reported awareness that HPV causes (a) cervical cancer and (b) oropharyngeal cancer. The primary indicator is a variable for different sources of health information: The Internet, professional sources, print materials, friends/family and never looked for health information. Results: Being female, young, non‐Hispanic White and having college education is associated with higher odds of knowing about HPV‐related cervical cancer. Controlling for demographic factors, individuals using professionals and the Internet are more likely to know that HPV causes cervical cancer (aOR: 2.65, 95% CI: 1.66, 4.25; aOR: 2.47, 95% CI: 1.75, 3.50, respectively) compared to those who have never looked for health information. Similar results were found for HPV‐related oropharyngeal cancer. Conclusion: Findings provide implications for targeted messaging through effective channels to improve HPV vaccination uptake. [ABSTRACT FROM AUTHOR]

Purpose: To systematically assess the effectiveness of breast cancer (BC) interventions in improving breast self‐examination (BSE), clinical breast examination (CBE), mammogram screening rates, and preventive activities in Muslim refugee and immigrant women. Design Guided by the Health Belief Model, a mixed method systematic review and meta‐analysis was performed using a sequential design. Methods: This study followed the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis statement (PRISMA), the Critical Appraisal Skill Program Checklists, and the Joanna Briggs Institute (JBI) methodology for systematic review and meta‐analysis. A systematic search of English‐language peer‐reviewed articles was undertaken in multiple health and social sciences databases from January 1, 2015, to March 31, 2022. Randomized clinical trials and quasi‐experimental studies focused on the uptake of BSE, CBE, and mammograms were selected. Results: Fourteen articles were included in the review. Most of the studies relied on quasi‐experimental designs and were carried out in the United States of America. The qualitative analysis of BC screening interventions generated three themes: (1) education, (2) access‐focused, and (3) cultural and faith‐based. The meta‐analysis included three randomized control trials and two quasi‐experimental studies. The meta‐analysis demonstrates the effectiveness of community‐led cultural and faith‐based interventions in facilitating the completion of CBE and mammography screening. Education on BC and patient navigator interventions are more effectively used in conjunction than standalone interventions, yet community‐based cultural and faith‐based interventions are the most effective. Conclusion: This systematic and meta‐analysis review provides evidence on the effectiveness of access‐focused and cultural and faith‐based interventions in improving BC screening in Muslim refugee and immigrant women. Future research should focus on designing and measuring the effectiveness of cultural and faith‐based interventions to increase Muslim refugee and immigrant women's BC screening knowledge and practices. Clinical Relevance: This systematic and meta‐analysis review demonstrates the need to explore Muslim refugee and immigrant women's cultural contexts for developing culturally sensitive BC screening interventions. Knowledge and practice of BC and religiosity intersect with financial, geographic, and linguistic barriers to decrease participation in screening and preventive activities in Muslim refugee and immigrant women. [ABSTRACT FROM AUTHOR]

Aims: To examine whether polyuse of cigarettes and other smoked products (polysmoking) is predictive of quit attempts and quit success. Design: A prospective multi‐country cohort design. Setting: Australia, Canada, England and the United States. Participants: A total of 3983 adult daily cigarette smokers were surveyed in 2016 (wave 1 of data collection) and were re‐contacted in 2018 (wave 2) (i.e. waves 1–2 cohort) in the International Tobacco Control Four Country Smoking and Vaping (ITC 4CV) surveys; and 3736 smokers were surveyed in 2018 and re‐contacted in 2020 (wave 3) (i.e. waves 2–3 cohort). Measurements Participants were asked about their cigarette smoking and use of cigars, cigarillos, pipes and waterpipes. Outcomes were quit attempts between two survey waves and success, defined as having quit smoking all the combustible tobacco at the subsequent survey for 1 month or more. Findings Levels of polysmoking were 12.7% in the waves 1–2 cohort and 10.5% for the waves 2–3 cohort. Compared with cigarette‐only smokers, polysmokers were more likely to attempt to quit between waves 1 and 2 [54.9 versus 42.7%, adjusted odds ratio (aOR) = 1.37, 95% confidence interval (CI) = 1.08–1.74, P < 0.01], but not between waves 2 and 3 (43.8 versus 40.1%, aOR = 0.94, 95% CI = 0.72–1.22). Polysmoking predicted reduced likelihood of success in both cohorts among attempters and the overall samples. Between waves 2 and 3 there were significantly more transitions to non‐daily smoking among the polysmokers (12.4 versus 5.3%, χ2 = 40.4, P < 0.001). Conclusions: There is a consistent association between polysmoking (use of cigarettes together with other smoked products) and reduced quit success for combustible tobacco, but it is probably due to increased likelihood of transitioning to non‐daily use rather than complete cessation. [ABSTRACT FROM AUTHOR]

Transgender and nonbinary young adults report frequent parental rejection was linked to poor mental health. There are limited data about transgender and nonbinary young adult sibling relationships following disclosure or discovery of gender identity. The purpose of this analysis is to compare transgender and nonbinary young adults' perception of parental and sibling support specifically for gender identity immediately after disclosure and in the present day. Eligible respondents were recruited via paid social media advertisements. Respondents provided data on demographics, family relationships, and perceived support for gender identity. The sample consisted of 348 transgender and nonbinary young adults (Mean age: 21.5 years) who lived in the United States, identified as White and were assigned female at birth. The majority reported on a nuclear family. Nearly three‐quarters (71.3%) had disclosed their identity to at least one parent and had done so within the past 3 years. Overall, respondents perceived a significant increase in family members' support from the time of disclosure to the time of the survey. Most respondents reported improved family relationships since disclosing their gender identity. Siblings were perceived as significantly more supportive than either parent at both time points. Siblings could be an essential source of support for transgender/nonbinary young people, particularly if parents are not accepting or do not yet know their child's gender identity. Nurses and other professionals working with transgender and nonbinary young people in school, community, and clinical settings should assess perceived support across familial relationships. [ABSTRACT FROM AUTHOR]

BACKGROUND: Food insecurity (FI) rates in the United States are particularly high among households with children. This research set aims to analyze if high school students experiencing FI had higher risk for mental health and suicidal behaviors. METHODS: Using combined data from 11 states that conducted the 2017 Youth Risk Behavior Survey, a total of 26,962 and 24,051 high school students were used to estimate race/ethnicity and sex‐stratified prevalence ratios (PRs) from Poisson regression models. A single‐question was used to measure the exposure of FI and outcomes of mental health and suicidal behaviors. RESULTS: Overall, 10.8% of students reported FI. Students experiencing FI had increased risk for all mental health and suicide behavior outcomes, regardless of their race/ethnicity or sex. PRs ranged from 1.9 (95% confidence interval [CI]:1.8, 2.0) to 3.1 (CI: 2.7, 3.6). Among males, PRs for the association between FI and all outcomes were highest among non‐Hispanic black students (PRs ranged from 2.4 [CI: 1.7, 3.2] to 5.5 [CI: 2.3, 13.3]). Among females, PRs were highest among non‐Hispanic white students (PRs ranged from 1.9 [CI:1.7, 2.1] to 3.6 [CI:2.9, 4.5]). CONCLUSIONS: FI is consistently associated with mental health and suicidal behaviors among different subgroups of students. [ABSTRACT FROM AUTHOR]

Policy PointsMayoral officials' opinions about the existence and fairness of health disparities in their city are positively associated with the magnitude of income‐based life expectancy disparity in their city.Associations between mayoral officials' opinions about health disparities in their city and the magnitude of life expectancy disparity in their city are not moderated by the social or fiscal ideology of mayoral officials or the ideology of their constituents.Highly visible and publicized information about mortality disparities, such as that related to COVID‐19 disparities, has potential to elevate elected officials' perceptions of the severity of health disparities and influence their opinions about the issue. Context: A substantive body of research has explored what factors influence elected officials' opinions about health issues. However, no studies have assessed the potential influence of the health of an elected official's constituents. We assessed whether the magnitude of income‐based life expectancy disparity within a city was associated with the opinions of that city's mayoral official (i.e., mayor or deputy mayor) about health disparities in their city. Methods: The independent variable was the magnitude of income‐based life expectancy disparity in US cities. The magnitude was determined by linking 2010‐2015 estimates of life expectancy and median household income for 8,434 census tracts in 224 cities. The dependent variables were mayoral officials' opinions from a 2016 survey about the existence and fairness of health disparities in their city (n = 224, response rate 30.3%). Multivariable logistic regression was used to adjust for characteristics of mayoral officials (e.g., ideology) and city characteristics. Findings: In cities in the highest income‐based life expectancy disparity quartile, 50.0% of mayoral officials "strongly agreed" that health disparities existed and 52.7% believed health disparities were "very unfair." In comparison, among mayoral officials in cities in the lowest disparity quartile 33.9% "strongly agreed" that health disparities existed and 22.2% believed the disparities were "very unfair." A 1‐year‐larger income‐based life expectancy disparity in a city was associated with 25% higher odds that the city's mayoral official would "strongly agree" that health disparities existed (odds ratio [OR] = 1.25; P =.04) and twice the odds that the city's mayoral official would believe that such disparities were "very unfair" (OR = 2.24; P <.001). Conclusions: Mayoral officials' opinions about health disparities in their jurisdictions are generally aligned with, and potentially influenced by, information about the magnitude of income‐based life expectancy disparities among their constituents. [ABSTRACT FROM AUTHOR]

Background: Facebook is a frequently used social media platform and is often used for human health information, yet little research has been conducted on how pet owners use Facebook pet groups to obtain and share pet health information. Method: This study was designed to assess how pet owners use dog and cat Facebook groups to provide and receive pet health advice and their perception of these groups' trustworthiness. Two comparable questionnaires (dog and cat owners) were developed and distributed through an online survey platform. Results: Results suggest that Facebook groups are a common source of pet health information, with 56.2% of dog owners and 51.8% of cat owners reporting receiving health information through Facebook groups. Similar numbers report giving health information through Facebook groups: 55.0% of dog owners and 57.9% of cat owners. Dog health information most commonly exchanged related to dermatology, gastroenterology and orthopaedics and the most common cat health information focused on gastroenterology, renal and urinary‐related issues. While the majority of Facebook users report feeling that Facebook groups are not a trustworthy source of pet health information, a substantial minority of users do appear to be influenced by these groups. Conclusion: Approximately 50% of cat and dog owning respondents either give or receive pet health advice through Facebook groups. These results suggest that many owners deem Facebook groups as useful, but not entirely trustworthy, sources of information. [ABSTRACT FROM AUTHOR]

Background and Aims: Past research has found that young smokers are more likely to make quit attempts; however, there are conflicting findings regarding age and quit success. This study examined the degree to which smoker age is related to making quit attempts and quit success. Design Ten waves of the International Tobacco Control Policy Cohort survey (ITC‐4C) collected between 2002 and 2014, with nine wave‐to‐wave transitions with predictors at the first wave predicting quit attempts and success by the next wave. Setting: Canada, the United States, the United Kingdom and Australia. Participants: Data from 15 874 smokers categorized into four age groups at baseline (18–24, 25–39, 40–54 and 55+ years). Measurements Age, quit attempts and success (defined as ≥ 30 days abstinence confirmed, if possible, on a third wave for recent attempts). Findings Older smokers were more likely to smoke daily (χ2 = 1557.86, r = 0.136, P < 0.001) than younger smokers. Daily smokers were less likely to report quit attempts (38.1 versus 58.2%) and to achieve 30 days of abstinence (22.9 versus 34.3%) than non‐daily smokers. Older daily smokers were less likely to make quit attempts [0.61, confidence interval (CI) = 0.54–0.70, P < 0.001], even after controlling for indicators of nicotine dependence, country, sex, education, income, relationship status and household composition, than younger smokers. Younger smokers (< 25) were more likely to succeed for at least 30 days of abstinence, but only when compared with those aged 40–54 (OR = 0.83, 95% CI = 0.68–0.99). However, when controlling for heaviness of smoking the age effect disappeared. Significant interactions with age were found between age and intention when predicting quit attempts, and age and heaviness of smoking when predicting quit success. Conclusions: An international cohort study indicates that young smokers are more likely to attempt to quit and appear to have similar levels of success in abstaining from smoking compared with older smokers when controlling for dependence. Quit success in all ages is most predicted by lower levels of nicotine dependence. [ABSTRACT FROM AUTHOR]

This study aimed to examine the association between breastfeeding and childhood obesity. A multinational cross‐sectional study of 4,740 children aged 9–11 years was conducted from 12 countries. Infant breastfeeding was recalled by parents or legal guardians. Height, weight, waist circumference, and body fat were obtained using standardized methods. The overall prevalence of obesity, central obesity, and high body fat were 12.3%, 9.9%, and 8.1%, respectively. After adjustment for maternal age at delivery, body mass index (BMI), highest maternal education, history of gestational diabetes, gestational age, and child's age, sex, birth weight, unhealthy diet pattern scores, moderate‐to‐vigorous physical activity, sleeping, and sedentary time, exclusive breastfeeding was associated with lower odds of obesity (odds ratio [OR] 0.76, 95% confidence interval, CI [0.57, 1.00]) and high body fat (OR 0.60, 95% CI [0.43, 0.84]) compared with exclusive formula feeding. The multivariable‐adjusted ORs based on different breastfeeding durations (none, 1–6, 6–12, and > 12 months) were 1.00, 0.74, 0.70, and 0.60 for obesity (Ptrend =.020) and 1.00, 0.64, 047, and 0.64 for high body fat (Ptrend =.012), respectively. These associations were no longer significant after adjustment for maternal BMI. Breastfeeding may be a protective factor for obesity and high body fat in 9‐ to 11‐year‐old children from 12 countries. [ABSTRACT FROM AUTHOR]

BACKGROUND: In this study, we determined the prevalence of and factors associated with parent unawareness of youth tobacco use. METHODS: We used data from waves 1, 2, and 3 (2013‐2016) of the Population Assessment of Tobacco and Health study, a nationally representative study of 13,650 US youth ages 12 to 17 and their parents. We conducted weighted multivariate analyses comparing parent unawareness of youth‐reported ever use and associations between parents' unawareness of youth use and covariates. RESULTS: Youth ever tobacco use ranged from 21.8% in 2013‐2014, to 24.1% in 2014‐2015, to 23.4% in 2015‐2016. Parent unawareness ranged from 57.6% in 2013‐2014, to 61.9% in 2014‐2015, and 64.5% in 2015‐2016. Factors associated with higher parent unawareness of youth tobacco use in 2015‐2016 were youth being female, black, or Hispanic (adjusted odds ratio [AOR] = 1.24‐2.61; all ps <.05). Youth with lower academic performance, relatives who used tobacco, tobacco available in the home, or past 30‐day use, were less likely to have parents unaware of their use (AORs 0.33‐0.56; all ps <.05). CONCLUSIONS: Among youth who reported ever using tobacco, most had parents who were unaware of their use. School‐based efforts targeting specific sociodemographic factors could increase parent awareness of youth tobacco use. [ABSTRACT FROM AUTHOR]

Background: Amniotomy is a commonly used, inexpensive method of labour induction; however, the optimal timing of amniotomy during labour induction is debated. Aims: To investigate whether artificial rupture of membranes <4 cm dilation is associated with caesarean, severe maternal and neonatal morbidity, and labour induction duration. Materials and Methods: Retrospective cohort study of 228 438 deliveries at 19 US hospitals. Women with a viable, singleton gestation undergoing induction ≥37 weeks with cervical dilation <4 cm were included. Women were excluded if membranes spontaneously ruptured <4 cm. Women were compared by early amniotomy (<4 cm dilation) versus not early. The primary outcome was caesarean. Secondary outcomes included severe maternal and neonatal morbidity, and labour duration. Logistic and Cox proportional hazard regression estimated the association between early amniotomy and study outcomes. Results: Of 15 525 eligible women, 10 421 (67%) had early amniotomy. Early amniotomy was associated with higher adjusted odds of caesarean and severe maternal morbidity, but not neonatal morbidity. After accounting for interaction, early amniotomy was associated with increasingly higher odds of caesarean as body mass index increased. Early amniotomy was associated with lower odds of severe maternal morbidity among multiparas with mechanical ripening. Median labour induction was 2.5 h shorter with early amniotomy, significant in hazard regression. Conclusions: Early amniotomy was associated with increased odds of caesarean among obese women. The association between early amniotomy and severe maternal morbidity varied by maternal characteristics, but early amniotomy was not associated with neonatal morbidity. Early amniotomy in labour induction may be advantageous in certain populations, particularly non‐obese women requiring mechanical ripening. [ABSTRACT FROM AUTHOR]

Background: Stroke is one of the leading causes of death in the United States. Aphasia is a language impairment which results as a consequence of stroke. Gender differences are reported in underlying mechanisms of stroke, however, gender differences in aphasia type and severity remain unclear. Aims: To examine gender differences in aphasia impairment based on data from AphasiaBank, a research repository of data obtained from studies of aphasia. Methods & Procedures: The data were collected from AphasiaBank for 294 persons with aphasia (PWA) (172 men, 122 women). Baseline comparisons by gender groups were completed using independent samples t‐tests and Pearson Chi square statistics. Univariate comparisons of the total Western Aphasia Battery—Revised (WAB‐R) ‐AQ and ‐R subtests' scores were compared between the two groups using independent samples t‐tests. Multivariate comparisons were completed by using multivariate analysis of variance (MANOVA). Outcomes & Results: Gender differences were observed in the severity of aphasia with men exhibiting more severe aphasia than women. Analyses of WAB‐R indicated greater impairment among men based on AQ and greater impairment was observed in individual subtest performance. Men exhibited statistically significantly lower WAB‐R AQs than women (67.4 versus 75.6). Lower WAB‐R AQs were derived from lower scores among men on individual subtests; information content, fluency, repetition, sentence completion, responsive speech and tests of comprehension (yes/no, auditory word recognition and sequential commands). Conclusions & Implications: This study offers evidence of gender differences in aphasia severity, global communication impairment and lower scores on individual subtests used to derive the WAB‐R AQ. The limitations of the study with suggestions for future directions are presented. [ABSTRACT FROM AUTHOR]

High prevalence rates of both Vitamin B12 insufficiency and depressive symptoms exist in pregnant women. Although the association between depressive symptoms and certain nutrient deficiencies like iron, folate, or Vitamin B12 has been established, the specific relationship between low‐normal serum Vitamin B12 levels and depressive symptoms in pregnant women in the United States has not been studied closely. Using 2005–2006 National Health and Nutrition Examination Survey data, a secondary analysis was conducted to examine the association between low‐normal serum Vitamin B12 level and depression, as measured by a score of 10 or higher on the Patient Health Questionnaire‐9, in pregnant women (N = 174). In bivariate regression models, Vitamin B12 level, experiencing poverty, and pre‐pregnancy body mass index (BMI) were significant predictors of depression. In multivariate logistic regression models, pregnant women with low‐normal serum Vitamin B12 levels (OR = 3.82, 95% CI [1.10–13.31], p < 0.04) were 3.82 times more likely to experience depression, controlling for sociodemographic characteristics, pre‐pregnancy BMI, and the biomarkers hemoglobin and folate. Identifying and treating pregnant women with low‐normal Vitamin B12 levels may enhance prenatal depression management. [ABSTRACT FROM AUTHOR]

Background and Aims Including a low‐intensity blood collection method in population‐based alcohol studies would advance our ability to study biological mechanisms related to alcohol. However, the likelihood of participation in such a blood collection method remains understudied. This study's primary aims were to (1) estimate the return rate of mail‐in, self‐administered dried blood spot (saDBS) samples in national surveys and (2) test correlates of returning a sample. Design Re‐contact of all eligible participants from two telephone, population‐based alcohol surveys followed by χ2 tests and multivariate logistic regression analysis. Setting Non‐institutionalized US population in all 50 states and Washington, DC. Participants Adults aged 18+ who reported drinking at least one alcoholic beverage in the past 12 months (assessed 2017–18). Contact was made with 680 eligible participants, and 257 consented. Measurements The return rate of saDBS samples was defined as the proportion of returned samples among those who were eligible and contacted. Key correlates examined were gender, age, race/ethnicity and education. Findings Among the 680 eligible people contacted, 179 (26.3%) returned a saDBS sample. Blacks [odds ratio (OR) = 0.58, 95% confidence interval (CI) = 0.35–0.95], Latinos (OR = 0.40, 95% CI = 0.23–0.69) and those with a high school education or less (OR = 0.50, 95% CI = 0.31–0.81). Conclusions: The likelihood of participating in mail‐in, self‐administered dried blood spot (saDBS) sampling among drinkers in the US general population appears low, and blacks, Latinos and people with lower levels of education appear less likely to provide a saDBS sample compared with whites and people with higher levels of education. [ABSTRACT FROM AUTHOR]

In this systematic review and meta-analysis, we evaluated the effectiveness, safety and comfort of StatLock for the securement of peripherally-inserted central catheters. PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, WanFang Database, and China Science and Technology Journal Database were searched. Randomized, controlled trials comparing StatLock with tape or suture on the performance of securing peripherally-inserted central catheters were selected. Meta-analysis was performed using Review Manager 5.3 software. Thirteen randomized, controlled trials involving 1970 patients were included. Our results showed that StatLock reduced the incidence of catheter dislodgement and unplanned removal. Moreover, patients in the StatLock group had lower incidence of skin ulceration, phlebitis, catheter-related bloodstream infection, and cellulitis, and felt more comfortable compared with those in the control group. Current evidence suggests that the StatLock securement device offer advantages over tape and suture in preventing catheter-related complications and improving patient comfort. However, as considerable heterogeneity was found among the included studies, and the quality of evidence for main outcomes was relatively low, the results should be viewed with caution. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: To examine the relationship between area population density and community pharmacy‐based Alzheimer's Disease (AD)‐related services: pharmacists’ medication knowledge and counseling, immunizations, and in‐stock cognitive enhancers in 3 predominantly rural regions of the United States. Methods: A standardized interview was administered by telephone to a 100% sample of community pharmacies in 3 areas: Northern California/Southern Oregon (n = 206), North and South Dakota (n = 278), and West Virginia (n = 420). Key study outcomes included: pharmacists’ medication knowledge, availability of immunization services, and cognitive enhancers in stock. Respondents were classified by population density (persons/mi2) by pharmacy location to evaluate the relationship between rurality and AD‐related pharmacy services. Chi‐squared and logistic regression analyses were performed using Stata 10.1. Findings: Pharmacies in more rural areas (50.1‐100.0, 25.1‐50.0, and ≤25.0 persons/mi2) were about 50% less likely to offer immunizations (95% CI: 0.32‐0.91; 0.32‐0.76; 0.28‐0.80, respectively) compared to the least rural areas (>100.0 persons/mi2). Compared to the least rural areas, pharmacists in the most rural areas (≤25.0 persons/mi2) were less likely to name ≥2 gastrointestinal adverse effects of donepezil (OR = 0.50, 95% CI: 0.31‐0.82) or have memantine XR 28 mg (OR = 0.61, 95% CI: 0.41‐0.89) and other surveyed medications (OR = 0.57, 95% CI: 0.39‐0.82) in stock. Conclusions: We found disparities in AD‐related services in community pharmacies located in more rural counties, wherein individuals with AD and their caregivers may face barriers to obtaining quality pharmaceutical care. There is a need to strengthen pharmacists’ knowledge and improve pharmacy services to reduce disparities. [ABSTRACT FROM AUTHOR]

Mothers' interactions with their young children have predicted later child development, behavior, and health, but evidence has been developed mainly in at-risk clinical samples. An economically and racially diverse sample of pregnant women who were not experiencing a high-risk pregnancy were recruited to participate in a community-based, longitudinal study of factors associated with child cognitive and social-emotional development during the first 3 years. The purpose of the present analysis was to identify associations between the characteristics of 1125 mothers and their 1-year-olds and the mothers' and children's scores on the Nursing Child Assessment Teaching Scale (NCATS). A multivariable approach was used to identify maternal and child characteristics associated with NCATS scores and to develop prediction models for NCATS total and subscale scores of mothers and children. Child expressive and receptive communication and maternal IQ, marital status, age, and insurance predicted NCATS Mother total score, accounting for 28% of the score variance. Child expressive communication and birth weight predicted the NCATS Child total score, accounting for 4% of variance. Child's expressive communication and mother's IQ and marital status predicted NCATS mother-child total scores. While these findings were similar to reports of NCATS scores in at-risk populations, no previous teams examined all of the mother and child characteristics included in this analysis. These findings support the utility of the NCATS for assessing mother-child interaction and predicting child outcomes in community-based, non-clinical populations. © 2017 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Objective In a population sample of persons with migraine treating with a single category of acute migraine medication, to identify rates and factors associated with acute treatment outcomes, including 2-hour pain freedom (2hPF), 24-hour pain response (24hPR), and 24-hour sustained pain response (24hSPR). Key predictors include acute treatment type (triptans and other medication categories), the influence of allodynia on response to medication, and the interaction between medication category and presence of allodynia in response to treatment among people with migraine. Background Cutaneous allodynia was previously associated with inadequate 2hPF, 24hPR, and 24hSPR (sustained response at 24 hours among those with adequate 2hPF) among people with migraine in the American Migraine Prevalence and Prevention (AMPP) Study. Methods The AMPP Study obtained data from a representative US sample of persons with migraine by mailed questionnaire. The 2006 survey included 8233 people with migraine aged 18 or over who completed the Migraine Treatment Optimization Questionnaire (mTOQ). mTOQ was used to assess acute treatment outcomes including 2hPF, 24hPR, and 24hSPR. Eligible individuals used only a single category of acute prescription migraine treatments (n = 5236, 63.6%). This sample was stratified into 5 categories of type of acute prescription headache medication used (triptans, nonsteroidal anti-inflammatory drugs, barbiturate-combinations, opioids, and opioid combinations and ergot alkaloids). Separate binary logistic regression models evaluated: (1) triptans vs other medication types; (2) presence of allodynia vs no allodynia; and (3) the interaction of medication category with allodynia. Sociodemographic variables, health insurance status, over-the-counter and preventive medication use were included as covariates. Odds ratios (OR) and 95% confidence intervals (CI) were generated for each acute treatment outcome. Results Among eligible participants, the mean age was 46 years, and 82.5% were women. The triptan use group had better outcomes than other medication groups for 2hPF (OR range: 2.00-2.63, all significant except ergot alkaloids) and 24hPR (OR range: 2.10-6.22, all significant). No significant medication effects were found for the 24hSPR outcome. The presence of allodynia was associated with significantly worse outcomes for both 2hPF (OR range: 1.42-1.55, all significant) and 24hPR (OR range: 1.30-1.32, all significant, except for ergot alkaloids, P = .051). Allodynia effects were not significant for the 24hSPR. The interaction between medication and allodynia was also not significant (OR range for 2hPF: .68-2.02; OR range for 2hPR: .35-1.34; OR range for 24hSPR: 1.21-2.72) in any of the models, suggesting allodynia is an important predictor of treatment response regardless of the medication group prescribed. Conclusions The use of triptan medication was associated with significantly better 2hPF (except vs ergot alkaloids) and significantly better 24hPR outcomes compared with other acute medication categories. The presence of allodynia significantly increased the likelihood of an inadequate treatment response for both of these outcomes. Triptan use was generally associated with the best outcomes. Because allodynia was associated with inadequate outcomes for all medication groups, we suggest that allodynia is an area of unmet treatment need. [ABSTRACT FROM AUTHOR]

Aims To examine the transitions in smoking status among non-daily smokers who transitioned to daily or former smokers or remained as non-daily smokers during a 12-month period. We analyzed factors associated with these transitions, including the use of cigars and smokeless tobacco (SLT). Design Secondary data analyses using pooled data from the 2003, 2006/07 and 2010/11 Tobacco Use Supplements to the Current Population Survey (TUS-CPS). Setting United States. Participants Self-respondents aged 18+ who have smoked for more than 5 years and were non-daily smokers 12 months before the interview ( n = 13 673, or 14.5% of current smokers). Measurements Multinomial logistic regression model to determine the correlates of non-daily to daily, stable non-daily and non-daily to former smoking transitions among non-daily smokers at baseline. The model controlled for socio-demographic factors and the use of cigars and SLT. Findings Of the adults in our sample, 2.6% were non-daily smokers at baseline. Among these, 69.7% remained non-daily smokers (stable non-daily smokers), 18.4% became daily smokers (non-daily to daily smokers) and 11.9% quit smoking (non-daily to former smokers) after 12 months. The non-daily to daily versus stable non-daily smoking transition was less likely among those who were aged 65+ ( P = 0.018), male ( P < 0.001), Hispanic ( P < 0.001), with an income of $25 000-49 999 or ≥$75 000 and current users of SLT ( P = 0.003), but more likely among those without a college degree compared with the appropriate reference group. The non-daily to former versus stable non-daily smoking transition was less likely among those aged 25+, male ( P = 0.013), non-Hispanic Asian ( P = 0.032), without a college degree, widowed/divorced/separated ( P = 0.013) or never married ( P = 0.011) and current users of cigars ( P = 0.003) compared with the appropriate reference group. Conclusions While more than two-thirds of non-daily smokers in the United States remain as such after 12 months, others become daily smokers or quit. The likelihood of remaining stable non-daily smokers and of transition from non-daily to daily and non-daily to former smokers is associated with socio-demographic factors and current use of cigars and smokeless tobacco. [ABSTRACT FROM AUTHOR]

Background and aims Contingency management (CM) is one of the most effective behavioral interventions to promote drug abstinence, but availability of this treatment is limited. We evaluated the efficacy and acceptability of internet-based CM relative to an internet-based monitoring and goal-setting control group in a nationwide sample of cigarette smokers. Design Randomized controlled trial with 3- and 6-month follow-ups. Setting United States. Participants Smokers ( n = 94) from 26 states were enrolled (mean age 36, 56% female). Intervention and comparator Participants were randomized to earn financial incentives (up to $480 over 7 weeks) based on video-verified abstinence using breath carbon monoxide (CO) output ( n = 48; abstinent contingent group, AC), or based on submitting CO samples ( n = 46, submission contingent, SC). Both groups also received the same CO-based goals. A $50 deposit was required in both groups that could be recouped from initial earnings. Measures The primary outcome was point prevalence at week 4. Secondary outcomes were point prevalence at the 3- and 6-month follow-ups, percentages of negative CO samples, adherence to the CO sampling protocol, and treatment acceptability ratings on a 0-100-mm visual analog scale. Findings Abstinence rates differed at 4 weeks between the AC (39.6%) and SC (13.0%) groups [odds ratio (OR) = 4.4, 95% confidence interval (CI) = 1.6-12.3], but not at the 3- (29.2% AC and 19.6% SC, OR = 1.7, 95% CI = 0.6-4.4) or 6- (22.9% AC and 13.0% SC, OR = 2.0, 95% CI = 0.7-5.9) month follow-ups. During the two main treatment phases, there were significant differences in negative COs (53.9% AC and 24.8% SC, OR = 3.5, 95% CI = 3.1-4.0; 43.4% AC and 24.6% SC, OR = 2.3, 95% CI = 1.6-3.4). Adherence to the CO submission protocol was equivalent (78% AC and 85% SC, difference = 7.0%, 95% CI = −10.3 to 23.8 %, F < 1, P = 0.39). The lowest acceptability ratings were for the items assessing the deposit, whereas the highest ratings concerned the ease of the intervention, the graph of CO results, and earning money. Conclusions A contingency management/financial incentive program delivered via the internet improved short-term abstinence rates compared with an internet program without the incentives. [ABSTRACT FROM AUTHOR]

Background Alcohol consumption patterns on the U.S.-Mexico border and their relationships with DSM-5 alcohol use disorders ( AUD) have been understudied. Yet, the effects of drinking by Mexican-origin individuals may differ between cities on versus off the border both in the United States and in Mexico. We characterize prior 12-month drinking patterns and examine their relationships with AUD, in border and off-border cities of Texas and adjacent Mexican states. Methods Data come from the U.S.-Mexico Study of Alcohol and Related Conditions involving 2,336 Mexican Americans in Texas and 2,460 Mexicans in bordering states of Nuevo Leon and Tamaulipas in Mexico. Drinking pattern was defined as an interaction between volume and maximum amount, or intensity (never vs. ever 5+/4+ [men/women], 8+, and 12+ drinks in a day). DSM-5 AUD was assessed using an adaptation of the Alcohol Section of the World Health Organization Composite International Diagnostic Interview core. Separately by gender, 5 logistic regressions models controlling for age were estimated predicting symptoms in 2 or more AUD criteria domains from volume, heavy pattern and, successively, effects of country, and (by country) residing on vs. off the border, or in each of 3 cities/country. Results A segmentation analysis for Texas males based on rate of experiencing AUD generated several distinct volume groups, each partitioned by an empirically selected maximum, and helped identify a drinking-pattern typology. In gender-stratified models of AUD rates using this typology, adjusting for age, significant volume and intensity effects were seen, more strongly in the United States. Border versus interior differences implied more AUD for given patterns at the border in the United States and the reverse in Mexico, with some city differences also evident. Conclusions Drinking-pattern analyses confirm that border proximity may affect drinking problems but in opposite directions in the United States and Mexico, possibly related to economic and psychological stresses specific to respective communities. [ABSTRACT FROM AUTHOR]

This study investigated whether participating in inter-organisational (i.e. self-directed, non-strategic) employee volunteering, which is common but rarely studied, is associated with increased organisational commitment. We find evidence for this relation in a sample ( N = 385) of employee volunteers and their non-volunteering co-workers. We statistically account for self-selection into the volunteering program by incorporating individual motives for volunteering. Volunteers compared to non-volunteers exhibited relatively stronger motives of expressing altruistic values and avoiding negative affect, but a weaker motive of attaining career advancement. Our findings point to an efficient way of increasing organisational commitment that is relatively inexpensive to implement. They also complement existing research from other employee volunteering contexts, pointing to a possible trade-off between the desired outcomes of effectively managing volunteering programs. [ABSTRACT FROM AUTHOR]

Background Posttraumatic stress disorder ( PTSD) and alcohol use disorder disproportionately impact certain populations including American Indians/Alaska Natives ( AIAN). While PTSD and alcohol use disorder have been studied both separately and in tandem, less is known about the association in AIAN. The objective was to examine the association between lifetime PTSD and past year alcohol use disorder among AIAN and non-Hispanic Whites ( NHW). Methods Data come from the 2012 to 2013 U.S. National Epidemiologic Survey on Alcohol and Related Conditions- III. We used logistic regression to estimate odds of AUD among adults with and without PTSD by race. Results A total of 19,705 participants, of whom 511 were AIAN and 19,194 were NHW, were included in this study. The percentage of PTSD among AIAN was 22.9% ( n = 117) compared to 11.7% ( n = 2,251) in NHW ( p-value <0.0001). The percentage of past year alcohol use disorder among AIAN was 20.2% ( n = 103) compared to 14.2% ( n = 2,725) in NHW ( p-value <0.0001). The percentage of comorbid past year alcohol use disorder with lifetime PTSD among AIAN was 6.5% ( n = 33) compared to 2.4% ( n = 457) in NHW ( p-value <0.0001). Regarding the joint distribution of PTSD and AUD, AIAN men have greater than 3 times the percentage compared to NHW men (9.5% vs. 3.1%). When stratifying by race (after adjusting for age, sex, depression, and education), among AIAN, the odds of past year alcohol use disorder with (vs. without) lifetime PTSD were 1.76 (95% CI 1.07, 2.90) and among NHW, the odds were 1.59 (95% CI 1.41, 1.80). Conclusions PTSD is significantly associated with alcohol use disorder in the study populations. Despite a lack of pre- PTSD measures of alcohol use disorder, these findings show a trend indicating that AIAN exposed to PTSD are more burdened with alcohol use disorder compared to NHW in the general U.S. population. [ABSTRACT FROM AUTHOR]

Aims To compare the acute effects of alcohol on set-shifting task performance (relative to sober baseline performance) during ascending and descending limb breath alcohol concentration (BrAC), as well as possible moderation of these effects by baseline individual differences. Design Shifting performance was tested during an initial baseline and a subsequent drinking session, during which participants were assigned randomly to one of three beverage conditions (alcohol, placebo or control) and one of two BrAC limb conditions [ascending and descending (A/D) or descending-only (D-only)]. Setting A human experimental laboratory on the University of Missouri campus in Columbia, MO, USA. Participants A total of 222 moderate-drinking adults (ages 21-30 years) recruited from Columbia, MO and tested between 2010 and 2013. Measurements The outcome measure was performance on set-shifting tasks under the different beverage and limb conditions. Shifting performance assessed at baseline was a key moderator. Findings Although performance improved across sessions, this improvement was reduced in the alcohol compared with no-alcohol groups (post-drink latent mean comparison across groups, all Ps ≤ 0.05), and this effect was more pronounced in individuals with lower pre-drink performance (comparison of pre- to post-drink path coefficients across groups, all Ps ≤ 0.05). In the alcohol group, performance was better on descending compared with ascending limb ( P ≤ 0.001), but descending limb performance did not differ across the A/D and D-only groups. Conclusions Practising tasks before drinking moderates the acute effects of alcohol on the ability to switch between tasks. Greater impairment in shifting ability on descending compared with ascending breath alcohol concentration is not related to task practice. [ABSTRACT FROM AUTHOR]

Aims To conduct a cost-effectiveness analysis (CEA) comparing the delivery of brief intervention (BI) with brief treatment (BT) within Screening, Brief Intervention and Referral to Treatment (SBIRT) programs. Design Quasi-experimental differences in observed baseline characteristics between BI and BT patients were adjusted using propensity score techniques. Incremental comparison of costs and health outcomes associated with BI and BT. Setting Health-care settings in four US states participating in Substance Abuse and Mental Health Services Administration SBIRT grant programs. Participants Ninety patients who received BT and 878 who received BI. Measurements Per-patient cost of SBIRT, patient demographics and six measures of substance use: proportion using alcohol, proportion using alcohol to intoxication, days of alcohol use, days of alcohol use to intoxication, proportion using drugs and days using drugs. Findings BI and BT were associated with better outcomes. The cost of SBIRT was significantly higher for BT patients ($75.54 versus 16.32, 95% confidence interval, P < 0.01). BT would be cost-effective if the decision-maker had a willingness to pay of $8.90 for a 1 percentage point reduction in the probability of using any alcohol. For the other five outcomes, BT was less effective and more costly, and BI would be a better use of resources. Conclusions It might be cost-effective to offer brief treatment if the goal is to abstain from alcohol. However, the higher effectiveness of brief treatment for this outcome is associated with considerable uncertainty and, because both brief intervention and brief treatment improve all outcomes, brief treatment does not appear to be a good use of resources. [ABSTRACT FROM AUTHOR]

Introduction: Data regarding catheter ablation of atrial fibrillation (AF) in patients with chronic kidney disease (CKD) is limited. We therefore assessed the association of CKD with common safety and clinical outcomes in a nationwide sample of ablation recipients. Methods: UsingMarketScanR® Commercial Claims and Medicare Supplemental Databases, we evaluated 30-day safety and 1-year clinical outcomes in patients who underwent a first AF ablation procedure between 2007 and 2011. We calculated frequency of common 30-day complications and calculated frequencies, incidence rates, and Cox proportional hazards for outcomes at 1-year postablation. Results: Of 21,091 patients included, 1,593 (7.6%) had CKD. Patients with CKD were older (64 years vs. 59 years, P < 0.001) with higher CHA2DS2-VASc scores (3.2 vs. 1.8, P < 0.001). At 30 days postablation, patients with CKD had similar rates of stroke/TIA (0.13% vs. 0.13%, P = 0.99), perforation/tamponade (3.2% vs. 3.1%, P = 0.83), and vascular complications (2.4% vs. 2.2%, P = 0.59) as patients without CKD, but were more likely to be hospitalized for heart failure (2.1% vs. 0.4%, P < 0.001). In multivariate analysis, there were no significant differences in hazards of AF hospitalization (adjusted HR: 1.02, 95%CI: 0.87-1.20), cardioversion (adjusted HR: 0.99, 95%CI: 0.87-1.12), or repeat AF ablation (adjusted HR: 0.89, 95%CI: 0.76-1.06) at 1 year. Conclusions: Among patients selected for AF ablation, those with and without CKD had similar rates of postprocedural complications although they were more likely to be re-admitted for heart failure. CKD was not independently associated with AF hospitalization, cardioversion, and repeat ablation. These findings can inform clinical decision-making in patients with AF and CKD. [ABSTRACT FROM AUTHOR]

Aims To test whether exposure to party-related alcohol advertising is associated with drinking behavior in a national US sample of adolescents and young adults, independently of exposure to other alcohol advertising. Design Longitudinal telephone- and web-based surveys conducted in 2011 and 2013. Setting All regions of the United States, participants selected via mixed-mode random-digit-dial landline and cellphone frames. Participants A sample of 705 respondents who never had a whole drink of alcohol at baseline (mean age 16.9 years, 53.3% female) and a sample of 1036 who never had six or more drinks during one drinking occasion (mean age 17.4 years, 55.8% female). Measurements Outcome measures were onset of alcohol use and binge drinking during the study interval. Primary predictor was exposure to television alcohol advertising, operationalized as contact frequency and brand recall for 20 randomly selected alcohol advertisements. Independent post-hoc analyses classified all advertisements as 'party' or 'non-party' advertisements. Socio-demographics, sensation-seeking, alcohol expectancies and alcohol use of friends and family were assessed as covariates. Findings Onset rates for having the first whole drink of alcohol and for first binge drinking were 49.2% and 29.5%, respectively. On average, approximately half (median = 10.2) of the 20 alcohol advertisements in each individual survey were 'party' advertisements. If both types of exposures ('party' and 'non-party') were included in the regression model, only 'party' exposure remained a significant predictor of alcohol use onset [adjusted odds ratio (AOR) = 19.17; 95% confidence interval (CI) = 3.72-98.79] and binge drinking onset (AOR = 3.87; 95% CI = 1.07-13.99) after covariate control. Conclusions Adolescents and young adults in the United States appear to have higher rates of alcohol use and binge drinking onset if they have higher exposure to alcohol advertisements using a partying theme, independently of the amount of exposure to alcohol advertisements with non-party themes. [ABSTRACT FROM AUTHOR]

Aims To test whether, in comparison to usual care, brief motivational or reduction interventions increase quit attempts (QA) or abstinence among smokers who are not ready to quit. Design A parallel-group randomized controlled trial of brief motivational ( n = 185), reduction ( n = 186) or usual care ( n = 189) telephone interventions delivered over the course of 4 weeks. Outcomes were assessed at 6- and 12-month follow-ups. No medication was provided. Setting United States. Participants A total of 560 adult smokers of ≥ 10 cigarettes per day who were not ready to quit in the next 30 days. Measurements The primary outcomes were whether participants made a QA that lasted ≥ 24 hours and whether they made a QA of any length between baseline and 6 months. Secondary outcomes included 7-day point-prevalence abstinence at 6 and 12 months. The 12-month follow-up was added after the study began. Findings A priori-defined comparisons were between motivational versus usual care and reduction versus usual care conditions. The probability of making a QA that lasted ≥ 24 hours was not significantly different between the motivational (38%) or the reduction (31%) conditions and the usual care (34%) condition [motivational versus usual care odds ratio (OR) = 1.19, 95% confidence interval (CI) = 0.78-1.82; reduction versus usual care OR = 0.89, 95% CI = 0.57-1.36]. Bayes factors ranged from 0.13 to 0.18. Findings regarding a QA of any length were similar. At 6 months, the motivational condition had marginally more abstinence than usual care (11 versus 5%, OR = 2.17, 95% CI = 0.99-4.77), but the reduction condition was not significantly different from usual care (8 versus 5%, OR = 1.57, 95% CI = 0.69-3.59). At 12 months, the motivational condition had significantly more abstinence than usual care (10 versus 4%, OR = 2.80, 95% CI = 1.14-6.88) and the reduction condition had marginally more abstinence than usual care (9 versus 4%, OR = 2.45, 95% CI = 0.98-6.09). Conclusions Among adult smokers who are not ready to quit, both logistic regression and Bayesian analysis indicate that neither motivational nor reduction-based telephone interventions increased the odds of making a quit attempt in comparison to usual care at 6 months. The motivational intervention appeared to increase abstinence at 6 months and did increase abstinence at 12 months. The reduction intervention did not increase abstinence at 6 months but appeared to increase abstinence at 12 months. [ABSTRACT FROM AUTHOR]

Aims To identify the developmental course of non-medical use of four separate prescription drug classes (opioids, sedatives, stimulants and tranquilizers) by examining the general functional growth and related covariates during the transition from adolescence to adulthood in the United States. Design Nationally representative probability samples of high school seniors were followed longitudinally across five waves (waves 1, 2, 3, 4 and 5: modal ages 18, 19/20, 21/22, 23/24 and 25/26 years, respectively). Setting Data were collected via self-administered questionnaires to high school seniors and young adults in the United States. Participants The sample consisted of nearly 72 000 individuals in 30 cohorts (high school senior years of 1977-2006) who participated in at least one wave. Measurements Self-reports of annual non-medical use of prescription opioids, sedatives, stimulants, and tranquilizers. Findings The annual non-medical use of prescription opioids, sedatives, stimulants and tranquilizers was highest at wave 1 over the five waves. There was a consistent descending path (linear and quadratic slopes, P < 0.001) in annual non-medical use from baseline across all four prescription drug classes (e.g. opioids linear slope = −0.043 and opioids quadratic slope = 0.034, P < 0.001). While the annual non-medical use of stimulants declined over time (linear slope = 0.063, P < 0.01; quadratic slope = −0.133, P < 0.001), the same decrease was not observed for the annual non-medical use of prescription opioids, sedatives or tranquilizers when controlling for socio-demographic and substance use behaviors at baseline. The covariates associated with the general functional growth differed across the four prescription drug classes. Conclusions The non-medical use of prescription opioids, sedatives, stimulants and tranquilizers appears to peak during late adolescence, suggesting preventive intervention efforts should be initiated in early adolescence. The developmental course of non-medical use is not the same among all four classes of prescription drugs, suggesting that each drug class warrants individual research. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Childhood obesity is a major public health concern. Children with disabilities have a higher prevalence of obesity. OBJECTIVE We examined factors associated with obesity within a cross-sectional study of US adolescents with and without disabilities. METHODS Data were obtained from the 2011 Youth Risk Behavior Survey. Logistic regression models were fitted to assess effects of dietary habits, physical activity, and unhealthy weight control behaviors on obesity. Effect modification by disability status was examined. RESULTS Twenty percent (1986 of 9775 participants) reported a disability. Adolescents with disabilities were more likely to be obese (odds ratio [ OR] = 1.7; 95% confidence interval [ CI]: 1.3-2.1) and have at least 1 unhealthy weight control behavior ( OR = 2.0; 95% CI: 1.6-2.5), and were less likely to be physically active ( OR = 0.5; 95% CI: 0.4-0.6). Lack of physical activity, increased television watching/video game playing, and unhealthy weight loss behaviors were significantly associated with obesity regardless of disability status (p-for-interaction >.05). CONCLUSIONS Successful obesity interventions should target diet, physical activity, and weight control among adolescents with disabilities. Understanding barriers to healthier diet and physical activity for this population is critical to developing effective obesity prevention programs and reducing the prevalence of unhealthy weight control behaviors. [ABSTRACT FROM AUTHOR]

Aims To determine whether abstinence or relapse on a quit attempt in the previous year is associated with current depressive symptoms. Design Prospective cohort with approximately annual waves. Mixed-effect logistic regressions tested whether time 2 (T2) quitting status was associated with reporting symptoms at T2, and whether time 1 (T1) symptoms moderated this relationship. Setting Waves 5-8 of the Four-Country International Tobacco Control Study: a quasi-experimental cohort study of smokers from Canada, the United States, the United Kingdom and Australia. Participants A total of 6978 smokers who participated in telephone surveys. Measurements T1 and T2 depressive symptoms in the last 4 weeks were assessed with two screening items from the PRIME-MD questionnaire. Quitting status at T2: (1) no attempt since T1; (2) attempted and relapsed; and (3) attempted and abstinent at T2. Findings Compared with no attempt, relapse was associated with reporting T2 symptoms [odds ratio (OR) = 1.46, 95% confidence interval (CI) = 1.33, 1.59]). Associations between T2 quitting status and T2 symptoms were moderated by T1 symptoms. Relapse was associated positively with T2 symptoms for those without T1 symptoms (OR = 1.71, 95% CI = 1.45, 2.03) and those with T1 symptoms (OR = 1.45, 95% CI = 1.23, 1.70). Abstinence was associated positively for those without T1 symptoms (OR = 1.37, 95% CI = 1.10, 1.71) and negatively for those with T1 symptoms (OR = 0.74, 95% CI = 0.59, 0.94). Age moderated these associations significantly. Relapse did not predict T2 symptoms for those aged 18-39 irrespective of T1 symptoms. The negative effect of abstinence on T2 symptoms for those with T1 symptoms was significant only for those aged 18-39 (OR = 0.61, 95% CI = 0.40, 0.94) and 40-55 (OR = 0.58, 95% CI = 0.40, 0.84). The positive effect of abstinence on T2 symptoms for those without T1 symptoms was significant only for those aged more than 55 (OR =1.97, 95% CI = 1.35, 2.87). Conclusions Most people who stop smoking appear to be at no greater risk of developing symptoms of depression than if they had continued smoking. However, people aged more than 55 who stop smoking may be at greater risk of developing symptoms of depression than if they had continued smoking. [ABSTRACT FROM AUTHOR]

The current UK Department of Health advice is to introduce solid foods to infants at around 6 months of age, when the infant is showing signs of developmental readiness for solid foods. However, many mothers introduce solid foods before this time, and for a wide variety of reasons, some of which may not promote healthy outcomes. The aim of the current study was to examine infant and maternal characteristics associated with different reasons for introducing solid foods. Seven hundred fifty‐six mothers with an infant aged 6–12 months old completed a questionnaire describing their main reason for introducing solid foods alongside demographic questions, infant weight, gender, breast/formula feeding and timing of introduction to solid foods. The majority of mothers introduced solid foods for reasons explicitly stated in the Department of Health advice as not signs of readiness for solid foods. These reasons centred on perceived infant lack of sleep, hunger or unsettled behaviour. Maternal age, education and parity, infant weight and gender and breast/formula feeding choices were all associated with reasons for introduction. A particular association was found between breastfeeding and perceiving the infant to be hungrier or needing more than milk could offer. Male infants were perceived as hungry and needing more energy than female infants. Notably, signs of readiness may be misinterpreted with some stating this reason for infants weaned prior to 16 weeks. The findings are important for those working to support and educate new parents with the introduction of solid foods in understanding the factors that might influence them. [ABSTRACT FROM AUTHOR]

Background: There is a critical need to understand better speech and language development in bilingual children learning two spoken languages who use cochlear implants (CIs) and hearing aids (HAs). The paucity of knowledge in this area poses a significant barrier to providing maximal communicative outcomes to a growing number of children who have a hearing loss (HL) and are learning multiple spoken languages. In fact, the number of bilingual individuals receiving CIs and HAs is rapidly increasing, and Hispanic children display a higher prevalence of HL than the general population of the United States. In order to serve better bilingual children with CIs and HAs, appropriate and effective therapy approaches need to be designed and tested, based on research findings. Aims: This study investigated the effects of supporting both the home language (Spanish) and the language of the majority culture (English) on language outcomes in bilingual children with HL who use CIs and HAs as compared to their bilingual peers who receive English-only support. Methods & Procedures: Retrospective analyses of language measures were completed for two groups of Spanishand English-speaking bilingual children with HL who use CIs and HAs matched on a range of demographic and socio-economic variables: those with dual-language support versus their peers with English-only support. Dependent variables included scores from the English version of the Preschool Language Scales, 4th Edition. Outcomes & Results: Bilingual children who received dual-language support outperformed their peers who received English-only support at statistically significant levels as measured by Total Language and Expressive Communication as raw and language age scores. No statistically significant group differences were found on Auditory Comprehension scores. Conclusions & Implications: In addition to providing support in English, encouraging home language use and providing treatment support in the first language may help rather than hinder development of both English and the home language in bilingual children with HL who use CIs and HAs. In fact, dual-language support may yield better overall and expressive English language outcomes than English-only support for this population. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Studies have assessed health in schoolchildren. Less is known about the environmental and occupational health of teachers. METHODS A cross-sectional survey of teachers was conducted in 24 randomly selected public elementary schools. Questionnaire included sociodemographic information, healthcare, school conditions, and health outcomes. Chi-square and logistic regression were used to analyze bivariate relationships. Multivariable logistic regression model was created for each health outcome, adjusted for sex and smoking to calculate estimates of association ( OR) for variables that were significant in bivariate analysis. RESULTS Response rate was 71.2 % (N = 797). Classroom conditions significantly associated with respiratory symptoms included having no windows or windows that do not open were associated with asthma or colds ( OR 2.0); carpeting was associated with having asthma, itchy eyes, and eye irritation ( OR 1.9); mold or water damage was associated with respiratory infections, eye irritation ( OR 2.1), nasal congestion ( OR 2.4), and sore throat ( OR 2.7); visible dust was associated with frequent colds ( OR 2.2), nasal congestion ( OR 1.7), and sore throat (1.9). CONCLUSIONS Asthma, respiratory infections, colds, eye irritation, nasal congestion, and sore throat were associated with the classroom environment. Results indicate that the school environment could affect teachers' respiratory health. Further assessments are necessary to establish causation. [ABSTRACT FROM AUTHOR]

Background Despite the prevalence of fetal alcohol spectrum disorders (FASD) and the importance of accurate identification of patients, clinical diagnosis may not be consistent across sites due to the heterogeneous nature of FASD and the characteristics of different diagnostic systems used. Here, we compare 5 systems designed to operationalize criteria recommended for the diagnosis of effects of prenatal alcohol exposure ( PAE). We determined the extent of consistency among them as well as factors that may reduce intersystem reliability. Compared are: Emory Clinic, Seattle 4-Digit System (Diagnostic Guidelines for Fetal Alcohol Spectrum Disorders: The 4-Digit Diagnostic Code, Seattle, WA, University Publication Services, 2004), Centers for Disease Control and Prevention (Fetal Alcohol Syndrome: Guidelines for Referral and Diagnosis, Department of Health and Human Services, Centers for Disease Control and Prevention, Atlanta, GA, 2004), Canadian Guidelines (CMAJ, 172, 2005, S1), and the Hoyme Modifications (Pediatrics, 115, 2005, 39). Methods Subjects were 1,581 consecutively registered patients applying for evaluation at a university-based clinic treating alcohol and drug-exposed children. Records of the multidisciplinary evaluation (pediatric, social, psychological) were abstracted. Diagnostic criteria for all 5 systems were applied, and patients were diagnosed according to each of the systems. We compared results using Cohen's Kappa to evaluate the extent of agreement. Results Percent of individuals diagnosed with FASD ranged from 4.74% ( CDC) to 59.58% (Hoyme). Examination using Cohen's Kappa found modest agreement among systems, particularly when individual diagnoses, Fetal Alcohol Syndrome ( FAS), partial FAS ( pFAS), and Alcohol-Related Neurodevelopmental Disorder ( ARND) were used. Examination of diagnostic criteria found almost perfect agreement on growth (weight; height), with limited overlap for physical features (palpebral fissures, hypoplastic philtrum, upper vermillion) and for neurobehavioral outcomes. Child's race and age influenced agreement among systems, with African American and older children more frequently diagnosed. Conclusions Results suggest problems in convergent validity among these systems, as demonstrated by a lack of reliability in diagnosis. Absence of an external standard makes it impossible to determine whether any system is more accurate, but outcomes do suggest areas for future research that may refine diagnosis. [ABSTRACT FROM AUTHOR]

Background There is considerable variation in alcohol use and problems across the United States, suggesting that systematic regional differences might contribute to alcohol involvement. Several neighborhood contextual factors may be important aspects of this 'alcohol environment.' Methods Participants were 15,197 young adults (age 18 to 26) from Wave III of the National Longitudinal Study of Adolescent to Adult Health, a nationally representative U.S. survey. Measures of past-year alcohol use and problems were obtained via structured in-home interviews. Tract-level neighborhood contextual factors (density of on- and off-premises alcohol outlets, neighborhood disadvantage, rural vs. urban residence) were derived from census indicators and geocoded state-level alcohol outlet licenses. Multivariate logistic regression, ordered logistic regression, or negative binomial regression models, including age, sex, race, and household income as covariates, were fit to examine the relation of the neighborhood contextual factors with alcohol use and problems. Results The most consistent finding across 4 of the 5 measures of alcohol involvement was their association with neighborhood advantage; the active ingredient underlying this effect was primarily the proportion of educated residents in the neighborhood. The densities of alcohol outlets were associated with any alcohol use-they were not associated with binge drinking or alcohol problems, nor could they explain any of the neighborhood advantage effects. The influence of alcohol outlet densities on alcohol involvement did not differ for those above or below the legal age to purchase alcohol. Living in a rural versus an urban neighborhood was associated with a different alcohol use pattern characterized by a lower likelihood of any drinking, but among those who drank, consuming more alcohol per occasion. Conclusions Living in a more advantaged and educated urban neighborhood with greater densities of bars and restaurants is associated with greater alcohol involvement among 18- to 26-year-olds in the United States. [ABSTRACT FROM AUTHOR]

Background Children with autism spectrum disorder (ASD) experience a range of severity levels characterised as levels of support they need for everyday functioning. By this definition, greater levels of severity should warrant greater use of services and supports among children with ASD. In previous studies, Latino children with ASD in the USA have been shown to have lower access to diagnosis and treatment services than White children. However, none have examined service use in relation to severity. In this study, we examined whether there are ethnic disparities between Latino and White children with ASD in specialty autism-related services, and whether functional severity moderates the relationship between ethnicity and receipt of autism services. Methods We used data from the Survey of Pathways to Diagnosis and Services, a supplement to the National Survey of Children with Special Health Care Needs and analysed four specialty services commonly used by children with ASD, adjusting for demographic variables. Results We found that Latino children with ASD who had severe limitations received fewer specialty autism-related services than White children with similarly severe conditions. These disparities were evident despite the fact that the sample of Latino children in these data were more privileged than the general US Latino population. Conclusion Assertive policy initiatives are needed to address these disparities and ensure that these highly vulnerable children with severe functional limitations receive appropriate services and supports. [ABSTRACT FROM AUTHOR]

Background This research extends prior epidemiological estimates for the United States and re-examines a previously described male excess in alcohol drinking. Its aim was to estimate fine-grained age-specific incidence of becoming a drinker among 12- to 24-year-old U.S. males and females, and to compare incidence estimates with prevalence proportions. Methods The study population is 12- to 24-year-old noninstitutionalized U.S. civilian residents. Estimates are from 12 successive U.S. National Surveys on Drug Use and Health ( NSDUH), with nationally representative samples drawn each year from 2002 to 2013 and assessed via computer-assisted self-interviews ( n ~ 390,000). Analysis-weighted incidence and prevalence estimates are generated using the NSDUH Restricted Data Analysis System for 6 year-pairs. Meta-analysis-derived summary estimates are provided, treating each year-pair as a replication. Results In this 21st century evidence, there no longer is male excess of incidence with respect to underage drinking. Indeed, in mid-adolescence, there is a clear female excess for the risk of becoming an underage drinker. Meta-analytic summaries disclosed no other male-female differences in incidence. Nevertheless, a male excess in the prevalence of recently active drinking can be seen after the age of 19 years. Conclusions This new evidence from the United States shows that the so-called 'gender gap' in risk of becoming a drinker has narrowed to the point of there being no gap at all. Indeed, in mid-adolescence, risk of starting to drink is greater for females than for males. [ABSTRACT FROM AUTHOR]

Background Reducing the nicotine content in cigarettes could improve public health by reducing smoking and toxicant exposure, but may also have unintended consequences on alcohol use. The primary objective of this study was to examine the effect of reducing the nicotine content in cigarettes on alcohol outcomes. The secondary aim was to examine whether the effects of these cigarettes on alcohol outcomes were mediated by changes in nicotine exposure, smoking behavior, or withdrawal. Methods Between June 2013 and July 2014, we conducted a 7-arm, double-blind, randomized clinical trial at 10 U. S.-based sites. Daily smokers not currently interested in quitting ( n = 839) were assigned to equally sized groups to smoke for 6 weeks cigarettes containing either normal nicotine content ( NNC; 15.8 mg/g, 9 mg tar), moderate nicotine content (5.2 mg/g nicotine, 9 mg tar), or very low nicotine content ( VLNC; 0.4 to 2.4 mg/g, 9 to 13 mg tar). This investigation focused on a subsample of current drinkers ( n = 403). Each reduced nicotine content cigarette condition was compared to the NNC control condition with respect to trajectories over the 6-week period of average daily alcohol use and occurrence of binge drinking. Moderating variables were considered. Mediation analyses tested potential explanatory processes including changes in nicotine exposure, cigarettes per day, and withdrawal. Results Over time, reduced nicotine exposure and smoking rate mediated effects of VLNC cigarette use on reduced alcohol use. There was no evidence of compensatory drinking in response to nicotine reduction or nicotine withdrawal, even among subgroups expected to be at greater risk (e.g., relatively heavier drinkers, highly nicotine-dependent individuals). Conclusions The findings suggest that compensatory drinking is unlikely to occur in response to switching to VLNC cigarettes. In contrast, reducing the nicotine content of cigarettes may reduce alcohol use (clinicalTrials.gov number, NCT01681875). [ABSTRACT FROM AUTHOR]

Background Latinas have high overall breastfeeding initiation rates, yet Puerto Ricans have among the lowest exclusive breastfeeding rates. This study sought to determine if acculturation was associated with intent to breastfeed in a predominantly Puerto Rican population. Methods A cohort of Latina women were enrolled in Proyecto Buena Salud, and provided information on infant feeding intent ( n = 1,323). Acculturation was assessed via the Psychological Acculturation Scale ( PAS), language preference, and generation in the United States. Results Increasing acculturation as measured by English language preference ( aOR 0.61 [95% CI 0.42-0.88]) and second or third generation in the United States ( aOR 0.70 [95% CI 0.52-0.95)] was inversely associated with odds of intending to exclusively breastfeed. Similarly, women with higher levels of acculturation as measured by the PAS ( aOR 0.67 [95% CI 0.45-0.99]), English language preference ( aOR 0.48 [95% CI 0.33-0.70]) and second or third generation in the United States ( aOR 0.42 [95% CI 0.31-0.58]) were less likely to report intent to combination feed as compared with women with lower acculturation. Conclusions Acculturation was inversely associated with intent to exclusively breastfeed and intent to combination feed in this predominantly Puerto Rican sample. [ABSTRACT FROM AUTHOR]