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Although menthol cigarettes are a starter product for youth, menthol was exempted from the 2009 Tobacco Control Act, which banned all other characterizing flavors. Minneapolis and Duluth, Minnesota, implemented menthol tobacco sales restrictions in 2018 to advance health equity for youth, African American, lesbian, gay, bisexual, trans, and queer (LGBTQ), and other communities adversely affected by menthol. This evaluation assesses the policy impact on youth access to menthol tobacco, exposure to menthol advertising, and tobacco use. A core group of youth aged 14 to 17 years (n = 30) was recruited from Minneapolis and Duluth to gather data through photo voice and peer interviews 2 months before and after policy implementation. This evaluation shares the results of focus groups with these core youth where they reflected on what they observed in the community and heard from peers. The core youth identified and categorized emergent themes using the evaluation questions. Following the focus groups, the evaluation staff used these preliminary themes and coded remaining transcripts. The core youth had mixed reactions to the impact of policies on access and use because many tobacco users in their age group obtain tobacco informally through peers, family members, and online. They observed decreases in retail advertising of menthol cigarettes, although many felt e-cigarettes and online advertising were more significant issues for their age group. Findings show a need for increased education and more comprehensive policy approaches, including addressing use of flavored e-cigarettes, online tobacco sales, and informal access, making youth access to tobacco more difficult.

Research shows that homeless youth are uniquely vulnerable to commercial sexual exploitation (CSE). But what are young adult perspectives on definitions and pathways of CSE? We analyze focus group data from participatory research with a homeless youth-serving agency. Participants were a ethnically diverse sample/ethnically diverse sample of twenty four female-identifying young adults (ages 18–23) receiving services. Some perceptions of the participants were consistent with previously documented pathways into CSE. But, important novel themes emerged, including: sexual exploitation as a continuum of sexually explicit interactions (i.e. stripping, fetish, survival sex, trafficking); ever-present conversations and decision-making about CSE in homeless youth and young adult culture; and the paradoxical issue that service-seeking around homelessness and overt identification of CSE victims can target them for greater victimization.

Go-along interviews, which are interviews conducted whilst being in and moving within participant selected spaces, were conducted with 66 LGBTQ adolescents (14-19 years old) in their self-identified communities to explore perceived community attributes, including safe spaces, resources, and supports; this paper highlights methodological lessons learned. Successful recruitment in two countries and varied community settings required partnership with local LGBTQ supporting agencies, including school-based Gay Straight Alliances. Youth chose to walk, use public transportation, and drive to community locations, identifying numerous formal and informal resources in their communities. Participant reflections highlighted that go-along interviews can be conducted in safe ways that encourage LGBTQ youth to express themselves about communities in which they live, study, work, play, and relax.

An important limitation of antireflux surgery is a 5%-10% failure rate. We investigated the correlation between various diaphragm stressors and failure of antireflux surgery. Forty-one study cases who underwent a reoperative antireflux operation from 1997 to 2001 and 50 control patients who had undergone a successful laparoscopic Nissen fundoplication during the same period without clinical or symptomatic evidence of failure were randomly selected for comparison. A retrospective analysis was conducted utilizing a standardized diaphragm stressor questionnaire, addressing the period between the primary and secondary operation. Stressors considered in the study included height, body mass index (BMI), postoperative gagging, vomiting, weight lifting (greater than 100 pounds), coughing, hiccuping, motion sickness, retching, belching, antidepressant use, smoking, preoperative grade of esophagitis, size of hiatal hernia, lower esophageal sphincter pressure, esophageal body pressures, and preoperative response to proton pump inhibitors. Of the potential stressors investigated, the following were significantly associated with surgical failure after adjusting for other variables through multivariate analysis: gagging (P = 0.005), belching (P = 0.02), and hernia size greater than 3 cm (P = 0.04; Table 1). Other potential risk factors show trends as obvious in Fig. 2. Vomiting was significant (P = 0.01) in the earlier models but lost significance when logistic regression was applied. Patients with postoperative gagging and an intraoperative hiatal hernia (greater than 3 cm) have a poorer outcome, whereas patients with postoperative belching have a better long-term outcome.

The majority of febrile neonates have negative bacterial cultures and presumed viral infections. During November 2014, four febrile neonates in southeastern Wisconsin required intensive care admission for human parechovirus (HPeV) infection in the blood and/or cerebral spinal fluid (CSF). Both vertical and horizontal transmission led to disease, and a variety of signs and symptoms, including tachycardia, hypotension, neutropenia, rash and irritability accompanied fever. All neonates recovered clinically, although concern for neurodevelopmental delay remains for those with meningoencephalitis. This case series describes the presentation and short-term outcomes of neonates requiring intensive care for HPeV infections.

Background Schools are the most frequent target for intervention programs aimed at preventing child obesity; however, the overall effectiveness of these programs has been limited. It has therefore been recommended that interventions target multiple ecological levels (community, family, school and individual) to have greater success in changing risk behaviors for obesity. This study examined the immediate and short-term, sustained effects of the Switch program, which targeted three behaviors (decreasing children's screen time, increasing fruit and vegetable consumption, and increasing physical activity) at three ecological levels (the family, school, and community). Methods Participants were 1,323 children and their parents from 10 schools in two states. Schools were matched and randomly assigned to treatment and control. Measures of the key behaviors and body mass index were collected at baseline, immediately post-intervention, and 6 months post-intervention. Results The effect sizes of the differences between treatment and control groups ranged between small (Cohen's d = 0.15 for body mass index at 6 months post-intervention) to large (1.38; parent report of screen time at 6 months post-intervention), controlling for baseline levels. There was a significant difference in parent-reported screen time at post-intervention in the experimental group, and this effect was maintained at 6 months post-intervention (a difference of about 2 hours/week). The experimental group also showed a significant increase in parent-reported fruit and vegetable consumption while child-reported fruit and vegetable consumption was marginally significant. At the 6-month follow-up, parent-reported screen time was significantly lower, and parent and child-reported fruit and vegetable consumption was significantly increased. There were no significant effects on pedometer measures of physical activity or body mass index in the experimental group. The intervention effects were moderated by child sex (for fruit and vegetable consumption, physical activity, and weight status), family involvement (for fruit and vegetable consumption), and child body mass index (for screen time). The perception of change among the experimental group was generally positive with 23% to 62% indicating positive changes in behaviors. Conclusion The results indicate that the Switch program yielded small-to-modest treatment effects for promoting children's fruit and vegetable consumption and minimizing screen time. The Switch program offers promise for use in youth obesity prevention.