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

Flavor additives are commonly used in combustible tobacco products to mask harshness and increase appeal. However, research on the availability of flavored waterpipe tobacco (WT) is lacking, yet is important to support implementation of policies. We completed a comprehensive online search in 2020 to identify WT brands and flavors sold online in the USA. We conducted a descriptive content analysis categorizing flavors as explicit (i.e., clear taste/flavor) or concept (i.e., no clear taste/flavor); and coded for 23 flavor descriptors (e.g., fruit, mint/menthol, tobacco). Flavor names were double-coded and discrepancies were resolved by a third coder. We identified 66 WT brands with 118 product lines (i.e., sub-brands). We found 2953 flavors, including 1871 unique flavors. Brands averaged 45 flavors (range: 1–183). Almost three quarters (73.5%, n = 2171) used explicit flavor names and 26.5% (n = 782) used concept flavor names. Concept flavors varied widely, and included names such as 1001 Nights and California Dream. The most common flavor descriptors were fruit (54.1%) and mint/menthol (12.5%). Tobacco was rarely (0.2%) used as a flavor descriptor. Flavor descriptors also included location (10.7%), color (11.1%), candy (6.3%), cool/ice (5.3%), and alcohol (5.5%). WT is available in 1871 unique flavors, likely contributing to product appeal and use. Like other tobacco products, fruit and mint/menthol are common flavors. Given the significant health consequences associated with WT smoking and the role of flavors in product use, regulatory action specifically targeting WT flavors is urgently needed. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Brain cell–derived small extracellular vesicles (sEVs) in blood offer unique cellular and molecular information related to the onset and progression of Alzheimer's disease (AD). We simultaneously enriched six specific sEV subtypes from the plasma and analyzed a selected panel of microRNAs (miRNAs) in older adults with/without cognitive impairment. METHODS: Total sEVs were isolated from the plasma of participants with normal cognition (CN; n = 11), mild cognitive impairment (MCI; n = 11), MCI conversion to AD dementia (MCI‐AD; n = 6), and AD dementia (n = 11). Various brain cell–derived sEVs (from neurons, astrocytes, microglia, oligodendrocytes, pericytes, and endothelial cells) were enriched and analyzed for specific miRNAs. RESULTS: miRNAs in sEV subtypes differentially expressed in MCI, MCI‐AD, and AD dementia compared to the CN group clearly distinguished dementia status, with an area under the curve (AUC) > 0.90 and correlated with the temporal cortical region thickness on magnetic resonance imaging (MRI). DISCUSSION: miRNA analyses in specific sEVs could serve as a novel blood‐based molecular biomarker for AD. Highlights: Multiple brain cell–derived small extracellular vesicles (sEVs) could be isolated simultaneously from blood.MicroRNA (miRNA) expression in sEVs could detect Alzheimer's disease (AD) with high specificity and sensitivity.miRNA expression in sEVs correlated with cortical region thickness on magnetic resonance imaging (MRI).Altered expression of miRNAs in sEVCD31 and sEVPDGFRβ suggested vascular dysfunction.miRNA expression in sEVs could predict the activation state of specific brain cell types. [ABSTRACT FROM AUTHOR]

Successful transition from a pediatric to adult diabetes care provider is associated with reduced ambulatory diabetes care visits and increased acute complications. This study aimed to determine whether the degree of independence in diabetes care and the rate of acute complications after transition to adult diabetes care were associated with individuals' student or employment status. Nonstudents were found to be less likely than students to be independent with diabetes care, and employed nonstudents were at lower risk of diabetic ketoacidosis than unemployed nonstudents. Additional support may be needed for young adults who are not students or are unemployed to improve independence and reduce the risk for acute complications. [ABSTRACT FROM AUTHOR]

School psychologists' attitudes and feelings toward gay and lesbian parents were surveyed in relation to their training and exposure, and professional services offered to gay and lesbian parents and their children. The relationship between attitudes, feelings, training, exposure, and demographic characteristics was explored as well. A stratified random sample of 500 school psychologists who were members of NASP was surveyed using a 30-item questionnaire. Out of the 500 surveys sent, 267 school psychologists (53.4%) returned them. Overall, school psychologists have positive attitudes and feelings toward gay and/or lesbian parents. More specifically, school psychologists who were female, homosexual/bisexual, or living in the Western region of the United States had significantly more positive attitudes and feelings toward gay and/or lesbian parents. Although few school psychologists (30%) received any formalized training, those who had some training indicated more positive attitudes. The majority of school psychologists (89.4%) reported having personal associations with homosexual individuals. More exposure to homosexual individuals by a school psychologist indicated more positive attitudes as well as feelings. Implications of the findings and future research directions are discussed.

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

Background: Obesity disproportionately affects children of Latino farmworkers. Further research is needed to identify patterns of physical activity (PA) in this group and understand how PA affects Body Mass Index (BMI) percentile. Methods: Two hundred and forty-four participants ages 2.5 to 3.5 in the Niños Sanos longitudinal study wore accelerometers that measured daily PA. Several PA-related parameters formed a profile for conducting hidden Markov modeling (HMM), which identified different states of PA. Results: Latino farmworker children were generally sedentary. Two different states were selected using HMM--less active and more active. In the more active state; members spent more minutes in moderate-vigorous physical activity (MVPA). Most children were in the less active state at any given time; however, switching between states occurred commonly. One variable--mother's concern regarding lack of PA--was a marginally significant predictor of membership in the more active state. State did not predict BMI or weight percentile after adjusting for caloric intake. Conclusion: Most children demonstrated high amounts of sedentary behavior, and rates of MVPA fell far below recommended levels for both states. The lack of statistically significant results for risk factors and PA state on weight-related outcomes is likely due to the homogeneous behaviors of the children. [ABSTRACT FROM AUTHOR]