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This study showed that a severe acute respiratory syndrome coronavirus 2 infection reduced the risk of reinfection among vaccinated individuals by 0.50 (95% CI, 0.39-0.64) over a 1-year period, after accounting for unreported infections using avidity-based serology. Reciprocally, chronic symptoms increased from a baseline of 21% (95% CI, 16%-28%) among infection-naïve individuals to 43% (95% CI, 30%-61%) in reinfected individuals., Competing Interests: Potential conflicts of interest. All authors: B.A. received honoraria for participation in live meetings from Sanofi Pasteur France and Canada related to pertussis and RSV, is a co-investigator on studies funded by GSK, Pfizer, Merck, Moderna, Vaccitech and Inventprise. All funds have been paid to his institute, and he has not received any personal payments. Other authors report no relevant conflicts to report., (© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)

Detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfections is challenging with current serology assays and is further complicated by the marked decrease in routine viral testing practices as viral transmission increased during Omicron. Here, we provide proof-of-principle that high-avidity anti-nucleocapsid (N) antibodies detects reinfections after a single infection with higher specificity (85%; 95% confidence interval [95% CI], 80%-90%) compared to anti-N antibody levels (72%; 95% CI, 66%-79%) in a vaccinated cohort. This method could be used to retroactively investigate the epidemiology and incremental long-term health consequences of SARS-CoV-2 reinfections., Competing Interests: Potential conflicts of interest . B. A. R. has received honoraria for participation in live meetings from Sanofi Pasteur France and Canada related to pertussis and RSV, but not for this work. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed., (© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)

Objective: To determine the SARS-CoV-2 seroprevalence among school workers within the Greater Vancouver area, British Columbia, Canada, after the first Omicron wave., Design: Cross-sectional study by online questionnaire, with blood serology testing., Setting: Three main school districts (Vancouver, Richmond and Delta) in the Vancouver metropolitan area., Participants: Active school staff enrolled from January to April 2022, with serology testing between 27 January and 8 April 2022. Seroprevalence estimates were compared with data obtained from Canadian blood donors weighted over the same sampling period, age, sex and postal code distribution., Primary and Secondary Outcomes: SARS-CoV-2 nucleocapsid antibody testing results adjusted for test sensitivity and specificity, and regional variation across school districts using Bayesian models., Results: Of 1850 school staff enrolled, 65.8% (1214/1845) reported close contact with a COVID-19 case outside the household. Of those close contacts, 51.5% (625/1214) were a student and 54.9% (666/1214) were a coworker. Cumulative incidence of COVID-19 positive testing by self-reported nucleic acid or rapid antigen testing since the beginning of the pandemic was 15.8% (291/1845). In a representative sample of 1620 school staff who completed serology testing (87.6%), the adjusted seroprevalence was 26.5% (95% CrI 23.9% to 29.3%), compared with 32.4% (95% CrI 30.6% to 34.5%) among 7164 blood donors., Conclusion: Despite frequent COVID-19 exposures reported, SARS-CoV-2 seroprevalence among school staff in this setting remained no greater than the community reference group. Results are consistent with the premise that many infections were acquired outside the school setting, even with Omicron., Competing Interests: Competing interests: CO'R is an employee of the Vancouver School District, but the latter was not involved in the design, analysis, interpretation of data or the drafting of this manuscript. LifeLabs played no role in the study other than providing a service for the collection of blood samples., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

We prospectively studied SARS-CoV-2 transmission at schools in an era of variants of concern, offering all close contacts serial viral asymptomatic testing up to 14 days. From the 69 primary cases detected in schools, 392 close contacts were identified and offered asymptomatic testing. A total of 229 (58%) were close school contacts, and of these, 3 tested positive (1.3%), 2 of which were detected through asymptomatic testing. This is in contrast to the 117 household contacts, where 43 (37%) went on to become secondary cases. Routine asymptomatic testing of close contacts should be examined in the context of local testing rates, preventive measures, programmatic costs, and health impacts of asymptomatic transmission. IMPORTANCE There is concern that schools may be a setting where asymptomatic infections might result in significant "silent" transmission of SARS-CoV-2, particularly after the emergence of more transmissible variants of concern. After the programmatic implementation of a strategy of asymptomatic testing of close COVID-19 contacts as part of contact tracing in the school setting, the majority of the secondary cases were still found to have occurred in home or social contacts. However, for the 6.2% of secondary cases that occurred in close school contacts, the majority were detected through asymptomatic testing. The potential added yield of this approach needs to be considered within the overall setting, including consideration of the local epidemiology, ongoing goals of case and contact management, additional costs, logistical challenges for families, and possible health impacts of asymptomatic transmission.

Background: The purpose of this study was to explore factors associated with COVID-19 vaccine intentions among school staff as high vaccine uptake is essential to ensure schools return to normal activities., Methods: Staff (e.g., teachers, administrators, student support workers) from three urban school districts in the Greater Vancouver Area of British Columbia, Canada completed a survey between February and June 2021 ( n = 2,393) on COVID-19 vaccine intentions and perceptions (i.e., acceptance of routine vaccines, benefits and risks of vaccination, susceptibility to, and severity of COVID-19, recommendation by authority figures, information mistrust and conspiracy beliefs) as part of a COVID-19 seroprevalence study. Confirmatory factor analysis followed by multiple logistic regression models adjusting for relevant covariates were used to identify vaccine perceptions uniquely associated with (a) intention to get the COVID-19 vaccine ( intention ), and (b) intention to get vaccinated right away ( urgency )., Results: In total, 95.4% of participants of the seroprevalence study completed the vaccine questionnaire, corresponding to 17.7% of the target population. Vaccine intention was associated with staff who valued expert recommendations (AOR = 10.5, 95% CI = 7.39-14.90) accepted routine vaccines (AOR = 1.94, 95% CI = 1.26-2.98) and perceived higher benefits (AOR = 1.29, 95% CI = 1.01-1.65) and lower safety risks of vaccination (AOR = 0.40, 95% CI = 0.29-0.54). Comparable associations were found with vaccine urgency . Perceived susceptibility to the COVID-19 virus was uniquely associated with vaccine urgency (AOR = 1.30, 95% CI = 1.05-1.61). A significant interaction effect ( p = 0.01) revealed that staff who expressed mistrust in COVID-19 information intended to get vaccinated only if they also perceived high benefits of vaccination., Conclusions: Education about the risks and benefits of COVID-19 vaccines from a trusted source had the strongest relationship with vaccine intentions among this occupational group. Notably, those who expressed mistrust in information still intended to get vaccinated if they also perceived strong benefits of the vaccine., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Watts, Hutchison, Bettinger, Gadermann, Oberle, Oberlander, Goldfarb, Lavoie and Mâsse.)

Objectives: Few studies reported COVID-19 cases in schools during the 2020/21 academic year in a setting of uninterrupted in-person schooling. The main objective was to determine the SARS-CoV-2 seroprevalence among school staff in Vancouver public schools., Design: Cumulative incident COVID-19 cases among all students and school staff based on public health data, with an embedded cross-sectional serosurvey among a school staff sample that was compared to period, age, sex and geographical location-weighted data from blood donors., Setting: Vancouver School District (British Columbia, Canada) from kindergarten to grade 12., Participants: Active school staff enrolled from 3 February to 23 April 2021 with serology testing from 10 February to 15 May 2021., Main Outcome Measures: SARS-CoV-2 seroprevalence among school staff, based on spike (S)-based (unvaccinated staff) or N-based serology testing (vaccinated staff)., Results: Public health data showed the cumulative incidence of COVID-19 among students attending in-person was 9.8 per 1000 students (n=47 280), and 13 per 1000 among school staff (n=7071). In a representative sample of 1689 school staff, 78.2% had classroom responsibilities, and spent a median of 17.6 hours in class per week (IQR: 5.0-25 hours). Although 21.5% (363/1686) of surveyed staff self-reported close contact with a COVID-19 case outside of their household (16.5% contacts were school-based), 5 cases likely acquired the infection at school based on viral testing. Sensitivity/Specificity-adjusted seroprevalence in 1556/1689 staff (92.1%) was 2.3% (95% CI: 1.6% to 3.2%), comparable to a sex, age, date and residency area-weighted seroprevalence of 2.6% (95% CI: 2.2% to 3.1%) among 5417 blood donors., Conclusion: Seroprevalence among staff was comparable to a reference group of blood donors from the same community. These data show that in-person schooling could be safely maintained during the 2020/21 school year with mitigation measures, in a large school district in Vancouver, Canada., Competing Interests: Competing interests: CO'R is an employee of the Vancouver School District, but the District was not involved in the design, analysis, interpretation of the data or the drafting of this manuscript; MS has been an investigator on projects funded by GlaxoSmithKline, Merck, Pfizer, Sanofi-Pasteur, Seqirus, Symvivo and VBI Vaccines. All funds have been paid to his institute, and he has not received any personal payments; the authors declare no relevant conflicts of interest. LifeLabs and Dynacare played no role in the study other than providing a service for the collection of blood samples., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Research addressing the linkages between acculturation and markers of adolescent well-being across multiple ethnic minority groups is limited in scope and breadth, even though children of immigrant origin are the fastest growing population. We examined cross-sectional relationships between acculturation and substance use, socioemotional well-being, and academic achievement. Somali, Latino, and Hmong adolescents in Minnesota provided data as part of the EAT 2010 (Eating and Activity in Teens) cohort study ( N = 1,066). Acculturation was based on nativity, language usually spoken at home, and length of residence in the United States. Chi-square, ANOVA, and regression models were used to test for differences in adolescent well-being by acculturation and ethnic group, and interaction terms were added to models to test effect modification by ethnicity. Hmong adolescents had the highest mean acculturation scores (4.4 ± 1.5), whereas Somali adolescents (2.2 ± 1.8) were the least acculturated. Independent of ethnicity, acculturation was positively associated with marijuana (OR: 1.38; CI [1.25, 1.53]) and alcohol use (OR: 1.12; CI [1.02, 1.22]), and was negatively associated with academic achievement, based on grade point average (β = -0.07; CI [-0.12, -0.03]). Interaction effects indicated significant differences by ethnicity only for academic achievement; significant associations between acculturation and academic achievement were evident only for Somali and Latino youth. Prevention programming should include supports for multilingual and multicultural learners and account for cultural assets within immigrant origin families that maintain and nurture protective factors as adolescents acculturate and transition into young adulthood. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The authors present the case of a 27-year-old patient who suffered from spontaneous bleeding during infancy and from a severe and central venous thrombosis in adult years. The patient underwent a thorough laboratory work-up on both occasions and was diagnosed with hypofibrinogenaemia as well as protein S deficiency, 2 diseases that contrast in their intrinsic bleeding/thrombotic risk. The patient's high-risk pregnancy was carried out up to a successful full-term eutocic delivery which required fibrinogen concentrate to reduce life-threatening bleeding. The patient's child was also diagnosed with hypofibrinogenaemia, later on confirmed with the pathogenic mutation Fibrinogen Marseilles II. This case was used to conduct a literature review of congenital fibrinogen disorders, rare entities that require more awareness for early diagnosis and accurate management., Learning Points: Fibrinogen disorders are uncommon causes of either bleeding or thrombotic events and may be acquired or inherited in a recessive or dominant autosomal manner.Congenital fibrinogen deficiencies are rare but should be investigated when undergoing diagnostic work-up for thrombotic or haemorrhagic events in adult years.Determination of molecular defects is important for confirmation and to elaborate a treatment strategy according to the inherent risk for either thrombotic or haemorrhagic events., Competing Interests: Conflicts of Interests: The Authors declare that there are no competing interests., (© EFIM 2020.)

This study explored the perceived impact of yoga on body image. Young adults (n= 34 female, 12 male; M age  = 30.6 [SD = 1.6]) practicing yoga were interviewed and data were analyzed for emerging themes across weight status. In general, participants discussed the positive impact of yoga on their body image, but some described both a positive and negative impact. Yoga was perceived as having a positive impact on body image via perceived physical changes, gratitude for one's body, a sense of accomplishment within one's yoga practice, self-confidence, and witnessing different types of bodies practicing yoga. Yoga was perceived to have a negative impact on body image via comparative critique (e.g., upward comparisons with others) and inner critique (e.g., negative self-talk). Themes were generally similar across weight status; exceptions were that participants at higher weight status were more likely than those at lower weight status to discuss accomplishment within one's yoga practice as a positive impact on body image and comparative critique as a negative impact on body image. Yoga studios and instructors can take steps to further enhance the positive impact of yoga and to provide environments that are inclusive of participants with diverse body shapes and sizes., (Copyright © 2018. Published by Elsevier Ltd.)

Purpose: To examine personal, home, peer, school, neighborhood, and media correlates of sugar-sweetened beverage (SSB) intake in a diverse sample of adolescents., Methods: Cross-sectional, population-based study (EAT 2010: Eating and Activity in Teens) of 2793 adolescents (54% female, mean age [SD] = 14.5 [2.0], 80% nonwhite) attending public secondary schools in Minneapolis-St. Paul, Minnesota. Adolescents completed a food frequency questionnaire and answered survey questions about their diet/health perceptions and behaviors. Socio-environmental data were collected from parents/caregivers, peers, school personnel, Geographic Information Systems (e.g., distance to food outlet), and a content analysis of favorite TV shows. Individual and mutually adjusted mixed-effects regression models examined associations between multi-contextual factors and estimated daily servings of SSB, controlling for relevant covariates., Results: The contextual factors examined accounted for 24% of the variance in adolescents' SSB consumption. The proportion of variance explained by each context was 13% personal, 16% home/family, 3% peer, 1% school, 0.1% media, and 0% neighborhood. The strongest correlate of SSB intake was home soda availability (adjusted for covariates: β = 0.26, p < 0.01; adjusted for all multi-contextual factors: β = 0.18, p < 0.01). Other significant correlates of SSB intake included personal behaviors (e.g., fast food intake, sleep), home/family factors (e.g., parent modeling) and peer influences (e.g., friends' SSB intake)., Conclusions: Public health policies and programs to reduce adolescent SSB intake should target personal behaviors (e.g., limit fast food, encourage adequate sleep), address the home setting (e.g., help parents to reduce SSB availability and model healthy eating habits) and involve peers (e.g., identify and enable peers to model healthy eating behaviors)., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Background: A regular yoga practice may have benefits for young adult health, however, there is limited evidence available to guide yoga interventions targeting weight-related health. The present study explored the relationship between participation in yoga, healthy eating behaviors and physical activity among young adults., Methods: The present mixed-methods study used data collected as part of wave 4 of Project EAT (Eating and Activity in Teens and Young Adults), a population-based cohort study in Minneapolis-St. Paul, Minnesota. Young adults (n = 1820) completed the Project EAT survey and a food frequency questionnaire, and a subset who reported practicing yoga additionally participated in semi-structured interviews (n = 46). Analyses of survey data were used to examine cross-sectional associations between the frequency of yoga practice, dietary behaviors (servings of fruits and vegetables (FV), sugar-sweetened beverages (SSBs) and snack foods and frequency of fast food consumption), and moderate-to-vigorous physical activity (MVPA). Thematic analysis of interview discussions further explored yoga's perceived influence on eating and activity behaviors among interview participants., Results: Regular yoga practice was associated with more servings of FV, fewer servings of SSBs and snack foods, less frequent fast food consumption, and more hours of MVPA. Interviews revealed that yoga supported healthy eating through motivation to eat healthfully, greater mindfulness, management of emotional eating, more healthy food cravings, and the influence of the yoga community. Yoga supported physical activity through activity as part of yoga practice, motivation to do other forms of activity, increased capacity to be active, and by complementing an active lifestyle., Conclusions: Young adult yoga practitioners reported healthier eating behaviors and higher levels of physical activity than non-practitioners. Yoga should be investigated as an intervention for young adult health promotion and healthy weight management.

This study explored the potential for yoga to promote body satisfaction in a general population of young adults. The sample included 1664 participants (M age: 31.1, SD=1.6years) in Project EAT, a 15-year longitudinal study. Data from the third and fourth waves (EAT-III and EAT-IV), collected five years apart, were utilized. Practicing yoga (≥30min/week) was reported by 16.2% of young adults. After adjusting for EAT-III body satisfaction and body mass index, yoga practitioners had higher concurrent body satisfaction at EAT-IV than those not practicing yoga (difference: 1.5 units [95% CI: 0.1-2.8], p=.03). Among participants within the lowest quartile of prior (EAT-III) body satisfaction, there was preliminary evidence that body satisfaction at EAT-IV was higher among yoga practitioners than in other young adults. Findings suggest that yoga may be associated with improved body satisfaction, particularly among young adults with low prior body satisfaction., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Background: The home food environment may be an important target for addressing adolescent obesity. The aim of this study was to investigate associations between aspects of the home food environment and the diets of adolescents who present for obesity treatment., Methods: Cross-sectional baseline data were collected from 167 overweight/obese adolescent-parent pairs participating in an e-health lifestyle modification intervention. Adolescent intake of specific foods (fruit and vegetables, total fat, sugar-sweetened beverages, desserts/treats, and snacking occasions) was assessed by three 24-h dietary recalls, while household factors were collected from adolescent and parent questionnaires. Structural Equation Modeling, controlling for relevant covariates, was used to examine the relationship between adolescent diet and the following household factors: parent modeling, parenting style, family meal practices, and home food/beverage availability., Results: Findings reveal that few characteristics of the home food environment were associated with adolescent dietary intake. Greater home availability of high-fat foods was moderately associated with adolescent snack intake (β = 0.27, p  < .001). Associations with fruit/vegetables and fat intake were small and some were in unexpected directions. Parent modeling of healthful food choices and healthier family meal practices were associated with lower availability of high-fat foods and treats in the home, but were not directly associated with adolescent diets., Conclusions: Parent modeling of healthy foods and positive mealtime routines might contribute to the healthfulness of foods offered in the homes of adolescents who are overweight/obese. Additional research is needed to better characterize the complex aspects of the household environment that influence adolescent diet., Competing Interests: Competing interestsThe authors declare that they have no competing interests., (© The Author(s). 2018.)

Purpose: To examine the influence of peers and the source of meals and snacks on the dietary quality of adolescents seeking obesity treatment., Methods: Baseline surveys were completed by 173 adolescents with overweight or obesity (11-16 years old) enrolled in an e-health intervention in Vancouver, British Columbia. Dietary quality was assessed with three 24-h dietary recalls used to compute a Healthy Eating Index adapted to the Canadian context (HEI-C). Multiple linear regression examined associations between HEI-C scores and the frequency of: (i) meals prepared away from home, (ii) purchasing snacks from vending machines or stores, (iii) eating out with friends, and (iv) peers modeling healthy eating., Results: Adolescents reported eating approximately 3 lunch or dinner meals prepared away from home and half purchased snacks from vending machines or stores per week. After adjusting for socio-demographics, less frequent purchases of snacks from vending machines or stores (b = -3.00, P = 0.03) was associated with higher HEI-C scores. More frequent dinner meals prepared away from home and eating out with friends were only associated with lower HEI-C scores in unadjusted models., Conclusions: Snack purchasing was associated with lower dietary quality among obesity treatment-seeking adolescents. Improving the healthfulness of foods obtained away from home may contribute to healthier diets among these adolescents.

Background: Yoga may provide a strategy for healthy weight management in young adults. This study examined prevalence and characteristics of young adults' yoga practice and associations with changes in body mass index., Methods: Surveys were completed by 1830 young adults (31.1 ± 1.6 y) participating in Project EAT-IV. Cross-sectional and 5-year longitudinal analyses were conducted stratified by initial weight status., Results: Two-thirds (66.5%) of nonoverweight women and 48.9% of overweight women reported ever doing yoga, while 27.2% of nonoverweight women and 16.4% of overweight women practiced regularly (≥30 min/wk). Fewer men practiced yoga. Among young adults practicing regularly (n = 294), differences were identified in intensity, type, and location of yoga practice across weight status. Young adults who were overweight and practiced yoga regularly showed a nonsignificant 5-year decrease in their body mass index (-0.60 kg/m 2 ; P = .49), whereas those not practicing regularly had significant increases in their body mass index (+1.37 kg/m 2 ; P < .01). Frequency of yoga was inversely associated with weight gain among both overweight and nonoverweight young adults practicing yoga regularly., Conclusions: Young adults of different body sizes practice yoga. Yoga was associated with less weight gain over time, particularly in overweight young adults. Practicing yoga on a regular basis may help with weight gain prevention.

Background: Parents are an important influence on children's dietary intake and eating behaviors. However, the lack of a conceptual framework and inconsistent assessment of food parenting practices limits our understanding of which food parenting practices are most influential on children. The aim of this study was to develop a food parenting practice conceptual framework using systematic approaches of literature reviews and expert input., Method: A previously completed systematic review of food parenting practice instruments and a qualitative study of parents informed the development of a food parenting practice item bank consisting of 3632 food parenting practice items. The original item bank was further reduced to 110 key food parenting concepts using binning and winnowing techniques. A panel of 32 experts in parenting and nutrition were invited to sort the food parenting practice concepts into categories that reflected their perceptions of a food parenting practice conceptual framework. Multi-dimensional scaling produced a point map of the sorted concepts and hierarchical cluster analysis identified potential solutions. Subjective modifications were used to identify two potential solutions, with additional feedback from the expert panel requested., Results: The experts came from 8 countries and 25 participated in the sorting and 23 provided additional feedback. A parsimonious and a comprehensive concept map were developed based on the clustering of the food parenting practice constructs. The parsimonious concept map contained 7 constructs, while the comprehensive concept map contained 17 constructs and was informed by a previously published content map for food parenting practices. Most of the experts (52%) preferred the comprehensive concept map, while 35% preferred to present both solutions., Conclusion: The comprehensive food parenting practice conceptual map will provide the basis for developing a calibrated Item Response Modeling (IRM) item bank that can be used with computerized adaptive testing. Such an item bank will allow for more consistency in measuring food parenting practices across studies to better assess the impact of food parenting practices on child outcomes and the effect of interventions that target parents as agents of change.

High rates of disordered eating exist among adolescents with overweight and among ethnic/racial minority adolescents. Given the lack of research examining how eating disorder risk is moderated by both overweight and ethnicity/race, this study aimed to explore interactions between ethnicity/race and overweight status on disordered eating behaviors in a population-based adolescent sample. Cross-sectional data from adolescents (n = 2,271; 52% females) of White (23%), Black (34%), Hispanic (20%), and Asian (23%; 82% Hmong) ethnicity/race participating in the EAT 2010 study were used to examine associations between overweight status and disordered eating behaviors across ethnic/racial groups. Disordered eating behaviors occurred more frequently among adolescents with overweight compared with those without overweight across all ethnic/racial groups. Although some differences in the prevalence of disordered eating were found by ethnicity/race, particularly in girls, no consistent patterns of interaction emerged. Overweight White and Hispanic girls reported the highest risk for dieting, while the highest risk for unhealthy weight control behaviors was among overweight Black girls, and for overeating among overweight White and Asian girls. Within a society in which thinness is highly valued and being overweight is stigmatized, across diverse cultural groups, adolescents with overweight are at risk for disordered eating., (© 2016 Wiley Periodicals, Inc.)

Background: Despite research linking family meals to healthier diets, some families are unable to have regular meals together. These families need guidance about other ways to promote healthy eating among adolescents., Objective: Our aim was to examine the association between various parenting practices and adolescent fruit and vegetable (F/V) intake at different levels of family meal frequency., Design: We conducted a cross-sectional, population-based survey of influences on adolescent weight-related behaviors using Project EAT (Eating and Activity in Teens) 2010., Participants/setting: Participants were 2,491 adolescents recruited from middle/high schools in Minneapolis/St Paul, MN., Measures: Adolescent F/V intake was ascertained with a food frequency questionnaire. Survey items assessed frequency of family meals and F/V parenting practices (availability, accessibility, parent modeling, parent encouragement, and family communication)., Statistical Analyses: Linear regression models were used to examine associations with and interactions among family meals and parenting practices. Models were adjusted for age, sex, socioeconomic status, race/ethnicity, and energy intake (kilocalories per day)., Results: Family meals, F/V availability, F/V accessibility, F/V modeling, and encouragement to eat healthy foods were independently associated with higher F/V intake. Of the 949 (34%) adolescents who reported infrequent family meals (≤2 days/wk), mean F/V intake was 3.6 servings/day for those with high home F/V availability vs 3.0 servings/day for those with low home F/V availability. Similar differences in mean F/V intake (0.3 to 0.6 servings/day) were found for high vs low F/V accessibility, parental modeling, and parent encouragement for healthy eating. Frequent family meals in addition to more favorable parenting practices were associated with the highest F/V intakes., Conclusions: Food parenting practices and family meals are associated with greater adolescent F/V intake. Longitudinal and intervention studies are needed to determine which combination of parenting practices will lead to improvements in adolescent diets., (Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Frequent consumption of energy-dense, nutrient-poor snack foods is an eating behavior of public health concern. This study was designed to inform strategies for reducing adolescent intake of energy-dense snack foods by identifying individual and environmental influences. Surveys were completed in 2009-2010 by 2540 adolescents (54% females, mean age = 14.5 ± 2.0, 80% nonwhite) in Minneapolis-St. Paul, Minnesota schools. Daily servings of energy-dense snack food was assessed using a food frequency questionnaire that asked about consumption of 21 common snack food items, such as potato chips, cookies, and candy. Data representing characteristics of adolescents' environments were collected from parents/caregivers, friends, school personnel, Geographic Information System sources, and a content analysis of favorite television shows. Linear regression was used to examine relationships between each individual or environmental characteristic and snack food consumption in separate models and also to examine relationships in a model including all of the characteristics simultaneously. The factors found to be significantly associated with higher energy-dense snack food intake represented individual attitudes/behaviors (e.g., snacking while watching television) and characteristics of home/family (e.g., home unhealthy food availability), peer (friends' energy-dense snack food consumption), and school (e.g., student snack consumption norms) environments. In total, 25.5% of the variance in adolescents' energy-dense snack food consumption was explained when factors from within each context were examined together. The results suggest that the design of interventions targeting improvement in the dietary quality of adolescents' snack food choices should address relevant individual factors (e.g., eating while watching television) along with characteristics of their home/family (e.g., limiting the availability of unhealthy foods), peer (e.g., guiding the efforts of a peer leader in making healthy choices), and school environments (e.g., establishing student norms for selecting nutrient-dense snack foods)., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Background: Few studies have evaluated the effect of adherence to a lifestyle intervention on adolescent health outcomes. The objective of this study was to determine whether adolescent and parental adherence to components of an e-health intervention resulted in change in adolescent body mass index (BMI) and waist circumference (WC) z-scores in a sample of overweight/obese adolescents., Methods: In total, 159 overweight/obese adolescents and their parents participated in an 8-month e-health lifestyle intervention. Each week, adolescents and their parents were asked to login to their respective website and to monitor their dietary, physical activity, and sedentary behaviours. We examined participation (percentage of webpages viewed [adolescents]; number of weeks logged in [parents]) and self-monitoring (number of weeks behaviors were tracked) rates. Linear mixed models and multiple regressions were used to examine change in adolescent BMI and WC z-scores and predictors of adolescent participation and self-monitoring, respectively., Results: Adolescents and parents completed 28% and 23%, respectively, of the online component of the intervention. Higher adolescent participation rate was associated with a decrease in the slope of BMI z-score but not with change in WC z-score. No association was found between self-monitoring rate and change in adolescent BMI or WC z-scores. Parent participation was not found to moderate the relationship between adolescent participation and weight outcomes., Conclusions: Developing strategies for engaging and promoting supportive interactions between adolescents and parents are needed in the e-health context. Findings demonstrate that improving adolescents' adherence to e-health lifestyle intervention can effectively alter the weight trajectory of overweight/obese adolescents.

Background: The purpose of this study was to compare the physical activity parenting practices (PAPPs) parents report using with the PAPPs incorporated in the published literature., Methods: PAPPs in the literature were identified by reviewing the content of 74 published PAPP measures obtained from current systematic reviews supplemented with a literature search. The types of PAPPs used by parents were identified by surveying a stratified sample of 134 Canadian and US parents of 5- to 12 year-old children. Items from the literature and parent responses were coded using the same coding scheme. Differences between the PAPPs emphasized by the parents and the literature were examined., Results: Parents significantly emphasized different issues than what is measured in the literature (P < .001). Parents emphasized more control (13.6% vs. 6.9%), modeling and teaching (13.2% vs. 9.2%), and structural strategies (32.2% vs. 28.6%) and less autonomy support (11.8% vs. 14.0%), logistical support (9.9% vs. 12.8%), and responsiveness strategies (19.3% vs. 28.5%)., Conclusions: Physical activity practices most often employed by parents are not the ones emphasized in current measures. The extent to which putting more emphasis on the areas identified by parents will increase the predictive validity of the measures warrants further examination.

Purpose: To examine longitudinal risk factors and short-term risk correlates for the development of extreme forms of restrictive eating among adolescent dieters., Methods: Data from Project Eating and Activity in Teens and Young Adults, a population-based study of 2,516 students aged 12-18 years, were collected in 1998-1999 (Time 1) and 5 years later (Time 2). Within this sample, 243 adolescents who reported dieting but not engaging in disordered forms of restrictive eating (e.g., fasting, skipping meals) at Time 1 were followed to determine the self-reported psychological, familial, and social variables predicting initiation of disordered restrictive eating at Time 2. To investigate short-term risk correlates of initiating disordered restrictive eating, the same risk factors were also compared cross-sectionally at Time 2 between the dieters who had and had not initiated disordered restrictive eating. Poisson regression models with robust standard errors were fit for each predictor adjusted for covariates., Results: Depressive symptoms and low self-esteem were significantly associated with the initiation of disordered restrictive eating in both longitudinal and cross-sectional analyses. Poor family communication/caring and maternal dieting significantly predicted long-term risk for escalating restrictive eating severity; whereas, individual body image issues (i.e., weight concerns, body dissatisfaction) and social concerns (i.e., weight-related teasing, peer dieting) were significant short-term correlates of initiating disordered restrictive eating., Conclusions: Depressive symptoms and low self-esteem may be especially important targets for risk identification and prevention for disordered restrictive eating. Intervening on family influences may decrease long-term risk, whereas intervening on body image and responses to social influences may decrease short-term risk for disordered restrictive eating., (Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Research to understand how parents influence their children's dietary intake and eating behaviors has expanded in the past decades and a growing number of instruments are available to assess food parenting practices. Unfortunately, there is no consensus on how constructs should be defined or operationalized, making comparison of results across studies difficult. The aim of this study was to develop a food parenting practice item bank with items from published scales and supplement with parenting practices that parents report using. Items from published scales were identified from two published systematic reviews along with an additional systematic review conducted for this study. Parents (n = 135) with children 5-12 years old from the US and Canada, stratified to represent the demographic distribution of each country, were recruited to participate in an online semi-qualitative survey on food parenting. Published items and parent responses were coded using the same framework to reduce the number of items into representative concepts using a binning and winnowing process. The literature contributed 1392 items and parents contributed 1985 items, which were reduced to 262 different food parenting concepts (26% exclusive from literature, 12% exclusive from parents, and 62% represented in both). Food parenting practices related to 'Structure of Food Environment' and 'Behavioral and Educational' were emphasized more by parent responses, while practices related to 'Consistency of Feeding Environment' and 'Emotional Regulation' were more represented among published items. The resulting food parenting item bank should next be calibrated with item response modeling for scientists to use in the future., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Background: Most adolescents consume ≥1 snack/d; exploring the relevance of snacking patterns for overall diet and weight status is important to guide dietary counseling and public health strategies for obesity prevention., Objective: This study examined intake of common energy-dense snack foods, total number of snacks consumed, frequency of consuming snacks prepared away from home, and frequency of snacking while watching television in adolescents and how these behaviors may be linked to diet and weight status. Relations were examined with attention to potential confounders that may help explain the mixed findings of previous research., Methods: Survey measures of snacking behavior, a food-frequency questionnaire, and anthropometric measurements were completed by 2793 adolescents (53.2% girls, mean age = 14.4 y) in Minneapolis-St. Paul school classrooms in 2009-2010. Linear regression was used to examine associations with adjustment for sociodemographic characteristics and other potential confounding factors, such as meal skipping, underreporting energy intake, dieting to lose weight, and physical activity., Results: Adolescents reported consuming a mean of 2.2 energy-dense snack food servings/d and 4.3 snacks/d and purchasing snacks prepared away from home on 3.2 occasions/wk. More than two-thirds of adolescents reported that they sometimes, usually, or always consumed a snack while watching television. The measures of snacking were directly associated (P < 0.01) with higher energy, lower fruit/vegetable, higher sugar-sweetened beverage, and more frequent fast-food intakes in all models except for one: energy-dense snack food servings were not related to sugar-sweetened beverage intake. A direct relation between daily servings of energy-dense snack foods and body mass index (BMI) z score was found; however, the snacking behaviors were inversely related to BMI z score (P < 0.01)., Conclusions: The observed cross-sectional associations suggest that snack consumption is a risk factor for poor diet, but unless energy-dense foods are consumed, snacking does not consistently contribute to overweight in US adolescents., (© 2016 American Society for Nutrition.)

Reducing socioeconomic disparities in weight-related health is a public health priority. The purpose of this paper was to examine 10-year longitudinal patterns in overweight and weight-related behaviors from adolescence to young adulthood as a function of family-level socioeconomic status (SES) and educational attainment. Project EAT (Eating and Activity in Teens and Young Adults) followed a diverse sample of 2287 adolescents from 1999 to 2009. Mixed-effects regression tested longitudinal trends in overweight, fast food, breakfast skipping, physical inactivity, and screen use by family-level SES. The influence of subsequent educational attainment in young adulthood was examined. Results revealed that the prevalence of overweight increased significantly from adolescence to young adulthood with the greatest change seen in those from low SES (mean change=30.7%, 95% CI=25.6%-35.9%) as compared to high SES families (mean change=21.7%, 95% CI=18.2%-25.1%). Behavioral changes from adolescence to young adulthood also differed by SES background; the prevalence of frequent fast food intake (≥3times/week) increased most dramatically in those from low SES (mean change=6%, 95% CI=0.5%-11%) as compared to high SES families (mean change=-1.2%, 95% CI=-5.2%-2.9%). Overall trends suggest that a higher educational attainment mitigates the negative impacts of a low SES background. These findings suggest that continued effort is needed to ensure that public health strategies addressing obesity and related behaviors reach adolescents and young adults from low SES backgrounds and do not contribute to widening socioeconomic gaps in weight-related health., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Purpose: To explore 10-year longitudinal predictors (personal, psychological, behavioral, and socioenvironmental) of exiting obesity from adolescence to young adulthood., Methods: Data were collected from a population-based cohort of adolescents (n = 2,287) attending middle/high schools in Minneapolis-St. Paul in 1998-1999 (mean age = 14.9) and again in 2008-2009 (mean age = 25.3) participating in Project Eating and Activity Among Teens and Young Adults. Self-reported height and weight were used to calculate weight status change between adolescence and young adulthood, among participants with obesity at baseline (n = 175). Questionnaires assessed personal, psychological, behavioral, and socioenvironmental factors hypothesized to play a role in obesity. Modified Poisson regressions estimated adjusted relative risks (RRs) for exiting obesity as a function of each baseline and 10-year change in predictor, controlling for relevant covariates., Results: Thirty-two percent of adolescents exited obesity in young adulthood. Reductions in fast food intake (RR = .73, 95% confidence interval [CI] = .61-.87) and screen time (RR = .98, 95% CI = .96-.99), and increases in fruit/vegetable intake (RR = 1.06, 95% CI 1.01-1.12), moderate-to-vigorous physical activity (RR = 1.06, 95% CI = 1.00-1.12), home fruit/vegetable availability (RR = 1.58, 95% CI = 1.19-2.09), family meals (RR = 1.12, 95% CI = 1.03-1.22), and serving vegetables at dinner (RR = 1.45, 95% CI = 1.10-1.92) were associated with exiting obesity. Not dieting as an adolescent and improvements in body satisfaction, depressive symptoms, self-esteem, and weight teasing were also associated with exiting obesity., Conclusions: Promoting healthy eating and activity, and improving the healthfulness of home food environments may be promising intervention targets for promoting healthier weights in adolescents and young adults with obesity. Addressing dieting behavior and the psychosocial health of adolescents with obesity may also be needed throughout the transition to young adulthood., (Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Background: The purpose of this study was to describe the workplace environments of young adults and examine associations with diet, physical activity (PA) and body mass index (BMI)., Methods: Cross-sectional data were collected (2008-2009) from 1538 employed young adult participants in Project EAT (Eating and Activity among Teens and Young Adults), a diverse population-based sample. Survey measures assessed height, weight, diet, moderate-to-vigorous PA, transportation-related PA and perceptions of the workplace food and PA environments (eg, soda availability, coworker support). Healthful characteristics were summed to reflect overall workplace healthfulness. Modified Poisson regression analyses conducted in 2015 identified associations between workplace food and PA environments and diet, PA and BMI., Results: The healthfulness of workplace environments was suboptimal. Greater exposure to healthful workplace characteristics was related to more young adults engaged in favourable diet and PA behaviours and a lower prevalence obesity. For example, adjusted rates of obesity were 24% and 17% among those reporting low (≤1 characteristic) versus high (≥3 characteristics) exposure to healthful food environments, respectively (p<0.05). Workplace characteristics independently associated with weight-related outcomes included soda availability, proximity to a fast food outlet, living close to work and perceived ease of eating a healthy diet or being active at work., Conclusions: A more healthful workplace environment overall, including physical attributes and perceived social norms, may contribute to more favourable weight-related behaviours and lower prevalence of obesity among young adults. Employer-initiated and community-initiated policies may represent one way to create healthier workplace environments for young adults., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)

This study explored perceived barriers and facilitators to healthful eating in schools and communities among overweight teens who completed an E-health intervention. Twenty-two teens were recruited to a photovoice study and asked to take pictures of things that made it easier or harder to make healthful food choices at school and in their community. Digital photographs were reviewed using semi-structured interviews. Transcribed audio-recordings were analyzed using constant comparative analysis. Similar themes emerged from the school and community environments with food/beverage availability emerging most frequently, followed by peer influence, accessibility/convenience, price, classroom practices, marketing and online influences. Teens described an obesity-promoting environment and perceived very limited healthful options. Policy-driven environmental changes as well as strategies that help teens navigate food choices in their schools and communities are needed to support healthful eating., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Objective: To explore perceived factors that impede or facilitate healthful eating within the home environment among overweight/obese adolescents., Design: In the present qualitative photovoice study, participants were instructed to take photographs of things that made it easier or harder to make healthful food choices at home. Digital photographs were reviewed and semi-structured interviews were conducted to promote discussion of the photographs. Data were analysed using constant comparative analysis., Setting: Vancouver, Canada, in 2012-2013., Subjects: Twenty-two overweight/obese adolescents who completed a family-based lifestyle modification intervention., Results: The mean age of participants was 14 (sd 1.9) years, 77% were female and their mean BMI Z-score was 2.4 (sd 0.6). Adolescents talked about six aspects of the home environment that influenced their eating habits (in order of frequency): home cooking, availability and accessibility of foods/beverages, parenting practices, family modelling, celebrations and screen use/studying. In general, homes with availability of less healthful foods, where family members also liked to eat less healthful foods and where healthier foods were less abundant or inaccessible were described as barriers to healthful eating. Special occasions and time spent studying or in front of the screen were also conducive to less healthful food choices. Home cooked meals supported adolescents in making healthier food choices, while specific parenting strategies such as encouragement and restriction were helpful for some adolescents., Conclusions: Adolescents struggled to make healthful choices in their home environment, but highlighted parenting strategies that were supportive. Targeting the home food environment is important to enable healthier food choices among overweight/obese adolescents.

Background: The purpose of this study was to examine the association between parent and adolescent levels of physical activity, sedentary behaviors, and sleep among a group of overweight and obese adolescents., Methods: Baseline data of parent-adolescent pairs who enrolled in a lifestyle modification intervention were analyzed for this study (n = 176). Participants completed questionnaires about their screen time (TV, video game, and computer time), wore an accelerometer for 8 days, and completed a sleep diary for 1 week. In total, 98 parent-adolescent dyads provided valid data for the analyses. Multivariable regression analyses were conducted to assess the relationship between parent and adolescent's moderate-to-vigorous activity (MVPA), step counts, sedentary behaviors, and sleep duration. Analyses were split by weekday, weekday evening and weekend., Results: Parent-adolescent MVPA was significantly associated on weekdays (b = 0.18; SE = 0.08; β = 0.26), weekday evenings (b = 0.21; SE = 0.08; β = 0.28), and weekends (b = 0.29; SE = 0.12; β = 0.27). This study found associations between parent-child video game time on weekends (b = 1.10; SE = 0.49; β = 0.24) and computer time on weekdays (b = 0.42; SE = 0.19; β = 0.23). Adolescent sleep was associated with parental sleep on weekdays only (b = 0.38; SE = 0.09; β = 0.46)., Conclusion: The findings warrant further investigation into the direction and mechanism of the relationship between parent and adolescent weight related behaviors.

Purpose: This study examines the relationship between body satisfaction of overweight adolescents and 10-year changes in body mass index (BMI)., Methods: Participants who were overweight as adolescents (n = 496) were drawn from Project Eating and Activity in Teens and Young Adults (Project EAT), a 10-year longitudinal study., Results: Among overweight girls, a significant difference in 10-year BMI change across baseline body satisfaction quartiles was observed. Overweight girls with the lowest body satisfaction at baseline had a nearly three unit greater increase in BMI at follow-up, compared with overweight girls in the high body satisfaction quartile; this difference has important clinical significance. Among overweight boys, no significant associations between body satisfaction quartile and change in BMI were not observed., Conclusion: Overall, findings indicate that among overweight adolescents, a high level of body satisfaction during adolescence was not harmful, and in fact may be beneficial for girls, in terms of long-term weight management. These findings refute the commonly held notion that overweight young people should be dissatisfied with their bodies to motivate positive change., (Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Background: Adherence to e-health obesity interventions is a significant challenge., Purpose: We examined the individual and household predictors of adolescents' adherence to a Web-based lifestyle intervention., Methods: One hundred sixty overweight/obese adolescents and one of their parents enrolled in the 8-month e-health intervention. Structural equation modeling was used to examine individual factors from the theory of planned behavior and self-determination theory and household factors (food/soda availability, parenting, environment) that predict adolescents' adherence to components of the intervention., Results: We explained 10.8 to 36.9% of the total variance in adherence to components of the intervention. Intrinsic motivation and parenting practices and styles directly predicted adherence. Relatedness and autonomy support indirectly predicted adherence via intrinsic motivation. Finally, household income modulated these effects., Conclusion: Taking a self-regulatory perspective (i.e., accounting for intrinsic motivation) contributes to our understanding of intervention adherence, but the household environment may play a greater role in facilitating adolescent behavior change.

Few studies have compared parent-child dietary intake among adolescents who are overweight or obese. The purpose of our study was to determine the relationship between parent-teen intake of selected dietary components among this sample. Baseline data from 165 parent and adolescent (aged 11 to 16 years) pairs who presented for a lifestyle behavior modification intervention were collected between 2010 and 2012. Parent and adolescent dietary intake (servings of fruits and vegetables [F/V]; grams of sugar; and percent energy from total fat, saturated fat, dessert/treats, sugar-sweetened beverages, and snacks) was assessed using web-based 24-hour dietary recalls. Multivariable linear and negative binomial regression models identified associations between parent and child dietary intake adjusting for relevant covariates. A large proportion of adolescents and parents did not meet dietary recommendations for F/V, total fat, and saturated fat. Parent-adolescent intake of F/V, total fat, saturated fat, sugar, sugar-sweetened beverages, and snacks were positively associated (r=0.19 to 0.37). No relationship was observed for dessert/treats. In multivariate models, significant interaction effects suggest that the parent-child association in diet was weaker for fat intake among parents with higher educational attainment (b=-.31; P<0.05) and for snacking among adolescent boys (b=-.30; P<.05). Parent intake of several dietary components important for good health, and related to obesity, was associated with adolescent intake. Helping parents improve their diet may promote improvements in their adolescent's diet and is a potential target for interventions designed to increase healthy eating among adolescents., (Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.)

Background: High rates of childhood obesity have generated interest among policy makers to improve the school food environment and increase students' levels of physical activity. The purpose of this study was to examine school-level changes associated with implementation of the Food and Beverage Sales in Schools (FBSS) and Daily Physical Activity (DPA) guidelines in British Columbia, Canada., Methods: Elementary and middle/high school principals completed a survey on the school food and physical activity environment in 2007-08 (N=513) and 2011-12 (N=490). Hierarchical mixed effects regression was used to examine changes in: 1) availability of food and beverages; 2) minutes per day of Physical Education (PE); 3) delivery method of PE; and 4) school community support. Models controlled for school enrollment and community type, education and income., Results: After policy implementation was expected, more elementary schools provided access to fruits and vegetables and less to 100% fruit juice. Fewer middle/high schools provided access to sugar-sweetened beverages, French fries, baked goods, salty snacks and chocolate/candy. Schools were more likely to meet 150 min/week of PE for grade 6 students, and offer more minutes of PE per week for grade 8 and 10 students including changes to PE delivery method. School community support for nutrition and physical activity policies increased over time., Conclusion: Positive changes to the school food environment occurred after schools were expected to implement the FBSS and DPA guidelines. Reported changes to the school environment are encouraging and provide support for guidelines and policies that focus on increasing healthy eating and physical activity in schools.

Background: Increasing attention has been paid to the school food environment as a strategy to reduce childhood obesity. The purpose of this study was to examine associations between the school food environment, students' dietary intake, and obesity in British Columbia (BC), Canada., Methods: In 2007/08, principal responses about the school environment (N=174) were linked to grades 7-12 students (N=11,385) from corresponding schools, who participated in the BC Adolescent Health Survey. Hierarchical mixed-effect regression analyses examined the association between the school food environment and student's intake of sugar-sweetened beverages (SSBs), food consumption, and body mass index. Analyses controlled for school setting, neighborhood education level and student's age and sex., Results: School availability of SSBs was positively associated with moderate (Odds Ratio (OR)=1.15, 95% Confidence Interval (CI)=1.02-1.30) and high (OR=1.43, 95% CI=1.13-1.80) SSB intake as were less healthful school nutrition guidelines for moderate SSB consumers only (OR=0.65, 95% CI=0.48-0.88). Availability of SSBs at school and its consumption were positively associated with student obesity (OR=1.50, 95% CI=1.12-2.01 and OR=1.66, 95% CI=1.19-2.34, respectively) but not with overweight. In contrast, consumption of less healthful food was positively associated with overweight (OR=1.03, 95% CI=1.01-1.06)., Conclusions: The results of this study provide further evidence to support the important role of schools in shaping adolescents' dietary habits. Availability and consumption of SSBs, but not less healthful foods, at school were associated with higher adolescent obesity highlighting that other environments also contribute to adolescent obesity.

Parents can play a crucial role in the development of children's behaviors associated with dietary habits, physical activity, and sedentary lifestyles. Many parenting practices and/or styles measures have been developed; however, there is little agreement as to how the influence of parenting should be measured. More importantly, our ability to relate parenting practices and/or styles to children's behaviors depends on its accurate assessment. While there is a need to standardize our assessment to further advance knowledge in this area, this article will discuss areas that may stimulate advances in the measurement of parenting constructs. Because self-report measures are important for the assessment of parenting, this article discusses whether solutions to improve self-report measures may lie in: (1) Improving the questions asked; (2) improving the methods used to correct for social desirability or measurement errors; (3) changing our measurement paradigm to assess implicit parenting behaviors; (4) changing how self-report is collected by taking advantage of ecological momentary assessment methods; (5) using better psychometric methods to validate parenting measures or alternatively using advances in psychometric methods, such as item banking and computerized adaptive testing, to solve common administration issues (i.e., response burden and comparability of results across studies); and (6) employing novel technologies to collect data such as portable technologies, gaming, and virtual reality simulation. This article will briefly discuss the potential of technologies to measure parenting constructs.

Objective: The workplace represents an important setting for increasing physical activity levels. The purpose of the present study was to investigate the relationship between the workplace environment and leisure-time physical activity, using a nationally representative sample of the Canadian population., Methods: This study used cross-sectional, self-reported data from 48,916 participants who completed relevant questions on the 2008 Canadian Community Health Survey. Associations between supportive workplace environments for physical activity (e.g., perceived range of amenities available such as a pleasant place to walk, fitness facility, showers, and health program) and leisure-time physical activity level (active, moderately active, inactive) were examined using multinomial logistic regression., Results: Approximately three quarters (n=36,216) of participants had access to at least one amenity that supported physical activity while at work. Females in the lowest age category (18-35 years) who perceived a more supportive workplace environment for physical activity had higher odds of being moderately active (AOR 1.06, 95% CI 1.04-1.08) and active (AOR 1.15, 95% CI 1.13-1.17) as compared to inactive in their leisure time. The strength of this association was slightly higher with age and for males., Conclusions: Since the majority of Canadian adults do not meet recommended levels of physical activity, the workplace offers a promising and modifiable target for increasing opportunities to be physically active. Employers who can provide a more supportive workplace environment for physical activity would benefit, as it can increase employees' physical activity levels and ultimately improve their productivity and overall health. These benefits may be increased for males and with employees' age.

Coal-tar-based sealcoat products, widely used in the central and eastern U.S. on parking lots, driveways, and even playgrounds, are typically 20-35% coal-tar pitch, a known human carcinogen that contains about 200 polycyclic aromatic hydrocarbon (PAH) compounds. Research continues to identify environmental compartments-including stormwater runoff, lake sediment, soil, house dust, and most recently, air-contaminated by PAHs from coal-tar-based sealcoat and to demonstrate potential risks to biological communities and human health. In many cases, the levels of contamination associated with sealed pavement are striking relative to levels near unsealed pavement: PAH concentrations in air over pavement with freshly applied coal-tar-based sealcoat, for example, were hundreds to thousands of times higher than those in air over unsealed pavement. Even a small amount of sealcoated pavement can be the dominant source of PAHs to sediment in stormwater-retention ponds; proper disposal of such PAH-contaminated sediment can be extremely costly. Several local governments, the District of Columbia, and the State of Washington have banned use of these products, and several national and regional hardware and home-improvement retailers have voluntarily ceased selling them.

Coal-tar based sealcoat has been identified as a source of polycyclic aromatic hydrocarbons (PAHs) in the environment. This study measured the long-term release of PAHs in parking lot runoff and found that the presence of coal tar sealant increased the mass of PAHs released in runoff by over an order of magnitude. PAH concentrations in stormwater from two coal tar sealed parking lots and one unsealed parking lot (control) were monitored over a two-year period. The measured flow volume and concentrations were used to calculate a mass of 9.8-10.8 kg total Σ16 PAHs per hectare exported in stormwater runoff from the two sealed parking lots and 0.34 kg total Σ16 PAHs per hectare from the unsealed control. The study also measured sediment PAH concentration changes in a receiving drainage and found that even partial coverage of a drainage area by coal tar sealant resulted in measurable increases in PAH sediment concentrations; PAH concentrations in sediment in a stormwater swale receiving runoff from both sealed and unsealed lots increased near the outfall from less than 4 mg/kg prior to sealing to 95.7 mg/kg after sealing. Compound ratio plots and principal components analysis were examined and were able to clearly differentiate between pre- and postsealant samples.

Objective: The objective of this study was to explore students' perceptions of school policy characteristics that influence the location of smoking while at school., Methods: Data were collected from a nationally representative sample of Canadian youth in grades 7-12 as part of the 2006-2007 Youth Smoking Survey. We used multilevel logistic regression to examine how students' perceptions of school policies predicted smoking behavior on and off school grounds in 11,881 students who had ever smoked. Separate analyses were conducted for grades 7-9 and 10-12., Results: In both grades 7-9 and 10-12, perceiving clear rules about smoking decreased the likelihood that a student would smoke on school grounds, while perceiving that a high percentage of peers smoke, that there are school rules about smoking, that students obey the rules, and that students can be fined for smoking increased the likelihood that a student would smoke off school grounds., Conclusions: Clearly perceived rules about smoking encourage students not to smoke on school grounds; however, perceptions of rules, along with strong enforcement, may displace behavior off of school grounds. Non-smoking policies should be part of a comprehensive approach, that supports cessation.

Polycyclic aromatic hydrocarbon (PAH) concentrations were measured in Spartina alterniflora plants grown in pots of contaminated sediment, plants grown in native sediment at a marsh contaminated with up to 900 microg/g total PAHs, and from plants grown in uncontaminated control sediment. The roots and leaves of the plants were separated, cleaned, and analyzed for PAHs. PAH compounds were detected at up to 43 microg/g dry weight in the root tissue of plants grown in pots of contaminated soil. PAH compounds were detected at up to 0.2 microg/g in the leaves of plants grown in pots of contaminated soil. Concentrations less than 0.004 microg/g were detected in the leaves of plants grown at a reference site. Root concentration factor (RCF) values ranged from 0.009 to 0.97 in the potted plants, and from 0.004 to 0.31 at the contaminated marsh site. Stem concentration factor (SCF) values ranged from 0.00004 to 0.03 in the potted plants and 0.0002 to 0.04 at the contaminated marsh. No correlation was found between the RCF value and PAH compound or chemical properties such as logKOW. SCF values were higher for the lighter PAHs in the potted plants, but not in the plants collected from the contaminated marsh. PAH concentrations in the roots of the potted plants are strongly correlated with soil concentrations, but there is less correlation for the roots grown in natural sediments. Additional plants were grown directly in PAH-contaminated water and analyzed for alkylated PAH homologs. No difference was found in leaf PAH concentrations between plants grown in contaminated water and control plants.