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1.
Nat Mater ; 23(10): 1402-1410, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39198713

RESUMO

Novel two-dimensional semiconductor crystals can exhibit diverse physical properties beyond their inherent semiconducting attributes, making their pursuit paramount. Memristive properties, as exemplars of these attributes, are predominantly manifested in wide-bandgap materials. However, simultaneously harnessing semiconductor properties alongside memristive characteristics to produce memtransistors is challenging. Herein we prepared a class of semiconducting III-V-derived van der Waals crystals, specifically the HxA1-xBX form, exhibiting memristive characteristics. To identify candidates for the material synthesis, we conducted a systematic high-throughput screening, leading us to 44 prospective III-V candidates; of these, we successfully synthesized ten, including nitrides, phosphides, arsenides and antimonides. These materials exhibited intriguing characteristics such as electrochemical polarization and memristive phenomena while retaining their semiconductive attributes. We demonstrated the gate-tunable synaptic and logic functions within single-gate memtransistors, capitalizing on the synergistic interplay between the semiconducting and memristive properties of our two-dimensional crystals. Our approach guides the discovery of van der Waals materials with unique properties from unconventional crystal symmetries.

2.
Subst Use Misuse ; : 1-7, 2024 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-39344153

RESUMO

Introduction: Flavorings are one of the major appealing factors of current tobacco products, especially for young adults. They constantly evolve, and new flavorings are introduced to the market every year, but little is known about user profiles of flavored tobacco products (FTPs). Methods: We analyzed young adult (ages 18-24) tobacco product users (N = 4,707) from Wave 5 of the Population Assessment of Tobacco and Health Study. We applied bivariate analyses to compare individuals who use FTP and non-FTPs by different flavor types (i.e., menthol/mint, fruit, candy/sweets, and tobacco). Parameter estimates were weighted by applying the sample and replicate weights for the complex study design to produce population-representative estimates. Results: Sixty percent of the current combustible tobacco users and 90% of electronic nicotine delivery systems (ENDS) users were FTP users. FTP users were more likely to be multiple product users than non-FTP users. Being non-Hispanic White, drinking alcohol in the past year, experiencing internalizing problems in the past month, and having tobacco dependence were associated with FTP use. Flavored ENDS users had different sociodemographic characteristics by flavor types but did not differ significantly in vaping-related behaviors (e.g., frequency). Also, preferred flavors differed among tobacco user groups (i.e., ENDS, hookah, and cigars). Conclusions: FTPs appear to be gaining popularity among young adults and tend to show co-use with multiple tobacco products and other substances. Future studies are warranted to monitor the risk factors of young adult FTP use, especially in the context of flavor ban on ENDS products.

3.
Tob Control ; 32(3): 352-358, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-34326194

RESUMO

OBJECTIVES: An increasing number of US states have required a tax on electronic nicotine delivery systems (ENDS) in the past few years. This study evaluated the effect of statewide vaping product excise tax policy on ENDS use among young adults. METHODS: We used the two recent waves (2014-2019) of the Tobacco Use Supplement to the Current Population Survey. A total of 17 896 US young adults were analysed. Difference-in-differences approach along with weighted multilevel logistic regressions was used to evaluate the association of vaping product excise tax policy adoption with current ENDS use, accounting for the clustering of respondents within the same states. RESULTS: There was an increase in current ENDS use prevalence from 2014-2015 (3.4%) to 2018-2019 (5.4%). Respondents living in states with vaping product excise tax policy showed significantly lower increase in ENDS use prevalence during the study period (interaction between within-state changes and between-state differences: adjusted OR (AOR)=0.57, 95% CI=0.35 to 0.91), controlling for other state-level policies and sociodemographic characteristics. Additional stratified analysis with state-fixed effects by vaping product excise tax policy implementation status showed consistent findings. CONCLUSIONS: Our findings suggest that adopting a vaping product excise tax policy may help reduce ENDS use and suppress the increase of ENDS use prevalence among young adults. Considering that there are still a number of US states that have not implemented vaping product excise tax policy, wider adoption of such policy across the nation would likely help mitigate ENDS use prevalence.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Vaping , Humanos , Adulto Jovem , Estados Unidos , Vaping/epidemiologia , Uso de Tabaco , Políticas , Prevalência
4.
BMC Geriatr ; 23(1): 232, 2023 04 17.
Artigo em Inglês | MEDLINE | ID: mdl-37069507

RESUMO

BACKGROUND: A few studies suggest that Taekwondo is an effective intervention in increasing physical functions among older adults. This study is intended to focus on a multitude of health benefits of participation in a modified Taekwondo activity for nursing home residents in the U.S. METHODS: This qualitative study used semi-structured, in-depth interviews with seven participants consisting of 2 males and 5 females older adults from a community nursing home. The interview protocol included content mapping and content mining interview questions. The study followed the five steps of constant comparative analysis. RESULTS: Four main themes were identified as health benefits resulting from a modified Taekwondo participation: (a) promoting mental health, (b) increasing physical functions, (c) stimulating cognitive abilities, and (d) facilitating positive social interaction. DISCUSSION: This study indicates modified Taekwondo can be instrumental in promoting their physical functioning, cognitive functioning, social interactions, and mental health. Practical implications and further discussion are addressed in this paper.


Assuntos
Promoção da Saúde , Artes Marciais , Saúde Mental , Casas de Saúde , Idoso , Feminino , Humanos , Masculino , Pesquisa Qualitativa , Interação Social , Cognição
5.
J Behav Med ; 46(4): 668-679, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-36637734

RESUMO

We aimed to examine how bidirectional relationships between mental health problems and tobacco use are formed over time by types of tobacco use in recent samples of U.S. youth. Data were drawn from Waves 1-4 of the Population Assessment of Tobacco and Health Study (N = 10,082) and analyzed using cross-lagged panel models. A high level of internalizing problems at Wave 1 predicted conventional cigarette smoking (adjusted odds ratio [AOR] = 1.19, 95% CI = 1.06-1.34) and e-cigarette use (AOR = 1.25, 95% CI = 1.09-1.43) at Wave 2, but not vice versa. Both cigarette smoking and e-cigarette use at Wave 2 tended to persist into Wave 3, which, in turn, increased the risk of subsequent internalizing problems in late adolescence or young adulthood (Wave 4). The bidirectional relationship between tobacco use and internalizing problems seems to begin as a procession from internalizing problems to tobacco use, and then from persistent tobacco use to exacerbated internalizing problems over time.


Assuntos
Fumar Cigarros , Sistemas Eletrônicos de Liberação de Nicotina , Produtos do Tabaco , Humanos , Adolescente , Adulto Jovem , Adulto , Saúde Mental , Estudos Longitudinais , Uso de Tabaco/epidemiologia , Uso de Tabaco/psicologia , Nicotiana
6.
Harm Reduct J ; 20(1): 159, 2023 10 27.
Artigo em Inglês | MEDLINE | ID: mdl-37891632

RESUMO

BACKGROUND: Opioid overdose deaths are of great concern to public health, with over one million lives lost since 1999. While many efforts have been made to mitigate these, Black communities continue to experience a greater burden of fatalities than their white counterparts. This study aims to explore why by working with Black community members in Indianapolis through semi-structured interviews. METHODS: Semi-structured one-on-one in-depth interviews were conducted in spring and summer of 2023 with Black residents (N = 23) of zip codes 46202, 46205, 46208, and 46218 in Indianapolis. Ten interview questions were used to facilitate conversations about opioid overdoses, recovery, fatality prevention tools such as calling 911 and naloxone, law enforcement, and racism. Data were analyzed using grounded theory and thematic analysis. RESULTS: Interviews revealed access barriers and intervention opportunities. Racism was present in both. Mental access barriers such as stigma, fear, and mistrust contributed to practical barriers such as knowledge of how to administer naloxone. Racism exacerbated mental barriers by adding the risk of race-based mistreatment to consequences related to association with substance use. Participants discussed the double stigma of substance use and being Black, fear of being searched in law enforcement encounters and what would happen if law enforcement found naloxone on them, and mistrust of law enforcement and institutions that provide medical intervention. Participants had favorable views of interventions that incorporated mutual aid and discussed ideas for future interventions that included this framework. CONCLUSIONS: Racism exacerbates Blacks' mental access barriers (i.e., help-seeking barriers), which, in turn, contribute to practical barriers, such as calling 911 and administering naloxone. Information and resources coming from people within marginalized communities tend to be trusted. Leveraging inter-community relationships may increase engagement in opioid overdose fatality prevention. Interventions and resources directed toward addressing opioid overdose fatalities in Black communities should use mutual aid frameworks to increase the utilization of the tools they provide.


Assuntos
Overdose de Drogas , Overdose de Opiáceos , Transtornos Relacionados ao Uso de Opioides , Transtornos Relacionados ao Uso de Substâncias , Humanos , Antagonistas de Entorpecentes/uso terapêutico , Overdose de Opiáceos/tratamento farmacológico , Naloxona/uso terapêutico , Overdose de Drogas/prevenção & controle , Overdose de Drogas/tratamento farmacológico , Transtornos Relacionados ao Uso de Substâncias/tratamento farmacológico , Analgésicos Opioides/uso terapêutico , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico
7.
Nicotine Tob Res ; 24(4): 590-597, 2022 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-34758071

RESUMO

OBJECTIVES: Prior studies that examined the role of electronic nicotine delivery systems (ENDS) use in smoking cessation have shown divergent conclusions. This study examined the time-course of ENDS-associated smoking abstinent behaviors among continuing cigarette smokers who were willing but unable to quit smoking. METHODS: Data were drawn from the four waves of the Population Assessment of Tobacco and Health Study. Of the 1684 smokers who tried to quit smoking completely at Wave 1, a total of 1094 who were continuing smokers until Wave 4 and were not lost to follow-ups comprised the sample. Using generalized linear mixed modeling, we fitted weighted negative binomial regression models to examine within-person associations of ENDS use with quit attempts and number of days abstinent from smoking. RESULTS: Quit attempt frequency and smoking abstinent days were highest at Wave 1, dropped at Wave 2, and then either increased a little or remained stagnant in later waves. ENDS use to quit smoking was associated with more frequent quit attempts (aIRR = 1.67, 95% CI = 1.42-1.95) and more abstinent days (aIRR = 3.28, 95% CI = 2.43-4.44), and the magnitude of such associations became stronger over time. ENDS use was associated with becoming a nondaily smoker among baseline daily smokers. CONCLUSIONS: ENDS use among continuing smokers may help increase the number of quit attempts and smoking abstinent days. Given that the study sample is continuing smokers who failed in complete smoking cessation, future research would be desirable that evaluates whether such abstinent behaviors sustain and manifest harm reduction with improved health outcomes. IMPLICATIONS: Smokers increasingly adopt electronic nicotine delivery systems (ENDS) to quit smoking. However, the association of ENDS use with smoking cessation efforts among continuing cigarette smokers who were willing but unable to quit smoking is largely unknown. This study found that quit attempts and smoking abstinent days increased with ENDS use to quit smoking by following up with population-representative continuing smokers. Additionally, this study assessed whether cigarette smokers' abstinent behaviors vary with their use of ENDS by estimating within-person associations with frequent assessments of both exposures and outcomes in a long-term perspective.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Abandono do Hábito de Fumar , Produtos do Tabaco , Adulto , Humanos , Fumantes , Fumar
8.
Prev Med ; 145: 106418, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33422574

RESUMO

Intervention strategies to prevent adolescents from using electronic nicotine delivery systems (ENDS) should be based on robust predictors of ENDS use that may differ from predictors of conventional cigarette use. Literature points to the need for uncovering emerging predictors of ENDS use. This study identified emerging predictors of adolescent ENDS use using machine learning (ML) techniques. We analyzed nationally representative multi-wave longitudinal survey data (2013-2018) drawn from the Population Assessment of Tobacco and Health Study. A sample of adolescents (12-17 years) who never used any tobacco products at baseline and completed Wave 2 (n = 7958), Wave 3 (n = 6260) and Wave 4 (n = 4544) were analyzed. We developed a supervised ML prediction model using the penalized logistic regression to assess self-reported past-month ENDS use (i.e., current use) at Waves 2-4 based on the variables measured at the previous wave. We then extracted important predictors from each model. The penalized logistic regression models showed suitable capability to discriminate between ENDS uses and non-uses at each wave based on the area under the receiver operating characteristic curve and the area under the precision-recall curve. Interestingly, social media use emerged as an important variable in predicting adolescent ENDS use. ML models appear to be a promising method to identify unique population-level predictors for U.S. adolescent ENDS use behaviors. More research is warranted to investigate emerging predictors of ENDS use and experimentally examine the mechanism by which these emerging predictors affect ENDS use behavior across different spectrum of populations.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Produtos do Tabaco , Adolescente , Humanos , Aprendizado de Máquina , Nicotiana , Uso de Tabaco
9.
Tob Control ; 30(3): 336-343, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-32269171

RESUMO

OBJECTIVES: South Korea implemented an unprecedented cigarette tax increase in 2015, raising its cigarette price by 80%. This study evaluated the extent to which the 2015 cigarette tax increase affected Korean adult smokers in terms of quit attempts, successful quitting and smoking intensity. METHODS: Data were drawn from a nationally representative longitudinal study, the Korean Welfare Panel Study (waves 9-12, 2014-2017). Korean adults who smoked before the 2015 cigarette tax increase comprised the sample (n=2114). We used the multiple logistic regressions to examine factors of quit attempts and successful quitting and the generalised estimating equations to estimate changes in smoking intensity among continued smokers. RESULTS: After the cigarette tax increase, 60.9% (n=1334) of baseline smokers attempted to quit and 34.7% of the attempters succeeded in quitting. The smokers aged ≥ 65 years and light smokers both attempted more (p<0.01) and succeeded more (p<0.05) in quitting than smokers aged 35-44 years and heavy smokers, respectively. The successful quitting was not significantly associated with income levels. Depressive symptoms, first cigarette use before age 19 and smoking a pack or more a day at baseline were associated with failures in quitting. Smoking intensity among continued smokers decreased after the cigarette tax increase (p<0.001), but such a decrease was not observed in light smokers, young smokers and high-income smokers. CONCLUSION: The current study findings imply that the Korean government may consider implementing periodic increases in cigarette tax which should reflect the rate of inflation and income growth. Smoking cessation programmes need to address depressive symptoms.


Assuntos
Fumantes , Produtos do Tabaco , Adulto , Comércio , Humanos , Estudos Longitudinais , República da Coreia/epidemiologia , Fumar/epidemiologia , Adulto Jovem
10.
Prev Med ; 130: 105896, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31730945

RESUMO

Preventing adolescents from using e-cigarettes is crucial given that e-cigarette use can lead to conventional cigarette smoking. In order to inform prevention efforts, the present study examined the role of susceptibility measures as well as psychosocial, behavioral, and environmental factors in prospectively predicting ever use of electronic cigarettes among adolescents. We analyzed Wave 1 and Wave 2 of the Population Assessment of Tobacco and Health (PATH), nationally representative longitudinal panel datasets. Nicotine naïve adolescents, ages 12-17 at baseline (N = 7933) were included in the study sample. Multivariable logistic regression was conducted to examine the determinants of adolescents' ever use of e-cigarettes. Overall, 12.3% (n = 983) of adolescents who were naïve to nicotine products at Wave 1 became ever users of e-cigarettes at Wave 2. Susceptibility to e-cigarette use at Wave 1 was a significant predictor of ever use at Wave 2 (adjusted odds ratio = 2.27; 95% CI = 1.92, 2.68). Adolescents who were not susceptible to e-cigarette use at Wave 1 but became ever users at Wave 2 were more likely to show a higher level of alcohol use, marijuana use, other substance use, have modified family, be exposed to secondhand tobacco smoke, and have a higher level of psychological problems. The specificity of susceptibility measure was 73.2% (5080/6936) and sensitivity was 57.3% (563/983). The findings of the present study appear to support the predictive validity of the susceptibility to e-cigarette use measure as a significant predictor of future e-cigarette use.


Assuntos
Comportamento do Adolescente/psicologia , Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Vaping/epidemiologia , Vaping/psicologia , Adolescente , Criança , Feminino , Humanos , Estudos Longitudinais , Masculino , Reprodutibilidade dos Testes , Medição de Risco/métodos , Fumar , Estados Unidos/epidemiologia
11.
Prev Med ; 130: 105886, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31705938

RESUMO

This study evaluated prediction performance of three different machine learning (ML) techniques in predicting opioid misuse among U.S. adolescents. Data were drawn from the 2015-2017 National Survey on Drug Use and Health (N = 41,579 adolescents, ages 12-17 years) and analyzed in 2019. Prediction models were developed using three ML algorithms, including artificial neural networks, distributed random forest, and gradient boosting machine. The performance of the ML prediction models was compared with performance of the penalized logistic regression. The area under the receiver operating characteristic curve (AUROC) and the area under the precision-recall curve (AUPRC) were used as metrics of prediction performance. We used the AUPRC as the primary measure of prediction performance given that it is considered more informative for assessing binary classifiers on imbalanced outcome variable than AUROC. The overall rate of opioid misuse among U.S. adolescents was 3.7% (n = 1521). Prediction performance was similar across the four models (AUROC values range from 0.809 to 0.815). In terms of the AUPRC, the distributed random forest showed the best performance in prediction (0.172) followed by penalized logistic regression (0.162), gradient boosting machine (0.160), and artificial neural networks (0.157). Findings suggest that machine learning techniques can be a promising technique especially in the prediction of outcomes with rare cases (i.e., when the binary outcome variable is heavily lopsided) such as adolescent opioid misuse.


Assuntos
Aprendizado de Máquina , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Adolescente , Comportamento do Adolescente , Algoritmos , Área Sob a Curva , Criança , Feminino , Humanos , Modelos Logísticos , Masculino , Medição de Risco/métodos , Inquéritos e Questionários , Estados Unidos/epidemiologia
12.
Prev Med ; 131: 105969, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31931980

RESUMO

Tumin and Bhalla mentioned challenges associated with the use of population-based survey and machine learning (ML) results on adolescent opioid misuse to clinical settings. In a clinical setting, medical providers do know patient's identity. So, it is not surprising that drug misuse is rarely identified through patient's self-report especially if it involves illicit drug. Even though self-report is susceptible to bias, it is a valid and affordable tool to gather data on illicit drug use at the population level. Use of audio computer-assisted self-interviewing (ACASI) and computer-assisted personal interviewing (CAPI) in NSDUH provides the respondent with a highly private and confidential mode for responding to questions, which helps increase the level of honest reporting of illicit drug use and other sensitive behaviors. As acknowledged in the paper, opioid misuse should not be inferred at the individual level from our ML models. Such interpretations may lead to ecological fallacy. Predicting opioid misuse at the population level is different from identifying opioid misuse in individual patients. Nonetheless, we believe that coordinated multisectoral collaborations that leverage the expertise and resources of both public health and clinical sectors would offer a promising model for addressing the opioid crisis.


Assuntos
Usuários de Drogas , Uso Indevido de Medicamentos sob Prescrição , Adolescente , Analgésicos Opioides , Humanos , Aprendizado de Máquina , Autorrelato
13.
J Prim Prev ; 41(2): 87-103, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31953593

RESUMO

Indiana recently implemented a statewide smoke-free indoor air law that has prohibited smoking in both restaurants and non-hospitality workplaces. Evidence for the effectiveness of the recent statewide smoke-free indoor law may persuade 14 states that do not have any statewide smoke-free laws to enact such laws. We evaluated the effectiveness of Indiana's State Smoke-Free Air Law, implemented July 2012, in reducing adult smoking prevalence. We analyzed samples of U.S. adults using a nonequivalent control group design with multi-year, cross-sectional data from the 2011-2016 Behavioral Risk Factor Surveillance System ( N= 2,259,014). Four state groups with different levels of comprehensiveness in regard to statewide smoke-free indoor air laws in 2011-2016 served as the comparison groups, namely those with: (1) no law; (2) a partial law (prohibiting smoking in either one or two of these three settings, namely non-hospitality workplaces, restaurants, and bars); (3) a comprehensive law (prohibiting smoking in all non-hospitality workplaces, restaurants, and bars); and (4) those that changed from a partial to a comprehensive law. We used a difference-in-differences approach with multiple logistic regressions to assess the net effect of the policy with a secular trend removed. The decline rate of cigarette smoking in Indiana was steeper, from 21.2% in 2011-2012 to 17.8% in 2013-2016, than in states in our four comparison groups, which suggests a significant reduction in adult cigarette smoking prevalence above and beyond the downward secular trend observed. All the comparison groups showed higher odds of cigarette smoking than Indiana (adjusted odds ratios range from 1.08 to 1.16). Although a long-term effect of Indiana's State Smoke-Free Air Law has yet to be evaluated, current data indicate that such a policy appears to be effective in reducing smoking prevalence. The implementation of statewide smoke-free indoor air laws in all restaurants and non-hospitality workplaces may help reduce smoking rates in the 14 states that still do not have any statewide smoke-free indoor air laws.


Assuntos
Poluição do Ar em Ambientes Fechados/legislação & jurisprudência , Restaurantes/legislação & jurisprudência , Política Antifumo/legislação & jurisprudência , Poluição por Fumaça de Tabaco/legislação & jurisprudência , Local de Trabalho/legislação & jurisprudência , Adolescente , Adulto , Idoso , Sistema de Vigilância de Fator de Risco Comportamental , Estudos Transversais , Feminino , Humanos , Indiana , Masculino , Pessoa de Meia-Idade , Estados Unidos
14.
Prev Med ; 119: 118-123, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30594535

RESUMO

Cigarette smoking is a well-established cause of excess morbidity and mortality in the United States and globally. The current study builds on the existing literature by examining how smoking trajectories might be a mechanism through which adolescent tolerance for deviance predicts premature all-cause and tobacco-specific mortality. Participants were from a cohort-sequential study conducted in the Midwestern United States of the natural history of cigarette smoking from adolescence through midlife that collected nine waves of data from 1980 to 2011. For the current study, we selected participants who were measured at least once at age 18 or older and who did not die before age 24 (n = 7575). Participants' tolerance for deviance was assessed in adolescence, smoking trajectory group was based on self-reported smoking status during the first six waves of data collection, and cause of death for deceased participants (n = 222) was obtained from the National Death Index. Mediation analyses using the joint significance test were conducted separately for all-cause mortality and tobacco-specific mortality. Adolescent tolerance for deviance significantly predicted smoking trajectory group over and above the influence of covariates. Adolescents with higher tolerance for deviance were more likely to belong to any smoking trajectory group compared to abstainers, and membership in a smoking trajectory group characterized by early onset and heavy, persistent smoking was related to premature all-cause and tobacco-specific mortality. Finally, smoking trajectory group was a significant mediator of the relation between adolescent tolerance for deviance and all-cause mortality.


Assuntos
Comportamento do Adolescente/psicologia , Comportamento Aditivo , Fumar Cigarros/mortalidade , Mortalidade Prematura , Adolescente , Adulto , Comportamento Aditivo/epidemiologia , Comportamento Aditivo/psicologia , Fumar Cigarros/efeitos adversos , Feminino , Humanos , Estudos Longitudinais , Masculino , Meio-Oeste dos Estados Unidos/epidemiologia , Personalidade , Adulto Jovem
15.
Int J Behav Med ; 25(5): 540-547, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29728989

RESUMO

PURPOSE: This study aims to investigate the socioeconomic disparities in health risk behavior clusterings among Korean adolescents and to assess the mediating role of stress on this association. METHOD: We analyzed the 2015 Korean Youth Risk Behavior Survey, a nationally representative sample of Korean middle and high school students aged 12-18 years (N = 68,043). The co-occurrence of multiple health risk behaviors (i.e., cigarette smoking, drinking, and unprotected sex) was used to operationalize health risk behavior clusterings that ranged from zero to three. Ordinal and multinomial logistic regressions were conducted to examine socioeconomic disparities in health risk behavior clusterings and mediating effect of perceived stress between socioeconomic status (SES) and health risk behaviors. RESULTS: When SES was grouped into five groups, adolescents in the lowest SES [adjusted odds ratio (AOR) = 2.15, 95% confidence interval (CI) = 1.90-2.44] and the highest SES (AOR = 1.29, 95% CI = 1.18-1.40) showed a higher likelihood of risk behavior clusterings than any other SES groups. Stress partially mediated the relationship between SES and co-occurrence of multiple health risk behaviors while accounting for their demographic characteristics. Adolescents in the lowest and highest SES reported higher stress than other SES groups, which, in turn, was associated with the co-occurrence of multiple health risk behaviors. CONCLUSION: The results suggest that perceived stress level partly explains why affluent as well as low-SES adolescents engage in multiple risk behaviors. The findings also discourage use of a linear approach in socioeconomic disparity investigation in relation to adolescent health behaviors.


Assuntos
Comportamento do Adolescente/psicologia , Comportamentos de Risco à Saúde , Disparidades nos Níveis de Saúde , Estresse Psicológico/psicologia , Estudantes/psicologia , Adolescente , Criança , Análise por Conglomerados , Feminino , Humanos , Masculino , Razão de Chances , Classe Social
16.
Prev Med ; 97: 100-108, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28137662

RESUMO

Between body mass index (BMI) ≥30 and waist circumference (WC) ≥102/88cm, we investigated which of the two measures is a better predictor of two of the most common chronic diseases - diabetes mellitus and hypertension while also examining differential association by gender, age group, and race/ethnicity. Meta-analysis was conducted for all longitudinal studies with at least 12months of follow-up published up to April 2015. Ratio of relative risk (rRR) and relative risk of diseases were computed and compared by baseline obesity measurement. The final sample included 23 longitudinal observation studies involving 62 study arms with 259,200 individuals. WC≥102/88cm was a better predictor than BMI≥30 for development of diabetes (rRR=0.81, 95% CI=0.68-0.96), but not for hypertension (rRR=0.92, 95% CI=0.80-1.06). Subgroup analyses showed WC≥102/88cm was a better predictor for diabetes in women than men, and for ages 60 and older than other ages. Only WC≥102/88cm, not BMI≥30, predicted development of hypertension among Hispanic/Latinos. Neither BMI≥30 nor WC≥102/88cm were significant predictors of hypertension when age group was controlled. Central obesity may be a more serious risk factor for diabetes development in women and for older ages. The predictive power of BMI≥30 or WC≥102/88cm in hypertension development should not be emphasized as either could mask the effect of age.


Assuntos
Índice de Massa Corporal , Diabetes Mellitus/diagnóstico , Hipertensão/diagnóstico , Circunferência da Cintura/etnologia , Diabetes Mellitus/epidemiologia , Etnicidade , Humanos , Hipertensão/epidemiologia , Estudos Longitudinais , Obesidade/etnologia , Grupos Raciais , Fatores de Risco
17.
Am J Public Health ; 106(4): 672-8, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26794178

RESUMO

OBJECTIVES: We assessed whether e-cigarette use is associated with (1) intention to smoke cigarettes among never-smoking youths and youth experimenters, and (2) intention to quit smoking among current youth smokers. METHODS: We categorized participants from the 2012 National Youth Tobacco Survey data (n = 20 193) as never-smoking youth (n = 16 238), youth experimenters (n = 3248), and current youth smokers (n = 707). We matched groups on the basis of a propensity score comprising covariates predicting e-cigarette use. RESULTS: E-cigarette users who had never smoked cigarettes (adjusted odds ratio [AOR] = 3.62; 95% confidence interval [CI] = 2.04, 6.45) and who had experimented with smoking (AOR = 1.99; 95% CI = 1.50, 2.64) had elevated intention to smoke cigarettes compared with their counterparts who had never used e-cigarettes. We did not find any significant association between e-cigarette use and intention to quit smoking among current youth smokers (P = .33). CONCLUSIONS: E-cigarette use among US youths is associated with intention to smoke but not with intention to quit smoking.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Intenção , Abandono do Hábito de Fumar , Fumar , Adolescente , Comportamento do Adolescente , Feminino , Humanos , Masculino , Pontuação de Propensão , Abandono do Hábito de Fumar/métodos , Abandono do Hábito de Fumar/psicologia , Inquéritos e Questionários , Estados Unidos
18.
BMC Public Health ; 16: 682, 2016 08 02.
Artigo em Inglês | MEDLINE | ID: mdl-27485724

RESUMO

BACKGROUND: Youth's physical activity (PA) may change across developmental periods. Although previous studies have observed a decline in levels of PA during adolescence, few studies have explored trends in PA during the transition from adolescence to young adulthood and what factors may impact the transitional change. The purpose of this study was to examine changes and predictors of change over time in PA from 10(th) grade to post-high school. METHODS: The NEXT Generation Health Study recruited a nationally-representative cohort of US 10(th)-graders, and administered longitudinal surveys in four waves (years) to follow up the participants to their first year after high school. Using transition models, the self-reported outcomes, moderate-to-vigorous PA (MVPA) and vigorous PA (VPA) each of which was repeatedly measured by one question, were modelled in association with wave-4 environmental-status variables and time-varying covariates. RESULTS: There was a continuous decline in the proportion of respondents who met or exceeded the minimum recommended level for either MVPA (from 55.97 to 34.33 %) or VPA (from 65.96 to 54.90 %) from W1 to W4. Higher scores of peer PA, family support and VPA planning were prospectively associated with higher likelihood of meeting the MVPA/VPA recommendations. At wave 4, compared to those not working, attending 4-year colleges, or living on campus, participants working full/part time, not attending school or attending community-college level schools, and living at home or in own place were more likely to engage in MVPA. CONCLUSIONS: Peer PA, family support, self-regulatory skills, and environmental status after high school are critical factors that can promote MVPA/VPA among adolescents and emerging adults.


Assuntos
Exercício Físico , Família , Comportamentos Relacionados com a Saúde , Grupo Associado , Instituições Acadêmicas , Meio Social , Universidades , Adolescente , Adulto , Emprego , Meio Ambiente , Feminino , Humanos , Acontecimentos que Mudam a Vida , Estudos Longitudinais , Masculino , Autonomia Pessoal , Características de Residência , Inquéritos e Questionários , Estados Unidos , Adulto Jovem
19.
J Natl Med Assoc ; 108(1): 77-85, 2016 02.
Artigo em Inglês | MEDLINE | ID: mdl-26928491

RESUMO

BACKGROUND: Little is known about correlates of overweight, obesity, and physical inactivity among African American students at historically Black colleges and universities. OBJECTIVE: To assess overweight, obesity, and physical inactivity among African American college students at a historically Black university in Maryland in the USA. METHODS: Data were collected from 268 African American college students in 2013. Data were analyzed with percentage difference z-tests, chi-square tests, and multiple logistic regression. DESIGN: Cross-sectional survey (student response rate = 49.9%). RESULTS: The overweight/obesity rate of participants was 47.5%, which was higher than that of the U.S. college student population overall (34.1%) and a representative sample of African American college students (38.3%). When age and sex were controlled, a family history of obesity, skipping breakfast, drinking caffeinated drinks, lower family income, and smoking a pipe, cigars, or cigarettes daily were significant correlates of overweight (obesity included). The percentage of physical inactivity was 68.3, and physical inactivity was higher among women and overweight or obese students. CONCLUSION: Given the high overweight and obesity prevalence among African American college students, historically Black colleges and universities in the USA should increase health promotion efforts targeting weight-related behaviors, particularly physical activity.


Assuntos
Negro ou Afro-Americano/estatística & dados numéricos , Exercício Físico/fisiologia , Sobrepeso/epidemiologia , Estudantes/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Masculino , Maryland , Obesidade , Universidades , Adulto Jovem
20.
Am J Public Health ; 105(8): 1617-22, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26066917

RESUMO

OBJECTIVES: We evaluated the impact of comprehensive statewide smoke-free indoor air laws on secondhand smoke (SHS) exposure, asthma prevalence, and asthma-related doctor visits. METHODS: We used the 2007-2011 Behavioral Risk Factor Surveillance System data sets. We employed a paired t test to determine whether comprehensive statewide smoke-free indoor air laws reduced SHS exposure. We performed weighted logistic and Poisson regressions to obtain likelihood of reporting asthma symptoms and incidence rate ratio (IRR) of doctor visits owing to severe asthma symptoms. RESULTS: After such laws were enacted, people in states with comprehensive smoke-free indoor air laws had a lower level of SHS exposure (P < .01), decreased odds of reporting current asthma symptoms (adjusted odds ratio [AOR] = 0.57; 95% confidence interval [CI] = 0.51, 0.63), and a decreased frequency of doctor's visits owing to severe asthma symptoms (IRR = 0.80; 95% CI = 0.69, 0.92) than did their counterparts in fully adjusted models. CONCLUSIONS: Comprehensive statewide smoke-free indoor air laws appear to be effective in reducing SHS exposure and improving asthma outcomes. Regulations requiring smoke-free indoor environments and public areas are beneficial, and smoke-free indoor air laws should be enforced in all states.


Assuntos
Asma/epidemiologia , Política Antifumo/legislação & jurisprudência , Poluição por Fumaça de Tabaco/estatística & dados numéricos , Asma/terapia , Sistema de Vigilância de Fator de Risco Comportamental , Criança , Feminino , Humanos , Modelos Logísticos , Masculino , Distribuição de Poisson , Prevalência , Governo Estadual , Estados Unidos/epidemiologia
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