Cigar Product Modification Among High School Youth.

Introduction: Prevalence of cigar use has been increasing among youth. Research indicates that youth are modifying cigar products either by "freaking" (ie, removing the filter paper) or "blunting" (removing the tobacco and supplementing or replacing with marijuana), yet little is known about youth who engage in this behavior. Thus, this study examines demographic and concurrent substance use behaviors of youth who modify cigars. Methods: Data from the 2013 Cuyahoga County Youth Risk Behavior survey were examined (n = 16 855). The survey collected data on demographics, cigar product use, cigar modification behaviors, and current cigarette, hookah and marijuana use. Responses to cigar product use items were used to create a composite to classify youth in one of eight unique user categories. Univariate and bivariate statistics were calculated using SPSS complex samples procedures. Results: Overall, 15.2% reported current cigar product use, 11.0% reported current freaking, and 18.5% reported current blunt use; taken together, 25.3% of respondents reported any current use of a cigar product. When examined by user category, of those who endorsed any cigar product use, cigars, cigarillos, and little cigars use only was most endorsed (26.3%), followed by Blunt only (25.2%) and all three (ie, cigars, cigarillos, and little cigars, freaking, and blunting; 17.4%). Conclusion: A substantial proportion of high school youth who report using cigar products are modifying them in some way, with nearly half freaking and nearly two-thirds blunting. Given the FDA Center for Tobacco products recent extension of its regulatory authority to include cigar products, it is imperative to understand more about the prevalence of and reasons for cigar modification behaviors. Implications: Although the FDA has recently enacted regulatory authority over cigar products, little is known about cigar product modification. This is the first study to concurrently examine two unique cigar modification behaviors, "freaking" (ie, removing the filter paper) and "blunting" (removing the tobacco and supplementing or replacing with marijuana). A significant proportion of high school youth are modifying cigar products to be used as a tobacco product and as a mechanism to smoke marijuana. More research is needed to understand these behaviors to prevent and reduce the use of cigar products among youth.

Individual, Parental, and Environmental Correlates of Cigar, Cigarillo, and Little Cigar Use Among Middle School Adolescents.

INTRODUCTION: Youth use of cigars, cigarillos, and little cigars (CCLC) is increasing. While correlates of cigarette smoking have been well documented, use of CCLC is not as well understood among young adolescents. This study assessed whether smoking beliefs, parenting practices, and environmental exposures were associated with CCLC use among 7th to 8th grade youth in an urban, mid-Western city. METHODS: The Cleveland Youth Risk Behavior Survey was conducted with 7th to 8th grade students in spring 2012. CCLC use was assessed by asking if students had smoked CCLC in the past 30 days. Covariates include self-reported gender, race, grade, acceptability of smoking, parental monitoring, hours of self-care, visits to corner stores, and current cigarette smoking. Bivariate and multivariate analyses were conducted to determine associations with current CCLC use. RESULTS: Overall, 14.3% of youth reported current CCLC use. Students reporting higher acceptability of smoking, lower parental monitoring, longer periods of self-care, more visits to corner stores and current cigarette smoking were more likely to report current CCLC use in both bivariate and multivariable logistic regression models. CONCLUSIONS: CCLC use is associated with multiple levels of influence, indicating that prevention of youth CCLC use must utilize a multilevel approach. Increased utilization of corner stores was associated with higher odds of CCLC use, and could indicate that youth stopping at corner stores may be exposed to increased tobacco retail advertising and tobacco products. The findings of this study have implications for FDA regulation to prevent CCLC initiation among youth. IMPLICATIONS: While correlates of cigarette smoking have been well documented, use of CCLC is not as well understood among young adolescents. This is the first study that has examined the association between individual, family, and environmental characteristics and CCLC use. The results of this study illustrate that youth attitudes, perceived parenting practices, and environmental exposure are associated with adolescent CCLC use. This is important as the tobacco control community begins to identify strategies to prevent and reduce CCLC use. The findings of this study have clear implications for FDA regulation to prevent CCLC initiation among youth.

Youth Acquisition and Situational Use of Cigars, Cigarillos, and Little Cigars:: A Cross-sectional Study.

INTRODUCTION: Although adolescent use of cigars, cigarillos, and little cigars (CCLCs) has been increasing, little research has been conducted to understand how adolescents acquire CCLCs and the situations in which they smoke CCLCs. Thus, this study aims to understand how adolescent smokers acquire CCLCs and the situations in which they smoke them. METHODS: Data were drawn from the 2011 Cuyahoga County Youth Risk Behavior Survey. Current CCLC smoking was assessed; analysis was limited to current smokers (n=1,337). Current users were asked to identify situations in which they use cigars and ways in which they get cigars. Bivariate analyses assessed differences by sex, race, and concurrent substance use. Data were analyzed in 2014. RESULTS: Youth acquired CCLCs most commonly by buying (64.2%). CCLC smokers also reported high rates of social use (81.1%). There were no significant differences is situational use across sexes, but female adolescents were significantly more likely than male adolescents to share CCLCs and significantly less likely to buy or take CCLCs. Conversely, significant differences were seen for situational use by race/ethnicity, with whites significantly more likely to use in social situations and less likely to use in solitary situations versus blacks and Hispanics. Finally, significant differences were observed in both acquisition and use for youth who concurrently used CCLCs and cigarettes compared with CCLCs only; fewer differences were noted among those who concurrently used CCLCs and marijuana compared with CCLCs only. CONCLUSIONS: These findings highlight how adolescents acquire and use CCLCs and can inform tobacco control strategies to prevent and reduce CCLC use.

Neurological soft-signs and minor physical anomalies in schizophrenia: differential transmission within families.

Markers of vulnerability have been identified in schizophrenia, and among them, neurological soft-signs (NSS) and minor physical anomalies (MPAs) also seem to occur in biological relatives. The similarities of these developmental markers within families may depend on either genetic or non-genetic factors. The aim of the study was to investigate the intra-familial similarities of NSS and MPAs within 18 nuclear families (18 probands with schizophrenia and 36 of their non-psychotic parents). A general linear model showed similarities within families for NSS (intra-class coefficient [ICC] = 0.64; F = 2.6; df = 17.17; p = 0.02) but not for MPAs (ICC = -0.10; F = 0.7; df = 17.17; ns). We thus found a direct evidence for the intra-familial transmission of NSS but not of MPAs, suggesting that this morphological phenotypic trait could be more dependent on epigenetic influences.

Tardive dyskinesias and antipsychotics: a review.

Currently, tardive dyskinesia (TD) remains an important clinical problem. The average prevalence is estimated at 30%. The appearance of antipsychotics has opened new paths. The extrapyramidal profile of these molecules is more favorable than that of conventional neuroleptics. In order to assess their prophylactic as well as curative potential, we reviewed the literature concerning four of these atypical antipsychotics: clozapine, risperidone olanzapine and amisulpride. Clozapine seems to induce fewer cases of TD than the conventional neuroleptics, and has a specific therapeutic effect. However, the risk of agranulocytosis reduces the possibility of utilisation. Risperidone appears to be an effective therapy, but several authors report cases of TD during treatment. Furthermore, larger studies and longer follow-ups are necessary to confirm the efficiency of olanzapine and amisulpride. Further studies and observations are still necessary before drawing any conclusion for these new atypical antipsychotic actions. They are doubtlessly promising, but we cannot ignore the notion of risk-benefit; regular monitoring and listening to the subjective experience of the patients must remain uppermost in the choice of therapy.

Emotional declarative memory assessment of patients with mesial temporal lobe epilepsy and patients submitted to mesial temporal lobectomy.

Epileptic seizures generate cognitive and behavioral impacts in individuals who suffer from epilepsy. Declarative memory is one of the cognitive functions that can be affected by epileptic seizures. The main objective of this work was to investigate neurocognitive function, especially the emotional working memory of patients with unilateral mesial temporal lobe epilepsy, and that of patients submitted to unilateral mesial temporal lobectomy. A face recognition test that can simultaneously recruit the frontal lobe (working memory) and mesial temporal lobe (emotional memory) was used to investigate emotional working memory. Our findings showed that the epilepsy factor significantly compromised the performance in the emotional memory test. On the other hand, surgical removal of the epileptic focus promoted an improvement in the emotional working memory of these patients, in addition to the significantly decrease in the number of seizures.

Comparison between two scoring systems of the Rey-Osterrieth Complex Figure in left and right temporal lobe epileptic patients.

The Rey-Osterrieth Complex Figure (ROCF) is probably one of the most popular measurement instruments of visuoconstructional abilities and nonverbal memory. It is frequently part of neuropsychological test protocols in epilepsy surgery centers. In this study we compared the traditional scoring system of the ROCF developed by Taylor (1998) with a qualitative system that assesses spatial-relational errors devised by Loring et al. [Loring, D. W., Lee, G. P., & Meador, K. J. (1988). Revising the Rey-Osterrieth: Rating right hemisphere recall. Archives of Clinical Neuropsychology, 3, 239-247] in a sample of left and right temporal lobe epilepsy patients undergoing pre-surgical evaluation. We investigated whether the relational-spatial scoring system would be more sensitive to right-sided memory deficits than the traditional Taylor version. There was no difference in the copy phase of the ROCF between the clinical and control groups. There was a significant difference between the control and the clinical groups when the 30-min delayed recall drawings were scored with the Taylor system. However, this system failed to find differences between left and right temporal lobe epileptic patients. On the other hand, comparisons with the qualitative scoring criteria used by Loring et al. [Loring, D. W., Lee, G. P., & Meador, K. J. (1988). Revising the Rey-Osterrieth: Rating right hemisphere recall. Archives of Clinical Neuropsychology, 3, 239-247] revealed that right temporal lobe patients made more spatial-relational errors than patients with left-sided foci. Frequency distribution of these scores for all the three groups and sensitivity and specificity to correctly classify right temporal lobe patients are presented. This investigation demonstrated that applying qualitative, material-specific scoring criteria improves temporal lobe epilepsy presurgical protocols.

Health risk behaviors in a unique population-first ring suburban adolescents.

This study aims to call attention to First Ring suburban communities as a unique and unrecognized population and to characterize health risk behaviors of adolescents within these communities. A risk behavior profile of the First Ring suburbs surrounding a large Midwestern city is presented and compared to the frequency of these behaviors in a national sample. In 2002, a representative sample of 3428 high school students from First Ring suburban communities in an urban county completed the Youth Risk Behavior Survey. A 20-item risk score composed of "current" risk behaviors was compiled in order to compare the relative number of risk behaviors exhibited by the First Ring schools to a 2001 national sample. Prevalence of individual behaviors was also determined and compared to data collected nationally. Prevalence was further subdivided by gender, race, and grade in order to explore risk groups within First Ring suburbs. Despite the perception that the "urbanization" of First Ring suburbs is synonymous with "urban" problems and risk behaviors, First Ring students reported significantly fewer current risk behaviors than did students nationally. Significant differences in behavior were found between First Ring and national gender and racial groups. Some patterns of behavior within gender and racial groups differed from national patterns. The commonly held presumption that First Ring suburbs are riskier for students due to increased urbanization of these communities appears unfounded. The contribution of these destructive misperceptions to social migration away from urban centers and the need for local data collection are discussed.

Emotional declarative memory assessment of patients with mesial temporal lobe epilepsy and patients submitted to mesial temporal lobectomy / Avaliação da memória declarativa emocional em pacientes com epilepsia temporal mesial e pacientes submetidos à lobectomia temporal mesial

Epileptic seizures generate cognitive and behavioral impacts in individuals who suffer from epilepsy. Declarative memory is one of the cognitive functions that can be affected by epileptic seizures. The main objective of this work was to investigate neurocognitive function, especially the emotional working memory of patients with unilateral mesial temporal lobe epilepsy, and that of patients submitted to unilateral mesial temporal lobectomy. A face recognition test that can simultaneously recruit the frontal lobe (working memory) and mesial temporal lobe (emotional memory) was used to investigate emotional working memory. Our findings showed that the epilepsy factor significantly compromised the performance in the emotional memory test. On the other hand, surgical removal of the epileptic focus promoted an improvement in the emotional working memory of these patients, in addition to the significantly decrease in the number of seizures.

Crises epilépticas geram impactos comportamentais e cognitivos em indivíduos que sofrem de epilepsia. Uma das funções cognitivas que pode ser afetada pelas crises epilépticas é a memória declarativa. O objetivo do nosso estudo foi investigar funções cognitivas, especialmente a memória operacional emocional de pacientes com epilepsia temporal mesial unilateral e pacientes submetidos a lobectomia temporal mesial unilateral. Para investigar a memória operacional emocional foi utilizado um teste de reconhecimento de faces que pode recrutar simultaneamente o lobo frontal (memória operacional) e o lobo temporal mesial (memória emocional). Nossos resultados demonstram que o fator epilepsia compromete de forma significativa o desempenho no teste de memória emocional. Por outro lado, a remoção cirúrgica do foco epiléptico promoveu uma melhora na memória emocional desses pacientes, além de diminuir o número de crises.

Lateralized impairment of the emotional enhancement of verbal memory in patients with amygdala-hippocampus lesion.

This study investigated amygdala-hippocampus's functional asymmetry in the emotional modulation of memory for stories. Thirty-nine, right-handed, drug-resistant epilepsy patients who had been submitted to unilateral temporal lobectomy (19 left and 20 right) watched either an arousing or neutral version of a story presented audio-visually. The slide sequence was the same in the neutral and arousing version, the narratives were matched for structure and comprehensibility. The set and order of the 11 slide sequence were identical in both conditions. Free recall and recognition measures were taken 2h after story presentation. Subjects in the TLE group who watched the arousing version recalled more details than the subjects who watched the neutral version (t(37)=3.4,p<.001). The group who watched the arousing version recalled more details of the phase 2 of the story (t(37)=6.76,p<.001). Scores in both conditions did not differ between control subjects and temporal lobectomy patients. When the right and left lesioned groups' results were analyzed separately, it was observed that the two groups did not differ in their recall of the neutral version. The right lesioned group recalled more items of the arousal than the neutral version (Z=-3.55,p<.001). However the left lesioned group did not show the memory enhancement for the emotional version, in this group it was only found an enhanced recall of the more pictorial emotional segment of the narrative (Z=-3.11,p<.001). This illustrates that the right amygdala can influence retention of complex emotional stimuli with verbal and pictorial arousing properties. We concluded that an intact left amygdala-hippocampus is important for enhancement of memory related to emotionally arousing verbal material.

Rememoração, subjetividade e as bases neurais da memória autobiográfica / Remembering, subjectivity and the neural basis of the autobiographic memory

Nesta revisão abordamos o sistema de memória autobiográfica como um processo de rememoração subjetiva graças à ativação de um substrato neural próprio para esta qualidade mnemônica. A rememoração autobiográfica recruta vias corticais extensas tendo como ponto de convergência a região frontal e suas interconexões, culminando com a área orbitofrontal. Trata-se de um processamento neural complexo capaz de integrar diferentes aspectos da evocação, tais como auto-identidade, controle, seletividade e emoção. Analisamos também a noção de amnésia orgânica e amnésia funcional com base em achados recentes sobre os efeitos do estresse no cérebro. Dentre estas evidências, destacam-se as alterações morfológicas e neuroquímicas no cérebro produzidas por estímulos estressantes assim como o alívio destes efeitos através da psicoterapia. Este conhecimento representa um avanço considerável nos conceitos de psicopatologia, abrindo caminhos para a compreensão das bases neurais da personalidade.

Alteração de memória na epilepsia de lobo temporal: [revisão] / Alteration of memory processes in temporal lobe epilepsy: [review]

As crises epiléticas temporais podem causar importantes impactos cognitivos e comportamentais nosindivíduos que sofrem de epilepsia. As estruturas do lobo temporal medial, incluindo-se hipocampo, amígdala e córtex entorrinal, são vitais para aquisição e consolidação das memórias declarativas em associação com as áreas corticais frontais. Portanto, uma das funções cognitivas que pode ser afetada por crises epiléticas é a memória declarativa. No presente estudo, faz-se uma revisão seletiva da bibliografia sobre os efeitos da epilepsia do lobo temporal mesial na memória. Os estudos sobre distúrbios de memória na epilepsia temporal foram analisados em relação aos prejuízos focais neurocognitivos devido tanto às alterações funcionais decorrentes do distúrbio como do seu substrato anatomopatológico.

Epileptic seizures can cause important cognitive and behavioral impact on the individuals that suffer fromepilepsy. Medial temporal lobe structures, including the hippocampus, amygdale and entorhinal cortex, are crucial for the acquisition and consolidation of declarative memories together with the frontal cortical areas. Therefore, one of the cognitive functions that can be affected by epileptic seizures is the declarative memory. The present study brings a selective bibliographic review about the effects of mesial temporal lobe epilepsy on memory. The studies about memory disturbances on the temporal lobe epilepsy were analyzed according to the focal neurocognitive impairment caused both by the functional alterations of the disease and its anatomopathologic basis.

Conceito de qualidade de vida em epilepsia / The concept of quality of life epilepsy

Neste artigo de revisäo da literatura a autora identifica as principais linhas de pesquisa sobre qualidade de vida e epilepsia. Em relaçäo ao domínio psicossocial, säo analisados problemas na classificaçäo de termos e falta de clareza teórica para a realizaçäo de pesquisas. É proposta uma expansäo da linha de pesquisa sobre a relaçäo entre locus de controle e o desamparo aprendido na etilogia dos problemas psicossociais da epilepsia

Emoçäo e cogniçäo: uma inter-relaçäo neuropsicológica / Emotion and cognition: a neuropsychological interrelationship

Os autores analisam o estado-da-arte da inter-relaçäo entre cogniçäo e emoçäo e o seu subtrato neurológico na perspectiva do modelo de múltiplos níveis de processamento. O processamento de emoçäo é visto como o meio de avaliar as contigências positivas e negativas, permitindo ao organismo adaptar-se a ambientes complexos e diversificados. Esta abordagem neuropsicológica da emoçäo, é analisada com base na pesquisa recente sobre o papel de vias neurais mesolímbicas e frontais