Missing class increases the daily frequency of screen use among schoolchildren / Faltar à aula eleva a frequência diária de uso de telas entre estudantes

We analyzed the association between school attendance and the daily frequency of use of different forms of screens (TV, computer, cell phone and video game) among children and adolescents. Lon-gitudinal study with four repeated measures during the 2015 school year. Children and adolescents from a public school participated in the study (n = 463, 53.6% boys; 9.3 ± 1.3 years old). The daily frequency of screen use was the outcome analyzed, which was reported on an online questionnaire for the previous-day recall, illustrated with 32 icons of activities including 4 types of electronic de-vices. The participant answered "What did you do yesterday?" in the morning, afternoon, and night. School attendance was assessed by responding to the item "Did you go to school yesterday?". The analysis was conducted using generalized estimation equations, with adjustment by sex, age, BMI z-scores, and season of the year. The average percentage of absences during the follow-up was 28.7%. The use of screens was 13% higher among students who missed class. Playing a video game was 37% higher among students who missed class. The daily frequency of screen use was 26% higher among adolescents (10-12 years) compared to children (7-9 years), especially in the analysis performed indi-vidually for TV and cell phone. The daily frequency of screen use and watching TV among students who missed classes during the winter was, respectively, 24% (IRR = 1.24; 95%CI = 1.11 - 1.39) and 35% (IRR = 1.35; 95%CI = 1.10 - 1.66) higher compared to those who missed classes during the fall. In conclusion, the use of screens predominated among students who missed class, mainly in winter

Nós analisamos a associação longitudinal entre presença na escola e frequência diária de uso de diferentes tipos de telas (TV, celular, computador e videogame). O follow-up incluiu quatro medidas repetidas durante o ano letivo de 2015. Participaram do estudo crianças e adolescentes de escola pública (n = 463; 53,6% meninos; 9,3 ± 1,3 anos). O uso de telas foi o desfecho analisado, relatado em um questionário online para a recordação do dia anterior, ilustrado com 32 ícones de atividades, incluindo 4 tipos de dispositivos eletrônicos. O participante respondeu "O que você fez ontem?" pela manhã, tarde e noite. A frequência escolar foi avaliada por meio do item "Você veio à escola ontem?". A análise foi conduzida via equações de estimativa generalizada, com ajuste por sexo, idade, estação do ano e escore-z de IMC. O percentual médio de faltas no período foi de 28,7%. De maneira geral, o uso de telas foi 13% mais frequente entre estudantes que faltaram à aula, com destaque para vídeogame, cuja frequência diária foi 37% maior. Adolescentes (10-12 anos) exibiram frequência diária de telas 26% maior quando comparados com as crianças (7-9 anos), especialmente de TV (36%) e celular (32%). A frequência diária de uso de telas e de assistir TV entre os alunos que faltaram às aulas no inverno foi, respectivamente, 24% (IRR = 1,24; IC95% = 1,11 - 1,39) e 35% (IRR = 1,35; IC95% = 1,10 - 1,66) maior em relação aos que faltaram às aulas no outono. Concluímos que o uso de telas predominou entre estudantes que faltaram à aula, sobretudo no período do inverno

Childhood weight status and timing of first substance use in an ethnically diverse sample.

BACKGROUND: We examined associations between weight status during childhood and timing of first cigarette, alcohol, and marijuana use in an ethnically diverse sample. METHODS: Data were drawn from child respondents of the 1979 National Longitudinal Survey of Youth, including 1448 Hispanic, 2126 non-Hispanic Black, and 3304 non-Hispanic, non-Black (White) respondents aged 10 years and older as of last assessment. Cox proportional hazards regression was conducted predicting age at first use from weight status (obese, overweight, and underweight relative to healthy weight) assessed at ages 7/8, separately by substance class, sex, and race/ethnicity. Tests of interactions between weight status and respondent sex and race/ethnicity were also conducted. RESULTS: Compared to healthy-weight females of the same race/ethnicity, overweight Hispanic females were at increased likelihood of alcohol and marijuana use and overweight White females were at increased likelihood of cigarette and marijuana use. Compared to healthy-weight males of the same race/ethnicity, obese White males were at decreased likelihood of cigarette and alcohol use and underweight Hispanic and Black males were at decreased likelihood of alcohol and marijuana use. Significant differences in associations by sex and race/ethnicity were observed in tests of interactions. CONCLUSIONS: Findings highlight childhood weight status as a predictor of timing of first substance use among Hispanic and Non-Hispanic Black and White female and male youth. Results suggest that collapsing across sex and race/ethnicity, a common practice in prior research, may obscure important within-group patterns of associations and thus may be of limited utility for informing preventive and early intervention efforts.

Social Risk Factors of Black and White Adolescents' Substance Use: The Differential Role of Siblings and Best Friends.

Efforts to understand peer influence among adolescents have established the robust relationship between having substance using peers and future substance use. Still, research suggests that peer influence affects different types of adolescents in different ways. Black adolescents may be less susceptible to friends compared to white adolescents and possess stronger family-orientation, suggesting that siblings may affect deviance of Black adolescents whereas friends will have a minimal impact. This study used data from the first two waves of the National Longitudinal Study of Adolescent to Adult Health to evaluate the relative strength of best friend and siblings' influence as risk factors for Black and White adolescents' alcohol and cigarette use. Approximately 182 Black sibling pairs (37 % male) and 657 white sibling pairs (46 % male) that ranged in ages from 11 to 19 were in the longitudinal analyses for the current study. The findings demonstrated that sibling and best friends' substance use explained white adolescents' cigarette and alcohol use, whereas Black adolescents' cigarette and alcohol use was predominantly explained by siblings' substance use. Ultimately, the results indicated the nuanced role that two types of peers have in explaining variation in substance use across Black and White adolescents.

INTERGENERATIONAL EDUCATIONAL ATTAINMENT, FAMILY CHARACTERISTICS AND CHILD OBESITY.

This study used US National Longitudinal Study of Youth data to explore how exposure to different socioeconomic conditions (proxied by maternal education) before birth can shape child weight. Using endogenous selection regression models, the findings suggest that educational selectivity affects weight gain. Mothers whose mothers graduated from high school were more likely to complete high school, and mothers reared in an intact family had higher levels of education. However, mothers who had given birth as a teenager had the same educational outcomes as mothers who gave birth in their post-teenage years. Based on this intergenerational educational selectivity, caretaking (e.g. breast-feeding) was found to be associated with a lower child body mass index (BMI), while negative maternal characteristics (e.g. mothers with high BMIs) were associated with higher child BMIs. Thus, educational selectivity influences child health through values passed on to the child and the lifestyle in which the child is reared. Maternal education may be tied to parenting, which relates to child obesity risk.

Relation of peer effects and school climate to substance use among Asian American adolescents.

Using a nationally representative, longitudinal sample of Asian American late adolescents/young adults (ages 18-26), this article investigates the link between peer effects, school climate, on the one hand, and substance use, which includes tobacco, alcohol, and other illicit mood altering substance. The sample (N = 1585) is drawn from the National Longitudinal Study of Adolescent Health (Waves I and III). The study is set to empirically test premises of generational, social capital and stage-environment fit theories. The exploratory variables include individual-level (immigrant generation status, ethnic origin, co-ethnic and co-generational peers - peers from the same immigrant generation) as well as school-level measures (average school socio-economic status and school climate). Multilevel modeling (logistic and negative binomial regression) was used to estimate substance use. Results indicate that preference for co-generational friends is inversely associated with frequency of cannabis and other illicit drug use and preference for co-ethnic peers is inversely associated with other illicit drug use. We also find that school climate is a strong and negative predictor of frequency of cannabis and other illicit drug use as well as of heavy episodic drinking. In terms of policy, these findings suggest that Asian American students should benefit from co-ethnic and co-generational peer networks in schools and, above all, from improving school climate.

Risk behaviors and negative health outcomes for adolescents with late bedtimes.

Late bedtimes in adolescence may be a serious risk factor for later poor health and functional outcomes. The current study sought to extend existing cross sectional data by examining whether late bedtimes in adolescence predicts poor outcomes in young adulthood. Data from wave 2 (1996) and wave 3 (2001-2002) of the nationally representative sample of US youth (National Longitudinal Study of Adolescent Health) was used to examine the longitudinal relationship between late bedtime, and several risk behaviors and negative health outcomes following 3,843 adolescents into young adulthood. At wave 2 the mean age was 16 with 52.1% female. At wave 3 the mean age was 21.8. In cross sectional analyses, late bedtime was associated with 1.5 to over 3 times greater odds of involvement in risk behaviors and negative health outcomes, including emotional distress, suicidality, criminal and violent activity, and use of cigarettes, alcohol and illicit drugs. In longitudinal analyses, late bedtime assessed at wave 2 predicted a number of serious health outcomes at wave 3, with late bedtime in adolescence associated with around 1.5 greater odds of involvement in health jeopardizing behaviors such as criminal activity, alcohol abuse, cigarette use, illicit drug use and emotional distress in young adulthood. There was also a dose effect, such that the later the bedtime in adolescence, the greater the risk of involvement in risk behaviors in young adulthood. This research suggests that late bedtime in adolescence predicts multiple serious risk behaviors and health outcomes in young adulthood.

Lifestyle behaviors and illness-related factors as predictors of recurrent headache in U.S. adolescents.

PURPOSE: This study describes a multivariate model showing how lifestyle behaviors (skipping meals, water intake, tobacco use, alcohol use, and physical activity) and illness-related factors (depression, somatic complaints, insomnia, and obesity) work together to predict headache in an adolescent population. METHOD: A descriptive, cross-sectional, secondary analysis using survey data from the National Longitudinal Study of Adolescent Health (1996) is reported. The National Longitudinal Study of Adolescent Health is a large database providing a nationally representative sample of adolescents (aged 11-17 years, n = 13,570). The database evaluated adolescent headache and is inclusive of all the predictors specific to this study. Frequency analysis and forward logistic regression were performed using each of the lifestyle behaviors and illness-related factors. RESULTS: Approximately 26% of the adolescents experienced recurrent headache. Recurrent headache was reported by 19% of male adolescents and 26% of female adolescents. A multivariate model was developed that showed how lifestyle behaviors and illness-related factors predict recurrent headache in adolescents. The final model (Wald F = 86.88, p = .00) consisted of the following predictors: chest pain, muscle and joint pain, skip breakfast three or more times a week, skip lunch one or more times a week, and physical activity. The interactions of gender and age group, race and smoking regularly, and depression and insomnia were also included in the final model. CONCLUSION: Providing evidence to clinicians that lifestyle behaviors and illness-related factors are associated with adolescent headache may improve overall headache assessment and may result in a more comprehensive plan of treatment.

Race/ethnic and socioeconomic differences in stress and immune function in The National Longitudinal Study of Adolescent Health.

Stress and immune function may be important mediators of the strong association between social factors and health over the life course, but previous studies have lacked the data to fully explore these links in a population-based sample. This study utilizes data from Waves I-IV of the U.S. National Longitudinal Study of Adolescent Health (Add Health) to test the associations of race/ethnicity and socioeconomic status (SES) with levels of perceived stress and exposure to stressful life events (SLE) among 11,050 adult respondents aged 24-32 in 2008-2009. We further tested whether race/ethnicity and SES were associated with Epstein-Barr Virus (EBV) specific IgG antibodies, an indirect marker of cell-mediated immune function. Finally, we tested whether measures of stress were associated with EBV IgG and whether there was evidence that they explain any associations between race/ethnicity, SES and EBV IgG. We found strong associations between lower SES and higher levels of perceived stress (OR 2.07, 95% CI 1.73-2.48 for < high school vs. college or above) and a high level of stressful life events (OR 7.47, 95% CI 5.59-9.98 for < high school vs. college or above). Blacks had higher odds of a high level of stressful life events compared to whites (OR 2.00, 95% CI 1.63-2.47), but not higher perceived stress (OR 1.11, 95% CI 0.96-1.28). Blacks also had significantly higher EBV levels compared to whites (ß = 0.136, p < 0.01), but lower SES was not associated with higher EBV IgG. We found no evidence that stressful life events or perceived stress were associated with EBV IgG in this sample, and thus did not account for racial differences in EBV IgG. These results suggest consistent race/ethnic and SES differences in stressful life events, and confirm race/ethnic differences in markers of immune function that may have health implications across the life course.

Peer influence and context: the interdependence of friendship groups, schoolmates and network density in predicting substance use.

This article focuses on the degree to which friends' influence on substance use is conditioned by the consistency between their behavior and that of schoolmates (individuals enrolled in the same school, but not identified as friends), contributing to the literature on the complexity of interactive social influences during adolescence. Specifically, it hypothesizes that friends' influence will diminish as their norms become less similar to that of schoolmates. The authors also propose that this conditioning relationship is related to the density of the friendship group. This study uses data from the National Longitudinal Survey of Adolescent Health (AddHealth) (n ~ 8,000, 55% female) to examine the interactive relationship between friend and schoolmate influences on adolescent substance use (smoking and drinking). The sample contains students ranging from age 11 to 22 and is 60% White. The findings demonstrate that, as the substance use of the friendship group becomes more dissimilar from schoolmates' substance use, the friendship group's influence on adolescent substance use diminishes. Further, the results demonstrate that this conditioning relationship does not emerge when the friendship group is highly dense.

Effects of exposure to violence with a weapon during adolescence on adult hypertension.

OBJECTIVES: To examine the longitudinal associations between exposure to violence with a weapon during the past year among adolescents and hypertension during adulthood, including the extent to which adult cardiovascular risk factors mediated the association. METHODS: Secondary analysis of the National Longitudinal Study of Adolescent Health, 1994-2008. The sample included 3555 male and 4416 female participants who were aged 11-17 years at wave 1 (1994-1995). Participants were categorized as hypertensive if they had a mean systolic blood pressure of 140 mm Hg or higher or a mean diastolic pressure of 90 mm Hg or higher at wave 4 (2008). Witnessed violence with a weapon was defined as having seen a shooting or stabbing during the year before wave 1, whereas victim of violence with a weapon was defined as having been shot, cut, or stabbed or had a gun or knife drawn on them during the year before wave 1. Potential mediators of adult cardiovascular risk (wave 4) included body mass index, daily smoking, alcohol abuse, and depression. RESULTS: Males who witnessed violence and females who were victims of violence in the year before wave 1 had an increased odds of hypertension at wave 4 compared with their unexposed peers (adjusted odds ratio, 1.45; 95% confidence interval, 1.003-2.10 and adjusted odds ratio, 1.72; 95% confidence interval, 1.04-2.84, respectively). The hypothesized adult cardiovascular risk mediators did not significantly attenuate the associations for either the male or female samples. CONCLUSIONS: Interventions addressing prior violence exposure are needed to promote adult cardiovascular health.

Selected preconception health indicators and birth weight disparities in a national study.

BACKGROUND: This analysis explored the effect of timing, sequencing, and change in preconception health across adolescence and young adulthood on racial/ethnic disparities in birth weight in a diverse national cohort of young adult women. METHODS: Data came from Waves I (1994-1995), III (2001-2002), and IV (2007-2008) of the National Longitudinal Study of Adolescent Health. Eligibility was restricted to all singleton live births to female non-Hispanic White, non-Hispanic Black, Mexican-origin Latina, or Asian/Pacific Islander participants (n = 3,014) occurring between the Wave III (ages 18-26 years) and IV (ages 24-32 years) interviews. Birth weight was categorized into low (<2,500 g), normal (2,500-4,000 g), and macrosomic (>4,000 g). Preconception health indicators were cigarette smoking, heavy alcohol consumption, overweight or obesity, and inadequate physical activity, measured in adolescence (Wave I, ages 11-19 years) and early adulthood (Wave III) and combined into four-category variables to capture the timing and sequencing of exposure. FINDINGS: Measures of preconception health did not explain the Black-White disparity in low birth weight, which increased after adjustment for confounders (odds ratio [OR], 2.17; 95% confidence interval [CI], 1.33-3.53) and effect modification by overweight/obesity (OR, 3.58; 95% CI, 1.65-7.78). A positive association between adult-onset overweight/obesity and macrosomia was modified by race (OR, 3.83; 95% CI, 1.02-14.36 for Black women). CONCLUSIONS: This longitudinal analysis provides new evidence on preconception health and racial/ethnic disparities in birth weight. Specifically, it indicates that interventions focused on prevention of overweight/obesity and maintenance of healthy weight during the transition to adulthood, especially among Black females, may be warranted.

Youth violence and connectedness in adolescence: what are the implications for later sexually transmitted infections?

PURPOSE: To examine associations between (1) youth violence victimization and perpetration and later sexually transmitted infections (STI) and (2) parent-family and school connectedness and later STI, and to explore the moderating role of connectedness on the associations between youth violence victimization and perpetration and later STI. METHODS: We used data from Waves I and IV of the National Longitudinal Study of Adolescent Health, which provided a baseline weighted sample of 14,800 respondents. We used logistic regression to examine associations between youth violence and connectedness with self-reported ever STI diagnosis, including gonorrhea, chlamydia, syphilis, genital herpes, genital warts or human papillomavirus, or human immunodeficiency virus. If participants reported having an STI at Wave I they were excluded from the analysis. RESULTS: Controlling for biological sex, race/ethnicity, age, parent's highest education level, and parent's marital status, both youth violence victimization and perpetration were associated with an increased risk of later STI (adjusted odds ratio [AOR], 1.27, 95% confidence interval [CI], 1.07-1.52; and AOR, 1.21, 95% CI, 1.04-1.41, respectively). Parent-family and school connectedness in adolescence were associated with a decreased risk for later STI (AOR, .96, 95% CI, .95-.98; and AOR, .97, 95% CI, .95-.99, respectively); however, connectedness did not moderate the associations between nonsexual violence involvement and later STI. CONCLUSIONS: These results indicate that youth violence victimization and perpetration may be risk factors for STI later in life. Conversely, parent-family and school connectedness in adolescence appear to protect against subsequent STI. The findings suggest that provider efforts to address youth violence and connectedness in adolescence can promote positive sexual health outcomes in adulthood.

Peer influence on marijuana use in different types of friendships.

PURPOSE: Although several social network studies have demonstrated peer influence effects on adolescent substance use, findings for marijuana use have been equivocal. This study examines whether structural features of friendships moderate friends' influence on adolescent marijuana use over time. METHODS: Using 1-year longitudinal data from the National Longitudinal Study of Adolescent Health, this article examines whether three structural features of friendships moderate friends' influence on adolescent marijuana use: whether the friendship is reciprocated, the popularity of the nominated friend, and the popularity/status difference between the nominated friend and the adolescent. The sample consists of students in grade 10/11 at wave I, who were in grade 11/12 at wave II, from two large schools with complete grade-based friendship network data (N = 1,612). RESULTS: In one school, friends' influence on marijuana use was more likely to occur within mutual, reciprocated friendships compared with nonreciprocated relationships. In the other school, friends' influence was stronger when the friends were relatively popular within the school setting or much more popular than the adolescents themselves. CONCLUSIONS: Friends' influence on youth marijuana use may play out in different ways, depending on the school context. In one school, influence occurred predominantly within reciprocated relationships that are likely characterized by closeness and trust, whereas in the other school adopting friends' drug use behaviors appeared to be a strategy to attain social status. Further research is needed to better understand the conditions under which structural features of friendships moderate friends' influence on adolescent marijuana use.

Sexual orientation and gender differences in markers of inflammation and immune functioning.

BACKGROUND: Sexual minorities have documented elevated risk factors that can lead to inflammation and poor immune functioning. PURPOSE: This study aims to investigate disparities in C-reactive protein (CRP) and Epstein-Barr virus (EBV) by gender and sexual orientation. METHODS: We used the National Longitudinal Study of Adolescent Health to examine disparities in CRP (N = 11,462) and EBV (N = 11,812). RESULTS: Among heterosexuals, women had higher levels of CRP and EBV than men. However, sexual minority men had higher levels of CRP and EBV than heterosexual men and sexual minority women. Lesbians had lower levels of CRP than heterosexual women. CONCLUSIONS: Gender differences in CRP and EBV found between men and women who identify as 100 % heterosexual were reversed among sexual minorities and not explained by known risk factors (e.g., victimization, alcohol and tobacco use, and body mass index). More nuanced approaches to addressing gender differences in sexual orientation health disparities that include measures of gender nonconformity and minority stress are needed.

Life course transitions and racial and ethnic differences in smoking prevalence.

This study aims to: (1) describe trajectories in the likelihood of smoking by racial or ethnic group across the transition to adulthood, (2) identify the influence of achieved socioeconomic status (SES) and the nature and timing of adult role transitions, and (3) determine the extent to which achieved SES and adult roles mediate the effects of race and ethnicity on smoking. The analyses use U.S. longitudinal data from the National Longitudinal Study of Adolescent Health (Add Health), which follows a representative national sample over four waves and from ages 11-17 in 1994/95 to 26-34 in 2007/08. Growth curve models compare trajectories of smoking likelihood for white, black, Hispanic, Asian/Pacific Islander, and American Indian/Alaska Native individuals. While whites have higher rates of smoking than blacks and Hispanics during their teen years and 20s, blacks and Hispanics lose their advantage relative to whites as they approach and enter their 30s. American Indian/Alaska Natives show high rates of smoking at earlier ages and an increasing likelihood to smoke. Although life course transitions are influential for smoking prevalence in the overall U.S. population, SES and the nature and timing of adult role transitions account for little of the gap between whites and black, Hispanic, and American Indian/Alaska Native individuals. Racial and ethnic disparities in adult smoking are independent of SES and life transitions, pointing to explanations such as culturally specific normative environments or experiences of discrimination.

Social networks and smoking: exploring the effects of peer influence and smoker popularity through simulations.

Adolescent smoking and friendship networks are related in many ways that can amplify smoking prevalence. Understanding and developing interventions within such a complex system requires new analytic approaches. We draw on recent advances in dynamic network modeling to develop a technique that explores the implications of various intervention strategies targeted toward micro-level processes. Our approach begins by estimating a stochastic actor-based model using data from one school in the National Longitudinal Study of Adolescent Health. The model provides estimates of several factors predicting friendship ties and smoking behavior. We then use estimated model parameters to simulate the coevolution of friendship and smoking behavior under potential intervention scenarios. Namely, we manipulate the strength of peer influence on smoking and the popularity of smokers relative to nonsmokers. We measure how these manipulations affect smoking prevalence, smoking initiation, and smoking cessation. Results indicate that both peer influence and smoking-based popularity affect smoking behavior and that their joint effects are nonlinear. This study demonstrates how a simulation-based approach can be used to explore alternative scenarios that may be achievable through intervention efforts and offers new hypotheses about the association between friendship and smoking.

Socioeconomic indices as independent correlates of C-reactive protein in the National Longitudinal Study of Adolescent Health.

OBJECTIVES: To examine the association between socioeconomic status (SES) and C-reactive protein (CRP) to understand how SES may increase the risk of cardiovascular disease and thus identify targets for prevention measures. METHODS: Path models were used to examine direct and indirect associations of four indices of SES (objective early life built environment ratings, parental and participant education, and income) with CRP measured during early adulthood using data from the National Longitudinal Adolescent Health Study (n = 11,371; mean age = 29 years, range = 24-32 years; 53.8% women, 28.0% black participants). The present study examined potential mediation of the association of SES with CRP by way of body mass index (BMI), smoking, and alcohol consumption within white and black men and women. RESULTS: BMI was a mediator of the relation between parent education and CRP for white men (path coefficient [γ] = -0.05, p < .001) and women (γ = -0.05, p < .001). Smoking mediated the income-CRP (γ = -0.01, p < .01) and the education-CRP (γ = -0.07, p < .001) relation for white men. BMI mediated the relation between all measures of SES and CRP for white women (γ values between -0.02 and -0.05; p values < .01). None of the risk factors mediated the SES-CRP relation in black participants. CONCLUSIONS: These findings indicate that the association of SES with CRP is influenced by both the timing and type of SES measure examined. In addition, race and sex play a role in how potential mediators are involved with the SES-CRP relationship, such that BMI and smoking were mediators in white men, whereas BMI was the sole mediator in white women.

Differences in cigarette use behaviors by age at the time of diagnosis with diabetes from young adulthood to adulthood: results from the National Longitudinal Study of Adolescent Health.

OBJECTIVES: Previous observations propose that risk-taking behaviors such as cigarette smoking are prevailing among young people with chronic conditions including diabetes. The purpose of this study was to examine whether cigarette smoking is more prevalent among diabetics than non-diabetics and whether it differs by age at the time of diagnosis with diabetes from young adulthood (YAH) to adulthood (AH). METHODS: We used US panel data from the National Longitudinal Study of Adolescent Health (Add Health Study) during the years 2001 to 2002 (Wave III, YAH) and 2007 to 2008 (Wave IV, AH). Multivariate logistic regression models were applied to estimate odds ratios (ORs) and 95% confidence intervals (CIs) of cigarette use behaviors according to age at the time of diagnosis with diabetes, after adjusting for demographic and selected behavioral factors. RESULTS: Of 12 175 study participants, 2.6% reported having been diagnosed with diabetes up to AH. Early-onset diabetics (age at diagnosis <13 years) were more likely than non-diabetics to report frequent cigarette smoking (smoking on ≥20 days during the previous 30 days) in YAH (OR, 3.34; 95% CI, 1.27 to 8.79). On the other hand, late-onset diabetics (age at diagnosis ≥13 years) were more likely than non-diabetics to report heavy cigarette smoking (smoking ≥10 cigarettes per day during the previous 30 days) in AH (OR, 1.54; 95% CI, 1.03 to 2.30). CONCLUSIONS: The current study indicated that diabetics are more likely than non-diabetics to smoke cigarettes frequently and heavily in YAH and AH. Effective smoking prevention and cessation programs uniquely focused on diabetics need to be designed and implemented.

Maternal underestimation of child's sexual experience: suggested implications for HPV vaccine uptake at recommended ages.

PURPOSE: Despite official recommendation for routine HPV vaccination of boys and girls at age 11-12 years, parents and providers are more likely to vaccinate their children/patients at older ages. Preferences for vaccinating older adolescents may be related to beliefs about an adolescent's sexual experience or perceived parental resistance to vaccinating children who are assumed to be sexually inexperienced. METHODS: Using data from the 1995 wave of the National Longitudinal Study of Adolescent Health (ADD Health), a subset of a nationally representative sample of adolescents in grades 7 through 12 and their parents (n = 13,461), we investigated maternal underestimation of adolescent sexual experience. RESULTS: About one third (34.8%) of adolescents reported being sexually experienced and of these, 46.8% of their mothers inaccurately reported that their child was not sexually experienced. Underestimation varied by adolescent age with 78.1% of mothers of sexually active 11-13-year-olds reporting their child was not sexually active, compared with 56.4% of mothers of sexually active 14-16-year-olds and only 34.4% of mothers of 17-18-year-olds. CONCLUSIONS: Although most adolescents are not sexually active at age 11 or 12 years, waiting until a parent thinks a child is sexually active could result in missed opportunities for prevention.

Nicotinic receptor gene variants interact with attention deficient hyperactive disorder symptoms to predict smoking trajectories from early adolescence to adulthood.

OBJECTIVE: To examine the association of single nucleotide polymorphisms (SNPs) of the CHRNB3 (rs13280604) and CHRNA6 (rs892413) nicotinic acetylcholine receptor (nAChR) genes and symptoms of attention deficit hyperactivity disorder (ADHD) in predicting smoking patterns from early adolescence to adulthood. METHOD: A longitudinal cohort of 1137 unrelated youths from the National Longitudinal Study of Adolescent Health provided responses to four surveys from Waves I to IV, and a genetic sample in Wave III. Growth mixture modeling was used to identify smoking patterns and to assess the effects of the two SNPs and ADHD symptoms on cigarette use over time. RESULTS: There were significant main effects of ADHD symptoms and CHRNA6 variants in predicting the number of cigarettes smoked and the pattern of use over time, respectively. There were no main effects of the CHRNB3 variants. However, a significant CHRNB3 variant×ADHD symptom interaction was observed, such that individuals with elevated ADHD symptoms and a particular CHRNB3 variant were at increased risk of cigarette use over time. CONCLUSIONS: These findings demonstrate that a SNP in a nicotinic receptor gene may interact with ADHD symptoms to link with increased cigarette use across adolescence and young adulthood. Unique associations between specific variants and patterns of ADHD symptoms were identified which may be useful for targeting prevention efforts to individuals at greatest risk for cigarette smoking.