Brief Underage Alcohol Use Screener Scores Predict Health Risk Behaviors.

The aim of this study was to determine if adolescents' scores on a 2-item underage alcohol use screener predict risky consequences of past-year alcohol use and other health risk behaviors in a nonclinical, school-based sample of adolescents. A predominantly minority sample of 756 middle and high school students completed in-school tablet-based surveys on past-year underage alcohol use and a range of health risk behaviors. Higher scores for self alcohol risk and peer alcohol risk were associated with higher risk of past-year riding with a drunk driver and past 90-day measures of cigarette use, marijuana use, unplanned sex, and unprotected intercourse. The National Institute of Alcohol Abuse and Alcoholism Brief Alcohol Screener is a useful tool for school-based service providers, including school nurses, to identify and address the needs of adolescents at high risk of the development of alcohol use disorders, as well as a range of preventable health risk behaviors.

Preliminary Evaluation of the NIAAA/AAP Brief Alcohol Use Screener.

AIMS: To assess the concurrent validity of the two-item NIAAA/American Academy of Pediatrics Brief Alcohol Use Screener, a developmentally sensitive assessment instrument, in a school-based sample of adolescents. METHOD: The sample consisted of 756 adolescents (53% girls; Mage = 13.7 years; SD = 1.6 years) in the 6th (n = 192), 8th (n = 283), and the 10th (n = 281) grades from Miami-Dade County, FL and Prince George's County, MD. Adolescents completed the NIAAA/AAP Brief Alcohol Use Screener, which consists of two items asking about adolescents' alcohol use and about peers' alcohol use during the last year. Peer-Risk is categorized into 'No Peer-Risk' versus 'Heightened Concern'; Self-Risk is categorized into 'No-Risk,' 'Low-Risk,' 'Moderate-Risk' or 'High-Risk,' based on alcohol use patterns and age. Adolescents also completed measures of recent alcohol use and four previously validated screener instruments. RESULTS: Relative to the self-use 'No-Risk' category, adolescents classified into the 'Low-,' 'Moderate-' and 'High-Risk' categories reported progressively greater alcohol use and misuse during the last 90 days. Similar patterns were observed between the Peer-Risk categories. Combined, the two NIAAA/AAP screener items were positively related to recent alcohol use and outperformed the other screeners examined. CONCLUSIONS: Results from the present study support the concurrent validity of the single and combined items of the NIAAA/AAP Brief Alcohol Use Screener, as well as the measure's favorable concurrent validity compared to four previously validated screener instruments. SHORT SUMMARY: The current results support the concurrent validity of the single and combined items of the NIAAA/AAP Brief Alcohol Use Screener, as well as the measure's favorable concurrent validity compared to four previously validated screener instruments, in a school-based sample of adolescents.

Rhabdomyolysis Associated With "Pruno" Prison-Made Alcohol Intake in Corrections Facility: A Case Report.

In this study, a case of severe rhabdomyolysis in a 28-year-old incarcerated patient is presented. The patient initially presented with emesis, abdominal pain, and myalgias to the clinic at the corrections facility and was treated with antiemetics and analgesics. The onset of symptoms occurred approximately 24 h after ingestion of an illicit substance produced by inmates. Despite intervention, the patient was eventually transferred to the hospital on the third day after symptom onset for further evaluation and treatment. The manuscript presents the events that preceded the diagnosis of rhabdomyolysis, as well as symptoms of hyperactive delirium that developed during the patient's hospital course, leading to the high suspicion of illicit substance intoxication as a contributing inciting factor of rhabdomyolysis. This study aimed to bring awareness to the medical community about substance use in the correction system and its consequences.

The Patient-Provider Continuum of Care: Narratives of People Living With Comorbid HIV and Diabetes in Northern Thailand.

BACKGROUND: Among South-East Asia Region countries, Thailand has a high prevalence of HIV with an increasing significant comorbidity of diabetes mellitus (DM). OBJECTIVE: Guided by syndemics, the purpose of this qualitative study is to develop insight into the experience of patients living with comorbid HIV and DM in Northern Thailand for quality improvement. METHODS: Interviews were conducted in 2 groups for content analysis: (1) people living with comorbid HIV and DM and (2) health-care staff providing care to patients living with the comorbidity. RESULTS: Participants' (N = 12) ages ranged from 42 to 56 (mean = 49). Health staff (N = 12) generated complementary narratives. All participants reported onset of diabetes after discovering they were HIV infected. Content analysis revealed emergent themes regarding (1) knowledge and perceptions and (2) management framed by syndemics and chronicity. CONCLUSION: Findings suggest routine training for patient education and provider integration of care. Macrosocial factors such as limited access and resources and biological factor such as drug interactions are noted as key considerations for future interventions and alterations in the care for patients with comorbid HIV and DM.

A developmental cascade perspective of paediatric obesity: A systematic review of preventive interventions from infancy through late adolescence.

The goals of this systematic review were to identify and describe paediatric obesity prevention interventions from infancy to late adolescence and to provide recommendations for future intervention research in light of a recently proposed developmental cascade (DC) model of paediatric obesity. We conducted an electronic search of randomized controlled trials with a minimum 6-month postintervention follow-up published between 1995 and 2019. We included 74 interventions: prenatal/infancy (n = 4), early childhood (n = 11), childhood (n = 38), early to mid-adolescence (n = 18), and late adolescence (n = 3). Infancy and early childhood trials targeted early feeding and positive parenting skills. Half of the childhood and adolescence trials were school based and used universal prevention strategies; those classified as selective or indicated prevention tended to involve the family for more intensive lifestyle modification. Less than 10% of studies followed participants over long periods of time (greater than or equal to 5 years), and only 16% and 31% of studies assessed intervention mediators and moderators, respectively. We recommend that future interventions focus on early prevention, assess long-term intervention effects, use a standardized taxonomy for defining intervention behavioural strategies, assess underlying mechanisms of action and intervention moderators, target parent and family management strategies across development, and increase scientific equity. We also provide specific recommendations regarding intervention targets for each developmental stage.

Public Schools' Identification and Management of Underage Alcohol Use: A Qualitative Study.

OBJECTIVES: The objective of this qualitative study was to investigate how public schools in the Miami-Dade County School District identify and manage students' underage alcohol use and to explore the benefits and challenges of systematic screening for underage alcohol use in district schools. METHODS: Face-to-face interviews were conducted with 16 school officials directly responsible for addressing underage alcohol use incidents at district middle and high schools. These individuals included assistant principals, guidance counselors, social workers and school-based health care professionals. A grounded-theory approach was used to code and synthesize informants' responses. RESULTS: No informants reported systematic screening for underage alcohol use at their schools, although their middle and high schools employed a range of intervention strategies. Emergent themes reflected common ways by which students using alcohol were identified, factors influencing underage alcohol use, and barriers to screening intervention implementation. Lack of access to acute intoxication events, differing policies across schools, inadequate resources, and reliance on administrator discretion rather than explicit policy mandates appear to undermine the development of consistent strategies for addressing suspected or reported underage alcohol use. CONCLUSION: Public schools may serve as key implementation contexts for future universal or selected screening initiatives to identify and manage cases of underage alcohol use. The benefits and challenges perceived by school staff and administrators - especially for implementing consistent policies across schools - are critical to the development of acceptable, feasible, and sustainable alcohol screening initiatives.

Efficacy of a Family-Based Intervention on Parent-Adolescent Discrepancies in Positive Parenting and Substance Use Among Hispanic Youth.

PURPOSE: The research literature shows that discrepancies in positive parenting between parent and adolescent represents maladaptive parent-adolescent relationships, which are in turn positively linked to later substance use in Hispanic youth. However, questions remain about for whom interventions work and by what mechanisms they work to prevent discrepancies in positive parenting. The current study investigated the moderating and mediating roles of positive parenting discrepancy trajectories on the association between condition effect (i.e., a family-based intervention vs. prevention as usual condition) and substance use among Hispanic youth. METHODS: Eigth grade Hispanic adolescents (mean age = 13.86) and their primary caregivers (mean age = 42.32) were randomly assigned to two conditions: Familias Unidas (n = 376) or prevention as usual (n = 370). Participants were assessed at baseline and at 6, 18, and 30 months postbaseline. Using structural equation modeling, moderated mediation analyses were conducted to test whether the relationship between condition and past 90-day substance use at 30 months was mediated by discrepancy trajectories in positive parenting and whether direct and indirect relationships between condition and substance use were moderated by positive parenting discrepancies at baseline. RESULTS: The results showed that, relative to prevention as usual, Familias Unidas reduced positive parenting discrepancies across time, when parent reports were higher than adolescent reports at baseline; this in turn, predicted substance use at 30 months postbaseline. CONCLUSIONS: The findings provide important evidence supporting the need to collect multiple informant reports on positive parenting and examining the directionality of these reports among Hispanic families.