Adolescent risk behavior and the influence of parents and education.

BACKGROUND: Adolescent involvement with alcohol, drugs, tobacco, sexual relationships, and gang violence begins at increasingly younger ages. Awareness of the dangers and consequences of risk-taking behavior has not had a profound or lasting impact on adolescent behavior, and there appears to be no relation between risk behavior and general knowledge concerning these topics. METHODS: Using paired anonymous questionnaires, we surveyed 215 seventh-grade students and their parents about their experience with and attitudes toward adolescent risk-taking behaviors. The results of each student questionnaire were compared with results of his or her own parents. The survey instrument contained questions concerning tobacco, alcohol, and drug use, sexual activity, gang membership, general knowledge concerning these topics, and parental guidance given. Data were analyzed using the chi2 test of significance. RESULTS: Parent and student recollection of issues discussed and guidance given differed widely, as did the students' understanding of their parents' guidance. Factors found to have a meaningful impact on the reduction of risk behavior in the adolescent population were (1) students perceiving a satisfactory relationship with their parents, and (2) parents successfully communicating their expectations regarding these behaviors to their children. CONCLUSIONS: Parental direction has a powerful effect on the reduction of risk behavior in young adolescents. A limited ability for abstract reasoning during early adolescence requires clear anticipatory guidance by parents and an active effort to maintain communication in the child-parent relationship.

Expired nitric oxide as a marker for childhood asthma.

Expression of the inflammatory isoform of the enzyme nitric oxide synthase (NOS) is increased in airway-lining cells of patients with asthma. The NOS product nitric oxide (NO.) was measured in the expired gas of children with asthma. Vital capacity expirates from 21 control subjects and 13 subjects with asthma were assayed by chemiluminescence. Measurements were highly reproducible (coefficient of variation, 2.6% +/- 1.1%) and did not vary with age, sex, height, or weight. Patients with asthma had mean NO. levels (16.3 parts per billion) that were more than threefold higher than those of control subjects (5.05 ppb; p < 0.001). Expired NO. decreased as airflow obstruction improved during corticosteroid treatment (r2 = 0.77; n = 7; p < 0.001) but remained higher than normal (13.5 ppb; n = 5; p < 0.01) even after airflow obstruction resolved. We demonstrate the use of a reproducible test for asthma in children that is independent of measures of airflow obstruction. We speculate that expired NO assays may prove to be a more sensitive measure of childhood asthma than spirometry.